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Sample records for karolinska sleepiness scale

  1. Normative data on the diurnal pattern of the Karolinska Sleepiness Scale ratings and its relation to age, sex, work, stress, sleep quality and sickness absence/illness in a large sample of daytime workers.

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    Åkerstedt, Torbjorn; Hallvig, David; Kecklund, Göran

    2017-10-01

    Self-rated sleepiness responds to sleep loss, time of day and work schedules. There is, however, a lack of a normative reference showing the diurnal pattern during a normal working day, compared with a day off, as well as differences depending on stress, sleep quality, sex, age and being sick listed. The present study sought to provide such data for the Karolinska Sleepiness Scale. Participants were 431 individuals working in medium-sized public service units. Sleepiness (Karolinska Sleepiness Scale, scale 1-9) was rated at six times a day for a working week and 2 days off (>90.000 ratings). The results show a clear circadian pattern, with high values during the morning (4.5 at 07:00 hours) and evening (6.0 at 22:00 hours), and with low values (3-4) during the 10:00-16:00 hours span. Women had significantly higher (0.5 units) Karolinska Sleepiness Scale values than men, as did younger individuals (0.3 units), those with stress (1.3 units above the low-stress group) and those with poor sleep quality (1.0 units above those with qood sleep quality). Days off showed reduced sleepiness (0.7 units), while being sick listed was associated with an increased sleepiness (0.8 units). Multiple regression analysis of mean sleepiness during the working week yielded mean daytime stress, mean sleep quality, age, and sex as predictors (not sleep duration). Improved sleep quality accounted for the reduced sleepiness during days off, but reduced stress was a second factor. Similar results were obtained in a longitudinal mixed-model regression analysis across the 7 days of the week. The percentage of ratings at Karolinska Sleepiness Scale risk levels (8 + 9) was 6.6%, but most of these were obtained at 22:00 hours. It was concluded that sleepiness ratings are strongly associated with time of day, sleep quality, stress, work day/day off, being ill, age, and sex. © 2017 European Sleep Research Society.

  2. Modification of the Epworth Sleepiness Scale in Central China

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    Zhang, Jin Nong; Peng, Bo; Zhao, Ting Ting; Xiang, Min; Fu, Wei; Peng, Yi

    2011-01-01

    Purpose The well-known excessive daytime sleepiness (EDS) assessment, Epworth Sleepiness Scale (ESS), is not consistently qualified for patients with diverse living habits. This study is aimed to build a modified ESS (mESS) and then to verify its feasibility in the assessment of EDS for patients with suspected sleep-disordered breathing (SDB) in central China. Methods A Ten-item Sleepiness Questionnaire (10-ISQ) was built by adding two backup items to the original ESS. Then the 10-ISQ was adm...

  3. Longitudinal change in sleep and daytime sleepiness in postpartum women.

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    Ashleigh J Filtness

    Full Text Available Sleep disruption strongly influences daytime functioning; resultant sleepiness is recognised as a contributing risk-factor for individuals performing critical and dangerous tasks. While the relationship between sleep and sleepiness has been heavily investigated in the vulnerable sub-populations of shift workers and patients with sleep disorders, postpartum women have been comparatively overlooked. Thirty-three healthy, postpartum women recorded every episode of sleep and wake each day during postpartum weeks 6, 12 and 18. Although repeated measures analysis revealed there was no significant difference in the amount of nocturnal sleep and frequency of night-time wakings, there was a significant reduction in sleep disruption, due to fewer minutes of wake after sleep onset. Subjective sleepiness was measured each day using the Karolinska Sleepiness Scale; at the two earlier time points this was significantly correlated with sleep quality but not to sleep quantity. Epworth Sleepiness Scores significantly reduced over time; however, during week 18 over 50% of participants were still experiencing excessive daytime sleepiness (Epworth Sleepiness Score ≥12. Results have implications for health care providers and policy makers. Health care providers designing interventions to address sleepiness in new mothers should take into account the dynamic changes to sleep and sleepiness during this initial postpartum period. Policy makers developing regulations for parental leave entitlements should take into consideration the high prevalence of excessive daytime sleepiness experienced by new mothers, ensuring enough opportunity for daytime sleepiness to diminish to a manageable level prior to reengagement in the workforce.

  4. Relationships between Karolinska Personality Scales and the new factors and facets of the Zuckerman-Kuhlman-Aluja Personality Questionnaire (Relaciones entre las Escalas de Personalidad Karolinska y los nuevos factores y facetas del Cuestionario de Personalidad de ZuckermanKuhlman-Aluja

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    Sergio Escorial

    2015-12-01

    Full Text Available Psychobiological models of personality are of great use in clinical and research settings given their potential to construct working hypotheses on biological and behavioural correlates, as well as to predict vulnerability to mental disorders. Two personality models are rooted in this psychobiological tradition: Zuckerman`s Alternative Five Factors and the Karolinska Personality Scales (KSP. A new instrument (ZKA-PQ has been recently developed by Aluja, Kuhlman & Zuckerman (2010 to measure the Alternative Five Factors. The ZKA-PQ incorporates four new facets by each trait. This article analyses areas of overlap and differences between the ZKA-PQ and Karolinska Personality Scales. The total sample comprised 584 subjects (294 men and 290 women. The results suggest that sensation seeking (ZKA-PQ is mainly associated with monotony avoidance (KSP, neuroticism (ZKA-PQ with anxiety scales, aggressiveness (ZKAPQ with every KSP aggression scale, and extroversion (ZKA-PQ with the detachment scale (KSP. The discussion mainly centres on the information provided by the ZKA-PQ facets beyond basic personality traits, since in certain cases they qualify these general patterns, adding relevant information on the nature of the ZKA-PQ and Karolinska scales.

  5. The Epworth Sleepiness Scale: Self-Administration Versus Administration by the Physician, and Validation of a French Version

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    Marta Kaminska

    2010-01-01

    Full Text Available BACKGROUND/OBJECTIVES: The Epworth Sleepiness Scale (ESS measures sleepiness and is used for, among others, patients with obstructive sleep apnea (OSA. The questionnaire is usually self-administered, but may be physician administered. The aim was to compare the two methods of administration and to validate a French version.

  6. Development and psychometric testing of a barriers to HIV testing scale among individuals with HIV infection in Sweden; The Barriers to HIV testing scale-Karolinska version

    OpenAIRE

    2015-01-01

    © 2015 Wiklander et al. Background: Barriers to HIV testing experienced by individuals at risk for HIV can result in treatment delay and further transmission of the disease. Instruments to systematically measure barriers are scarce, but could contribute to improved strategies for HIV testing. Aims of this study were to develop and test a barriers to HIV testing scale in a Swedish context. Methods: An 18-item scale was developed, based on an existing scale with addition of six new it...

  7. Job demands and resting and napping opportunities for nurses during night shifts: impact on sleepiness and self-evaluated quality of healthcare.

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    Barthe, Béatrice; Tirilly, Ghislaine; Gentil, Catherine; Toupin, Cathy

    2016-01-01

    The aim of this field study is to describe night shift resting and napping strategies and to examine their beneficial effects on sleepiness and quality of work. The study was carried out with 16 nurses working in an intensive care unit. Data collected during 20 night shifts were related to job demands (systematic observations), to the duration and timing of rests and naps taken by nurses (systematic observations, sleep diaries), to sleepiness (Karolinska Sleepiness Scale), and to quality of work scores (visual analog scale). The results showed that the number of rests and naps depended on the job demands. Resting and napping lowered the levels of sleepiness at the end of the shift. There was no direct relationship between sleepiness and the quality of work score. Discussions about the choice of indicators for the quality of work are necessary. Suggestions for implementing regulations for prescribed napping during night shifts are presented.

  8. Acute versus chronic partial sleep deprivation in middle-aged people: differential effect on performance and sleepiness.

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    Philip, Pierre; Sagaspe, Patricia; Prague, Mélanie; Tassi, Patricia; Capelli, Aurore; Bioulac, Bernard; Commenges, Daniel; Taillard, Jacques

    2012-07-01

    To evaluate the effects of acute sleep deprivation and chronic sleep restriction on vigilance, performance, and self-perception of sleepiness. Habitual night followed by 1 night of total sleep loss (acute sleep deprivation) or 5 consecutive nights of 4 hr of sleep (chronic sleep restriction) and recovery night. Eighteen healthy middle-aged male participants (age [(± standard deviation] = 49.7 ± 2.6 yr, range 46-55 yr). Multiple sleep latency test trials, Karolinska Sleepiness Scale scores, simple reaction time test (lapses and 10% fastest reaction times), and nocturnal polysomnography data were recorded. Objective and subjective sleepiness increased immediately in response to sleep restriction. Sleep latencies after the second and third nights of sleep restriction reached levels equivalent to those observed after acute sleep deprivation, whereas Karolinska Sleepiness Scale scores did not reach these levels. Lapse occurrence increased after the second day of sleep restriction and reached levels equivalent to those observed after acute sleep deprivation. A statistical model revealed that sleepiness and lapses did not progressively worsen across days of sleep restriction. Ten percent fastest reaction times (i.e., optimal alertness) were not affected by acute or chronic sleep deprivation. Recovery to baseline levels of alertness and performance occurred after 8-hr recovery night. In middle-aged study participants, sleep restriction induced a high increase in sleep propensity but adaptation to chronic sleep restriction occurred beyond day 3 of restriction. This sleepiness attenuation was underestimated by the participants. One recovery night restores daytime sleepiness and cognitive performance deficits induced by acute or chronic sleep deprivation. Philip P; Sagaspe P; Prague M; Tassi P; Capelli A; Bioulac B; Commenges D; Taillard J. Acute versus chronic partial sleep deprivation in middle-aged people: differential effect on performance and sleepiness. SLEEP 2012;35(7):997-1002.

  9. Psychometric Properties of Turkish Version of Pediatric Daytime Sleepiness Scale (PDSS-T

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    Murat Bektas, PhD, RN

    2016-03-01

    Conclusions: The study's results showed that PDSS-T is a valid and reliable instrument for detecting Turkish-speaking children's and adolescents' daytime sleepiness. PDSS-T is convenient for professionals to prevent and manage daytime sleepiness.

  10. Correlation of Epworth Sleepiness Scale with multiple sleep latency test and its diagnostic accuracy in assessing excessive daytime sleepiness in patients with obstructive sleep apnea hypopnea syndrome

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    CAI Si-jie; CHEN Rui; ZHANG Yan-lin; XIONG Kang-ping; LIAN Yi-xin; LI Jie; SHEN Jiu-cheng

    2013-01-01

    Background Excessive daytime sleepiness (EDS) is often associated with obstructive sleep apnea hypopnea syndrome (OSAHS) and contributes to a number of comorbidities in these patients.Therefore,eady detection of EDS is critical in disease management.We examined the association between Epworth Sleepiness Scale (ESS) and multiple sleep latency test (MSLT) and diagnostic accuracy of ESS in assessing EDS in OSAHS patients.Methods The ESS,MSLT and overnight polysomnography were administered to 107 Chinese patients to assess EDS and its correlations with polysomnographic parameters.The diagnostic accuracy of ESS in classifying EDS (mean sleep latency (MSL) <10 minutes) was evaluated by calculating the area under ROC curve.Results As the severity of OSAHS increased,MSL decreased with increase in ESS score.Conversely,patients with worsening EDS (shorter MSL) were characterized by advanced nocturnal hypoxaemia and sleep disruption compared to those with normal MSL,suggesting EDS is associated with more severe OSAHS.There was a negative correlation between ESS score and MSL and both moderately correlated with some polysomnographic nocturnal hypoxaemic parameters.The area under ROC curve of ESS for identifying EDS was 0.80 (95% C/:0.71 to 0.88) and ESS score >12provided the best predictive value with a sensitivity of 80% and specificity of 69%.Conclusion The ESS score moderately correlates with MSL and our ROC study supports ESS as a screening strategy for assessing EDS in OSAHS.

  11. Effects of Shift Work on Cognitive Performance, Sleep Quality, and Sleepiness among Petrochemical Control Room Operators.

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    Kazemi, Reza; Haidarimoghadam, Rashid; Motamedzadeh, Majid; Golmohamadi, Rostam; Soltanian, Alireza; Zoghipaydar, Mohamad Reza

    2016-02-03

    Shift work is associated with both sleepiness and reduced performance. The aim of this study was to examine cognitive performance, sleepiness, and sleep quality among petrochemical control room shift workers. Sixty shift workers participated in this study. Cognitive performance was evaluated using a number of objective tests, including continuous performance test, n-back test, and simple reaction time test; sleepiness was measured using the subjective Karolinska Sleepiness Scale (KSS); and sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. ANCOVA, t-test, and repeated-measures ANOVA were applied for statistical analyses, and the significance level was set at p sleep quality on both day and night shifts, and there were significant differences between the day and night shifts in terms of subjective sleep quality and quantity (p sleep, induced cognitive performance decline at the end of both day and night shifts, and increased sleepiness in night shift. It, thus, seems necessary to take ergonomic measures such as planning for more appropriate shift work and reducing working hours.

  12. Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses.

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    Geiger-Brown, Jeanne; Rogers, Valerie E; Trinkoff, Alison M; Kane, Robert L; Bausell, R Barker; Scharf, Steven M

    2012-03-01

    Nurses working 12-h shifts complain of fatigue and insufficient/poor-quality sleep. Objectively measured sleep times have not been often reported. This study describes sleep, sleepiness, fatigue, and neurobehavioral performance over three consecutive 12-h (day and night) shifts for hospital registered nurses. Sleep (actigraphy), sleepiness (Karolinska Sleepiness Scale [KSS]), and vigilance (Performance Vigilance Task [PVT]), were measured serially in 80 registered nurses (RNs). Occupational fatigue (Occupational Fatigue Exhaustion Recovery Scale [OFER]) was assessed at baseline. Sleep was short (mean 5.5 h) between shifts, with little difference between day shift (5.7 h) and night shift (5.4 h). Sleepiness scores were low overall (3 on a 1-9 scale, with higher score indicating greater sleepiness), with 45% of nurses having high level of sleepiness (score  > 7) on at least one shift. Nurses were progressively sleepier each shift, and night nurses were sleepier toward the end of the shift compared to the beginning. There was extensive caffeine use, presumably to preserve or improve alertness. Fatigue was high in one-third of nurses, with intershift fatigue (not feeling recovered from previous shift at the start of the next shift) being most prominent. There were no statistically significant differences in mean reaction time between day/night shift, consecutive work shift, and time into shift. Lapsing was traitlike, with rare (39% of sample), moderate (53%), and frequent (8%) lapsers. Nurses accrue a considerable sleep debt while working successive 12-h shifts with accompanying fatigue and sleepiness. Certain nurses appear more vulnerable to sleep loss than others, as measured by attention lapses.

  13. The Epworth Sleepiness Scale in the Assessment of Sleep Disturbance in Veterans with Tinnitus

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    Yuan F. Liu

    2015-01-01

    Full Text Available Purpose. Tinnitus and sleep disturbance are prevalent in veterans, and a better understanding of their relationship can help with tinnitus treatment. Materials and Methods. Retrospective chart review of 94 veterans seen in audiology clinic between 2010 and 2013 is presented. Results. The mean age was 62 years, and 93 of 94 veterans were males. The majority (96% had hearing loss. The positive predictive value of the ESS for sleep disorder was 97% and the negative predictive value was 100%. Veterans with a Tinnitus Handicap Inventory (THI score ≥38 had significantly higher Epworth Sleepiness Scale (ESS scores compared to those with THI score <38 (P=0.006. The former had a significantly higher incidence of PTSD, anxiety, and sleep disorder. A subgroup of patients had normal sleep despite rising THI scores. Bilateral tinnitus, vertigo, and anxiety were found to be predictors of sleep disturbance. Conclusions. The ESS can be used as a tool in the initial assessment of sleep disorders in veterans with tinnitus. Higher tinnitus handicap severity is significantly associated with greater sleep disturbance. Optimal management of tinnitus may require concomitant treatment of sleep disorder, PTSD, anxiety, and depression.

  14. The Toronto Hospital Alertness Test scale: relationship to daytime sleepiness, fatigue, and symptoms of depression and anxiety

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    Shahid A

    2016-01-01

    Full Text Available Azmeh Shahid,1–5 Sharon A Chung,1,2,5 Lance Maresky,1 Affan Danish,1 Arina Bingeliene,1,4,5 Jianhua Shen,1 Colin M Shapiro1–5 1Sleep Research Laboratory, Department of Psychiatry, University Health Network, University of Toronto, 2Youthdale Treatment Centres, 3Youthdale Child and Adolescent Sleep Centre, 4Department of Psychiatry, University of Toronto, 5Department of Psychiatry, Toronto Western Hospital, University Health Network, Toronto, ON, Canada Objective: The Toronto Hospital Alertness Test (THAT scale was designed to measure alertness, defined as the capacity of the mind to respond appropriately to external and internal stimuli. The present study’s aim is to determine normative values of alertness on the THAT and to explore the relationship among excessive daytime sleepiness, fatigue, depressive symptoms, and alertness. Methods: Normative data were collected from 60 healthy males and females. To explore the relationship among alertness, daytime sleepiness, fatigue, depression, and anxiety, data were collected from charts of sleep clinic patients. All study subjects completed measures for fatigue, sleepiness, depressive symptoms, and anxiety. Results: The average score on the THAT was 34.9±7.2 (range 22–50 for the control group. The cutoff score for the THAT, indicative of clinically significant reduced alertness, was determined to be ≤20.5 (mean –2 SD. THAT alertness scores were found to be modestly, significantly, and negatively correlated with fatigue levels (r=–0.39, P<0.001, depressive symptoms (r=–0.53, P<0.001, and anxiety symptoms (r=–0.41, P<0.001. No correlations were found between alertness levels and daytime sleepiness. Regression analyses revealed a significant model (F=19.9, P<0.001, adjusted R2=0.35 with depressive symptoms (P<0.001 and fatigue (P=0.006 emerging as the only significant predictors of scores on the THAT. Conclusion: The findings of this study support that sleepiness is not the same as

  15. Epworth Sleepiness Scale- a novel tool to assess somnolence syndrome in patients receiving radiotherapy to the brain

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    Ritika Rajkumar Harjani

    2015-03-01

    Full Text Available Purpose: Radiation to brain causes early, early-delayed, and delayed side effects. There is paucity of literature regarding early-delayed effects like somnolence syndrome. Existing studies use general symptom assessment and visual analog scales. Epworth Sleepiness Scale (ESS is a time tested tool to assess daytime sleepiness in various conditions. In this study, the ESS has been used to determine the occurrence of somnolence in patients receiving cranial radiotherapy for primary and metastatic brain tumors. Thus the ESS has been used in a novel setting in our study. The ESS is a simple to administer questionnaire and may be useful in grading the severity of somnolence. To our knowledge, this is the second study to determine post radiation somnolence using ESS. Methods: This prospective study was conducted in 23 patients with primary and metastatic brain tumor. Patient demographics and tumor type and grade was noted. Those with Karnofsky Performance Scale (KPS less than 70 and with pre-existing sleep disorders were excluded. Radiotherapy regimen included palliative whole brain radiation for brain metastases and conformal adjuvant radiotherapy for primary brain tumors as per standard guidelines. All subjects included were administered ESS at baseline and weekly thereafter during and for 6 weeks after radiation. Results: All 23 patients (median age 50 years completed the planned questionnaires until 6 weeks post radiation. Twenty (87% patients had primary brain tumors whereas three (13% patients had metastatic lesions in brain. Of the 23 patients, 14 patients (60.86% had abnormal or increased daytime sleepiness; of which 3 had ESS scores greater than 16. Conclusion: Somnolence was noted in 60.86% of the patients, which is in accordance with existing literature. Epworth sleepiness scale is an effective tool to detect and quantify somnolence, However, it does not consider other symptoms of somnolence syndrome and hence should be combined with visual

  16. Comparing Treatment Effect Measurements in Narcolepsy: The Sustained Attention to Response Task, Epworth Sleepiness Scale and Maintenance of Wakefulness Test.

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    van der Heide, Astrid; van Schie, Mojca K M; Lammers, Gert Jan; Dauvilliers, Yves; Arnulf, Isabelle; Mayer, Geert; Bassetti, Claudio L; Ding, Claire-Li; Lehert, Philippe; van Dijk, J Gert

    2015-07-01

    To validate the Sustained Attention to Response Task (SART) as a treatment effect measure in narcolepsy, and to compare the SART with the Maintenance of Wakefulness Test (MWT) and the Epworth Sleepiness Scale (ESS). Validation of treatment effect measurements within a randomized controlled trial (RCT). Ninety-five patients with narcolepsy with or without cataplexy. The RCT comprised a double-blind, parallel-group, multicenter trial comparing the effects of 8-w treatments with pitolisant (BF2.649), modafinil, or placebo (NCT01067222). MWT, ESS, and SART were administered at baseline and after an 8-w treatment period. The severity of excessive daytime sleepiness and cataplexy was also assessed using the Clinical Global Impression scale (CGI-C). The SART, MWT, and ESS all had good reliability, obtained for the SART and MWT using two to three sessions in 1 day. The ability to distinguish responders from nonresponders, classified using the CGI-C score, was high for all measures, with a high performance for the SART (r = 0.61) and the ESS (r = 0.54). The Sustained Attention to Response Task is a valid and easy-to-administer measure to assess treatment effects in narcolepsy, enhanced by combining it with the Epworth Sleepiness Scale. © 2015 Associated Professional Sleep Societies, LLC.

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

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    Karhula, Kati; Härmä, Mikko; Sallinen, Mikael; Hublin, Christer; Virkkala, Jussi; Kivimäki, Mika; Vahtera, Jussi; Puttonen, Sampsa

    2013-01-01

    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 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.

  18. Sleep and sleepiness of fishermen on rotating schedules.

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    Gander, Philippa; van den Berg, Margo; Signal, Leigh

    2008-04-01

    Seafaring is a hazardous occupation with high death and injury rates, but the role of seafarer fatigue in these events is generally not well documented. The International Maritime Organization has identified seafarer fatigue as an important health and safety issue. Most research to date has focused on more regularly scheduled types of operations (e.g., merchant vessels, ferries), but there is relatively little information on commercial fishing, which often involves high day-to-day and seasonal variability in work patterns and workload. The present study was designed to monitor the sleep and sleepiness of commercial fishermen at home and during extended periods at sea during the peak of the hoki fishing season, with a view to developing better fatigue management strategies for this workforce. Sleep (wrist actigraphy and sleep diaries) and sleepiness (Karolinska Sleepiness Scale [KSS] before and after each sleep period) of 20 deckhands were monitored for 4-13 days at home and for 5-9 days at sea while working a nominal 12 h on/6 h off schedule. On the 12 h on/6 hoff schedule, there was still a clear preference for sleep at night. Comparing the last three days at home and the first three days at sea showed that fishermen were more likely to have split sleep at sea (Wilcoxon signed ranks p or= 7 on 24% of days at sea vs. 9% of days at home (Wilcoxon signed ranks p loss, and residual sleepiness after sleep, were much more common at sea than at home. The longer duration of trips during the peak of the fishing season increases the risk of performance impairment due to greater cumulative sleep loss than would be expected on typical three-day trips. Key fatigue management strategies in this environment include that fishermen report to work as well rested as possible. Once at sea, the day-to-day variability in activities due to uncontrollable factors, such as fishing success, repairing gear, and weather conditions, mean that contingency planning is required for managing

  19. SLEEPINESS AMONG IRANIAN LORRY DRIVERS

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    K. Sadeghniiat Y. Labbafinejad

    2007-06-01

    Full Text Available Excessive daytime sleepiness (EDS denotes a propensity to doze off or fall asleep unintentionally during the day, particularly in passive situations. There is cumulative evidence pointing to an association between sleepiness and probability of involvement in motor vehicle crashes. This study was designed to determine the prevalence of sleepiness in a group of Iranian lorry drivers and its association with accidents. A cross-sectional study was carried out in lorry drivers of Tehran goods transportation terminal in 2005. This study used a questionnaire and the Epworth Sleepiness Scale (ESS. The questionnaire included questions regarding demographic features, professional data, sleep habits and excessive daytime sleepiness. A total of 386 male drivers, aged 43.23 ± 9.72 years were included in the study. ESS was higher than 10 points in 9.1% of the interviewees; 50.8% never have driven drowsy, although 36% rarely, 7.3% half of the times, 4.9% almost always and 1% always have driven drowsy. Logistic regression analysis indicated that EDS, age and job satisfaction were associated with an increased risk of accidents. Sleepiness is a prevailing symptom in lorry drivers and is probably related to accidents.

  20. Effects of long working hours and the night shift on severe sleepiness among workers with 12-hour shift systems for 5 to 7 consecutive days in the automobile factories of Korea.

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    Son, Mia; Kong, Jeong-Ok; Koh, Sang-Baek; Kim, Jaeyoung; Härmä, Mikko

    2008-12-01

    We investigated the effects of 12-hour shift work for five to seven consecutive days and overtime on the prevalence of severe sleepiness in the automobile industry in Korea. [Correction added after online publication 28 Nov: Opening sentence of the summary has been rephrased for better clarity.] A total of 288 randomly selected male workers from two automobile factories were selected and investigated using questionnaires and sleep-wake diaries in South Korea. The prevalence of severe sleepiness at work [i.e. Karolinska Sleepiness Scale (KSS) score of 7 or higher] was modeled using marginal logistic regression and included theoretical risk factors related to working hours and potential confounding factors related to socio-economic status, work demands, and health behaviors. Factors related to working hours increased the risk for severe sleepiness at the end of the shift in the following order: the night shift [odds ratio (OR): 4.7; 95% confidence interval (CI): 3.6-6.0)], daily overtime (OR: 2.2; 95% CI: 1.7-2.9), weekly overtime (OR: 1.6; 95% CI: 1.0-2.6), and night overtime (OR: 1.6; 95% CI: 0.8-3.0). Long working hours and shift work had a significant interactive effect for severe sleepiness at work. Night shift workers who worked for 12 h or more a day were exposed to a risk of severe sleepiness that was 7.5 times greater than day shift workers who worked less than 11 h. Night shifts and long working hours were the main risk factors for severe sleepiness among automobile factory workers in Korea. Night shifts and long working hours have a high degree of interactive effects resulting in severe sleepiness at work, which highlight the need for immediate measures to address these characteristics among South Korean labor force patterns.

  1. Excessive Daytime Sleepiness

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    Yavuz Selvi

    2016-06-01

    Full Text Available Excessive daytime sleepiness is one of the most common sleep-related patient symptoms, with preva-lence in the community estimated to be as high as 18%. Patients with excessive daytime sleepiness may exhibit life threatening road and work accidents, social maladjustment, decreased academic and occupational performance and have poorer health than comparable adults. Thus, excessive daytime sleepiness is a serious condition that requires investigation, diagnosis and treatment primarily. As with most medical condition, evaluation of excessive daytime sleepiness begins a precise history and various objective and subjective tools have been also developed to assess excessive daytime sleepiness. The most common causes of excessive daytime sleepiness are insufficient sleep hygiene, chronic sleep deprivation, medical and psychiatric conditions and sleep disorders, such as obstructive sleep apnea, medications, and narcolepsy. Treatment option should address underlying contributors and promote sleep quantity by ensuring good sleep hygiene. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(2: 114-132

  2. Excessive Daytime Sleepiness

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    Yavuz Selvi; Ali Kandeger; Ayca Asena Sayin

    2016-01-01

    Excessive daytime sleepiness is one of the most common sleep-related patient symptoms, with preva-lence in the community estimated to be as high as 18%. Patients with excessive daytime sleepiness may exhibit life threatening road and work accidents, social maladjustment, decreased academic and occupational performance and have poorer health than comparable adults. Thus, excessive daytime sleepiness is a serious condition that requires investigation, diagnosis and treatment primarily. As with ...

  3. Daytime sleepiness in Parkinson's disease: a reappraisal.

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    Valérie Cochen De Cock

    Full Text Available Excessive daytime sleepiness is a frequent complaint in Parkinson's disease (PD; however the frequency and risk factors for objective sleepiness remain mostly unknown. We investigated both the frequency and determinants of self-reported and objective daytime sleepiness in patients with Parkinson's disease (PD using a wide range of potential predictors.One hundred and thirty four consecutive patients with PD, without selection bias for sleep complaint, underwent a semi-structured clinical interview and a one night polysomnography followed by a multiple sleep latency test (MSLT. Demographic characteristics, medical history, PD course and severity, daytime sleepiness, depressive and insomnia symptoms, treatment intake, pain, restless legs syndrome, REM sleep behaviour disorder, and nighttime sleep measures were collected. Self-reported daytime sleepiness was defined by an Epworth Sleepiness Scale (ESS score above 10. A mean sleep latency on MSLT below 8 minutes defined objective daytime sleepiness.Of 134 patients with PD, 46.3% had subjective and only 13.4% had objective sleepiness with a weak negative correlation between ESS and MSLT latency. A high body mass index (BMI was associated with both ESS and MSLT, a pain complaint with ESS, and a higher apnea/hypopnea index with MSLT. However, no associations were found between both objective and subjective sleepiness, and measures of motor disability, disease onset, medication (type and dose, depression, insomnia, restless legs syndrome, REM sleep behaviour disorder and nighttime sleep evaluation.We found a high frequency of self-reported EDS in PD, a finding which is however not confirmed by the gold standard neurophysiological evaluation. Current treatment options for EDS in PD are very limited; it thus remains to be determined whether decreasing pain and BMI in association with the treatment of sleep apnea syndrome would decrease significantly daytime sleepiness in PD.

  4. An experimental study of adolescent sleep restriction during a simulated school week: changes in phase, sleep staging, performance and sleepiness.

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    Agostini, Alex; Carskadon, Mary A; Dorrian, Jillian; Coussens, Scott; Short, Michelle A

    2017-04-01

    This laboratory study investigated the impact of restricted sleep during a simulated school week on circadian phase, sleep stages and daytime functioning. Changes were examined across and within days and during a simulated weekend recovery. Participants were 12 healthy secondary school students (six male) aged 15-17 years [mean = 16.1 years, standard deviation (SD) = 0.9]. After 2 nights with 10 h (21:30-07:30 hours), time in bed was restricted to 5 h for 5 nights (02:30-07:30 hours), then returned to 10 h time in bed for 2 nights (21:30-07:30 hours). Saliva was collected in dim light on the first and last sleep restriction nights to measure melatonin onset phase. Sleep was recorded polysomnographically, and the Psychomotor Vigilance Task (PVT) and Karolinska Sleepiness Scale were undertaken 3-hourly while awake. Average phase delay measured by melatonin was 3 h (SD = 50 min). Compared to baseline, sleep during the restriction period contained a smaller percentage of Stages 1 and 2 and rapid eye movement (REM) and a greater percentage of Stage 4. PVT lapses increased significantly during sleep restriction and did not return to baseline levels during recovery. Subjective sleepiness showed a similar pattern during restriction, but returned to baseline levels during recovery. Results suggest that sustained attention in adolescents is affected negatively by sleep restriction, particularly in the early morning, and that a weekend of recovery sleep is insufficient to restore performance. The discrepancy between sleepiness ratings and performance may indicate a lack of perception of this residual impairment.

  5. Recommendations from the ESO-Karolinska Stroke Update Conference, Stockholm 13–15 November 2016

    DEFF Research Database (Denmark)

    2017-01-01

    About the meeting: The purpose of the European Stroke Organisation (ESO)-Karolinska Stroke Update Conference is to provide updates on recent stroke therapy research and to give an opportunity for the participants to discuss how these results may be implemented into clinical routine. Several......://www.eso-karolinska.org/2016 and http://eso-stroke.org) and recommendations which were prepared by a writing committee consisting of session chair(s), secretary and speakers and presented to the 312 participants of the meeting. In the open meeting, general participants commented on the consensus statement and recommendations...

  6. Sleep and daytime sleepiness in methylphenidate medicated and ...

    African Journals Online (AJOL)

    impaired vigilance, decreased motivation, hyperactivity, aggressive ... sleep behaviour in the current diagnostic criteria (DSM-IV. TR), as the .... Studies evaluating the effects of ... questionnaire and the Wits Faces Sleepiness Scale, a pictorial ...

  7. Sleepiness, driving, and motor vehicle accidents: A questionnaire-based survey.

    Science.gov (United States)

    Zwahlen, Daniel; Jackowski, Christian; Pfäffli, Matthias

    2016-11-01

    In Switzerland, the prevalence of an excessive daytime sleepiness (EDS) in drivers undergoing a driving capacity assessment is currently not known. In this study, private and professional drivers were evaluated by means of a paper-based questionnaire, including Epworth Sleepiness Scale, Berlin Questionnaire, and additional questions to sleepiness-related accidents, near-miss accidents, health issues, and demographic data. Of the 435 distributed questionnaires, 128 completed were returned. The response rate was 29%. The mean age of the investigated drivers was 42.5 years (20-85 years). According to the Epworth Sleepiness Scale, 9% of the participants are likely to suffer from excessive daytime sleepiness. An equal percentage has a high risk for obstructive sleep apnea syndrome based on the Berlin Questionnaire. 16% admitted an involuntary nodding off while driving a motor vehicle. This subset of the participants scored statistically significant higher on the Epworth Sleepiness Scale (p = 0.036). 8% of the participants already suffered an accident because of being sleepy while driving. An equal number experienced a sleepiness-related near-miss accident on the road. The study shows that a medical workup of excessive daytime sleepiness is highly recommended in each driver undergoing a driving capacity assessment. Routine application of easily available and time-saving assessment tools such as the Epworth Sleepiness Scale questionnaire could prevent accidents in a simple way. The applicability of the Berlin Questionnaire to screen suspected fatal sleepiness-related motor vehicle accidents is discussed.

  8. Construct validity and factor structure of the pittsburgh sleep quality index and epworth sleepiness scale in a multi-national study of African, South East Asian and South American college students.

    Directory of Open Access Journals (Sweden)

    Bizu Gelaye

    Full Text Available The Pittsburgh Sleep Quality Index (PSQI and the Epworth Sleepiness Scale (ESS are questionnaires used to assess sleep quality and excessive daytime sleepiness in clinical and population-based studies. The present study aimed to evaluate the construct validity and factor structure of the PSQI and ESS questionnaires among young adults in four countries (Chile, Ethiopia, Peru and Thailand.A cross-sectional study was conducted among 8,481 undergraduate students. Students were invited to complete a self-administered questionnaire that collected information about lifestyle, demographic, and sleep characteristics. In each country, the construct validity and factorial structures of PSQI and ESS questionnaires were tested through exploratory and confirmatory factor analyses (EFA and CFA.The largest component-total correlation coefficient for sleep quality as assessed using PSQI was noted in Chile (r = 0.71 while the smallest component-total correlation coefficient was noted for sleep medication use in Peru (r = 0.28. The largest component-total correlation coefficient for excessive daytime sleepiness as assessed using ESS was found for item 1 (sitting/reading in Chile (r = 0.65 while the lowest item-total correlation was observed for item 6 (sitting and talking to someone in Thailand (r = 0.35. Using both EFA and CFA a two-factor model was found for PSQI questionnaire in Chile, Ethiopia and Thailand while a three-factor model was found for Peru. For the ESS questionnaire, we noted two factors for all four countries.Overall, we documented cross-cultural comparability of sleep quality and excessive daytime sleepiness measures using the PSQI and ESS questionnaires among Asian, South American and African young adults. Although both the PSQI and ESS were originally developed as single-factor questionnaires, the results of our EFA and CFA revealed the multi- dimensionality of the scales suggesting limited usefulness of the global PSQI and ESS

  9. Factors influencing excessive daytime sleepiness in adolescents

    Directory of Open Access Journals (Sweden)

    Thiago de Souza Vilela

    2016-04-01

    Full Text Available Abstract Objective: Sleep deprivation in adolescents has lately become a health issue that tends to increase with higher stress prevalence, extenuating routines, and new technological devices that impair adolescents' bedtime. Therefore, this study aimed to assess the excessive sleepiness frequency and the factors that might be associated to it in this population. Methods: The cross-sectional study analyzed 531 adolescents aged 10–18 years old from two private schools and one public school. Five questionnaires were applied: the Cleveland Adolescent Sleepiness Questionnaire; the Sleep Disturbance Scale for Children; the Brazilian Economic Classification Criteria; the General Health and Sexual Maturation Questionnaire; and the Physical Activity Questionnaire. The statistical analyses were based on comparisons between schools and sleepiness and non-sleepiness groups, using linear correlation and logistic regression. Results: Sleep deprivation was present in 39% of the adolescents; sleep deficit was higher in private school adolescents (p < 0.001, and there was a positive correlation between age and sleep deficit (p < 0.001; r = 0.337. Logistic regression showed that older age (p = 0.002; PR: 1.21 [CI: 1.07–1.36] and higher score level for sleep hyperhidrosis in the sleep disturbance scale (p = 0.02; PR: 1.16 [CI: 1.02–1.32] were risk factors for worse degree of sleepiness. Conclusions: Sleep deficit appears to be a reality among adolescents; the results suggest a higher prevalence in students from private schools. Sleep deprivation is associated with older age in adolescents and possible presence of sleep disorders, such as sleep hyperhidrosis.

  10. STOP-Bang questionnaire is superior to Epworth sleepiness scales,Berlin questionnaire, and STOP questionnaire in screening obstructive sleep apnea hypopnea syndrome patients

    Institute of Scientific and Technical Information of China (English)

    Luo Jinmei; Huang Rong; Zhong Xu; Xiao Yi; Zhou Jiong

    2014-01-01

    Background Obstructive sleep apnea hypopnea syndrome (OSAHS) is underdiagnosed.Screening patients at high risk of OSAHS is extremely important.Using the standard questionnaire to screen OSAHS is a practical method.This study aimed to evaluate the value of the STOP-Bang questionnaire (SBQ) in screening OSAHS in sleep-disordered breathing clinic by comparing it with the Epworth sleepiness scales (ESS),Berlin questionnaire,and STOP questionnaire.Methods In this study,212 patients at the sleep-disordered breathing clinic of the Peking Union Medical College Hospital between May 2011 and January 2012 were prospectively included.They were asked to fill in the SBQ,ESS,Berlin questionnaire,and STOP questionnaire before overnight polysomnography (PSG).Using PSG as gold standard,the sensitivities and specificities of SBQ were compared with those of ESS,Berlin questionnaire,and STOP questionnaire.Results There was no significance in applying ESS score ≥11 to screen OSAHS and detect moderate and severe OSAHS (P >0.05).SBQ was superior to Berlin questionnaire and STOP questionnaire in screening OSAHS and detecting the severity of OSAHS patients.The sensitivities of SBQ score ≥3 with apnea hypopnea index (AHI) ≥5/h,AHI ≥15/h,and AHI ≥30/h as gold standards were 94.9%,96.5%,and 97.7%,respectively.The specificities were 50.0%,28.6%,and 17.9%,respectively.The area upper curves were 0.815 (0.706-0.925,P <0.01),0.746 (0.665-0.828,P <0.01),and 0.751 (0.686-0.817,P <0.01),respectively.According to SBQ,the population was classified into high-risk group and low-risk group.The gender,BMI,neck circumference,AHI,LSpO2,and number of subjects ofAHI ≥5/h,AHI ≥15/h,and AHI ≥30/h of these two groups were significantly different.Conclusions The SBQ has superior predictive value compared with ESS,Berlin questionnaire,and STOP questionnaire.It should be used further in screening for OSAHS in the general population.

  11. Daytime sleepiness and related factors in nursing students.

    Science.gov (United States)

    Demir, Gökçe

    2017-08-26

    Evaluation of the frequency and causes of daytime sleepiness in nursing students because it is an important factor in improving the health status of the students, controlling sleep problems, improving students' academic achievements, and maintaining a healthy lifestyle. The aim of this study was to determine the prevalence of daytime sleepiness in nursing students and the factors associated with it. A cross-sectional research design was used in this study. Nursing students (n=382). Data were collected using a questionnaire prepared by the authors to assess socio-demographic characteristics, sleep habits, and problems of nursing students and the Epworth Sleepiness Scale (ESS), which assesses daytime sleepiness. Descriptive statistics included numbers, percentages, mean, median, and standard deviation. Mann-Whitney U test (Z) and Kruskal-Wallis (KW) analysis of variance were used for evaluating the relationship between ESS scores and independent variables. The prevalence of daytime sleepiness in the students was found to be 10.5%. Those in the 2nd grade, who were married, who did not consume coffee or tea, lived alone, regarded their own academic achievement as poor, and used the Internet during morning hours experienced increased daytime sleepiness. Moreover, students who talk in their sleep, grind their teeth, feel restless before sleep, experience problems in falling asleep, and wake up at night were found to experience increased daytime sleepiness. Daytime sleepiness is a considerably common health problem in nursing students. This study found that daytime sleepiness is associated with individual characteristics, lifestyle and consumption habits, and sleep habits. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. The effect of split sleep schedules (6h-on/6h-off) on neurobehavioural performance, sleep and sleepiness.

    Science.gov (United States)

    Short, Michelle A; Centofanti, Stephanie; Hilditch, Cassie; Banks, Siobhan; Lushington, Kurt; Dorrian, Jillian

    2016-05-01

    Shorter, more frequent rosters, such as 6h-on/6h-off split shifts, may offer promise to sleep, subjective sleepiness and performance by limiting shift length and by offering opportunities for all workers to obtain some sleep across the biological night. However, there exists a paucity of studies that have examined these shifts using objective measures of sleep and performance. The present study examined neurobehavioural performance, sleepiness and sleep during 6h-on/6h-off split sleep schedules. Sixteen healthy adults (6 males, 26.13 y ± 4.46) participated in a 9-day laboratory study that included two baseline nights (BL, 10h time in bed (TIB), 2200 h-0800 h), 4 days on one of two types of 6h-on/6h-off split sleep schedules with 5h TIB during each 'off' period (6h early: TIB 0300 h-0800 h and 1500 h-20000 h, or 6-h late: TIB 0900 h-1400 h and 2100 h-0200 h), and two recovery nights (10h TIB per night, 2200 h-0800 h). Participants received 10h TIB per 24h in total across both shift schedules. A neurobehavioural test bout was completed every 2 h during wake, which included the Psychomotor Vigilance Task (PVT) and the Karolinska Sleepiness Scale (KSS). Linear mixed effects models were used to assess the effect of day (BL, shift days 1-4), schedule (6h early, 6h late) and trial (numbers 1-6) on PVT lapses (operationalised as the number of reaction times >500 ms), PVT total lapse time, PVT fastest 10% of reaction times and KSS. Analyses were also conducted examining the effect of day and schedule on sleep variables. Overall, PVT lapses and total lapse time did not differ significantly between baseline and shift days, however, peak response speeds were significantly slower on the first shift day when compared to baseline, but only for those in the 6h-late condition. Circadian variations were apparent in performance outcomes, with individuals in the 6h-late condition demonstrated significantly more and longer lapses and slower peak reaction times at the end of their

  13. Portfolio of qualifications: a tool for evaluating academic productivity at the Karolinska Institutet.

    Science.gov (United States)

    Dahllöf, G; Ekstrand, J; Nordenström, J

    1999-02-01

    A Portfolio of Qualifications for academic appointments at the Karolinska Institutet has been developed to define more clearly the competence and qualifications which are given high priority for academic appointments at the Karolinska Institutet. The major fields of application are for new appointments and promotions, providing guidelines for the individual for improving his/her proficiency, and as a basis for determining individual salary rates. Four portfolios have been developed, a pedagogical, a clinical, a scientific, and a leadership, development and workplace relations portfolio. Attached to the portfolios are assessment forms. We consider the Qualifications Portfolio to be a reflection of changes in attitudes and values at the Karolinska Institutet. The system offers a method for the recognition of faculty productivity in different dimensions. This may be beneficial for the university in view of the increasing diversity and complexity of academic institutions. The Qualifications portfolio can be obtained from the world wide web, http:/(/)www.ki.se/ki/merit.se.html (in Swedish), http:/(/)www.ki.se/ki/merit.html (in English).

  14. Observer rated sleepiness and real road driving: an explorative study.

    Directory of Open Access Journals (Sweden)

    Anna Anund

    Full Text Available The aim of the present study was to explore if observer rated sleepiness (ORS is a feasible method for quantification of driver sleepiness in field studies. Two measures of ORS were used: (1 one for behavioural signs based on facial expression, body gestures and body movements labelled B-ORS, and (2 one based on driving performance e.g. if swerving and other indicators of impaired driving occurs, labelled D-ORS. A limited number of observers sitting in the back of an experimental vehicle on a motorway about 2 hours repeatedly 3 times per day (before lunch, after lunch, at night observed 24 participant's sleepiness level with help of the two observer scales. At the same time the participant reported subjective sleepiness (KSS, EOG was recorded (for calculation of blink duration and several driving measure were taken and synchronized with the reporting. Based on mixed model Anova and correlation analysis the result showed that observer ratings of sleepiness based on drivers' impaired performance and behavioural signs are sensitive to extend the general pattern of time awake, circadian phase and time of driving. The detailed analysis of the subjective sleepiness and ORS showed weak correspondence on an individual level. Only 16% of the changes in KSS were predicted by the observer. The correlation between the observer ratings based on performance (D-ORS and behavioural signs (B-ORS are high (r = .588, and the B-ORS shows a moderately strong association (r = .360 with blink duration. Both ORS measures show an association (r>0.45 with KSS, whereas the association with driving performance is weak. The results show that the ORS-method detects the expected general variations in sleepy driving in field studies, however, sudden changes in driver sleepiness on a detailed level as 5 minutes is usually not detected; this holds true both when taking into account driving behaviour or driver behavioural signs.

  15. Daytime sleepiness and sleep quality among Malaysian medical students.

    Science.gov (United States)

    Zailinawati, A H; Teng, C L; Chung, Y C; Teow, T L; Lee, P N; Jagmohni, K S

    2009-06-01

    Poor sleep quality and daytime somnolence is reported to be associated with cardiovascular events, road traffic accident, poor academic performance and psychological distress. Some studies documented that it is prevalent in most populations but its frequency among medical students has not been documented in Malaysia. This is a self-administered questionnaire survey of medical students from International Medical University, Malaysia. Daytime sleepiness of medical students was assessed using Epworth Sleepiness Scale (ESS). Student scoring ESS > 11 was regarded as having excessive daytime sleepiness. Psychological distress was measured using 12-item General Health Questionnaire (GHQ-12). A total of 799 medical students participated in this survey (response rate 69.5%). Daytime sleepiness occurred in 35.5%, psychological distress was present in 41.8% and 16.1% reported bad sleep quality. Daytime sleepiness was significantly more common among the clinical students, those with self-reported bad sleep quality and psychological distress; but unrelated to the number of hours sleep at night. We have documented high prevalence of daytime sleepiness, poor sleep quality and psychological distress. Higher frequency among clinical students and the significant relationship with psychological distress suggest possible link to the stressful clinical training.

  16. Caffeine: sleep and daytime sleepiness.

    Science.gov (United States)

    Roehrs, Timothy; Roth, Thomas

    2008-04-01

    Caffeine is one of the most widely consumed psychoactive substances and it has profound effects on sleep and wake function. Laboratory studies have documented its sleep-disruptive effects. It clearly enhances alertness and performance in studies with explicit sleep deprivation, restriction, or circadian sleep schedule reversals. But, under conditions of habitual sleep the evidence indicates that caffeine, rather then enhancing performance, is merely restoring performance degraded by sleepiness. The sleepiness and degraded function may be due to basal sleep insufficiency, circadian sleep schedule reversals, rebound sleepiness, and/or a withdrawal syndrome after the acute, over-night, caffeine discontinuation typical of most studies. Studies have shown that caffeine dependence develops at relatively low daily doses and after short periods of regular daily use. Large sample and population-based studies indicate that regular daily dietary caffeine intake is associated with disturbed sleep and associated daytime sleepiness. Further, children and adolescents, while reporting lower daily, weight-corrected caffeine intake, similarly experience sleep disturbance and daytime sleepiness associated with their caffeine use. The risks to sleep and alertness of regular caffeine use are greatly underestimated by both the general population and physicians.

  17. Driver Sleepiness and Risk of Car Crashes in Shenyang, a Chinese Northeastern City: Population-based Case-control Study

    Institute of Scientific and Technical Information of China (English)

    GAI-FEN LIU; SONG HAN; DUO-HONG LIANG; FENG-ZHI WANG; XIN-ZHU SHI; JIAN YU; ZHENG-LAI WU

    2003-01-01

    To estimate the association of driver sleepiness with the risk of car crashes.Methods A population-based case-control study was conducted in Shenyang, a northeastern city in China, between November 2001 and July 2002. The case group comprised 406 car drivers involved in crashes, and 438 car drivers recruited at randomly selected sites, and on the day of week, and the time of day when they were driving on highways in the study region during the study period were used as control groups. Face-to-face interviews with drivers were conducted according to a well-structured questionnaire covering the circumstances of their current trip and their background information.Stanford sleepiness scale and Epworth sleepiness scale were used to quantify acute sleepiness and chronic sleepiness respectively. Results There was a strong association between chronic sleepiness and the risk of car crash. Significantly increased risk of crash was associated with drivers who identified themselves as sleepy (Epworth sleepiness score ≥ 10 vs <10; adjusted odds ratio 2.07, 95%confidence interval 1.30 to 3.29), but no increased risk was associated with measures of acute sleepiness. Conclusions Chronic sleepiness in car drivers significantly increases the risk of car crash. Reductions in road traffic injuries may be achieved if fewer people drive when they are sleepy.

  18. Relationship between Daytime Sleepiness and Intrinsically Photosensitive Retinal Ganglion Cells in Glaucomatous Disease

    Directory of Open Access Journals (Sweden)

    Carolina P. B. Gracitelli

    2016-01-01

    Full Text Available Patients with glaucoma showed to have higher daytime sleepiness measured by Epworth sleepiness scale. In addition, this symptom was associated with pupillary reflex and polysomnography parameters. These ipRGC functions might be impaired in patients with glaucoma, leading to worse quality of life.

  19. Effects of a 12-hour shift on mood states and sleepiness of Neonatal Intensive Care Unit nurses.

    Science.gov (United States)

    Ferreira, Tadeu Sartini; Moreira, Clarice Zinato; Guo, James; Noce, Franco

    2017-03-09

    To assess the effect of a 12-hour shift on mood states and sleepiness at the beginning and end of the shift. Quantitative, cross-sectional and descriptive study.It was conducted with 70 neonatal intensive care unit nurses. The Brunel Mood Scale (BRUMS), Karolinska Sleepiness Scale (KSS), and a socio-demographic profile questionnaire were administered. When the KSS and BRUMS scores were compared at the beginning of the shift associations were found with previous sleep quality (p ≤ 0.01), and quality of life (p ≤ 0.05). Statistical significant effects on BRUMS scores were also associated with previous sleep quality, quality of life, liquid ingestion, healthy diet, marital status, and shift work stress. When the beginning and end of the shift were compared, different KSS scores were seen in the group of all nurses and in the night shift one. Significant vigor and fatigue scores were observed within shift groups. A good night's sleep has positive effects on the individual`s mood states both at the beginning and the end of the shift. The self-perception of a good quality of life also positively influenced KSS and BRUMS scores at the beginning and end of the shift. Proper liquid ingestion led to better KSS and BRUMS scores. Evaluar el efecto de un turno de 12 horas en estados de ánimo y somnolencia al principio y al final del turno. Estudio cuantitativo, transversal y descriptivo.Se realizó con 70 enfermeras de unidades de cuidados intensivos neonatales. Se administró la Escala de Humor Brunel (BRUMS), la Escala de Somnolencia de Karolinska (KSS) y un cuestionario de perfil sociodemográfico. Cuando se compararon las puntuaciones de KSS y BRUMS al comienzo del turno se encontraron asociaciones con calidad de sueño previa (p ≤ 0,01) y calidad de vida (p ≤ 0,05). Los efectos estadísticos significativos en las puntuaciones de BRUMS también se asociaron con la calidad previa del sueño, la calidad de vida, la ingestión de líquidos, la dieta saludable, el

  20. Excessive daytime sleepiness and its pattern among Indian college students.

    Science.gov (United States)

    Kaur, Gurjeet; Singh, Amarjeet

    2017-01-01

    The objective of this study was to determine the prevalence and pattern of excessive daytime sleepiness (EDTS) in Indian college students. This was a cross-sectional study that was conducted among 1215 undergraduate students, using the Epworth Sleepiness Scale (ESS) and a sociodemographic survey. A high proportion (45%) of EDTS was observed, and the problem was significantly greater in participants from professional courses. A probability of association of EDTS with coffee/tea consumption, alcohol consumption and smoking was also observed in the study. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. The Role of Daytime Sleepiness in Psychosocial Outcomes after Treatment for Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Esther Yuet Ying Lau

    2013-01-01

    Full Text Available We investigated the role of daytime sleepiness and sleep quality in psychosocial outcomes of patients with obstructive sleep apnea (OSA treated with continuous positive airway pressure (CPAP. Thirty-seven individuals with moderate to severe OSA and compliant with CPAP treatment for at least 3 months were compared to 27 age- and education-matched healthy controls. The OSA group and the control group were studied with overnight polysomnography (PSG and compared on measures of daytime sleepiness (Epworth Sleepiness Scale, sleep quality (Pittsburg Sleep Quality Index, mood (Beck Depression Inventory, Profile of Mood States, and functional outcomes (Functional Outcomes of Sleep Questionnaire. After CPAP treatment, the OSA group improved on sleep quality and sleepiness. As a group, they did not differ from controls on sleep architecture after CPAP. The OSA group also showed significant improvements in functional outcomes and was comparable to controls on mood and functional outcomes. Persistent difficulties included lowered activity level and residual sleepiness in some individuals. Sleepiness was found to be a significant predictor of mood and affective states, while both sleepiness and sleep quality predicted functional outcomes. These results highlight the importance of assessment and intervention targeting psychosocial functioning and sleepiness in individuals with OSA after treatment.

  2. Assessment of the effects of antihistamine drugs on mood, sleep quality, sleepiness, and dream anxiety.

    Science.gov (United States)

    Ozdemir, Pinar Guzel; Karadag, Ayşe Serap; Selvi, Yavuz; Boysan, Murat; Bilgili, Serap Gunes; Aydin, Adem; Onder, Sevda

    2014-08-01

    There are limited comparative studies on classic and new-generation antihistamines that affect sleep quality and mood. The purpose of this study was to determine and compare the effects of classic and new-generation antihistamines on sleep quality, daytime sleepiness, dream anxiety, and mood. Ninety-two patients with chronic pruritus completed study in the dermatology outpatient clinic. Treatments with regular recommended therapeutic doses were administered. The effects of antihistaminic drugs on mood, daytime sleepiness, dream anxiety, and sleep quality were assessed on the first day and 1 month after. Outpatients who received cetirizine and hydroxyzine treatments reported higher scores on the depression, anxiety, and fatigue sub-scales than those who received desloratadine, levocetirizine, and rupatadine. Pheniramine and rupatadine were found to be associated with daytime sleepiness and better sleep quality. UKU side effects scale scores were significantly elevated among outpatients receiving pheniramine. Classic antihistamines increased daytime sleepiness and decreased the sleep quality scores. New-generation antihistamines reduced sleep latency and dream anxiety, and increased daytime sleepiness and sleep quality. Both antihistamines, significantly increased daytime sleepiness and nocturnal sleep quality. Daytime sleepiness was significantly predicted by rupadatine and pheniramine treatment. Cetirizine and hydroxyzine, seem to have negative influences on mood states. Given the extensive use of antihistamines in clinical settings, these results should be more elaborately examined in further studies.

  3. Correlates of excessive daytime sleepiness in de novo Parkinson's disease: A case control study.

    Science.gov (United States)

    Simuni, Tanya; Caspell-Garcia, Chelsea; Coffey, Christopher; Chahine, Lama M; Lasch, Shirley; Oertel, Wolfgang H; Mayer, Geert; Högl, Birgit; Postuma, Ron; Videnovic, Aleksandar; Amara, Amy Willis; Marek, Ken

    2015-09-01

    This study was undertaken to determine the frequency and correlates of excessive daytime sleepiness in de novo, untreated Parkinson's disease (PD) patients compared with the matched healthy controls. Data were obtained from the Parkinson's Progression Markers Initiative, an international study of de novo, untreated PD patients and healthy controls. At baseline, participants were assessed with a wide range of motor and nonmotor scales, including the Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS). Excessive daytime sleepiness was assessed based on the Epworth Sleepiness scale (ESS), with a cutoff of 10. Four hundred twenty-three PD subjects and 196 healthy controls were recruited into the study. Mean ESS (min, max) score was 5.8 (0, 20) for the PD subjects and 5.6 (0, 19) for healthy controls (P = 0.54). Sixty-six (15.6%) PD subjects and 24 (12%) healthy controls had ESS of at least 10 (P = 0.28). No difference was seen in demographic characteristics, age of onset, disease duration, PD subtype, cognitive status, or utilization of sedatives between the PD sleepiness-positive versus the negative group. The sleepiness-positive group had higher MDS-UPDRS Part I and II but not III scores, and higher depression and autonomic dysfunction scores. Sleepiness was associated with a marginal reduction of A-beta (P = 0.05) but not alpha-synuclein spinal fluid levels in PD. This largest case control study demonstrates no difference in prevalence of excessive sleepiness in subjects with de novo untreated PD compared with healthy controls. The only clinical correlates of sleepiness were mood and autonomic dysfunction. Ongoing longitudinal analyses will be essential to further examine clinical and biological correlates of sleepiness in PD and specifically the role of dopaminergic therapy. © 2015 International Parkinson and Movement Disorder Society.

  4. Armodafinil for excessive daytime sleepiness.

    Science.gov (United States)

    Nishino, Seiji; Okuro, Masashi

    2008-06-01

    Armodafinil is the (R)-enantiomer of the wakepromoting compound modafinil (racemic), with a considerably longer half-life of 10-15 hours. Armodafinil (developed by Cephalon, Frazer, PA, USA) was approved in June 2007 for the treatment of excessive sleepiness associated with narcolepsy, obstructive sleep apnea syndrome and shift work disorder, and the indications are the same as those for modafinil. Like modafinil, the mechanisms of action of armodafinil are not fully characterized and are under debate. Clinical trials in these sleep disorders demonstrated an enhanced efficacy for wake promotion (wake sustained for a longer time period using doses lower than those of modafinil). The safety profile is consistent with that of modafinil, and armodafinil is well tolerated by the patients. Like modafinil, armodafinil is classified as a non-narcotic Schedule IV compound. Many patients with excessive sleepiness may prefer the longer duration of effect and may have better compliance (with low doses) with armodafinil. The commercial challenge to armodafinil may come from generic modafinil, which may become available in 2012, as well as from classical amphetamine and amphetamine-like compounds (for the treatment of narcolepsy).

  5. Heart rate variability for evaluating vigilant attention in partial chronic sleep restriction

    National Research Council Canada - National Science Library

    Henelius, Andreas; Sallinen, Mikael; Huotilainen, Minna; Müller, Kiti; Virkkala, Jussi; Puolamäki, Kai

    2014-01-01

    Examine the use of spectral heart rate variability (HRV) metrics in measuring sleepiness under chronic partial sleep restriction, and identify underlying relationships between HRV, Karolinska Sleepiness Scale ratings (KSS...

  6. Heart rate variability during sleep and subsequent sleepiness in patients with chronic fatigue syndrome.

    Science.gov (United States)

    Togo, Fumiharu; Natelson, Benjamin H

    2013-06-01

    We determined whether alterations in heart rate dynamics during sleep in patients with chronic fatigue syndrome (CFS) differed from controls and/or correlated with changes of sleepiness before and after a night in the sleep laboratory. We compared beat-to-beat RR intervals (RRI) during nocturnal sleep, sleep structure, and subjective scores on visual analog scale for sleepiness in 18 CFS patients with 19 healthy controls aged 25-55 after excluding subjects with sleep disorders. A short-term fractal scaling exponent (α1) of RRI dynamics, analyzed by the detrended fluctuation analysis (DFA) method, was assessed after stratifying patients into those who reported more or less sleepiness after the night's sleep (a.m. sleepier or a.m. less sleepy, respectively). Patients in the a.m. sleepier group showed significantly (psleep (Stages 1, 2, and 3 sleep) than healthy controls, although standard polysomnographic measures did not differ between the groups. The fractal scaling index α1 during non-REM sleep was significantly (psleep onset for healthy controls and patients in the a.m. less sleepy group, but did not differ between sleep stages for patients in the a.m. sleepier group. For patients, changes in self-reported sleepiness before and after the night correlated positively with the fractal scaling index α1 during non-REM sleep (psleep might be associated with disrupted sleep in patients with CFS.

  7. The sleepy teenager - diagnostic challenges

    Directory of Open Access Journals (Sweden)

    Anne-Marie eLandtblom

    2014-08-01

    Full Text Available The sleepy teenager is a diagnostic challenge because the problems may be physiological or pathological, with behavioural, social and pychological expressions. It is of great importance that health staff that encounter young people with sleep disturbance have good knowledge about the diseases that must be excluded. Narcolepsy, periodic hypersomnia like Kleine Levin syndrome, delayed sleep phase syndrome and obstructive sleep apnoea syndrome, depression and substance use as well as fatigue from chronic disease like multiple sclerosis should be investigated. Clinical assessment, neurophysiological and laboratory investigations constitute important support in these investigations. Functional methods, for example fMRI, are being developed. The role of computer gaming and use of social media in the night is discussed in relation to these diseases. Cognitive dysfunction may develop with several of the conditions. There is need for increased awareness of how to investigate sleep disturbance in children and young people.

  8. Human sciences in the first semester of the dental undergraduate course at the Karolinska Institute, Stockholm.

    Science.gov (United States)

    Röding, K

    1999-08-01

    The first 9 weeks of the dental undergraduate education at the Karolinska Institutet comprises a transition course, designed to introduce students to university studies leading to professional qualifications in patient-related health sciences. 1 week has been set aside for the theme Man and Society, highlighting the importance of the human sciences for the development of behavioural skills necessary for achieving professionalism and a holistic patient concept. Some essential ethical questions are addressed: intercultural communication, empathy, professional demeanour and the development of professional competence, and group dynamics. In this context, more specific subjects are considered, such as the emergence of the multicultural society and its implications for health services, interpersonal skills and patient communication in the health and medical fields. There are several reasons for including this theme, which forms the basis for the ethical and communicative strands throughout the entire curriculum. As 30-40% of freshmen dental students are of non-Swedish origin, it is essential to include cultural awareness seminars. Another reason is that within the EU, cultural and communicative skills are recognised proficiencies for health professionals; it is also acknowledged that effective delivery of health care may be impeded by misunderstandings in communication and conflict in ethical beliefs. Group discussions are scheduled during the week in order to allow the students to discuss their own experiences related to the theme. The students are also given a written assignment in relation to one of the seminars; the report is assessed as a part of the examination. The week is concluded by a plenum discussion summarising the group discussions. To date, 4 course evaluations, with a response rate of 92.5%, show that 97.3% of the students were positive to the theme as a whole or to specific seminars held during the week, especially intercultural communication, ethics and

  9. Risk Factors for Cardiovascular Disease, Metabolic Syndrome and Sleepiness in Truck Drivers

    Directory of Open Access Journals (Sweden)

    Antonio de Padua Mansur

    2015-01-01

    Full Text Available AbstractBackground:Truck driver sleepiness is a primary cause of vehicle accidents. Several causes are associated with sleepiness in truck drivers. Obesity and metabolic syndrome (MetS are associated with sleep disorders and with primary risk factors for cardiovascular diseases (CVD. We analyzed the relationship between these conditions and prevalence of sleepiness in truck drivers.Methods:We analyzed the major risk factors for CVD, anthropometric data and sleep disorders in 2228 male truck drivers from 148 road stops made by the Federal Highway Police from 2006 to 2011. Alcohol consumption, illicit drugs and overtime working hours were also analyzed. Sleepiness was assessed using the Epworth Sleepiness Scale.Results:Mean age was 43.1 ± 10.8 years. From 2006 to 2011, an increase in neck (p = 0.011 and abdominal circumference (p < 0.001, total cholesterol (p < 0.001, triglyceride plasma levels (p = 0.014, and sleepiness was observed (p < 0.001. In addition, a reduction in hypertension (39.6% to 25.9%, p < 0.001, alcohol consumption (32% to 23%, p = 0.033 and overtime hours (52.2% to 42.8%, p < 0.001 was found. Linear regression analysis showed that sleepiness correlated closely with body mass index (β = 0.19, Raj2 = 0.659, p = 0.031, abdominal circumference (β = 0.24, Raj2 = 0.826, p = 0.021, hypertension (β = -0.62, Raj2 = 0.901, p = 0.002, and triglycerides (β = 0.34, Raj2 = 0.936, p = 0.022. Linear multiple regression indicated that hypertension (p = 0.008 and abdominal circumference (p = 0.025 are independent variables for sleepiness.Conclusions:Increased prevalence of sleepiness was associated with major components of the MetS.

  10. Excessive sleepiness, sleep hygiene, and coping strategies among night bus drivers: A cross-sectional study

    Science.gov (United States)

    Krishnaswamy, Uma Maheswari; Chhabria, Mamta S.; Rao, Aditi

    2016-01-01

    Background: Sleep disruption and excessive sleepiness are the known consequences of shift work. The recent spate of night-time road and air accidents, with some being directly attributed to driver sleepiness prompted us to undertake this study. Aims: To screen for excessive sleepiness, coping practices, and post-shift sleep hygiene in night bus drivers. Settings and Design: This prospective study was carried out on night bus drivers of a public transport organization in Bengaluru, Karnataka, India. Materials and Methods: Bus drivers driving for ≥8 h at night were screened with the Epworth Sleepiness Scale (ESS) and a prevalidated shift work questionnaire. Statistical Analysis: Descriptive statistics were used to analyze the compiled data using Statistical Package for the Social Sciences (SPSS) version 20. Results: One hundred and eighty bus drivers aged 22–63 years were screened. Excessive Sleepiness: Although only 2 (1.1%) drivers scored above the cutoff on ESS, 10 (5.6%) and 103 (57.2%) drivers admitted to feeling sleepy during daytime and night driving respectively. None of the drivers admitted to causing accidents related to sleepiness. The coping strategies for nocturnal sleepiness included consuming coffee/tea (16.7%), chewing tobacco (12.8%), smoking (6.1%), and walking (3.9%). Post-Shift Sleep Practices: Post-shift sleep duration ranged between 1 h and 10 h. Twenty-six (14.4%) and 16 (8.9%) drivers had difficulty initiating and maintaining sleep, respectively, while 9 (5%) reported frequent awakening during daytime sleep. Conclusion and Implications: This study has demonstrated a high incidence of nocturnal sleepiness and daytime sleep disruption among night bus drivers, thus necessitating the need for education about shift work and alertness testing among shift workers in critical professions. PMID:28194081

  11. Risk Factors for Cardiovascular Disease, Metabolic Syndrome and Sleepiness in Truck Drivers

    Science.gov (United States)

    Mansur, Antonio de Padua; Rocha, Marcos ABS; Leyton, Vilma; Takada, Julio Yashio; Avakian, Solange Desirée; Santos, Alexandre J; Novo, Gisele C; Nascimento, Arledson Lima; Muñoz, Daniel Romero; Rohlfs, Waldo J C

    2015-01-01

    Background Truck driver sleepiness is a primary cause of vehicle accidents. Several causes are associated with sleepiness in truck drivers. Obesity and metabolic syndrome (MetS) are associated with sleep disorders and with primary risk factors for cardiovascular diseases (CVD). We analyzed the relationship between these conditions and prevalence of sleepiness in truck drivers. Methods We analyzed the major risk factors for CVD, anthropometric data and sleep disorders in 2228 male truck drivers from 148 road stops made by the Federal Highway Police from 2006 to 2011. Alcohol consumption, illicit drugs and overtime working hours were also analyzed. Sleepiness was assessed using the Epworth Sleepiness Scale. Results Mean age was 43.1 ± 10.8 years. From 2006 to 2011, an increase in neck (p = 0.011) and abdominal circumference (p < 0.001), total cholesterol (p < 0.001), triglyceride plasma levels (p = 0.014), and sleepiness was observed (p < 0.001). In addition, a reduction in hypertension (39.6% to 25.9%, p < 0.001), alcohol consumption (32% to 23%, p = 0.033) and overtime hours (52.2% to 42.8%, p < 0.001) was found. Linear regression analysis showed that sleepiness correlated closely with body mass index (β = 0.19, Raj2 = 0.659, p = 0.031), abdominal circumference (β = 0.24, Raj2 = 0.826, p = 0.021), hypertension (β = -0.62, Raj2 = 0.901, p = 0.002), and triglycerides (β = 0.34, Raj2 = 0.936, p = 0.022). Linear multiple regression indicated that hypertension (p = 0.008) and abdominal circumference (p = 0.025) are independent variables for sleepiness. Conclusions Increased prevalence of sleepiness was associated with major components of the MetS. PMID:26761367

  12. Yawning and subjective sleepiness in the elderly.

    Science.gov (United States)

    Zilli, Iole; Giganti, Fiorenza; Uga, Valeria

    2008-09-01

    Yawning is related to sleep/wake transitions and time of day, probably reflecting the time course of sleepiness. As aging modifies sleep-wake and sleepiness rhythms, we suppose that yawning frequency and its time course vary as a function of age. Thirteen aged healthy subjects (77.15 +/- 4.09 years) and 12 young adults (24.41 +/- 3.31 years) were instructed to keep their habitual sleep schedules for three consecutive work-days, during which they were required to signal every yawning occurrence and to evaluate hourly their sleepiness level. Results showed that aged subjects yawn less frequently than young adults, particularly during morning and mid-afternoon hours. The time course of yawning was different between the two age groups: aged subjects showed earlier morning peak and evening rise compared with young adults; in addition, aged subjects showed two minor peaks in-between. Differences as a function of age in the time course of yawning were associated with differences in the time course of sleepiness. The only exception pertained to the early morning yawning peak, which was close to the awakening but it was not associated with high sleepiness in aged subjects. Our study discloses that aging modifies yawning frequency and its time course. Furthermore, as in the elderly yawning after the awakening is not associated with high sleepiness level as in young adult, we put forward that sleepiness level and the proximity of sleep/wake transitions could separately affect yawning.

  13. Wake-up stroke: Clinical characteristics, sedentary lifestyle, and daytime sleepiness.

    Science.gov (United States)

    Diniz, Deborath Lucia de Oliveira; Barreto, Pedro Rodrigues; Bruin, Pedro Felipe Carvalhedo de; Bruin, Veralice Meireles Sales de

    2016-10-01

    Wake-up stroke (WUS) is defined when the exact time of the beginning of the symptoms cannot be determined, for the deficits are perceived upon awakening. Sleep alterations are important risk factors for stroke and cardiovascular diseases. This study evaluates the characteristics of patients with and without WUS, the presence of daytime sleepiness, and associated risk factors. Patients with ischemic stroke were investigated about the presence of WUS. Clinical and demographic characteristics were evaluated. Stroke severity was studied by the National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (MRS), and daytime sleepiness severity was studied by the Epworth Sleepiness Scale (ESS). Seventy patients (57.1% men) aged from 32 to 80 years (58.5±13.3) were studied. WUS was observed in 24.3%. Arterial hypertension (67.1%), type 2 diabetes (27.1%), and hyperlipidemia (22.8%) were frequent. Type 2 diabetes and sedentary lifestyle were more common in patients with WUS (p10). No differences were found between patients with and without WUS as regards stroke severity or excessive daytime sleepiness. Patients with excessive daytime sleepiness were younger and had more sedentary lifestyle (psedentary lifestyle. Daytime sleepiness is frequent and is associated with sedentary lifestyle and heavy drinking.

  14. SAQLI及ESS问卷在UPPP术后评估中的应用%Evaluation the Effects of Uvulopalatopharyngoplasty on the Sleep Apnea Quality of Life Index and Epworth Sleepiness Scale

    Institute of Scientific and Technical Information of China (English)

    赵训东; 季文樾

    2013-01-01

    Ojective:To investigate the significance of the sleep apnea quality of life index (SAQLI) and the epworth sleepness scale for quality of life in patients with obstruction Sleep apnea hypopnea syndrome(OSAHS) after uvulopalatopharyngoplasty(UPPP). Methods:Tirty patients with OSAHS were treated by UPPP. SAQLI and ESS was surveyed before and six months after surgery. Results:Compared with the qualities of life after operation,by SA-QLI and ESS, statistical significance was obvious, (P<0.01). Quality of life was improved in 83.3%eases in general. Conclusion: The amelioration of quality of life in OSAHS patients is significant after UPPP.SAQLI and ESS can be a valuable measurement in quality of life in patients with OSAHS after UPPP.%目的:探讨睡眠呼吸暂停生活质量指数(the sleep apnea quality of life index SAQLI)问卷及 Epworth睡眠量表(Epworth sleepiness scale ESS)在阻塞性睡眠呼吸暂停低通气综合征(obstructive sleep apnea hypopnea syndrome,OSAHS)患者行悬雍垂腭咽成形术(uvulopalatopharyngoplasty,UPPP)后评估中的应用。方法30例诊断为OSAHAS并行UPPP手术的患者,术前及术后半年行SAQLI问卷调查及ESS量表评估,对结果进行比较。结果手术治疗前后 ESS得分及 SAQLI调查问卷各维度得分差异显著,(P<0.01),83.3%的患者生活质量得到改善。结论 UPPP手术能明显提高OSAHS患者的生活质量,SAQLI及 ESS可用于对成人 OSAHS患者行UPPP术后生活质量的评估。

  15. Sleep complaints and daytime sleepiness among pharmaceutical ...

    African Journals Online (AJOL)

    Sleep complaints and daytime sleepiness among pharmaceutical students in Tripoli. ... Background: The effect of sleep difficulties has achieved a great deal of ... not increasing education programs or tea/coffee consumption is associated with ...

  16. Associations of Subjective Sleep Quality and Daytime Sleepiness With Cognitive Impairment in Adults and Elders With Heart Failure.

    Science.gov (United States)

    Byun, Eeeseung; Kim, Jinyoung; Riegel, Barbara

    2016-04-26

    This study examined the association of subjective nighttime sleep quality and daytime sleepiness with cognitive impairment in 105 adults (old) and 167 elders (≥ 60 years old) with heart failure. Nighttime sleep quality and daytime sleepiness were measured by the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale. Cognitive impairment was assessed using a neuropsychological battery measuring attention, memory, and processing speed. Multivariate logistic regression was used. In adults, daytime sleepiness was associated with cognitive impairment, whereas poor nighttime sleep quality was associated with cognitive impairment in elders. Age may play an important role in how sleep impacts cognition in persons with heart failure. Improving nighttime sleep quality and daytime sleepiness in this population may improve cognition.

  17. Association between reported sleep need and sleepiness at the wheel: comparative study on French highways between 1996 and 2011

    Science.gov (United States)

    Quera-Salva, M A; Sauvagnac-Quera, R; Sagaspe, P; Taillard, J; Contrand, B; Micoulaud, J A; Lagarde, E; Barbot, F; Philip, P

    2016-01-01

    Objective To investigate the evolution over 15 years of sleep schedules, sleepiness at the wheel and driving risk among highway drivers. Methods Comparative survey including questions on usual sleep schedules and before the trip, sleepiness at the wheel, the Epworth sleepiness scale, Basic Nordic Sleep Questionnaire (BNSQ) and a travel questionnaire. Results 80% of drivers stopped by the highway patrol agreed to participate in both studies with a total of 3545 drivers in 2011 and 2196 drivers in 1996 interviewed. After standardisation based on sex, age and mean annual driving distance, drivers in 2011 reported shorter sleep time on week days (p15 indicating severe sleepiness. Conclusions Even if drivers in 2011 reported good sleep hygiene prior to a highway journey, drivers have reduced their mean weekly sleep duration over 15 years and have a higher risk of sleepiness at the wheel. Sleep hygiene for automobile drivers remains an important concept to address. PMID:28003284

  18. Insomnia and sleepiness in Parkinson disease: associations with symptoms and comorbidities.

    Science.gov (United States)

    Chung, Seockhoon; Bohnen, Nicolaas I; Albin, Roger L; Frey, Kirk A; Müller, Martijn L T M; Chervin, Ronald D

    2013-11-15

    Insomnia and daytime sleepiness are common complaints in Parkinson disease (PD), but the main causes remain unclear. We examined the potential impact of both motor and non-motor symptoms of PD on sleep problems. Patients with PD (n = 128) were assessed using the Insomnia Severity Index, Epworth Sleepiness Scale, Unified Parkinson Disease Rating Scale, Beck Depression Inventory, Fatigue Severity Scale, Survey of Autonomic Symptoms, and the 39-item Parkinson Disease Questionnaire. A subset of subjects (n = 38, 30%) also completed nocturnal polysomnography and a multiple sleep latency test (MSLT). Multivariate stepwise logistic regression models revealed that subjective insomnia was independently associated with depressed mood (odds ratio [OR] = 1.79; 95% confidence interval (CI) [1.01-3.19]), autonomic symptoms (1.77 [1.08-2.90]), fatigue (1.19 [1.02-1.38]), and age (0.61 [0.39-0.96]). Subjective daytime sleepiness was associated with dosage of dopaminergic medication (1.74 [1.08-2.80]) and fatigue (1.14 [1.02-1.28]). On polysomnography, longer sleep latency correlated with autonomic symptoms (rho = 0.40, p = 0.01) and part I (non-motor symptoms) of the Unified PD Rating Scale (rho = 0.38, p = 0.02). Decreased sleep efficiency correlated with autonomic symptoms (rho = -0.42, p < 0.0001). However, no significant difference emerged on polysomnography and MSLTs between patients with or without insomnia or daytime sleepiness. Higher rates of apneic events did predict shorter sleep latencies on the MSLTs. Non-motor symptoms appear to be associated with subjective insomnia, whereas fatigue and dopaminergic medication are associated with subjective daytime sleepiness. Objective sleep laboratory data provided little insight into complaints of insomnia and sleepiness, though obstructive sleep apnea predicted worsened sleepiness when measured objectively.

  19. Portuguese-language version of the Epworth sleepiness scale: validation for use in Brazil Validação da escala de sonolência de Epworth em português para uso no Brasil

    Directory of Open Access Journals (Sweden)

    Alessandra Naimaier Bertolazi

    2009-09-01

    Full Text Available OBJECTIVE: The aim of this study was to develop a Portuguese-language version of the Epworth sleepiness scale (ESS for use in Brazil. METHODS: The steps involved in creating the ESS in Brazilian Portuguese (ESS-BR were as follows: translation; back-translation; comparison (by a committee between the translation and the back-translation; and testing in bilingual individuals. The ESS-BR was applied to a group of patients who were submitted to overnight polysomnography in order to identify obstructive sleep apnea-hypopnea syndrome (OSAHS, insomnia and primary snoring. A control group was composed of subjects with a history of normal sleep habits, without reported snoring. RESULTS: A total of 114 patients and 21 controls were included. The 8-item scores of the ESS-BR had an overall reliability coefficient of 0.83. The study group was composed of 59 patients with OSAHS, 34 patients with primary snoring and 21 patients with insomnia. One-way ANOVA demonstrated significant differences in ESS-BR scores among the four diagnostic groups (p 0.05. The ESS-BR scores were significantly higher for OSAHS patients and for primary snorers than for controls (p OBJETIVO: Desenvolver uma versão da escala de sonolência de Epworth (ESE para o português para uso no Brasil. MÉTODOS: A versão no português do Brasil (ESE-BR foi desenvolvida de acordo com as seguintes etapas: tradução; retrotradução; comparação entre a tradução e a retrotradução (por um comitê; e aplicação em indivíduos bilíngues. A ESE-BR foi aplicada a um grupo de pacientes submetidos à polissonografia de noite inteira para identificar síndrome da apneia-hipopneia obstrutiva do sono (SAHOS, insônia e ronco primário. Um grupo controle foi composto de indivíduos com história de hábitos normais de sono, sem ronco aparente. RESULTADOS: Um total de 114 pacientes e 21 controles foram incluídos. Os 8 itens do ESE-BR tiveram um coeficiente de confiabilidade total de 0,83. O grupo em

  20. Excessive daytime sleepiness in patients with Parkinson's disease.

    Science.gov (United States)

    Knie, Bettina; Mitra, M Tanya; Logishetty, Kartik; Chaudhuri, K Ray

    2011-03-01

    Excessive daytime sleepiness (EDS) is described as inappropriate and undesirable sleepiness during waking hours and is a common non-motor symptom in Parkinson's disease, affecting up to 50% of patients. EDS has a large impact on the quality of life of Parkinson's disease patients as well as of their caregivers, in some cases even more than the motor symptoms of the disease. Drug-induced EDS is a particular problem as many dopamine agonists used for the treatment of Parkinson's disease have EDS as an adverse effect. Dopaminergic treatment may also render a subset of Parkinson's disease patients at risk for sudden-onset sleep attacks that occur without warning and can be particularly hazardous if the patient is driving. This demonstrates the need for early recognition and management not only to increase health-related quality of life but also to ensure patient safety. There are many assessment tools for EDS, including the Epworth Sleepiness Scale (ESS) and the Multiple Sleep Latency Test (MSLT), although only the Parkinson's Disease Sleep Scale (PDSS) and the SCales for Outcomes in PArkinson's Disease-Sleep (SCOPA-S) are specifically validated for Parkinson's disease. Polysomnography can be used when necessary. Management comprises non-pharmacological and pharmacological approaches. Non-pharmacological approaches can be the mainstay of treatment for mild to moderate EDS. Advice on good sleep hygiene is instrumental, as pharmacological approaches have yet to provide consistent and reliable results without significant adverse effects. The efficacy of pharmacological treatment of EDS in Parkinson's disease using wakefulness-promoting drugs such as modafinil remains controversial. Further areas of research are now also focusing on adenosine A(2A) receptor antagonists, sodium oxybate and caffeine to promote wakefulness. A definitive treatment for the highly prevalent drug-induced EDS has not yet been found.

  1. Excessive daytime sleepiness in multiple system atrophy (SLEEMSA study).

    Science.gov (United States)

    Moreno-López, Claudia; Santamaría, Joan; Salamero, Manuel; Del Sorbo, Francesca; Albanese, Alberto; Pellecchia, Maria Teresa; Barone, Paolo; Overeem, Sebastiaan; Bloem, Bastiaan; Aarden, Willemijn; Canesi, Margherita; Antonini, Angelo; Duerr, Susanne; Wenning, Gregor K; Poewe, Werner; Rubino, Alfonso; Meco, Giuseppe; Schneider, Susanne A; Bhatia, Kailash P; Djaldetti, Ruth; Coelho, Miguel; Sampaio, Cristina; Cochen, Valerie; Hellriegel, Helge; Deuschl, Günther; Colosimo, Carlo; Marsili, Luca; Gasser, Thomas; Tolosa, Eduardo

    2011-02-01

    Sleep disorders are common in multiple system atrophy (MSA), but the prevalence of excessive daytime sleepiness (EDS) is not well known. To assess the frequency and associations of EDS in MSA. Survey of EDS in consecutive patients with MSA and comparison with patients with Parkinson disease (PD) and individuals without known neurologic disease. Twelve tertiary referral centers. Eighty-six consecutive patients with MSA; 86 patients with PD matched for age, sex, and Hoehn and Yahr stage; and 86 healthy subject individuals matched for age and sex. Epworth Sleepiness Scale (ESS), modified ESS, Sudden Onset of Sleep Scale, Tandberg Sleepiness Scale, Pittsburgh Sleep Quality Index, disease severity, dopaminergic treatment amount, and presence of restless legs syndrome. Mean (SD) ESS scores were comparable in MSA (7.72 [5.05]) and PD (8.23 [4.62]) but were higher than in healthy subjects (4.52 [2.98]) (P 10) was present in 28% of patients with MSA, 29% of patients with PD, and 2% of healthy subjects (P < .001). In MSA, in contrast to PD, the amount of dopaminergic treatment was not correlated with EDS. Disease severity was weakly correlated with EDS in MSA and PD. Restless legs syndrome occurred in 28% of patients with MSA, 14% of patients with PD, and 7% of healthy subjects (P < .001). Multiple regression analysis (with 95% confidence intervals obtained using nonparametric bootstrapping) showed that sleep-disordered breathing and sleep efficiency predicted EDS in MSA and amount of dopaminergic treatment and presence of restless legs syndrome in PD. More than one-quarter of patients with MSA experience EDS, a frequency similar to that encountered in PD. In these 2 conditions, EDS seems to be associated with different causes.

  2. "Sleepiness" is serious in adolescence: Two surveys of 3235 Canadian students

    Directory of Open Access Journals (Sweden)

    Ogilvie Robert

    2006-05-01

    Full Text Available Abstract Background Evidence is growing that sleep problems in adolescents are significant impediments to learning and negatively affect behaviour, attainment of social competence and quality of life. The objectives of the study were to determine the level of sleepiness among students in high school, to identify factors to explain it, and to determine the association between sleepiness and performance in both academic and extracurricular activities Methods A cross-sectional survey of 2201 high school students in the Hamilton Wentworth District School Board and the Near North District School Board in Ontario was conducted in 1998/9. A similar survey was done three years later involving 1034 students in the Grand Erie District School Board in the same Province. The Epworth Sleepiness Scale (ESS was used to measure sleepiness and we also assessed the reliability of this tool for this population. Descriptive analysis of the cohort and information on various measures of performance and demographic data were included. Regression analysis, using the generalised estimating equation (GEE, was utilized to investigate factors associated with risk of sleepiness (ESS>10. Results Seventy per cent of the students had less than 8.5 hours weeknight sleep. Bedtime habits such as a consistent bedtime routine, staying up late or drinking caffeinated beverages before bed were statistically significantly associated with ESS, as were weeknight sleep quantity and gender. As ESS increased there was an increase in the proportion of students who felt their grades had dropped because of sleepiness, were late for school, were often extremely sleepy at school, and were involved in fewer extracurricular activities. These performance measures were statistically significantly associated with ESS. Twenty-three percent of the students felt their grades had dropped because of sleepiness. Most students (58–68% reported that they were "really sleepy" between 8 and 10 A

  3. Daytime sleepiness and sleep habits as risk factors of traffic accidents in a group of Turkish public transport drivers

    Science.gov (United States)

    Özer, Cahit; Etcibaşı, Şeref; Öztürk, Levent

    2014-01-01

    Aim: To explore the association of daytime sleepiness, sleep complaints and sleep habits with self-reported car crashes among public transport drivers. Methods: A cross-sectional descriptive study was carried out on male professional public drivers in two different cities using a validated, self-administered sleep questionnaire which comprised of symptoms suggesting sleep disorders, a subjective report of daytime sleepiness and driving characteristics. The subjects (mean age±SD, 40±11 years) were divided into two groups: (1) accident group and (2) no accident group. Results: Forty nine (15.3%) of the 320 public drivers reported that they had at least one sleepiness related motor vehicle accident and/or near-missed accident (Group 1). The mean age, body mass index and annual distance driven were similar in both groups. Although Group 1 reported less sleep time per night, more witnessed apneas, abnormal sleep, alcohol use and had higher mean Epworth Sleepiness Scale scores than Group 2, multivariate analysis of risk factors revealed that only daytime sleepiness increase the risk of traffic accidents [OR: 1.32 (1.19-1.47)]. Conclusion: These results suggest that self-reported sleepiness is a predictive sign of traffic accidents due to driver sleepiness. PMID:24482715

  4. Multilevel Intervention Mapping with sleepiness in focus

    NARCIS (Netherlands)

    Hof, T.; Wilschut, E.S.

    2011-01-01

    This report provides an overview of methods to prevent drowsy driving of drivers (Wilschut et al., 2009). Several preventive approaches were discussed such as the use of questionnaires, campaigns and fatigue management plans. A search for law enforcement instruments to prevent sleepiness at the whee

  5. Subjective sleep quality and daytime sleepiness in late midlife and their association with age-related changes in cognition

    DEFF Research Database (Denmark)

    Waller, Katja Linda; Mortensen, Erik Lykke; Avlund, Kirsten

    2016-01-01

    UNLABELLED: In an increasingly aged population, sleep disturbances and neurodegenerative disorders have become a major public health concern. Poor sleep quality and cognitive changes are complex health problems in aging populations that are likely to be associated with increased frailty, morbidity......) or cognitively impaired (N = 92). METHODS: The Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale measured subjective sleep quality and daytime sleepiness, respectively. Depressive symptoms were determined using Beck's Depression Inventory (BDI-II). A neuropsychological battery was administered...

  6. Associations of Caffeinated Beverage Consumption and Screen Time with Excessive Daytime Sleepiness in Korean High School Students

    OpenAIRE

    Jun, Nuri; Lee, Aeri; Baik, Inkyung

    2017-01-01

    The present study investigated caffeinated beverage consumption and screen time in the association with excessive daytime sleepiness (EDS) and sleep duration. We conducted a cross-sectional study including 249 Korean male high school students. These participants responded to a questionnaire inquiring the information on lifestyle factors, consumption of caffeinated beverages, time spent for screen media, and sleep duration as well as to the Epworth Sleepiness Scale (ESS) questionnaire. EDS was...

  7. Can variations in visual behavior measures be good predictors of driver sleepiness? A real driving test study.

    Science.gov (United States)

    Wang, Yonggang; Xin, Mengyang; Bai, Han; Zhao, Yangdong

    2017-02-17

    The primary purpose of this study was to examine the association between variations in visual behavior measures and subjective sleepiness levels across age groups over time to determine a quantitative method of measuring drivers' sleepiness levels. A total of 128 volunteer drivers in 4 age groups were asked to finish 2-, 3-, and 4-h continuous driving tasks on expressways, during which the driver's fixation, saccade, and blink measures were recorded by an eye-tracking system and the subjective sleepiness level was measured through the Stanford Sleepiness Scale. Two-way repeated measures analysis of variance was then used to examine the change in visual behavior measures across age groups over time and compare the interactive effects of these 2 factors on the dependent visual measures. Drivers' visual behavior measures and subjective sleepiness levels vary significantly over time but not across age groups. A statistically significant interaction between age group and driving duration was found in drivers' pupil diameter, deviation of search angle, saccade amplitude, blink frequency, blink duration, and closure duration. Additionally, change in a driver's subjective sleepiness level is positively or negatively associated with variation in visual behavior measures, and such relationships can be expressed in regression models for different period of driving duration. Driving duration affects drivers' sleepiness significantly, so the amount of continuous driving time should be strictly controlled. Moreover, driving sleepiness can be quantified through the change rate of drivers' visual behavior measures to alert drivers of sleepiness risk and to encourage rest periods. These results provide insight into potential strategies for reducing and preventing traffic accidents and injuries.

  8. Longitudinal assessment of excessive daytime sleepiness in early Parkinson's disease.

    Science.gov (United States)

    Amara, Amy W; Chahine, Lama M; Caspell-Garcia, Chelsea; Long, Jeffrey D; Coffey, Christopher; Högl, Birgit; Videnovic, Aleksandar; Iranzo, Alex; Mayer, Geert; Foldvary-Schaefer, Nancy; Postuma, Ron; Oertel, Wolfgang; Lasch, Shirley; Marek, Ken; Simuni, Tanya

    2017-08-01

    Excessive daytime sleepiness (EDS) is common and disabling in Parkinson's disease (PD). Predictors of EDS are unclear, and data on biological correlates of EDS in PD are limited. We investigated clinical, imaging and biological variables associated with longitudinal changes in sleepiness in early PD. The Parkinson's Progression Markers Initiative is a prospective cohort study evaluating progression markers in participants with PD who are unmedicated at baseline (n=423) and healthy controls (HC; n=196). EDS was measured with the Epworth Sleepiness Scale (ESS). Clinical, biological and imaging variables were assessed for associations with EDS for up to 3 years. A machine learning approach (random survival forests) was used to investigate baseline predictors of incident EDS. ESS increased in PD from baseline to year 3 (mean±SD 5.8±3.5 to 7.55±4.6, p<0.0001), with no change in HC. Longitudinally, EDS in PD was associated with non-tremor dominant phenotype, autonomic dysfunction, depression, anxiety and probable behaviour disorder, but not cognitive dysfunction or motor severity. Dopaminergic therapy was associated with EDS at years 2 and 3, as dose increased. EDS was also associated with presynaptic dopaminergic dysfunction, whereas biofluid markers at year 1 showed no significant associations with EDS. A predictive index for EDS was generated, which included seven baseline characteristics, including non-motor symptoms and cerebrospinal fluid phosphorylated-tau/total-tau ratio. In early PD, EDS increases significantly over time and is associated with several clinical variables. The influence of dopaminergic therapy on EDS is dose dependent. Further longitudinal analyses will better characterise associations with imaging and biomarkers. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Sleep complaints and daytime sleepiness among pharmaceutical students in Tripoli

    Directory of Open Access Journals (Sweden)

    Yousef A. Taher

    2012-10-01

    Full Text Available Background: The effect of sleep difficulties has achieved a great deal of attention recently, with university students considered as a homogenized population, particularly affected by sleep habits. Aim: The objective of this study was to investigate whether Libyan college students experience sleep disturbance during their academic programmes. Methods: A cross-sectional survey was conducted in the college of Pharmacy, Tripoli University, during February 2010. A total of 201 students, including 179 females (89.05% and 22 males (10.95%, were recruited from different academic levels. Data were collected using a structured questionnaire and included a number of life-style variables. Epworth Sleepiness Scale (ESS was used for the assessment of daytime sleepiness. Results: This study showed that the total sleep time (TST on a weeknight was 6.40 h and 67 students reported napping during daytime. The TST plus naps totalled 7.39 h. Out of eight possible dozing situations, we found that the mean score for ESS was 8.78. In addition, 79 students showed an ESS score of >10. Furthermore, our results showed that the majority of students (>92% reported poor sleep satisfaction with quality and duration of sleep hours. Thinking about difficulty of study but not increasing education programs or tea/coffee consumption is associated with sleep difficulties reported. Moreover, 77.6% of students reported an irregular sleep–wake schedule. Conclusion: These findings indicate that students experienced excessive daytime sleepiness. The TST of pharmaceutical students in Libya, as in other developing countries, is less than those reported by Western students. Students experienced various environmental demands during their college years and, their quality of sleep was negatively affected.

  10. Sleep complaints and daytime sleepiness among pharmaceutical students in Tripoli.

    Science.gov (United States)

    Taher, Yousef A; Samud, Awatef M; Ratimy, Aya H; Seabe, Areeje M

    2012-01-01

    The effect of sleep difficulties has achieved a great deal of attention recently, with university students considered as a homogenized population, particularly affected by sleep habits. The objective of this study was to investigate whether Libyan college students experience sleep disturbance during their academic programmes. A cross-sectional survey was conducted in the college of Pharmacy, Tripoli University, during February 2010. A total of 201 students, including 179 females (89.05%) and 22 males (10.95%), were recruited from different academic levels. Data were collected using a structured questionnaire and included a number of life-style variables. Epworth Sleepiness Scale (ESS) was used for the assessment of daytime sleepiness. This study showed that the total sleep time (TST) on a weeknight was 6.40 h and 67 students reported napping during daytime. The TST plus naps totalled 7.39 h. Out of eight possible dozing situations, we found that the mean score for ESS was 8.78. In addition, 79 students showed an ESS score of >10. Furthermore, our results showed that the majority of students (>92%) reported poor sleep satisfaction with quality and duration of sleep hours. Thinking about difficulty of study but not increasing education programs or tea/coffee consumption is associated with sleep difficulties reported. Moreover, 77.6% of students reported an irregular sleep-wake schedule. These findings indicate that students experienced excessive daytime sleepiness. The TST of pharmaceutical students in Libya, as in other developing countries, is less than those reported by Western students. Students experienced various environmental demands during their college years and, their quality of sleep was negatively affected.

  11. Clinical and polysomnographic characteristics of excessive daytime sleepiness in children.

    Science.gov (United States)

    Lee, Jiwon; Na, Geonyoub; Joo, Eun Yeon; Lee, Munhyang; Lee, Jeehun

    2017-08-18

    This study aimed to delineate the clinical and polysomnography (PSG) characteristics of sleep disorders in children with excessive daytime sleepiness (EDS). Between February 2002 and June 2015, 622 pediatric patients with EDS were evaluated with overnight PSG and the Multiple Sleep Latency Test at the Samsung Medical Center. The medical records; questionnaire responses about depression, sleepiness, sleep habits; and sleep study data of 133 patients without obstructive sleep apnea (OSA) were reviewed retrospectively. The patients (63 girls, 70 boys) slept for an average of 7 h 30 min and 8 h 44 min on weekdays and weekends, respectively. The mean Epworth Sleepiness Scale score was 11.01 ± 4.09 and did not differ significantly among sleep disorders. Among the 102 patients who completed the depression questionnaire, 53 showed depressive feelings, which were moderate or severe in 39, with no significant differences among specific sleep disorders. Thirty-four patients exhibited normal PSG results. Seventeen of them were concluded as not having any sleep disorders, and the others as having delayed sleep phase disorder (DSPD). Narcolepsy (n = 78) was the most common disorder, followed by DSPD (n = 17) and idiopathic hypersomnia (n = 12). Pediatric patients with EDS had various sleep disorders and some did not have any sleep disorder despite EDS. More than half the patients with EDS showed depressive feelings affecting their daily lives. For pediatric patients with EDS, a systematic diagnostic approach including questionnaires for sleep habits and emotion and PSG is essential for accurate diagnosis and treatment.

  12. Objective, but Not Subjective, Sleepiness is Associated With Inflammation in Sleep Apnea.

    Science.gov (United States)

    Li, Yun; Vgontzas, Alexandros N; Fernandez-Mendoza, Julio; Kritikou, Ilia; Basta, Maria; Pejovic, Slobodanka; Gaines, Jordan; Bixler, Edward O

    2017-02-01

    Objective and subjective measures of excessive daytime sleepiness (EDS) are only weakly associated. No study, however, has examined whether these two measures of EDS differ in terms of underlying mechanisms and prognostic value. Pro-inflammatory cytokines, that is, interleukin-6 (IL-6) appear to promote sleepiness/fatigue, while the stress hormone cortisol promotes vigilance. We hypothesized that objective sleepiness is associated with increased levels of IL-6 and decreased levels of cortisol. We studied 58 obstructive sleep apnea (OSA) patients with clinical EDS and/or cardiovascular comorbidities who underwent 8-hour in-lab polysomnography for four consecutive nights. Objective and subjective daytime sleepiness were measured by Multiple Sleep Latency Test (MSLT), Epworth Sleepiness Scale (ESS), and Stanford Sleepiness Scale (SSS), respectively. Twenty-four-hour profiles of IL-6 and cortisol levels were assessed on the fourth day. The agreement between objective and subjective EDS in OSA patients was fair (kappa = 0.22). Objective EDS (lower MSLT) in OSA patients was associated with significantly elevated 24-hour (β = -0.34, p = .01), daytime (β = -0.30, p = .02) and nighttime (β = -0.38, p < .01) IL-6 levels, and significantly decreased daytime (β = 0.35, p = .01) cortisol levels. In contrast, subjective EDS (higher ESS/SSS) was not associated with either elevated IL-6 levels or decreased cortisol levels. Our findings suggest that OSA with objective EDS is the more severe phenotype of the disorder associated with low-grade inflammation, a link to cardiometabolic morbidity and mortality. Compared to subjective EDS, objective EDS is a stronger predictor of OSA severity and may be useful in the clinical management of the disorder.

  13. Excessive daytime sleepiness in the elderly: association with cardiovascular risk, obesity and depression

    Directory of Open Access Journals (Sweden)

    Johnnatas Mikael Lopes

    2013-12-01

    Full Text Available OBJECTIVE: To observe the relationship between Excessive Daytime Sleepiness (EDS and the presence of risk factors for cardiovascular dysfunction, depression and obesity in the elderly. METHODS: We interviewed 168 elderly from the community of Campina Grande, Paraíba. They were selected according to health districts in the period of 2010. We used the Epworth Sleepiness Scale to diagnose excessive daytime sleepiness (> 10 points; waist circumference for the risk of cardiovascular dysfunction (> 94 or > 80 cm; Geriatric Depression Scale for depression (>10 points and body mass index for obesity (> 25 kg/m2. Association analysis was performed by the Chi-square test adjusted for sex and age group, adopting α < 0.05. RESULTS: One hundred and sixty eight elderly individuals with mean age of 72.34 ± 7.8 years old participated in this study, being 122 (72.6% women. EDS was identified in 53 (31.5% of them; depression, in 72 (42.9%; overweight/obesity, in 95 (64.46%; and risk of cardiovascular dysfunction, in 129 (79.6%. Depressed men (78.6%, p = 0.0005 and risk of cardiovascular dysfunction (57.1%, p = 0.02 were more prone to EDS. In women, only obesity was related to sleepiness (42.1%, p = 0.01. Only those aged between 70 - 79 years old showed association between sleepiness and obesity. CONCLUSION: It was found that obesity for women, and depression and cardiovascular dysfunction risking for men were associated with EDS in the elderly. The variable sex is a confusion condition for the association with sleepiness.

  14. Armodafinil in the treatment of excessive sleepiness

    OpenAIRE

    Rosenberg, Russell

    2010-01-01

    Russell Rosenberg1, Richard Bogan21NeuroTrials Research, Atlanta, Georgia, USA; 2SleepMed of South Carolina, Columbia, South Carolina, USAAbstract: Excessive sleepiness (ES) is a widespread condition, commonly the result of a sleep/wake disorder such as obstructive sleep apnea (OSA), shift-work disorder (SWD), or narcolepsy. ES poses significant health and safety concerns in patients. Numerous interventions are available to treat the underlying causes of ES and ES itself, including behavioral...

  15. Armodafinil in the treatment of excessive sleepiness

    OpenAIRE

    Rosenberg, Russell; Bogan, Richard

    2010-01-01

    Excessive sleepiness (ES) is a widespread condition, commonly the result of a sleep/ wake disorder such as obstructive sleep apnea (OSA), shift-work disorder (SWD), or narcolepsy. ES poses significant health and safety concerns in patients. Numerous interventions are available to treat the underlying causes of ES and ES itself, including behavioral measures, mechanical devices, and pharmacologic agents. This review explores the evidence supporting the use of armodafinil to treat ES associated...

  16. Daytime Sleepiness and Sleep Inadequacy as Risk Factors for Dementia

    Directory of Open Access Journals (Sweden)

    Angeliki Tsapanou

    2015-07-01

    Full Text Available Background/Aims: To examine the association between self-reported sleep problems and incidence of dementia in community-dwelling elderly people. Methods: 1,041 nondemented participants over 65 years old were examined longitudinally. Sleep problems were estimated using the RAND Medical Outcomes Study Sleep Scale examining sleep disturbance, snoring, sleep short of breath or with a headache, sleep adequacy, and sleep somnolence. Cox regression analysis was used to examine the association between sleep problems and risk for incident dementia. Age, gender, education, ethnicity, APOE-ε4, stroke, heart disease, hypertension, diabetes, and depression were included as covariates. Results: Over 3 years of follow-up, 966 (92.8% participants remained nondemented, while 78 (7.2% developed dementia. In unadjusted models, sleep inadequacy (‘Get the amount of sleep you need' at the initial visit was associated with increased risk of incident dementia (HR = 1.20; 95% CI 1.02-1.42; p = 0.027. Adjusting for all the covariates, increased risk of incident dementia was still associated with sleep inadequacy (HR = 1.20; 95% CI 1.01-1.42; p = 0.040, as well as with increased daytime sleepiness (‘Have trouble staying awake during the day' (HR = 1.24; 95% CI 1.00-1.54; p = 0.047. Conclusion: Our results suggest that sleep inadequacy and increased daytime sleepiness are risk factors for dementia in older adults, independent of demographic and clinical factors.

  17. Daytime sleepiness and quality of life in peritoneal dialysis patients.

    Science.gov (United States)

    Bilgic, Ayse; Akman, Beril; Sezer, Siren; Arat, Zubeyde; Ozelsancak, Ruya; Ozdemir, Nurhan

    2011-12-01

    We aimed to compare automated peritoneal dialysis (APD) and continuous ambulatory peritoneal dialysis (CAPD) therapy with regard to patients' excessive daytime sleepiness (EDS) and quality of life (QOL). EDS was assessed with the Epworth Sleepiness Scale (ESS) and QOL with the Medical Outcomes Study 36-Item Short Form (SF-36) health survey. We included 59 patients (CAPD/APD, 30/29; male/female, 33/26; age, 45.3±15.8 years; dialysis duration, 42.0±33.6 months). The CAPD and APD groups were similar with respect to factors that affected sleep quality (age, sex, duration of PD), smoking, alcohol intake, socioeconomic status, body mass index, comorbid disease, and various laboratory parameters. Although one patient (3.3%) treated with CAPD and four patients (13.8%) treated with APD experienced EDS, there was no significant differences in ESS scores between the CAPD and APD patients. There was no difference in the SF-36 total and subscale scores when APD patients were compared with CAPD patients. The independent predictors of ESS were the serum albumin level (β= -2.04, P<0.01), total SF-36 score (β= 0.08, P=0.02), social functioning score (β= -2.47, P=0.01), and role-emotional subscale score (β= -1.12, P=0.05). The incidence of EDS was slightly higher in APD patients, but it did not negatively affect daily activities or QOL.

  18. Electrodermal lability as an indicator for subjective sleepiness during total sleep deprivation.

    Science.gov (United States)

    Michael, Lars; Passmann, Sven; Becker, Ruth

    2012-08-01

    The present study addresses the suitability of electrodermal lability as an indicator of individual vulnerability to the effects of total sleep deprivation. During two complete circadian cycles, the effects of 48h of total sleep deprivation on physiological measures (electrodermal activity and body temperature), subjective sleepiness (measured by visual analogue scale and tiredness symptom scale) and task performance (reaction time and errors in a go/no go task) were investigated. Analyses of variance with repeated measures revealed substantial decreases of the number of skin conductance responses, body temperature, and increases for subjective sleepiness, reaction time and error rates. For all changes, strong circadian oscillations could be observed as well. The electrodermal more labile subgroup reported higher subjective sleepiness compared with electrodermal more stable participants, but showed no differences in the time courses of body temperature and task performance. Therefore, electrodermal lability seems to be a specific indicator for the changes in subjective sleepiness due to total sleep deprivation and circadian oscillations, but not a suitable indicator for vulnerability to the effects of sleep deprivation per se.

  19. Self-Regulation and Sleep Duration, Sleepiness, and Chronotype in Adolescents.

    Science.gov (United States)

    Owens, Judith A; Dearth-Wesley, Tracy; Lewin, Daniel; Gioia, Gerard; Whitaker, Robert C

    2016-12-01

    To determine whether shorter school-night sleep duration, greater daytime sleepiness, and greater eveningness chronotype were associated with lower self-regulation among adolescents. An online survey of 7th- to 12th-grade students in 19 schools in Fairfax County, Virginia Public Schools was conducted in 2015. Self-regulation was measured with the Behavior Rating Inventory of Executive Function, 2nd edition, Screening Self-Report Form. Sleep measures included school night-sleep duration (hours between usual bedtime and wake time), daytime sleepiness (Sleepiness Scale in the Sleep Habits Survey, tertiles), and chronotype (Morningness-Eveningness Scale for Children, continuous score and tertiles). Sociodemographic factors and mental health conditions were analyzed as potential confounders. Among 2017 students surveyed, the mean age was 15.0 years (range, 12.1-18.9 years), and 21.7% slept self-regulation and both chronotype (P self-regulation, as did those in the eveningness tertile of chronotype compared with those in the morningness tertile (0.35 SD units lower; 95% confidence interval, 0.24-0.46). Among adolescents, greater daytime sleepiness and greater eveningness chronotype were independently associated with lower self-regulation, but shorter sleep duration was not. Aspects of sleep other than school-night sleep duration appear to be more strongly associated with self-regulation. Copyright © 2016 by the American Academy of Pediatrics.

  20. Sleepiness and Motor Vehicle Crashes in a Representative Sample of Portuguese Drivers: The Importance of Epidemiological Representative Surveys.

    Science.gov (United States)

    Gonçalves, M; Peralta, A R; Monteiro Ferreira, J; Guilleminault, Christian

    2015-01-01

    Sleepiness is considered to be a leading cause of crashes. Despite the huge amount of information collected in questionnaire studies, only some are based on representative samples of the population. Specifics of the populations studied hinder the generalization of these previous findings. For the Portuguese population, data from sleep-related car crashes/near misses and sleepiness while driving are missing. The objective of this study is to determine the prevalence of near-miss and nonfatal motor vehicle crashes related to sleepiness in a representative sample of Portuguese drivers. Structured phone interviews regarding sleepiness and sleep-related crashes and near misses, driving habits, demographic data, and sleep quality were conducted using the Pittsburgh Sleep Quality Index and sleep apnea risk using the Berlin questionnaire. A multivariate regression analysis was used to determine the associations with sleepy driving (feeling sleepy or falling asleep while driving) and sleep-related near misses and crashes. Nine hundred subjects, representing the Portuguese population of drivers, were included; 3.1% acknowledged falling asleep while driving during the previous year and 0.67% recalled sleepiness-related crashes. Higher education, driving more than 15,000 km/year, driving more frequently between 12:00 a.m. and 6 a.m., fewer years of having a driver's license, less total sleep time per night, and higher scores on the Epworth Sleepiness Scale (ESS) were all independently associated with sleepy driving. Sleepiness-related crashes and near misses were associated only with falling asleep at the wheel in the previous year. Sleep-related crashes occurred more frequently in drivers who had also had sleep-related near misses. Portugal has lower self-reported sleepiness at the wheel and sleep-related near misses than most other countries where epidemiological data are available. Different population characteristics and cultural, social, and road safety specificities may

  1. Causes and consequences of sleepiness among college students

    OpenAIRE

    Hershner SD; Chervin RD

    2014-01-01

    Shelley D Hershner, Ronald D ChervinDepartment of Neurology, University of Michigan, Ann Arbor, MI, USAAbstract: Daytime sleepiness, sleep deprivation, and irregular sleep schedules are highly prevalent among college students, as 50% report daytime sleepiness and 70% attain insufficient sleep. The consequences of sleep deprivation and daytime sleepiness are especially problematic to college students and can result in lower grade point averages, increased risk of academic failure, compromised ...

  2. Occupational Injuries related to Sleepiness in Indian Traditional Industries

    Directory of Open Access Journals (Sweden)

    Ajeet Jaiswal

    2012-08-01

    Full Text Available A cross-sectional study was done to evaluate the rate of sleepiness and its relation to occupational injuries in Indian Traditional Industries. Data was collected using pretested and structured questionnaire about eight sleep habits, symptoms of depression, occupational injury due to fatigue, demographics, presence of diseases and lifestyle factors from 920 workers between the ages of 18-65 (mean 433.5 year in small scale industries. Occupational injury was assessed by asking subjects 'Have you ever been injured during your work, including minor scratches and cuts (Yes/ No? Both sleep and injury were assessed over the previous one year period. One-third of workers answered that they had experienced injury. Workers with sleep features of DIS, sleeping poorly at night, insufficient sleep, and insomnia had a significantly higher prevalence for injury after adjusting for multiple confounders. The findings suggest that poor nocturnal sleep habits are associated with self-reported occupational injury.

  3. Five-hour sleep restriction for 7 days increases subjective sleepiness.

    Science.gov (United States)

    Kobayashi, Fumio; Yamamoto, Keiko; Tsuboi, Hirohito; Hori, Reiko; Watanabe, Misuzu; Akamatsu, Yasuhiro; Tomita, Teruyuki

    2007-01-01

    We investigated the effects of a 5-h sleep restriction for 7 d on subjective sleepiness in an ambulatory condition by comparing them with baseline conditions consisting of an 8-h sleep for 7 consecutive days. Subjects were 13 healthy male students (mean age 21.1 yr). Each subject was required to get 8 h of sleep (baseline, from 2300 to 0700) for 7 d, and 5 h of sleep (sleep restriction, from 0100 to 0600) for 7 d in an ambulatory condition. The order of the two sleep schedules was randomly assigned. Subjective sleepiness was assessed by a Visual Analog Scale (VAS) every 3 h at 0900, 1200, 1500, 1800, and 2100 for 7 successive days during each sleep schedule. The VAS score during sleep restriction gradually increased up to the 5th day and then reached a plateau. The patterns of time-course changes in the VAS score were similar to those at baseline. The VAS scores showed a peak at 0900, taking a dip at 1200, and then gradually increasing toward 2100. The mean VAS score of the last three days of the 5-h sleep restriction was significantly higher than that at baseline (psleep restriction for 7 d in an ambulatory condition increased subjective sleepiness up to the 5th day and then reached a plateau. The patterns of the time-course changes in sleepiness of 5-h sleep restriction per day did not differ from that at baseline.

  4. Sleep and sleepiness in children with attention deficit / hyperactivity disorder and controls.

    Science.gov (United States)

    Wiebe, Sabrina; Carrier, Julie; Frenette, Sonia; Gruber, Reut

    2013-02-01

    The present study assessed the association between habitual sleep patterns and one night of PSG measured sleep with daytime sleepiness in children with ADHD and typically developing children. Eighty-two children (26 ADHD, 56 typically developing children), between 7 and 11 years, had nighttime sleep recorded using actigraphy over five nights (habitual sleep patterns) and polysomnography during one night (immediate sleep patterns), both within their home environments. Daytime sleepiness was examined using the multiple sleep latency test within a controlled laboratory setting the following day. Using Spearman correlations, the relationships between mean sleep latencies on the multiple sleep latency test and scores on a modified Epworth Sleepiness Scale with polysomnographic measures of sleep quality and architecture and with actigraphic sleep quality measures were examined. Longer sleep latency, measured using polysomnography and actigraphy, was related to longer mean sleep latencies on the multiple sleep latency test in typically developing participants, whereas actigraphic measures of sleep restlessness (time awake and activity during the night), as well as time in slow-wave sleep, were positively related to mean sleep latency on the multiple sleep latency test in children with ADHD. These results show a differential relationship for children with ADHD and typically developing children between habitual and immediate sleep patterns with daytime sleepiness and suggest that problems initiating and maintaining sleep may be present both in nighttime and daytime sleep.

  5. Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN

    OpenAIRE

    Wahlgren, N; Moreira, T.; Michel, P.; Steiner, T.; Jansen, O; Cognard, C; Mattle, H P; van Zwam, W.; Holmin, S.; Tatlisumak, T.; Petersson, J; Caso, V.; Hacke, W; Mazighi, M.; Arnold, M.

    2016-01-01

    The original version of this consensus statement on mechanical thrombectomy was approved at the European Stroke Organisation (ESO)-Karolinska Stroke Update conference in Stockholm, 16–18 November 2014. The statement has later, during 2015, been updated with new clinical trials data in accordance with a decision made at the conference. Revisions have been made at a face-to-face meeting during the ESO Winter School in Berne in February, through email exchanges and the final version has then bee...

  6. Gender differences in excessive daytime sleepiness among Japanese workers.

    Science.gov (United States)

    Doi, Yuriko; Minowa, Masumi

    2003-02-01

    Excessive daytime sleepiness (EDS) is serious concern in the workplace with respect to errors, accidents, absenteeism, reduced productivity and impaired personal or professional life. Previous community studies found a female preponderance of EDS, however, there is little research on EDS and gender in occupational settings. We examined the gender differences in prevalence and risk factors of EDS among employees working at a telecommunications company in the Tokyo metropolitan area. Our outcome measure of EDS was the Epworth Sleepiness Scale (ESS). A self-administered questionnaire on health and sleep including ESS was distributed to 5,571 workers between December 1999 and January 2000, and 5,072 responses were returned (91.0%). A total of 4,722 full-time, non-manual and non-shift employees aged 20-59 were used for analysis (3,909 men and 813 women). Chi-squared tests and multiple logistic regression analyses were applied for examining the gender differences in the prevalence and risk factors of EDS. The prevalence rates of EDS were 13.3% for women and 7.2% for men (P<0.001). We identified that deprived nocturnal sleep, an irregular sleep-wake schedule and depression were the risk factors of EDS for both genders, and being married worked as a protective factor against EDS for men alone. It is obvious that a ban on overtime work and a provision of mental health hygiene are the general strategies for reducing EDS at worksites. In the case of women, we suggest the formation of effective strategies for improving women's status at home and in the workplace must also be a solution for the prevention of EDS (e.g. promoting gender equality in the division of labor at home and strengthening family care policies for working women).

  7. Classification algorithms for predicting sleepiness and sleep apnea severity.

    Science.gov (United States)

    Eiseman, Nathaniel A; Westover, M Brandon; Mietus, Joseph E; Thomas, Robert J; Bianchi, Matt T

    2012-02-01

    Identifying predictors of subjective sleepiness and severity of sleep apnea are important yet challenging goals in sleep medicine. Classification algorithms may provide insights, especially when large data sets are available. We analyzed polysomnography and clinical features available from the Sleep Heart Health Study. The Epworth Sleepiness Scale and the apnea-hypopnea index were the targets of three classifiers: k-nearest neighbor, naive Bayes and support vector machine algorithms. Classification was based on up to 26 features including demographics, polysomnogram, and electrocardiogram (spectrogram). Naive Bayes was best for predicting abnormal Epworth class (0-10 versus 11-24), although prediction was weak: polysomnogram features had 16.7% sensitivity and 88.8% specificity; spectrogram features had 5.3% sensitivity and 96.5% specificity. The support vector machine performed similarly to naive Bayes for predicting sleep apnea class (0-5 versus >5): 59.0% sensitivity and 74.5% specificity using clinical features and 43.4% sensitivity and 83.5% specificity using spectrographic features compared with the naive Bayes classifier, which had 57.5% sensitivity and 73.7% specificity (clinical), and 39.0% sensitivity and 82.7% specificity (spectrogram). Mutual information analysis confirmed the minimal dependency of the Epworth score on any feature, while the apnea-hypopnea index showed modest dependency on body mass index, arousal index, oxygenation and spectrogram features. Apnea classification was modestly accurate, using either clinical or spectrogram features, and showed lower sensitivity and higher specificity than common sleep apnea screening tools. Thus, clinical prediction of sleep apnea may be feasible with easily obtained demographic and electrocardiographic analysis, but the utility of the Epworth is questioned by its minimal relation to clinical, electrocardiographic, or polysomnographic features.

  8. Are insomniacs sleepy during the day? A pupillometric assessment.

    Science.gov (United States)

    Lichstein, K L; Johnson, R S; Sen Gupta, S; O'Laughlin, D L; Dykstra, T A

    1992-05-01

    A biodevelopmental model of insomnia is articulated specifying coordinated nighttime (disturbed sleep pattern) and daytime (no excessive daytime sleepiness) characteristics defining an insomnoid classification in at-risk groups: short sleepers and older adults. Pupillometry is proposed as a useful means of discriminating degree of daytime sleepiness to aid in the differential diagnosis of insomnia and insomnoid states, and the present study tested the discriminative validity of this approach. Noninsomniac (n = 34) and insomniac (n = 29) college students submitted to four 10 min pupillometry sessions tracking daytime sleepiness from morning arising to bedtime. Pupil diameter proved to be an able discriminator of these two groups though substantial overlap of the two distributions was also noted. The results supported the sensitivity of pupillometry in detecting daytime sleepiness, but yielded alternative interpretations. We observed statistical differentiation in insomniac and noninsomniac daytime sleepiness, but substantial, functional overlap between these groups. Assessment and treatment implications arising from the biodevelopmental model were hypothesized.

  9. Determinants of sleepiness at work among railway control workers.

    Science.gov (United States)

    Cotrim, Teresa; Carvalhais, José; Neto, Catarina; Teles, Júlia; Noriega, Paulo; Rebelo, Francisco

    2017-01-01

    In the last two decades the control of the Portuguese railway network has become much more centralized in three centres, there integrating the functions of route flow management, electrical control and signalling. This study aimed to investigate the influence of work and individual determinants in sleepiness among railway control workers, namely socio-demographic factors, work ability, psychosocial factors, shiftwork characteristics, fatigue perception, and sleep. Sleepiness by shift was associated with quality of sleep, job satisfaction, fatigue perception, quantitative demands, and age. The results indicate a high prevalence of sleepiness during the night shift and show the relevance of the quality of sleep as a predictor in the three models of sleepiness for morning, afternoon and night shifts. This study, done at the major Portuguese railway control centre, alerted managers to the importance of schedule planning as well as sleepiness prevention plans and makes these results a reference for future research. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. Attention Deficit Hyperactivity Disorder Symptoms, Sleepiness and Accidental Risk in 36140 Regularly Registered Highway Drivers

    Science.gov (United States)

    Philip, Pierre; Micoulaud-Franchi, Jean-Arthur; Lagarde, Emmanuel; Taillard, Jacques; Canel, Annick; Sagaspe, Patricia; Bioulac, Stéphanie

    2015-01-01

    Background Attention Deficit Hyperactivity Disorder (ADHD) is a frequent neurodevelopmental disorder that increases accidental risk. Recent studies show that some patients with ADHD can also suffer from excessive daytime sleepiness but there are no data assessing the role of sleepiness in road safety in patients with ADHD. We conducted an epidemiological study to explore sleep complaints, inattention and driving risks among automobile drivers. Methods and Findings From August to September 2014, 491186 regular highway users were invited to participate in an Internet survey on driving habits. 36140 drivers answered a questionnaire exploring driving risks, sleep complaints, sleepiness at the wheel, ADHD symptoms (Adult ADHD Self-Report Scale) and distraction at the wheel. 1.7% of all drivers reported inattention-related driving accidents and 0.3% sleep-related driving accidents in the previous year. 1543 drivers (4.3%) reported ADHD symptoms and were more likely to report accidents than drivers without ADHD symptoms (adjusted OR = 1.24, [1.03–1.51], p 15) versus 3.2% of drivers without ADHD symptoms and 20.5% reported severe sleepiness at the wheel versus 7.3%. Drivers with ADHD symptoms reported significantly more sleep-related (adjusted OR = 1.4, [1.21–1.60], p < .0001) and inattention-related (adjusted OR = 1.9, [1.71–2.14], p<0001) near misses than drivers without ADHD symptoms. The fraction of near-misses attributable to severe sleepiness at the wheel was 4.24% for drivers without ADHD symptoms versus 10,35% for drivers with ADHD symptoms. Conclusion Our study shows that drivers with ADHD symptoms have more accidents and a higher level of sleepiness at the wheel than drivers without ADHD symptoms. Drivers with ADHD symptoms report more sleep-related and inattention-related near misses, thus confirming the clinical importance of exploring both attentional deficits and sleepiness at the wheel in these drivers. Road safety campaigns should be improved to

  11. Association of anxiety, sleepiness, and sexual dysfunction with restless legs syndrome in hemodialysis patients.

    Science.gov (United States)

    Dikici, Suber; Bahadir, Anzel; Baltaci, Davut; Ankarali, Handan; Eroglu, Mustafa; Ercan, Nurten; Sav, Tansu

    2014-10-01

    Restless legs syndrome (RLS) is characterized by unpleasant sensations, pain in the legs along with irresistible urges to move the legs when at rest. It is often accompanied by sleep disturbance. The purpose of this study was to assess the association of anxiety and sleepiness with sexual function in hemodialysis patients with and without RLS. Sociodemographic parameters, laboratory data of hemodialysis patients from three dialysis centers were collected prospectively. Anxiety, sleepiness, sexual function, and presence of RLS symptoms were assessed with standardized questionnaires as the RLS Diagnosis and Scale, Hamilton Anxiety Rating Scale, Epworth Sleepiness Scale (ESS), Arizona Sex Experiences Scale (ASEX). Univariate, regression tree method were used for statistical analysis. RLS was observed in 45.9% (n = 113) of hemodialysis patients (n = 246). The mean age of patients and duration of hemodialysis were 59.7 ± 14.0 and 4.9 ± 4.2 years, respectively. The correlation between Arizona Sexual Experiences Scale (ASEX) and sociodemographic features was significant (P < 0.0001). Patients with RLS had higher scores for anxiety (9.4 ± 7.8 with RLS and 6.8 ± 6.0 without), higher ESS (ESS, 6.6 ± 5.2 with RLS and 4.6 ± 4.0 without), and higher ASEX (24.6 ± 5.7 with RLS and 22.5 ± 6.8 without) than did those without RLS. The presence of RLS symptoms in hemodialysis patients was associated with sleepiness, anxiety, and sexual dysfunction. A regression tree method, which is a different statistical method, can help physicians estimate patients ASEX, RLS, ESS, and anxiety scores. © 2014 International Society for Hemodialysis.

  12. Sonolência excessiva Excessive daytime sleepiness

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    Lia Rita Azeredo Bittencourt

    2005-05-01

    Full Text Available A sonolência é uma função biológica, definida como uma probabilidade aumentada para dormir. Já a sonolência excessiva (SE, ou hipersonia, refere-se a uma propensão aumentada ao sono com uma compulsão subjetiva para dormir, tirar cochilos involuntários e ataques de sono, quando o sono é inapropriado. As principais causas de sonolência excessiva são a privação crônica de sono (sono insuficiente, a Síndrome da Apnéia e Hipopnéia Obstrutiva do Sono (SAHOS, a narcolepsia, a Síndrome das Pernas Inquietas/Movimentos Periódicos de Membros (SPI/MPM, Distúrbios do Ritmo Circadiano, uso de drogas e medicações e a hipersonia idiopática. As principais conseqüências são prejuízo no desempenho nos estudos, no trabalho, nas relações familiares e sociais, alterações neuropsicológicas e cognitivas e risco aumentado de acidentes. O tratamento da sonolência excessiva deve estar voltado para as causas específicas. Na privação voluntária do sono, aumentar o tempo de sono e higiene do sono, o uso do CPAP (Continuous Positive Airway Pressure na Síndrome da Apnéia e Hipopnéia Obstrutiva do Sono, exercícios e agentes dopaminérgicos na Síndrome das Pernas Inquietas/Movimentos Periódicos de Membros, fototerapia e melatonina nos Distúrbios do Ritmo Circadiano, retiradas de drogas que causam sonolência excessiva e uso de estimulantes da vigília.Sleepiness is a physiological function, and can be defined as increased propension to fall asleep. However, excessive sleepiness (ES or hypersomnia refer to an abnormal increase in the probability to fall asleep, to take involuntary naps, or to have sleep atacks, when sleep is not desired. The main causes of excessive sleepiness is chronic sleep deprivation, sleep apnea syndrome, narcolepsy, movement disorders during sleep, circadian sleep disorders, use of drugs and medications, or idiopathic hypersomnia. Social, familial, work, and cognitive impairment are among the consequences of

  13. Clinical implications of daytime sleepiness for the academic performance of middle school-aged adolescents with attention deficit hyperactivity disorder.

    Science.gov (United States)

    Langberg, Joshua M; Dvorsky, Melissa R; Marshall, Stephen; Evans, Steven W

    2013-10-01

    This study investigated the relative impact of total time slept per night and daytime sleepiness on the academic functioning of 100 middle school-aged youth (mean age = 11.9) with attention deficit hyperactivity disorder (ADHD). The primary goal of the study was to determine if total time slept per night and/or daytime sleepiness, as measured by youth self-report on the Pediatric Daytime Sleepiness Scale (PDSS), predicted academic functioning above and beyond symptoms of ADHD and relevant covariates, such as intelligence, achievement scores and parent education level. Self-reported daytime sleepiness but not self-reported total time slept per night was associated significantly with all academic outcomes. When examined in a hierarchical regression model, self-reported daytime sleepiness significantly predicted parent-rated homework problems and academic impairment and teacher-rated academic competence above and beyond symptoms of ADHD and relevant covariates, but did not predict grade point average or teacher-rated academic impairment. The implications of these findings for understanding more clearly the association between ADHD and sleep and the functional implications of this relationship are discussed.

  14. Assessment of sleepiness, fatigue, and depression among Gulf Cooperation Council commercial airline pilots.

    Science.gov (United States)

    Aljurf, Tareq M; Olaish, Awad H; BaHammam, Ahmed S

    2017-09-07

    No studies have assessed the prevalence of fatigue, depression, sleepiness, and the risk of obstructive sleep apnea (OSA) among commercial airlines pilots in the Gulf Cooperation Council (GCC). This was a quantitative cross-sectional study conducted among pilots who were on active duty and had flown during the past 6 months for one of three commercial airline companies. We included participants with age between 20 and 65 years. Data were collected using a predesigned electronic questionnaire composed of questions related to demographic information in addition to the Fatigue Severity Scale (FSS), the Berlin Questionnaire, the Epworth Sleepiness Scale (ESS), and the Hospital Anxiety and Depression Scale (HADS). The study included 328 pilots with a mean age ± standard deviation of 41.4 ± 9.7 years. Overall, 224 (68.3%) pilots had an FSS score ≥ 36 indicating severe fatigue and 221 (67.4%) reported making mistakes in the cockpit because of fatigue. One hundred and twelve (34.1%) pilots had an ESS score ≥ 10 indicating excessive daytime sleepiness and 148 (45.1%) reported falling asleep at the controls at least once without previously agreeing with their colleagues. One hundred and thirteen (34.5%) pilots had an abnormal HADS depression score (≥ 8), and 96 (29.3%) pilots were at high risk for OSA requiring further assessment. Fatigue, sleepiness, risk of OSA, and depression are prevalent among GCC commercial airline pilots. Regular assessment by aviation authorities is needed to detect and treat these medical problems.

  15. The Romantic Prototype of The Legend of Sleepy Hollow

    Institute of Scientific and Technical Information of China (English)

    冯育军; 王艳

    2016-01-01

    "The Legend of Sleepy Hollow" is a short story of speculative fiction by American author Washington Irving, con-tained in his collection of 34 essays and short stories entitled The Sketch Book of Geoffrey Crayon, Gent. Written while Irving was living abroad in Birmingham, England,"The Legend of Sleepy Hollow"was first published in 1820. Along with Irving's com-panion piece"Rip Van Winkle","The Legend of Sleepy Hollow"is among the earliest examples of American fiction with endur-ing popularity, especially during the Halloween season.

  16. Fatigue and daytime sleepiness in patients with myotonic dystrophy type 1: to lump or split?

    Science.gov (United States)

    Laberge, Luc; Dauvilliers, Yves; Bégin, Paul; Richer, Louis; Jean, Stéphane; Mathieu, Jean

    2009-06-01

    We assessed the relationship and clinical correlates of fatigue and Excessive Daytime Sleepiness (EDS) in 200 myotonic dystrophy type 1 (DM1) patients by means of questionnaire and neuropsychological evaluation. Fatigue levels were higher in patients with EDS and daytime sleepiness levels higher in patients with excessive fatigue. However, EDS without fatigue was rarely observed. Also, DM1 patients with fatigue (with or without EDS) showed greater muscular impairment, CTG repeats, abnormalities regarding personality, depressive symptoms and lower health-related quality of life (HRQoL) than patients without these symptoms. These findings do not readily support the contention that fatigue and EDS constitute distinct clinical manifestations in DM1. Clinicians should systematically evaluate both symptoms since fatigue and EDS have a greater impact on HRQoL than fatigue alone. However, specific rating scales for fatigue in DM1 have yet to be devised.

  17. Residual sleepiness after N2O sedation: a randomized control trial [ISRCTN88442975

    Directory of Open Access Journals (Sweden)

    Lichtor J Lance

    2004-05-01

    Full Text Available Abstract Background Nitrous oxide (N2O provides sedation for procedures that result in constant low-intensity pain. How long do individuals remain sleepy after receiving N2O? We hypothesized that drug effects would be apparent for an hour or more. Methods This was a randomized, double blind controlled study. On three separate occasions, volunteers (N = 12 received 100% oxygen or 20% or 40% N2O for 30 min. Dependent measures included the multiple sleep latency test (MSLT, a Drug Effects/Liking questionnaire, visual analogue scales, and five psychomotor tests. Repeated measures analysis of variance was performed with drug and time as factors. Results During inhalation, drug effects were apparent based on the questionnaire, visual analogue scales, and psychomotor tests. Three hours after inhaling 100% oxygen or 20% N2O, subjects were sleepier than if they breathed 40% N2O. No other drug effects were apparent 1 hour after inhalation ceased. Patients did not demonstrate increased sleepiness after N2O inhalation. Conclusion We found no evidence for increased sleepiness greater than 1 hour after N2O inhalation. Our study suggests that long-term effects of N2O are not significant.

  18. Subjective sleepiness in heart failure patients with sleep-related breathing disorder

    Institute of Scientific and Technical Information of China (English)

    WANG Han-qiao; CHEN Gang; LI Jing; HAO Shu-min; GU Xin-shun; PANG Jiang-na; FU Xiang-hua

    2009-01-01

    Background Previous studies show that sleep-related breathing disorder (SRBD) is common in patients with heart failure (HF) and is associated with increased mortality. This study aimed to determine whether there was significant difference of subjective daytime sleepiness between HF patients with and without SRBD.Methods We enrolled, prospectively, 195 consecutive HF patients with left ventricular ejection fractions (LVEF)≮45%and all subjects underwent polysomnography to measure the sleep structure between 2005 and 2008. Patients were then assigned to those with SRBD including obstructive and central sleep apnea (apnea-hypopnea index (AHI)≯5/hour of sleep) and those without SRBD (AHI<5/hour) according to the sleep study. The subjective sleepiness was assessed withEpworth sleepiness scale (ESS).Results Among 195 HF patients, the prevalence of obstructive sleep apnea (OSA) was 53% and of central sleep apnea (CSA) was 27%. There was no significant difference of ESS scores between patients without SRBD (NSA) and with SRBD (NSA vs OSA: 6.7±0.6 VS 7.6±0.4, P=0.105 and NSA vs CSA: 6.7±0.6 vs 7.4±0.5, ,P=0.235, respectively),indicating that SRBD patients had no more subjective daytime sleepiness. Compared with NSA, patients with SRBD had increased arousal index (Arl) (NSA vs OSA: 14.1±1.4 vs 26.3±1.5, P <0.001 and NSA vs CSA: 14.1±1.4 vs 31.3±3.5, P <0.001, respectively), more awake number after sleep onset (NSA vs OSA: 19.2±1.5 vs 26.2±1.4, P=0.01 and NSA vs CSA: 19.2±1.5 vs 36.9±4.4, P <0.001, respectively), and reduced proportion of slow-wave sleep (SWS) (NSA vs OSA: 13.8±1.7 vs 9.3±0.7, ,P=0.024 and NSA vs CSA: 13.8±1.7 vs 8.9±0.9, P=0.024, respectively). Conclusions OSA and CSA remain common in patients with HF on optimal contemporary therapy. Patients with both HF and SRBD have no significant subjective daytime sleepiness compared with patients without SRBD, despite of significantly increased awake number, arousal and decreased proportion of deep

  19. Is the MDS-UPDRS a Good Screening Tool for Detecting Sleep Problems and Daytime Sleepiness in Parkinson's Disease?

    Science.gov (United States)

    Horváth, Krisztina; Aschermann, Zsuzsanna; Acs, Péter; Bosnyák, Edit; Deli, Gabriella; Pál, Endre; Janszky, József; Faludi, Béla; Késmárki, Ildikó; Komoly, Sámuel; Bokor, Magdolna; Rigó, Eszter; Lajtos, Júlia; Klivényi, Péter; Dibó, György; Vécsei, László; Takáts, Annamária; Tóth, Adrián; Imre, Piroska; Nagy, Ferenc; Herceg, Mihály; Kamondi, Anita; Hidasi, Eszter; Kovács, Norbert

    2014-01-01

    Movement Disorder Society-sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) has separate items for measuring sleep problems (item 1.7) and daytime sleepiness (1.8). The aim of our study was to evaluate the screening sensitivity and specificity of these items to the PD Sleep Scale 2nd version (PDSS-2) and Epworth Sleepiness Scale (ESS). In this nationwide, cross-sectional study 460 PD patients were enrolled. Spearman's rank correlation coefficients were calculated between the individual items, domains, and the total score of PDSS-2 and item 1.7 of MDS-UPDRS. Similarly, the items and the total score of ESS were contrasted to item 1.8 of MDS-UPDRS. After developing generalized ordinal logistic regression models, the transformed and observed scores were compared by Lin's Concordance Correlation Coefficient. Only item 3 difficulties staying asleep and the "disturbed sleep" domain of PDSS-2 showed high correlation with "sleep problems" item 1.7 of the MDS-UPDRS. Total score of PDSS-2 had moderate correlation with this MDS-UPRDS item. The total score of ESS showed the strongest, but still moderate, correlation with "daytime sleepiness" item 1.8 of MDS-UPDRS. As intended, the MDS-UPDRS serves as an effective screening tool for both sleep problems and daytime sleepiness and identifies subjects whose disabilities need further investigation.

  20. Armodafinil in the treatment of excessive sleepiness.

    Science.gov (United States)

    Rosenberg, Russell; Bogan, Richard

    2010-01-01

    Excessive sleepiness (ES) is a widespread condition, commonly the result of a sleep/ wake disorder such as obstructive sleep apnea (OSA), shift-work disorder (SWD), or narcolepsy. ES poses significant health and safety concerns in patients. Numerous interventions are available to treat the underlying causes of ES and ES itself, including behavioral measures, mechanical devices, and pharmacologic agents. This review explores the evidence supporting the use of armodafinil to treat ES associated with OSA, SWD, and narcolepsy. Armodafinil is an oral non-amphetamine wake-promoting agent, the R-isomer of racemic modafinil. Armodafinil and modafinil share many clinical and pharmacologic properties and are distinct from central nervous system stimulants; however, the mechanisms of action of modafinil and armodafinil are poorly characterized. Compared with modafinil, the wake-promoting effects of armodafinil persist later in the day. It is for this reason that armodafinil may be a particularly appropriate therapy for patients with persistent ES due to OSA, SWD, or narcolepsy.

  1. Mechanical thrombectomy in acute ischemic stroke: Consensus statement by ESO-Karolinska Stroke Update 2014/2015, supported by ESO, ESMINT, ESNR and EAN.

    Science.gov (United States)

    Wahlgren, Nils; Moreira, Tiago; Michel, Patrik; Steiner, Thorsten; Jansen, Olav; Cognard, Christophe; Mattle, Heinrich P; van Zwam, Wim; Holmin, Staffan; Tatlisumak, Turgut; Petersson, Jesper; Caso, Valeria; Hacke, Werner; Mazighi, Mikael; Arnold, Marcel; Fischer, Urs; Szikora, Istvan; Pierot, Laurent; Fiehler, Jens; Gralla, Jan; Fazekas, Franz; Lees, Kennedy R

    2016-01-01

    The original version of this consensus statement on mechanical thrombectomy was approved at the European Stroke Organisation (ESO)-Karolinska Stroke Update conference in Stockholm, 16-18 November 2014. The statement has later, during 2015, been updated with new clinical trials data in accordance with a decision made at the conference. Revisions have been made at a face-to-face meeting during the ESO Winter School in Berne in February, through email exchanges and the final version has then been approved by each society. The recommendations are identical to the original version with evidence level upgraded by 20 February 2015 and confirmed by 15 May 2015. The purpose of the ESO-Karolinska Stroke Update meetings is to provide updates on recent stroke therapy research and to discuss how the results may be implemented into clinical routine. Selected topics are discussed at consensus sessions, for which a consensus statement is prepared and discussed by the participants at the meeting. The statements are advisory to the ESO guidelines committee. This consensus statement includes recommendations on mechanical thrombectomy after acute stroke. The statement is supported by ESO, European Society of Minimally Invasive Neurological Therapy (ESMINT), European Society of Neuroradiology (ESNR), and European Academy of Neurology (EAN). © 2016 World Stroke Organization.

  2. Dissociations among daytime sleepiness, nighttime sleep, and cognitive status in Parkinson's disease.

    Science.gov (United States)

    Goldman, Jennifer G; Ghode, Reena A; Ouyang, Bichun; Bernard, Bryan; Goetz, Christopher G; Stebbins, Glenn T

    2013-09-01

    Daytime and nighttime sleep disturbances and cognitive impairment occur frequently in Parkinson's disease (PD), but little is known about the interdependence of these non-motor complications. Thus, we examined the relationships among excessive daytime sleepiness, nighttime sleep quality and cognitive impairment in PD, including severity and specific cognitive deficits. Ninety-three PD patients underwent clinical and neuropsychological evaluations including the Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Patients were classified as having normal cognition (PD-NC), mild cognitive impairment (PD-MCI), or dementia (PDD) using recently proposed Movement Disorder Society PD-MCI and PDD criteria. Relationships between the sleep and cognitive measures and PD cognitive groups were examined. The PD cohort included PD-NC (n = 28), PD-MCI (n = 40), and PDD (n = 25) patients. ESS scores, as a measure of daytime sleepiness, were significantly worse (p = 0.005) in cognitively impaired PD patients, particularly PDD patients. ESS scores correlated significantly with Mini-Mental State Examination scores and also with cognitive domain scores for attention/working memory, executive function, memory, and visuospatial function. In contrast, PSQI scores, as a measure of nighttime sleep quality, neither differed among cognitive groups nor correlated with any cognitive measures. Daytime sleepiness in PD, but not nighttime sleep problems, is associated with cognitive impairment in PD, especially in the setting of dementia, and attention/working memory, executive function, memory, and visuospatial deficits. The presence of nighttime sleep problems is pervasive across the PD cognitive spectrum, from normal cognition to dementia, and is not independently associated with cognitive impairment or deficits in cognitive domains. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Objective measurement of daytime napping, cognitive dysfunction and subjective sleepiness in Parkinson's disease.

    Directory of Open Access Journals (Sweden)

    Samuel J Bolitho

    Full Text Available INTRODUCTION: Sleep-wake disturbances and concomitant cognitive dysfunction in Parkinson's disease (PD contribute significantly to morbidity in patients and their carers. Subjectively reported daytime sleep disturbance is observed in over half of all patients with PD and has been linked to executive cognitive dysfunction. The current study used daytime actigraphy, a novel objective measure of napping and related this to neuropsychological performance in a sample of PD patients and healthy, age and gender-matched controls. Furthermore this study aimed to identify patients with PD who may benefit from pharmacologic and behavioural intervention to improve these symptoms. METHODS: Eighty-five PD patients and 21 healthy, age-matched controls completed 14 days of wrist actigraphy within two weeks of neuropsychological testing. Objective napping measures were derived from actigraphy using a standardised protocol and subjective daytime sleepiness was recorded by the previously validated Epworth Sleepiness Scale. RESULTS: Patients with PD had a 225% increase in the mean nap time per day (minutes as recorded by actigraphy compared to age matched controls (39.2 ± 35.2 vs. 11.5 ± 11.0 minutes respectively, p < 0.001. Significantly, differences in napping duration between patients, as recorded by actigraphy were not distinguished by their ratings on the subjective measurement of excessive daytime sleepiness. Finally, those patients with excessive daytime napping showed greater cognitive deficits in the domains of attention, semantic verbal fluency and processing speed. CONCLUSION: This study confirms increased levels of napping in PD, a finding that is concordant with subjective reports. However, subjective self-report measures of excessive daytime sleepiness do not robustly identify excessive napping in PD. Fronto-subcortical cognitive dysfunction was observed in those patients who napped excessively. Furthermore, this study suggests that daytime

  4. Daytime sleepiness and the COMT val158met polymorphism in patients with Parkinson disease.

    Science.gov (United States)

    Rissling, Ida; Frauscher, Birgit; Kronenberg, Florian; Tafti, Mehdi; Stiasny-Kolster, Karin; Robyr, Anne-Catherine; Körner, Yvonne; Oertel, Wolfgang Hermann; Poewe, Werner; Högl, Birgit; Möller, Jens Carsten

    2006-01-01

    A preliminary study by our group suggested an association between daytime sleepiness and the catechol-O-methyltransferase (COMT) val158met polymorphism (rs4680) in patients with Parkinson disease (PD). We sought to confirm this association in a large group of patients with PD. Genetic association study in patients with PD. Movement disorder sections at 2 university hospitals. PD patients with and without episodes of suddenly falling asleep matched for antiparkinsonian medication, disease duration, sex, and age, who participated in a previous genetic study on dopamine-receptor polymorphisms. Not applicable. In this study, 240 patients with PD (154 men; age 65.1 +/- 6.1 years; disease duration 9.4 +/- 6.0 years) were included. Seventy had the met-met (LL), 116 the met-val (LH), and 54 the val-val (HH) genotype. In the combined LL+LH group (featuring reduced COMT activity), the mean Epworth Sleepiness Scale (ESS) score was 9.0 +/- 5.9 versus 11.0 +/- 6.1 in the HH (high COMT activity) group (P = .047). Forty-seven percent of the LL and LH patients had sudden sleep onset compared with 61% of the HH patients (P = .07). Logistic regression, however, showed that both pathologic ESS scores (i.e., > 10) and sudden sleep onset were predicted by subjective disease severity (P < .001 each) but not by the COMT genotype. Our previous finding that the L-allele may be associated with daytime sleepiness could not be confirmed in the present study. Altogether, our data do not support a clinically relevant effect of the COMT genotype on daytime sleepiness in PD.

  5. Correlates of excessive daytime sleepiness in community-dwelling older adults: an exploratory study.

    Science.gov (United States)

    Lima, Camila Astolphi; Soares, Wuber Jefferson de Souza; Bilton, Tereza Loffredo; Dias, Rosângela Corrêa; Ferrioll, Eduardo; Perracini, Monica Rodrigues

    2015-01-01

    Excessive daytime sleepiness (EDS) imposes a wide range of adverse health-related outcomes in older people, such as disability, which impair everyday activities and may increase the risk of fall. Few studies have explored EDS in Brazilian older people living in the community who are typically cared in primary health services. This study aims to investigate the prevalence of EDS and its sociodemographic, physical and mental health correlates among community-dwelling older adults. This is an exploratory, population-based study derived from Frailty in Brazilian Older Adults (FIBRA) study including adults aged 65 years and older. Participants with a score ≥ 11 points on the Epworth Sleepiness Scale were considered as having excessive daytime sleepiness. A structured, multidimensional questionnaire was used to investigate sociodemographic, physical and mental health, and self-rated health variables. The sample was composed of 776 older adults, of whom 21% (n = 162) presented excessive daytime sleepiness. Multivariate regression analysis revealed that EDS is associated with obesity (OR = 1.50; 95%CI 1.02 - 2.20), urinary incontinence (OR = 1.53; 95%CI 1.01 - 2.31), poor self-rated health (OR = 1.54; 95%CI 1.06 - 2.24), and depression symptoms (OR = 1.49; 95%CI 1.00 - 2.20). Our results suggest that healthcare professionals should identify older adults with EDS and implement intervention strategies to minimize the negative impact of the co-occurrence of this condition with obesity, depression and urinary incontinence over health and quality of life.

  6. Avaliação da escala de Epworth em pacientes com a Síndrome da apnéia e hipopnéia obstrutiva do sono Evaluation of Epworth Sleepiness Scale in patients with obstructive sleep apnea-hypopnea syndrome

    Directory of Open Access Journals (Sweden)

    Letícia Boari

    2004-12-01

    Full Text Available A síndrome da apnéia e hipopnéia obstrutiva do sono (SAHOS é, atualmente, considerada um problema de saúde pública por causar aumento da morbi-mortalidade cardiovascular e acidentes de trânsito. A polissonografia assistida é o padrão-ouro para o diagnóstico e acompanhamento destes pacientes. No entanto, por ser onerosa, demorada e de acesso restrito, outros métodos tem sido desenvolvidos. A escala de sonolência de Epworth (ESE é uma avaliação subjetiva, porém, rápida, sem custos e simples de ser aplicada. OBJETIVO: Avaliar a correlação entre a pontuação da ESE e o índice de apnéia e hipopnéia (IAH da polissonografia de pacientes com SAHOS. FORMA DE ESTUDO: Clínico retrospectivo. MATERIAL E MÉTODO: Revisão de prontuário de 66 pacientes com queixa de roncopatia que foram submetidos a procedimento cirúrgico (uvulopalatofaringoplastia com ou sem abordagem nasal. Avaliaram-se a pontuação da ESE e o IAH da polissonografia pré e pós-operatórios. RESULTADOS: 78,7% pacientes com grau normal de IAH tiveram pontuação de ESE menor do que 10 e 65% pacientes com grau severo de IAH tiveram pontuação maior do que 10. Não houve resultados estatisticamente significantes para os grupos moderado e leve. CONCLUSÃO: A escala de Epworth pode distinguir os graus normais e severos sem, no entanto, determinar os graus moderado e leve. Assim, pode ser utilizada para acompanhamento de pacientes com SAHOS sem, no entanto, substituir a polissonografia uma vez que não consegue avaliar todos os graus de severidade.Today obstructive sleep apnea–hypopnea syndrome (OSAHS is a public health issue, since it increases cardiovascular morbidity-mortality rate and the risk of car crashes. Overnight polysomnography is the gold standard for diagnosis and follow-up of affected patients. However, because the test is expensive, time-consuming and of difficult access, others methods have been proposed. Although the Epworth Sleepiness Scale (ESS is

  7. THE APPLICATION VALUE OF EPWORTH SLEEPINESS SCALE TO SCREEN OBSTRUCTIVE SLEEP APNEA HYPOPNEA SYNDROME PATIENTS IN MENTAL WORKERS%Epworth嗜睡量表在脑力劳动者中筛查阻塞性睡眠呼吸暂停低通气综合征患者的应用价值

    Institute of Scientific and Technical Information of China (English)

    李文; 张晓晴

    2011-01-01

    [目的]探讨Epworth嗜睡量表(ESS)在脑力劳动者中筛查阻塞性睡眠呼吸暂停低通气综合征(OSAHS)患者的应用价值. [方法]对因打鼾而就诊的脑力劳动者206人进行ESS评分(EP值),计算体重指数(BMI),测量颈围,对所有患者行整夜多导睡眠监测(PSG),并根据PSG结果(呼吸紊乱指(AHI)和最低血氧饱和度(LSaO2)把患者分为无OSAHS组和OSAHS(轻、中、重)组,比较组间基本情况、临床指标和EP值的差异,分析AHI与临床指标和EP值之间的相关性,以AHI大干5为诊断OSAHS的金标准,做EP值的ROC曲线,并选择最佳诊断点. [结果]无OSAHS组与OSAHS各组间BMI、颈围、EP值、AHI和LSaO2差异均有统计学意义(P< 0.01); AHI与BMI、EP值、颈围和LSaO2有较高的相关性,相关系数分别为0.596,0.660,0.596,-0.849,且差异均有统计学意义(P<0.01),EP值的ROC曲线下面积为0.807 (P< 0.01),当EP=7.5时,其灵敏度为0.859,特异度为0.733. [结论]用Epworth嗜睡量表来筛查脑力劳动者中的OSAHS患者具有较高的应用价值.%[Objective] To explore the application value of Epworth sleepiness scale (ESS) in screening obstructive sleep apnea hypopnea syndrome (OSAHS) patients in mental workers. [Methods] 206 metal workers due to snoring were calculated for the ESS scores (EP scores) and body mass indices (BMI), measured for the neck circumferences. All patients were monitored by the whole night polysomnography (PSG), and were divided into non-OSAHS group and OSAHS (light, medium, heavy) group according to the results of PSG (Apnea Hyponea Index (AHI) and lowest saturation of blood oxygen (LSaCK). The differences of basic situations, clinical indicators and EP scores were compared between groups. The correlations were analyzed between AHI and clinical indicators, EP scores, respectively. With more than 5 of AHI for the gold standard of diagnosis OSAHS, we did the ROC curve of the EP scores, and chose the best diagnosis point [Results

  8. Epworth嗜睡量表在妊娠晚期孕妇睡眠呼吸障碍调查中的应用价值%Value of Epworth Sleepiness Scale Used in the Survey of Sleep-disordered Breathing in Pregnant Women at the Third Trimester

    Institute of Scientific and Technical Information of China (English)

    邵俊涛; 刘晓东; 于杰; 齐俊巧

    2012-01-01

    [Objective] To explore the value of Epworth sleepiness scale(ESS) used in the survey of sleep disordered breathing in the third trimester pregnant women. [Methods] Totally 126 pregnant women at the third trimester were enrolled in this study. According to ESS score, all pregnant women were divided into group A with ESS≥9( n = 70) and group B with ESS<9( n =56). The sleep duration at night and daytime and sleep status were compared between two groups. The correlation between these indicators and EES was analyzed. [Results] The sleep duration at night in group A was obviously shorter than that in group B, while the sleep duration at daytime was opposite, and there was significant difference between 2 groups( P <0. 05). The incidence of snoring, mouth breathing and sleep sweat in group A was higher than that in group B( P < 0. 05). ESS score had no correlation with the pregnant women's age(r= -0. 059, P =0. 511) and gestational week(r = 0. 047, P =0.601). ESS was negatively correlated with sleep duration at night(r = - 0. 384, P = 0. 000) and positively correlated with the sleep duration at daytime(r = 0. 213, P =0. 016).[Conclusion]The ESS might be a screening method of sleep disordered breathing in the third trimester pregnant women.%[目的]探讨Epworth嗜睡量表(Epworth sleepiness scale,ESS)在妊娠晚期孕妇睡眠呼吸障碍中的应用价值.[方法]选择妊娠晚期妇女126例,按ESS≥ 9分为切点,大于 9分孕妇70例(A组)和小于 9分孕妇56例(B组).比较两组夜间、日间睡眠时间及睡眠情况并分析这些指标与ESS评分的相关性.[结果]A组孕妇夜间睡眠时间显著短于B组孕妇,日间睡眠时间显著长于B组孕妇,其差异均有显著性(P<0.05);A组孕妇发生打鼾、张口呼吸及睡眠中多汗的比例高于B组(P<0.05).ESS评分与孕妇年龄(r=-0.059,P=0.511)和孕周(r=0.047,P=0.601)无相关性,与夜间睡眠时间(r=-0.384,P=0.000)呈负相关,与日间睡眠时间(r=0.213,P=0.016)呈正相

  9. Causes and consequences of sleepiness among college students

    Directory of Open Access Journals (Sweden)

    Hershner SD

    2014-06-01

    Full Text Available Shelley D Hershner, Ronald D ChervinDepartment of Neurology, University of Michigan, Ann Arbor, MI, USAAbstract: Daytime sleepiness, sleep deprivation, and irregular sleep schedules are highly prevalent among college students, as 50% report daytime sleepiness and 70% attain insufficient sleep. The consequences of sleep deprivation and daytime sleepiness are especially problematic to college students and can result in lower grade point averages, increased risk of academic failure, compromised learning, impaired mood, and increased risk of motor vehicle accidents. This article reviews the current prevalence of sleepiness and sleep deprivation among college students, contributing factors for sleep deprivation, and the role of sleep in learning and memory. The impact of sleep and sleep disorders on academics, grade point average, driving, and mood will be examined. Most importantly, effective and viable interventions to decrease sleepiness and sleep deprivation through sleep education classes, online programs, encouragement of naps, and adjustment of class time will be reviewed. This paper highlights that addressing sleep issues, which are not often considered as a risk factor for depression and academic failure, should be encouraged. Promotion of university and college policies and class schedules that encourage healthy and adequate sleep could have a significant impact on the sleep, learning, and health of college students. Future research to investigate effective and feasible interventions, which disseminate both sleep knowledge and encouragement of healthy sleep habits to college students in a time and cost effective manner, is a priority.Keywords: grade point average, GPA, sleep deprivation, academic performance, adolescence, sleep education programs

  10. Sleep disorders, sleepiness and traffic safety: a public health menace

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    S.R. Pandi-Perumal

    2006-07-01

    Full Text Available Sleep disorders are not uncommon and have been widely reported throughout the world. They have a profound impact on industrialized 24-h societies. Consequences of these problems include impaired social and recreational activities, increased human errors, loss of productivity, and elevated risk of accidents. Conditions such as acute and chronic insomnia, sleep loss, excessive sleepiness, shift-work, jet lag, narcolepsy, and sleep apnea warrant public health attention, since residual sleepiness during the day may affect performance of daily activities such as driving a car. Benzodiazepine hypnotics and zopiclone promote sleep, both having residual effects the following day including sleepiness and reduced alertness. In contrast, the non-benzodiazepine hypnotics zolpidem and zaleplon have no significant next-day residual effects when taken as recommended. Research on the effects of wakefulness-promoting drugs on driving ability is limited. Countermeasures for excessive daytime sleepiness have a limited effect. There is a need for a social awareness program to educate the public about the potential consequences of various sleep disorders such as narcolepsy, sleep apnea, shift-work-related sleep loss, and excessive daytime sleepiness in order to reduce the number of sleep-related traffic accidents.

  11. Insomnia, excessive sleepiness, excessive fatigue, anxiety, depression and shift work disorder in nurses having less than 11 hours in-between shifts.

    Directory of Open Access Journals (Sweden)

    Maria Fagerbakke Eldevik

    Full Text Available STUDY OBJECTIVE: To assess if less than 11 hours off work between work shifts (quick returns was related to insomnia, sleepiness, fatigue, anxiety, depression and shift work disorder among nurses. METHODS: A questionnaire including established instruments measuring insomnia (Bergen Insomnia Scale, sleepiness (Epworth Sleepiness Scale, fatigue (Fatigue Questionnaire, anxiety/depression (Hospital Anxiety and Depression Scale and shift work disorder was administered. Among the 1990 Norwegian nurses who participated in the study; 264 nurses had no quick returns, 724 had 1-30 quick returns and 892 had more than 30 quick returns during the past year. 110 nurses did not report the number of quick returns during the past year. The prevalence of insomnia, excessive sleepiness, excessive fatigue, anxiety, depression and shift work disorder was calculated within the three groups of nurses. Crude and adjusted logistic regression analyses were performed to assess the relation between quick returns and such complaints. RESULTS: We found a significant positive association between quick returns and insomnia, excessive sleepiness, excessive fatigue and shift work disorder. Anxiety and depression were not related to working quick returns. CONCLUSIONS: There is a health hazard associated with quick returns. Further research should aim to investigate if workplace strategies aimed at reducing the number of quick returns may reduce complaints among workers.

  12. Does more sleep matter? Differential effects of NREM- and REM-dominant sleep on sleepiness and vigilance.

    Science.gov (United States)

    Neu, D; Mairesse, O; Newell, J; Verbanck, P; Peigneux, P; Deliens, G

    2015-05-01

    We investigated effects of NREM and REM predominant sleep periods on sleepiness and psychomotor performances measured with visual analog scales and the psychomotor vigilance task, respectively. After one week of stable sleep-wake rhythms, 18 healthy sleepers slept 3hours of early sleep and 3hours of late sleep, under polysomnographic control, spaced by two hours of sustained wakefulness between sleep periods in a within subjects split-night, sleep interruption protocol. Power spectra analysis was applied for sleep EEG recordings and sleep phase-relative power proportions were computed for six different frequency bands (delta, theta, alpha, sigma, beta and gamma). Both sleep periods presented with similar sleep duration and efficiency. As expected, phasic NREM and REM predominances were obtained for early and late sleep conditions, respectively. Albeit revealing additive effects of total sleep duration, our results showed a systematic discrepancy between psychomotor performances and sleepiness levels. In addition, sleepiness remained stable throughout sustained wakefulness during both conditions, whereas psychomotor performances even decreased after the second sleep period. Disregarding exchanges for frequency bands in NREM or stability in REM, correlations between outcome measures and EEG power proportions further evidenced directional divergence with respect to sleepiness and psychomotor performances, respectively. Showing that the functional correlation pattern changed with respect to early and late sleep condition, the relationships between EEG power and subjective or behavioral outcomes might however essentially be related to total sleep duration rather than to the phasic predominance of REM or NREM sleep.

  13. Excessive daytime sleepiness in multiple system atrophy (SLEEMSA study)

    NARCIS (Netherlands)

    Moreno-Lopez, C.; Santamaria, J.; Salamero, M.; Del Sorbo, F.; Albanese, A.; Pellecchia, M.T.; Barone, P.; Overeem, S.; Bloem, B.R.; Aarden, W.C.C.A.; Canesi, M.; Antonini, A.; Duerr, S.; Wenning, G.K.; Poewe, W.; Rubino, A.; Meco, G.; Schneider, S.A.; Bhatia, K.P.; Djaldetti, R.; Coelho, M.; Sampaio, C.; Cochen, V.; Hellriegel, H.; Deuschl, G.; Colosimo, C.; Marsili, L.; Gasser, T.; Tolosa, E.

    2011-01-01

    BACKGROUND: Sleep disorders are common in multiple system atrophy (MSA), but the prevalence of excessive daytime sleepiness (EDS) is not well known. OBJECTIVE: To assess the frequency and associations of EDS in MSA. DESIGN: Survey of EDS in consecutive patients with MSA and comparison with patients

  14. Excessive daytime sleepiness in multiple system atrophy (SLEEMSA study)

    NARCIS (Netherlands)

    Moreno-Lopez, C.; Santamaria, J.; Salamero, M.; Del Sorbo, F.; Albanese, A.; Pellecchia, M.T.; Barone, P.; Overeem, S.; Bloem, B.R.; Aarden, W.C.C.A.; Canesi, M.; Antonini, A.; Duerr, S.; Wenning, G.K.; Poewe, W.; Rubino, A.; Meco, G.; Schneider, S.A.; Bhatia, K.P.; Djaldetti, R.; Coelho, M.; Sampaio, C.; Cochen, V.; Hellriegel, H.; Deuschl, G.; Colosimo, C.; Marsili, L.; Gasser, T.; Tolosa, E.

    2011-01-01

    BACKGROUND: Sleep disorders are common in multiple system atrophy (MSA), but the prevalence of excessive daytime sleepiness (EDS) is not well known. OBJECTIVE: To assess the frequency and associations of EDS in MSA. DESIGN: Survey of EDS in consecutive patients with MSA and comparison with patients

  15. Evaluation of in-car systems that prevent sleepiness

    NARCIS (Netherlands)

    Wilschut, E.S.; Caljouw, C.J.; Valk, P.J.L.

    2011-01-01

    This report provides an overview of methods to prevent drowsy driving of drivers (Wilschut et al., 2009). Several preventive approaches were discussed such as the use of questionnaires, campaigns and fatigue management plans. A search for law enforcement instruments to prevent sleepiness at the whee

  16. Change in daytime sleepiness and cognitive function in a 6-month, double-blind study of lurasidone and quetiapine XR in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Philip D. Harvey

    2016-09-01

    Full Text Available Daytime sleepiness is a commonly reported adverse effect associated with psychotropic agents that may impair cognitive performance and functioning. The objective of this post-hoc analysis was to evaluate the long-term effects of lurasidone and quetiapine XR on daytime sleepiness and neurocognitive performance during a 6-month, double-blind continuation study, in subjects who completed an initial 6-week, randomized, placebo-controlled trial comparing these agents. Daytime sleepiness, cognitive performance, and health-related quality of life were assessed with the Epworth Sleepiness Scale (ESS, CogState computerized battery, and the Quality of Well-Being (QWB-SA Scale, respectively. Treatment with flexible-dose lurasidone 40–160 mg/d, administered once daily in the evening, was associated with significantly reduced daytime sleepiness compared with flexibly dosed quetiapine XR 200–800 mg/d (p = 0.03, effect size = 0.36 at week 32 (month 6 of the continuation study endpoint. Incidence of markedly high sleepiness (ESS >10 was significantly higher in the quetiapine XR (200–800 mg/d group compared with the lurasidone (40–160 mg/day group at both months 3 and 6 visits (p < 0.05. Lurasidone (40–160 mg/d significantly improved neurocognitive performance compared to quetiapine XR (200–800 mg/d before (effect size = 0.49 and after adjustment (effect size = 0.45 for sleepiness effect (p = 0.008 and 0.010, respectively. Increased daytime sleepiness was significantly associated with reduced neurocognitive performance (p = 0.019 and quality of well-being (p = 0.05. Our findings suggest that clinicians should actively monitor patients for the presence of daytime sleepiness due in part to its potential impact on neurocognitive performance and well-being.

  17. Adjunct modafinil for the short-term treatment of fatigue and sleepiness in patients with major depressive disorder: a preliminary double-blind, placebo-controlled study.

    Science.gov (United States)

    DeBattista, Charles; Doghramji, Karl; Menza, Matthew A; Rosenthal, Murray H; Fieve, Ronald R

    2003-09-01

    Fatigue and sleepiness are primary symptoms of depression that may not resolve with antidepressant therapy. Modafinil is a novel agent that has been shown to improve wakefulness and lessen fatigue in a variety of conditions. In this study, we examined the utility of modafinil as an adjunct therapy to treat fatigue and sleepiness in patients with major depression who are partial responders to antidepressants. Patients with partial response to anti-depressant therapy given for at least a 6-week period for a current major depressive episode (DSM-IV criteria) were enrolled in this 6-week, randomized, double-blind, placebo-controlled, parallel-group, multicenter study. Patients received once-daily doses (100-400 mg) of modafinil or matching placebo as adjunct treatment to ongoing antidepressant therapy. The effects of modafinil were evaluated using the Hamilton Rating Scale for Depression (HAM-D), the Fatigue Severity Scale (FSS), the Epworth Sleepiness Scale (ESS), the Clinical Global Impression of Change (CGI-C), and the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). Adverse events were monitored throughout the study. One hundred thirty-six patients were randomized to treatment, with 118 patients (87%) completing the study. Most patients (82%) were fatigued, and one half of patients (51%) were sleepy. Modafinil rapidly improved fatigue and daytime wakefulness, with significantly greater mean improvements from baseline than placebo in fatigue (FSS) scores at week 2 (p < .05) and sleepiness (ESS) scores at week 1 (p < .01); the differences between modafinil and placebo at week 6 were not statistically significant. Assessment of the augmentation effects of modafinil (HAM-D, CGI-C, and SF-36) did not significantly distinguish modafinil from placebo. Modafinil was well tolerated in combination with a variety of antidepressants. Modafinil may be a useful adjunct therapy for the short-term management of residual fatigue and sleepiness in patients who are

  18. A Clinical-EEG Study of Sleepiness and Psychological Symptoms in Pharmacoresistant Epilepsy Patients Treated with Lacosamide

    Directory of Open Access Journals (Sweden)

    Filippo S. Giorgi

    2013-01-01

    Full Text Available Our aim was to evaluate the EEG and clinical modifications induced by the new antiepileptic drug lacosamide (LCM in patients with epilepsy. We evaluated 10 patients affected by focal pharmacoresistant epilepsy in which LCM (mean 250 mg/day was added to the preexisting antiepileptic therapy, which was left unmodified. Morning waking EEG recording was performed before (t0 and at 6 months (t1 after starting LCM. At t0 and t1, patients were also administered questionnaires evaluating mood, anxiety, sleep, sleepiness, and fatigue (Beck Depression Inventory; State-Trait Anxiety Inventory Y1 and Y2; Pittsburgh Sleep Quality Index; Epworth Sleepiness Scale; Fatigue Severity Scale. We performed a quantitative analysis of EEG interictal abnormalities and background EEG power spectrum analysis. LCM as an add-on did not significantly affect anxiety, depression, sleepiness, sleep quality, and fatigue scales. Similarly, adding LCM to preexisting therapy did not modify significantly patient EEGs in terms of absolute power, relative power, mean frequency, and interictal abnormalities occurrence. In conclusion, in this small cohort of patients, we confirmed that LCM as an add-on does not affect subjective parameters which play a role, among others, in therapy tolerability, and our clinical impression was further supported by evaluation of EEG spectral analysis.

  19. Residual Daytime Sleepiness in Obstructive Sleep Apnea After Continuous Positive Airway Pressure Optimization: Causes and Management.

    Science.gov (United States)

    Chapman, Julia L; Serinel, Yasmina; Marshall, Nathaniel S; Grunstein, Ronald R

    2016-09-01

    Excessive daytime sleepiness (EDS) is common in obstructive sleep apnea (OSA), but it is also common in the general population. When sleepiness remains after continuous positive airway pressure (CPAP) treatment of OSA, comorbid conditions or permanent brain injury before CPAP therapy may be the cause of the residual sleepiness. There is currently no broad approach to treating residual EDS in patients with OSA. Individual assessment must be made of comorbid conditions and medications, and of lifestyle factors that may be contributing to the sleepiness. Modafinil and armodafinil are the only pharmacologic agents indicated for residual sleepiness in these patients.

  20. [Narcolepsy in sleepy obese children. Two case reports].

    Science.gov (United States)

    Rives-Lange, C; Karsenty, A; Chantereau, H; Oderda, L; Dubern, B; Lecendreux, M; Tounian, P

    2016-06-01

    Narcolepsy is a disabling disorder, characterized by excessive daytime sleepiness, irresistible sleep attacks, and partial or complete cataplexy. Many cases of obesity and precocious puberty have been reported in narcoleptic children, suggesting that the deficiency of hypocretin in narcolepsy could also be implicated in appetite stimulation. We report the observations of two young girls, who were referred for obesity and who developed narcolepsy accompanied by an abrupt weight gain. In both cases, specific drugs promoted wakefulness and overweight stabilization. Narcolepsy has to be suspected in sleepy obese children and not misdiagnosed as obstructive apnea. A nocturnal polysomnography with multiple sleep latency tests should be performed to confirm the diagnosis and begin specific treatment that is effective for sleep disorders and weight gain. Copyright © 2016. Published by Elsevier SAS.

  1. Children's Sleep, Sleepiness, and Performance on Cognitive Tasks

    OpenAIRE

    Buckhalt, Joseph A.

    2011-01-01

    While causal connections between sleep deprivation and attention, learning, and memory have been well established in adults, much less research has been done with children. Relations between the amount and quality of sleep and daytime sleepiness have been found for a number of cognitive and academic tasks in several groups of children. These relations have been found for children who have sleep disorders, for children with disorders involving cognitive impairment, and for typically developing...

  2. [Commuting accidents: the influence of excessive daytime sleepiness. A review of an Italian Police officers population].

    Science.gov (United States)

    Garbarino, S; Repice, A M; Traversa, F; Spigno, F; Mascialino, B; Mantineo, G; Ferrillo, F; Bonsignore, A D

    2007-01-01

    Commuting accidents (CA) play an important role in many systems of workers' compensation insurance and with good reason, as they generally bring about more serious consequences in terms of permanent disablement and death than ordinary occupational accidents; this usually leads to high social costs. Nevertheless, research investigations aimed at studying the possible causes underlying the phenomenon are not available in medical literature. Objective of the present study is to evaluate whether excessive daytime sleepiness (EDS) might influence the occurrence of CA. 463 CA occurred to 411 police officers in northern Italy during the period 1999 - 2002 were collected; 51.9% of the subjects were working on shifts, 48.1% were non-shift workers. The study was carried out by submitting a self-administered questionnaire to gather information on age and physical characteristics, working conditions, sleep-related problems and accidents occurrence; EDS was measured by the Epworth Sleepiness Scale (ESS). A large number of workers (36%) complained of EDS; a strict significant relationship between shift - work condition and the presence of EDS was found, thus suggesting that CA are significantly influenced by EDS. The shift work schedule adopted by Italian Police might be accountable for the disruption of the balance between circadian and homeostatic factors.

  3. [Excessive Daytime Sleepiness, Poor Quality Sleep, and Low Academic Performance in Medical Students].

    Science.gov (United States)

    Machado-Duque, Manuel Enrique; Echeverri Chabur, Jorge Enrique; Machado-Alba, Jorge Enrique

    2015-01-01

    Quality of sleep and excessive daytime sleepiness (EDS) affect cognitive ability and performance of medical students. This study attempts to determine the prevalence of EDS, sleep quality, and assess their association with poor academic performance in this population. A descriptive, observational study was conducted on a random sample of 217 medical students from the Universidad Tecnológica de Pereira, who completed the Pittsburgh Sleep Quality Index (PSQI) questionnaire and the Epworth sleepiness scale. Sociodemographic, clinic and academic variables were also measured. Multivariate analyses for poor academic performance were performed. The included students had a mean age of 21.7±3.3 years, of whom 59.4% were men. Almost half (49.8%) had EDS criteria, and 79.3% were poor sleepers (PSQI ≥ 5), while 43.3% had poor academic performance during the last semester. The bivariate analysis showed that having used tobacco or alcohol until intoxicated, fairly bad subjective sleep quality, sleep efficiency < 65%, and being a poor sleeper were associated with increased risk of low performance. Sleep efficiency < 65% was statistically associated with poor academic performance (P=.024; OR = 4.23; 95% CI, 1.12-15.42) in the multivariate analysis. A poor sleep quality determined by low efficiency was related to poor academic achievement at the end of semester in medical students. Copyright © 2015 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  4. Associations of Caffeinated Beverage Consumption and Screen Time with Excessive Daytime Sleepiness in Korean High School Students.

    Science.gov (United States)

    Jun, Nuri; Lee, Aeri; Baik, Inkyung

    2017-01-01

    The present study investigated caffeinated beverage consumption and screen time in the association with excessive daytime sleepiness (EDS) and sleep duration. We conducted a cross-sectional study including 249 Korean male high school students. These participants responded to a questionnaire inquiring the information on lifestyle factors, consumption of caffeinated beverages, time spent for screen media, and sleep duration as well as to the Epworth Sleepiness Scale (ESS) questionnaire. EDS was defined as ESS scores of 9 or greater. Students with EDS consumed greater amount of chocolate/cocoa drinks and spent longer time for a TV and a mobile phone than those without EDS (p students with short sleep (≤ 6 hours) consumed greater amount of coffee than others whereas students with long sleep (> 8 hours) consumed greater amount of chocolate/cocoa drinks than others (p consumption of certain types of caffeinated beverages is associated with EDS and sleep duration. Adolescents may need to reduce screen time and caffeine consumption to improve sleep quality and avoid daytime sleepiness.

  5. Associations of Caffeinated Beverage Consumption and Screen Time with Excessive Daytime Sleepiness in Korean High School Students

    Science.gov (United States)

    2017-01-01

    The present study investigated caffeinated beverage consumption and screen time in the association with excessive daytime sleepiness (EDS) and sleep duration. We conducted a cross-sectional study including 249 Korean male high school students. These participants responded to a questionnaire inquiring the information on lifestyle factors, consumption of caffeinated beverages, time spent for screen media, and sleep duration as well as to the Epworth Sleepiness Scale (ESS) questionnaire. EDS was defined as ESS scores of 9 or greater. Students with EDS consumed greater amount of chocolate/cocoa drinks and spent longer time for a TV and a mobile phone than those without EDS (p sleep (≤ 6 hours) consumed greater amount of coffee than others whereas students with long sleep (> 8 hours) consumed greater amount of chocolate/cocoa drinks than others (p sleep duration. Although these findings do not support causal relationships, they suggest that screen time is associated with EDS, but not with sleep duration, and that consumption of certain types of caffeinated beverages is associated with EDS and sleep duration. Adolescents may need to reduce screen time and caffeine consumption to improve sleep quality and avoid daytime sleepiness. PMID:28168182

  6. Are there differences in students' school success, biorhythm, and daytime sleepiness depending on their school starting times?

    Science.gov (United States)

    Milić, Jakov; Kvolik, Ana; Ivković, Martina; Cikes, Ana Babić; Labak, Irena; Benšic, Mirta; Ilakovac, Vesna; Zibar, Lada; Heffer, Marija

    2014-09-01

    Chronotype is a characteristic of a person in a certain point of one's lifetime and it slowly changes with age. Adolescents start to go to bed later while schools impose early starting hours, which may become a problem for students who are unable to adapt their circadian rhythm. The aim of this study was to determine if differences in school starting times affect the students' chronotype, school success, or daytime sleepiness. We tested a total of 1020 students from four high schools in Osijek, Croatia. The students had alternating school shifts (school starting hours 7 AM or 13 PM and 8 AM or 14 PM, every other week, alternatively, respectively). The participants were tested using the Epworth Sleepiness Scale and the Morningness--Eveningness Questionnaire. Earlier chronotypes were characteristic of the students starting school earlier, but without significant difference in daytime sleepiness in comparison with those starting school later. Differences were also found between different age and gender groups, female and older students having earlier chronotypes. Students going to school earlier showed better school success than the latter. In conclusion, the study shows that students starting school earlier also have earlier chronotypes, which might be consequence of the adaptation to one hour earlier school starting time.

  7. Excessive Daytime Sleepiness among Hypertensive US-Born Blacks and Foreign-Born Blacks: Analysis of the CAATCH Data

    Directory of Open Access Journals (Sweden)

    N. Williams

    2013-01-01

    Full Text Available Background. Evidence shows that blacks exhibit greater daytime sleepiness compared with whites, based on the Epworth Sleepiness Scale. In addition, sleep complaints might differ based on individuals’ country of origin. However, it is not clear whether individuals’ country of origin has any influence on excessive daytime sleepiness (EDS. Study Objectives. We tested the hypothesis that US-born blacks would show a greater level of EDS compared with foreign-born blacks. The potential effects of sociodemographic and medical risk were also determined. Design. We used the Counseling African-Americans to Control Hypertension (CAATCH data. CAATCH is a group randomized clinical trial that was conducted among 30 community healthcare centers in New York, yielding baseline data for 1,058 hypertensive black patients. Results. Results of univariate logistic regression analysis indicated that US-born blacks were nearly twice as likely as their foreign-born black counterparts to exhibit EDS (OR=1.87, 95% CI: 1.30–2.68, P<0.001. After adjusting for effects of age, sex, education, employment, body mass index, alcohol consumption, and smoking habit, US-born blacks were 69% more likely than their counterparts to exhibit EDS (OR=1.69, 95% CI: 1.11–2.57, P<0.01. Conclusion. Findings demonstrate the importance of considering individuals’ country of origin, in addition to their race and ethnicity, when analyzing epidemiologic sleep data.

  8. Sleep hygiene and its association with daytime sleepiness, depressive symptoms, and quality of life in patients with mild obstructive sleep apnea.

    Science.gov (United States)

    Lee, Sang-Ahm; Paek, Joon-Hyun; Han, Su-Hyun

    2015-12-15

    To investigate the direct and indirect associations of sleep hygiene with daytime sleepiness, depressive symptoms, and quality of life (QoL), in newly diagnosed, untreated patients with mild obstructive sleep apnea (OSA). Data were collected from adults with mild OSA. The Sleep Hygiene Index (SHI), Sleep Problems Index-1 (SPI-1) of the Medical Outcomes Study-Sleep Scale, Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI), and Medical Outcomes Study Short-Form Health survey (SF-36) were used to evaluate patients. To determine the indirect and direct associations between SHI and disease outcomes, the Sobel test and multiple linear regression analyses were used, respectively. When we evaluated the direct associations, we excluded 3 items of the original SHI which were more reflective of general health rather than sleep-specific habits and environments. In total, 260 patients with mild OSA participated in this study. The average age, AHI, and SHI scores were 49.1 years (SD 12.5), 9.3/h (SD 2.9), and 24.7 (SD 6.0), respectively. Here, ≥ 10% of participants indicated poor sleep hygiene behaviors on 7 of 13 items. Young age and men were associated with higher SHI scores (both phygiene is indirectly related to daytime sleepiness, depressive symptoms, QoL via sleep quality and also related to daytime sleepiness and QoL independent of sleep quality in mild OSA patients. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. Nocturnal sleep, daytime sleepiness, and quality of life in stable patients on hemodialysis

    Directory of Open Access Journals (Sweden)

    Bliwise Donald L

    2003-11-01

    Full Text Available Abstract Background Although considerable progress has been made in the treatment of chronic kidney disease, compromised quality of life continues to be a significant problem for patients receiving hemodialysis (HD. However, in spite of the high prevalence of sleep complaints and disorders in this population, the relationship between these problems and quality of life remains to be well characterized. Thus, we studied a sample of stable HD patients to explore relationships between quality of life and both subjective and objective measures of nocturnal sleep and daytime sleepiness Methods The sample included forty-six HD patients, 24 men and 22 women, with a mean age of 51.6 (10.8 years. Subjects underwent one night of polysomnography followed the next morning by a Multiple Sleep Latency Test (MSLT, an objective measure of daytime sleepiness. Subjects also completed: 1 a brief nocturnal sleep questionnaire; 2 the Epworth Sleepiness Scale; and, 3 the Quality of Life Index (QLI, Dialysis Version which provides an overall QLI score and four subscale scores for Health & Functioning (H&F, Social & Economic (S&E, Psychological & Spiritual (P&S, and Family (F. (The range of scores is 0 to 30 with higher scores indicating better quality of life. Results The mean (standard deviation; SD of the overall QLI was 22.8 (4.0. The mean (SD of the four subscales were as follows: H&F – 21.1 (4.7; S&E – 22.0 (4.8; P&S – 24.5 (4.4; and, F – 26.8 (3.5. H&F (rs = -0.326, p = 0.013 and F (rs = -0.248, p = 0.048 subscale scores were negatively correlated with periodic limb movement index but not other polysomnographic measures. The H&F subscale score were positively correlated with nocturnal sleep latency (rs = 0.248, p = 0.048 while the H&F (rs = 0.278, p = 0.030 and total QLI (rs = 0.263, p = 0.038 scores were positively associated with MSLT scores. Both of these latter findings indicate that higher life quality is associated with lower sleepiness levels. ESS

  10. Determinants of daytime sleepiness in first-year nursing students: a questionnaire survey.

    Science.gov (United States)

    Huang, Ching-Feng; Yang, Li-Yu; Wu, Li-Min; Liu, Yi; Chen, Hsing-Mei

    2014-06-01

    Daytime sleepiness may affect student learning achievement. Research studies have found that daytime sleepiness is common in university students; however, information regarding the determinants of daytime sleepiness in this population is still lacking. The purpose of this study was to investigate the determinants of daytime sleepiness in first-year nursing students. In particular, we looked for the relationship between perceived symptoms, nocturnal sleep quality, and daytime sleepiness. A cross-sectional and correlational design was employed. Participants were recruited from two nursing programs at an institute of technology located in southern Taiwan. Ninety-three nursing students completed the questionnaires one month after enrollment into their program. Approximately 35% of the participants experienced excessive daytime sleepiness at the beginning of the semester. Six variables (joining a student club, perceived symptoms, daytime dysfunction, sleep disturbances, sleep latency, and subjective sleep quality) were significantly correlated with daytime sleepiness. Among them, daytime dysfunction and perceived symptoms were two major determinants of daytime sleepiness, both accounting for 37.2% of the variance. Daytime sleepiness in students should not be ignored. It is necessary to help first-year students identify and mitigate physical and psychological symptoms early on, as well as improve daytime functioning, to maintain their daytime performance and promote learning achievement. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Subjective symptoms in idiopathic hypersomnia: beyond excessive sleepiness.

    Science.gov (United States)

    Vernet, Cyrille; Leu-Semenescu, Smaranda; Buzare, Marie-Annick; Arnulf, Isabelle

    2010-12-01

    Patients with idiopathic hypersomnia never feel fully alert despite a normal or long sleep night. The spectrum of the symptoms is insufficiently studied. We interviewed 62 consecutive patients with idiopathic hypersomnia (with a mean sleep latency lower than 8 min or a sleep time longer than 11 h) and 50 healthy controls using a questionnaire on sleep, awakening, sleepiness, alertness and cognitive, psychological and functional problems during daily life conditions. Patients slept 3 h more on weekends, holidays and in the sleep unit than on working days. In the morning, the patients needed somebody to wake them, or to be stressed, while routine, light, alarm clocks and motivation were inefficient. Three-quarters of the patients did not feel refreshed after short naps. During the daytime, their alertness was modulated by the same external conditions as controls, but they felt more sedated in darkness, in a quiet environment, when listening to music or conversation. Being hyperactive helped them more than controls to resist sleepiness. They were more frequently evening-type and more alert in the evening than in the morning. The patients were able to focus only for 1 h (versus 4 h in the controls). They complained of attention and memory deficit. Half of them had problems regulating their body temperature and were near-sighted. Mental fatigability, dependence on other people for awakening them, and a reduced benefit from usually alerting conditions (except being hyperactive or stressed) seem to be more specific of the daily problems of patients with idiopathic hypersomnia than daytime sleepiness. © 2010 European Sleep Research Society.

  12. Improvement in Fatigue, Sleepiness, and Health-Related Quality of Life with Bright Light Treatment in Persons with Seasonal Affective Disorder and Subsyndromal SAD

    Directory of Open Access Journals (Sweden)

    Cecilia Rastad

    2011-01-01

    Full Text Available Objective. To investigate the effects of bright light treatment for secondary outcome measures and to explore and validate empirically derived subgroups and treatment effects in subgroups. Methods. A descriptive design. A sample of forty-nine persons (mean age of 45.8 with clinically assessed seasonal affective disorder (SAD or subsyndromal SAD (S-SAD participated in a two-group clinical trial evaluating the effects of treatment with bright light therapy. A person-oriented cluster analysis was applied to study treatment effects in subgroups. Results. For the merged group, sleepiness (Epworth Sleepiness Scale, fatigue (fatigue questionnaire, and health-related quality of life (SF-36 were improved at posttreatment, and results were maintained at the one-month followup. Three distinct subgroups had a high level of fatigue in common, while the level of excessive daytime sleepiness and depressed mood differed between the subgroups. Over time, all subgroups improved following ten days treatment in a light room. Conclusion. Fatigue, excessive daytime sleepiness, and health-related quality of life improve in a similar way as depressed mood following treatment with bright light. The treatment was effective irrespective of the severity of the disorder, that is, for persons with SAD and subsyndromal SAD.

  13. Normal levels of cerebrospinal fluid hypocretin-1 and daytime sleepiness during attacks of relapsing-remitting multiple sclerosis and monosymptomatic optic neuritis

    DEFF Research Database (Denmark)

    Knudsen, S; Jennum, P J; Korsholm, K

    2008-01-01

    There is emerging evidence that multiple sclerosis (MS), the hypothalamic sleep-wake regulating neuropeptide hypocretin-1 (hcrt-1) and the sleep disorder narcolepsy may be connected. Thus, the major pathophysiological component of narcolepsy is lack of hcrt-1. Dysfunction of the hypocretin system...... has been reported in MS case reports with attacks of hypothalamic lesions, undetectable cerebrospinal fluid (CSF) hcrt-1 and hypersomnia, but not found during remission in small samples. Finally, daytime sleepiness, the major symptom of narcolepsy, is reported in several MS populations......, and there are case reports of co-existent narcolepsy and MS. However, it is unknown whether hcrt-1 and daytime sleepiness generally change during MS attacks. We therefore analyzed whether daytime sleepiness (using the Epworth Sleepiness Scale (ESS)) and CSF hcrt-1 levels differed between MS attack and remission......, in 48 consecutively referred patients with relapsing-remitting MS (RRMS) or monosymptomatic optic neuritis (MON). Twenty-seven patients were in attack and 21 in remission. ESS was normal both during attacks (5.4 +/- 3.0) and remission (5.8 +/- 2.6), and mean CSF hcrt-1 was normal (456 +/- 41 pg...

  14. Effects of armodafinil and cognitive behavior therapy for insomnia on sleep continuity and daytime sleepiness in cancer survivors.

    Science.gov (United States)

    Garland, Sheila N; Roscoe, Joseph A; Heckler, Charles E; Barilla, Holly; Gehrman, Philip; Findley, James C; Peoples, Anita R; Morrow, Gary R; Kamen, Charles; Perlis, Michael L

    2016-04-01

    This study involves the analysis of a secondary outcome of a trial examining whether cognitive behavior therapy for insomnia (CBT-I), a wake-promoting medication (armodafinil), or both results in greater improvement in prospectively assessed sleep continuity and daytime sleepiness than a placebo-alone group among a heterogeneous group of cancer survivors. Whether or not armodafinil alone, and/or when combined with CBT-I, affected adherence with CBT-I was evaluated. This study is a randomized, placebo-controlled, clinical trial. This study was conducted at two northeastern academic medical centers. Eighty-eight cancer survivors with chronic insomnia were recruited between October 2008 and November 2012. Participants were assigned to one of four conditions: 1) CBT-I and placebo (CBT-I+P); 2) CBT-I and armodafinil (CBT-I + A); 2) armodafinil alone (ARM); or 4) placebo alone (PLA). CBT-I was delivered in seven weekly individual therapy sessions (three in person, four via telephone). The armodafinil dosage was 50 mg BID. Sleep continuity was measured with daily sleep diaries assessing sleep latency (SL), wake after sleep onset (WASO), and total sleep time (TST). The Epworth Sleepiness Scale (ESS) measured daytime sleepiness. Compared to the PLA group, the CBT-I+P and CBT-I+A groups reported a significant reduction in SL with effect sizes of 0.67 and 0.58, respectively. A significant reduction was observed in WASO in the CBT-I+A group with an effect size of 0.64. An increasing trend of TST was observed in the CBT-I+P, CBT-I+A, and PLA groups, but not in the ARM group. No statistically significant reductions in daytime sleepiness (ESS) were observed for any of the groups. CBT-I alone and in combination with armodafinil caused significant improvement in sleep continuity. The addition of armodafinil did not appear to improve daytime sleepiness or enhance adherence to CBT-I. Copyright © 2015 Elsevier B.V. All rights reserved.

  15. Excessive daytime sleepiness and body composition: a population-based study of adults.

    Directory of Open Access Journals (Sweden)

    Amie C Hayley

    Full Text Available BACKGROUND: Excessive daytime sleepiness (EDS is often associated with increased adiposity, particularly when assessed in the context of samples of sleep-disordered patients; however, it is unclear if this relationship is sustained among non-clinical, population-based cohorts. This study aimed to investigate the relationship between EDS and a number of body composition markers among a population-based sample of men and women. METHODS: This study assessed 1066 women aged 21-94 yr (median = 51 yr, IQR 35-66, and 911 men aged 24-92 yr (median = 60 yr, IQR 46-73 who participated in the Geelong Osteoporosis Study (GOS between the years 2001 and 2008. Total body fat mass was determined from whole body dual-energy X-ray absorptiometry scans, and anthropometric parameters (weight, height, and waist circumference were measured. Lifestyle and health information was collected via self-report. Sleepiness was assessed using the Epworth Sleepiness Scale (ESS. Scores of ≥ 10 were considered indicative of EDS. RESULTS: Women: After adjusting for age, alcohol intake, antidepressant medication use and physical activity, EDS was associated with greater waist circumference and body mass index (BMI. EDS was also associated with 1.5-1.6-fold increased odds of being overweight or obese. Men: After adjusting for age, alcohol use, physical activity and smoking status, EDS was associated with greater BMI. These findings were not explained by the use of sedative or antidepressant medication. EDS was also associated with 1.5-fold increased likelihood of being obese, independent of these factors. No differences in lean mass, %body fat, or %lean mass were detected between those with and without EDS for men or women. CONCLUSIONS: These data suggest that EDS is associated with several anthropometric adiposity profiles, independent of associated lifestyle and health factors. Among women, symptoms of EDS are pervasive at both overweight and obese BMI classifications

  16. Excessive daytime sleepiness and metabolic syndrome: a cross-sectional study.

    Science.gov (United States)

    Hayley, Amie C; Williams, Lana J; Kennedy, Gerard A; Berk, Michael; Brennan, Sharon L; Pasco, Julie A

    2015-02-01

    Excessive daytime sleepiness (EDS) has been associated with singular independent symptoms of metabolic syndrome, such as insulin resistance and diabetes. The aim of this study was to assess whether this relationship is sustained among individuals who meet criteria for the whole syndrome. 994 Women aged 21-94 years (median 50.2 years, IQR 34-65) and 840 men aged 24-92 years (median 60.4 years, IQR 47-73) who resided in the Barwon Statistical Division, South-Eastern Australia, and participated in the Geelong Osteoporosis Study (GOS) between the years of 2001 and 2008. Anthropometric measurements, lifestyle, mood, demographic and health-related factors were obtained. Sleep duration was categorized as short (9 h). Sleepiness was assessed using the Epworth Sleepiness Scale (ESS), and scores of ≥ 10 indicated EDS. The presence of metabolic syndrome was assessed using a modified version of criteria as outlined by the International Diabetics Federations recommendations (2005). Women: 138 (14.0%) of the women reported EDS; those with EDS were heavier, had a greater body mass index (BMI) and were more likely to have metabolic syndrome. The association between EDS and metabolic syndrome was sustained following adjustment for age and hours sleep (adjusted OR=1.90, 95% CI 1.16-3.09), however BMI attenuated the relationship (adjusted OR=1.64, 95% CI =1.05-2.57). These findings were independent of smoking status, alcohol intake, medication use, socioeconomic status, physical activity and current diagnosis of a depressive illness. Men: 111 (13.2%) of the men reported EDS; those with EDS had a greater waist circumference and were more likely to have metabolic syndrome. Analysis of age-stratified data (metabolic syndrome (OR=1.71, 95% CI 1.01-2.92), however, age explained this association (age adjusted OR=1.51, 95% CI 0.88-2.60). In the younger age group, no association was detected between EDS and metabolic syndrome. For both men and women, the prevalence of combined EDS and

  17. Sleep patterns and sleepiness of working college students.

    Science.gov (United States)

    Teixeira, Liliane; Lowden, Arne; da Luz, Andrea Aparecida; Turte, Samantha Lemos; Valente, Daniel; Matsumura, Roberto Jun; de Paula, Leticia Pickersgill; Takara, Meire Yuri; Nagai-Manelli, Roberta; Fischer, Frida Marina

    2012-01-01

    The double journey (work and study) may result or aggravate health problems, including sleep disturbances, as observed in previous studies with high school students. The aim of this study is to analyze the sleep-wake cycle and perceived sleepiness of working college students during weekdays. Twenty-three healthy college male students, 21-24 years old, working during the day and attending classes in the evening, participated in this study. During five consecutive days, the students filled out daily activities logs and wore actigraphs. Mean sleeping time was lower than 6 hours per night. No significant differences were observed in the sleep-wake cycle during the weekdays. The observed lack of changes in the sleepwake cycle of these college students might occur as participants were not on a free schedule, but exposed to social constraints, as was the regular attendance to evening college and day work activities. Sleepiness worsened over the evening school hours. Those results show the burden carried by College students who perform double activities - work and study.

  18. The Defense Committees of Sleepy Lagoon: A Convergent Struggle against Fascism, 1942-1944

    Science.gov (United States)

    Barajas, Frank P.

    2006-01-01

    The Sleepy Lagoon Defense Committee originated as an ad hoc committee and evolved to a broad-based movement for legal justice on behalf of seventeen youth convicted of murder and assault charges in connection with the Sleepy Lagoon case in Los Angeles in January 1943. This essay chronicles the multidimensional organizing to shift public opinion in…

  19. The Defense Committees of Sleepy Lagoon: A Convergent Struggle against Fascism, 1942-1944

    Science.gov (United States)

    Barajas, Frank P.

    2006-01-01

    The Sleepy Lagoon Defense Committee originated as an ad hoc committee and evolved to a broad-based movement for legal justice on behalf of seventeen youth convicted of murder and assault charges in connection with the Sleepy Lagoon case in Los Angeles in January 1943. This essay chronicles the multidimensional organizing to shift public opinion in…

  20. Sleep length and quality, sleepiness and urinary melatonin among healthy Danish nurses with shift work during work and leisure time

    DEFF Research Database (Denmark)

    Garde, Anne Helene; Hansen, Åse Marie; Hansen, Johnni

    2009-01-01

    Sleep problems are common effects of shift work. The aim of the present study was to evaluate how different types of shift affect sleep and sleepiness, and to relate sleepiness to urinary 6-sulfatoxymelatonin....

  1. Children's Sleep, Sleepiness, and Performance on Cognitive Tasks.

    Science.gov (United States)

    Buckhalt, Joseph A

    2011-01-01

    While causal connections between sleep deprivation and attention, learning, and memory have been well established in adults, much less research has been done with children. Relations between the amount and quality of sleep and daytime sleepiness have been found for a number of cognitive and academic tasks in several groups of children. These relations have been found for children who have sleep disorders, for children with disorders involving cognitive impairment, and for typically developing children with no known disorders. The research is reviewed here with a focus on the types of cognitive and academic tasks that have been related to insufficient sleep. A series of studies is described that relates sleep parameters to the Woodcock-Johnson® III Tests of Cognitive Abilities and other, similar measures. Implications for educators and psychologists who work with children are discussed.

  2. Sonolência diurna excessiva em trabalhadores da área de enfermagem Excessive daytime sleepiness in nursing workers

    Directory of Open Access Journals (Sweden)

    José Carlos Souza

    2007-01-01

    Full Text Available OBJETIVO: A sonolência diurna excessiva (SDE caracteriza-se por episódios de sono em situações em que o indivíduo deveria estar acordado. Objetivou-se detectar a prevalência de SDE em trabalhadores da área de enfermagem. MÉTODOS: Fez-se um estudo, descritivo e de corte transversal em 226 trabalhadores de enfermagem de um hospital público de Campo Grande, MS. Foi aplicada a Escala de Sonolência de Epworth (ESE. RESULTADOS: Foi encontrada uma prevalência de 30,09% de SDE. Não foram detectadas relações entre SDE e gênero, idade, trabalho em turnos, uso de hipnóticos; 27,64% trabalhavam em turnos fixos e 32% alternados. CONCLUSÕES: Foi alta a prevalência de SDE em trabalhadores da área de enfermagem na amostra avaliada. Sugere-se que medidas sejam tomadas para uma abordagem adequada deste transtorno neste grupo.OBJETIVE: Excessive daytime sleepiness (EDS is characterized by episodes of naps or moments of sleep in situations where the individual should be awake. The objective was to detect the prevalence of EDS in nursing professionals. METHODS: A transverse study was carried out, descriptive, in 226 workers in the nursing in a public hospital in Campo Grande, Mato Grosso do Sul. The Epworth Sleepiness Scale (ESS was applied. RESULTS: It was found a prevalence of 30,09% of sleepiness. No connection was detected in the occurrence of EDS between the sexes, ages, shift work and use of hypnotics. 27,64% worked in fixed shift and 32,00% in alternating shift. CONCLUSIONS: The prevalence of EDS manifested among nursing professionals was shown to be high. Steps should be taken to provide treatment for this disturbance.

  3. Sleep Disruption and Daytime Sleepiness Correlating with Disease Severity and Insulin Resistance in Non-Alcoholic Fatty Liver Disease: A Comparison with Healthy Controls.

    Directory of Open Access Journals (Sweden)

    Christine Bernsmeier

    Full Text Available Sleep disturbance is associated with the development of obesity, diabetes and hepatic steatosis in murine models. Hepatic triglyceride accumulation oscillates in a circadian rhythm regulated by clock genes, light-dark cycle and feeding time in mice. The role of the sleep-wake cycle in the pathogenesis of human non-alcoholic fatty liver disease (NAFLD is indeterminate. We sought to detail sleep characteristics, daytime sleepiness and meal times in relation to disease severity in patients with NAFLD.Basic Sleep duration and latency, daytime sleepiness (Epworth sleepiness scale, Pittsburgh sleep quality index, positive and negative affect scale, Munich Chronotype Questionnaire and an eating habit questionnaire were assessed in 46 patients with biopsy-proven NAFLD and 22 healthy controls, and correlated with biochemical and histological parameters.In NAFLD compared to healthy controls, time to fall asleep was vastly prolonged (26.9 vs. 9.8 min., p = 0.0176 and sleep duration was shortened (6.3 vs. 7.2 hours, p = 0.0149. Sleep quality was poor (Pittsburgh sleep quality index 8.2 vs. 4.7, p = 0.0074 and correlated with changes in affect. Meal frequency was shifted towards night-times (p = 0.001. In NAFLD but not controls, daytime sleepiness significantly correlated with liver enzymes (ALAT [r = 0.44, p = 0.0029], ASAT [r = 0.46, p = 0.0017] and insulin resistance (HOMA-IR [r = 0.5, p = 0.0009] independent of cirrhosis. In patients with fibrosis, daytime sleepiness correlated with the degree of fibrosis (r = 0.364, p = 0.019.In NAFLD sleep duration was shortened, sleep onset was delayed and sleep quality poor. Food-intake was shifted towards the night. Daytime sleepiness was positively linked to biochemical and histologic surrogates of disease severity. The data may indicate a role for sleep-wake cycle regulation and timing of food-intake in the pathogenesis of human NAFLD as suggested from murine models.

  4. Driver sleepiness and risk of serious injury to car occupants: population based case control study

    Science.gov (United States)

    Connor, Jennie; Norton, Robyn; Ameratunga, Shanthi; Robinson, Elizabeth; Civil, Ian; Dunn, Roger; Bailey, John; Jackson, Rod

    2002-01-01

    Objectives To estimate the contribution of driver sleepiness to the causes of car crash injuries. Design Population based case control study. Setting Auckland region of New Zealand, April 1998 to July 1999. Participants 571 car drivers involved in crashes where at least one occupant was admitted to hospital or killed (“injury crash”); 588 car drivers recruited while driving on public roads (controls), representative of all time spent driving in the study region during the study period. Main outcome measures Relative risk for injury crash associated with driver characteristics related to sleep, and the population attributable risk for driver sleepiness. Results There was a strong association between measures of acute sleepiness and the risk of an injury crash. After adjustment for major confounders significantly increased risk was associated with drivers who identified themselves as sleepy (Stanford sleepiness score 4-7 v 1-3; odds ratio 8.2, 95% confidence interval 3.4 to 19.7); with drivers who reported five hours or less of sleep in the previous 24 hours compared with more than five hours (2.7, 1.4 to 5.4); and with driving between 2 am and 5 am compared with other times of day (5.6, 1.4 to 22.7). No increase in risk was associated with measures of chronic sleepiness. The population attributable risk for driving with one or more of the acute sleepiness risk factors was 19% (15% to 25%). Conclusions Acute sleepiness in car drivers significantly increases the risk of a crash in which a car occupant is injured or killed. Reductions in road traffic injuries may be achieved if fewer people drive when they are sleepy or have been deprived of sleep or drive between 2 am and 5 am. What is already known on this topicDriver sleepiness is considered a potentially important risk factor for car crashes and related injuries but the association has not been reliably quantifiedPublished estimates of the proportion of car crashes attributable to driver sleepiness vary from

  5. Ocular anatomy and retinal photoreceptors in a skink, the sleepy lizard (Tiliqua rugosa).

    Science.gov (United States)

    New, Shaun T D; Hemmi, Jan M; Kerr, Gregory D; Bull, C Michael

    2012-10-01

    The Australian sleepy lizard (Tiliqua rugosa) is a large day-active skink which occupies stable overlapping home ranges and maintains long-term monogamous relationships. Its behavioral ecology has been extensively studied, making the sleepy lizard an ideal model for investigation of the lizard visual system and its specializations, for which relatively little is known. We examine the morphology, density, and distribution of retinal photoreceptors and describe the anatomy of the sleepy lizard eye. The sleepy lizard retina is composed solely of photoreceptors containing oil droplets, a characteristic of cones. Two groups could be distinguished; single cones and double cones, consistent with morphological descriptions of photoreceptors in other diurnal lizards. Although all photoreceptors were cone-like in morphology, a subset of photoreceptors displayed immunoreactivity to rhodopsin-the visual pigment of rods. This finding suggests that while the morphological properties of rod photoreceptors have been lost, photopigment protein composition has been conserved during evolutionary history.

  6. Excessive Daytime Sleepiness and Epilepsy: A Systematic Review

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    Andre S. Giorelli

    2013-01-01

    Full Text Available Background. Sleep complaints are common in patients with epilepsy (PWE. Excessive daytime sleepiness (EDS is one of the most reported complaints and its impact is still a matter of debate. Objective. Evaluate the relationship between EDS and epilepsy, with emphasis on prevalence, assessment, and causes. Methods. A systematic review on PubMed database in the last 10 years (2002 to 2012. The search returned 53 articles and 34 were considered relevant. After citation analysis, 3 more articles were included. Results. Most studies were cross-sectional and questionnaire based. 14 papers addressed EDS as the primary endpoint. 14 adult and 3 children studies used subjective and objective analysis as methodology. The number of studies increased throughout the decade, with 21 in the last 5 years. Adult studies represent almost three times the number of children studies. EDS prevalence in PWE varies from 10 to 47.5%. Prevalence was higher in developing countries. Conclusion. EDS seems to be related more frequently to undiagnosed sleep disorders than to epilepsy-related factors, and although it affects the quality of life of PWE, it can be improved by treating comorbid primary sleep disorders.

  7. Excessive daytime sleepiness and epilepsy: a systematic review.

    Science.gov (United States)

    Giorelli, Andre S; Passos, Pâmela; Carnaval, Thiago; Gomes, Marleide da Mota

    2013-01-01

    Background. Sleep complaints are common in patients with epilepsy (PWE). Excessive daytime sleepiness (EDS) is one of the most reported complaints and its impact is still a matter of debate. Objective. Evaluate the relationship between EDS and epilepsy, with emphasis on prevalence, assessment, and causes. Methods. A systematic review on PubMed database in the last 10 years (2002 to 2012). The search returned 53 articles and 34 were considered relevant. After citation analysis, 3 more articles were included. Results. Most studies were cross-sectional and questionnaire based. 14 papers addressed EDS as the primary endpoint. 14 adult and 3 children studies used subjective and objective analysis as methodology. The number of studies increased throughout the decade, with 21 in the last 5 years. Adult studies represent almost three times the number of children studies. EDS prevalence in PWE varies from 10 to 47.5%. Prevalence was higher in developing countries. Conclusion. EDS seems to be related more frequently to undiagnosed sleep disorders than to epilepsy-related factors, and although it affects the quality of life of PWE, it can be improved by treating comorbid primary sleep disorders.

  8. Excessive Daytime Sleepiness in Stroke Survivors: An Integrative Review.

    Science.gov (United States)

    Ding, Qinglan; Whittemore, Robin; Redeker, Nancy

    2016-07-01

    Excessive daytime sleepiness (EDS) is a prevalent symptom among stroke survivors. This symptom is an independent risk factor for stroke and may reduce stroke survivors' quality of life, cognitive functioning, and daytime functional performance. The lack of a universally accepted definition of EDS makes it difficult to measure EDS and synthesize research. The purpose of this integrative review is to describe poststroke EDS, ascertain conceptual and operational definitions of EDS, identify factors that contribute to EDS in stroke survivors, and explore outcomes associated with EDS in stroke survivors. We searched the following databases: PubMed and MEDLINE (OvidSP 1946-April; Week 2, 2015), Embase (OvidSP 1974-March; Week 1, 2015), and PsycINFO (OvidSP 1967-April; Week 2, 2015). Our search yielded 340 articles, 27 of which met inclusion criteria. The literature reveals EDS to be a multidimensional construct that is operationalized with both subjective and objective measures. Choosing measures that can quantify both the objective and subjective components is useful for gaining a comprehensive understanding of EDS. The antecedents of EDS are stroke, sleep-disordered breathing, reversed Robin Hood syndrome, and depression. The outcomes associated with EDS in stroke patients are serious and negative. Via synthesis of this research, we propose a possible framework for poststroke EDS, which may be of use in clinical practice and in research to identify valid quantifying methods for EDS as well as to prevent harmful outcomes in stroke survivors. © The Author(s) 2016.

  9. Traffic crash accidents in Tehran, Iran: Its relation with circadian rhythm of sleepiness.

    Science.gov (United States)

    Sadeghniiat-Haghighi, Khosro; Yazdi, Zohreh; Moradinia, Mohsen; Aminian, Omid; Esmaili, Alireza

    2015-01-01

    Road traffic accidents are one of main problems in Iran. Multiple factors cause traffic accidents and the most important one is sleepiness. This factor, however, is given less attention in our country. Road traffic accidents relevant to sleepiness are studied. In this cross-sectional study, all road traffic accidents relevant to sleepiness, which were reported by police, were studied in Tehran province in 2009. The risk of road traffic accidents due to sleepiness was increased by more than sevenfold (odds ratio = 7.33) in low alertness hours (0:00-6:00) compared to other time of day. The risk of road traffic accidents due to sleepiness was decreased by 0.15-fold (odds ratio = 0.15) in hours with maximum of alertness (18:00-22:00) of circadian rhythm compared to other time of day. The occurrence of road traffic accidents due to sleepiness has significant statistical relations with driving during lowest point of alertness of circadian rhythm.

  10. Traffic crash accidents in Tehran, Iran: Its relation with circadian rhythm of sleepiness

    Institute of Scientific and Technical Information of China (English)

    Khosro Sadeghniiat-Haghighi; Zohreh Yazdi; Mohsen Moradinia; Omid Aminian; Alireza Esmaili

    2015-01-01

    Purpose:Road traffic accidents are one of main problems in Iran.Multiple factors cause traffic accidents and the most important one is sleepiness.This factor,however,is given less attention in our country.Road traffic accidents relevant to sleepiness are studied.Methods:In this cross-sectional study,all road traffic accidents relevant to sleepiness,which were reported by police,were studied in Tehran province in 2009.Results:The risk of road traffic accidents due to sleepiness was increased by more than sevenfold (odds ratio =7.33) in low alertness hours (0:00-6:00) compared to other time of day.The risk of road traffic accidents due to sleepiness was decreased by 0.15-fold (odds ratio-0.15) in hours with maximum of alertness (18:00-22:00) of circadian rhythm compared to other time of day.Conclusion:The occurrence of road traffic accidents due to sleepiness has significant statistical relations with driving during lowest point of alertness of circadian rhythm.

  11. Stress vulnerability and the effects of moderate daily stress on sleep polysomnography and subjective sleepiness.

    Science.gov (United States)

    Petersen, Helena; Kecklund, Göran; D'Onofrio, Paolo; Nilsson, Jens; Åkerstedt, Torbjörn

    2013-02-01

    The purpose of this study was to investigate if and how sleep physiology is affected by naturally occurring high work stress and identify individual differences in the response of sleep to stress. Probable upcoming stress levels were estimated through weekly web questionnaire ratings. Based on the modified FIRST-scale (Ford insomnia response to stress) participants were grouped into high (n = 9) or low (n = 19) sensitivity to stress related sleep disturbances (Drake et al., 2004). Sleep was recorded in 28 teachers with polysomnography, sleep diaries and actigraphs during one high stress and one low stress condition in the participants home. EEG showed a decrease in sleep efficiency during the high stress condition. Significant interactions between group and condition were seen for REM sleep, arousals and stage transitions. The sensitive group had an increase in arousals and stage transitions during the high stress condition and a decrease in REM, whereas the opposite was seen in the resilient group. Diary ratings during the high stress condition showed higher bedtime stress and lower ratings on the awakening index (insufficient sleep and difficulties awakening). Ratings also showed lower cognitive function and preoccupation with work thoughts in the evening. KSS ratings of sleepiness increased during stress for the sensitive group. Saliva samples of cortisol showed no effect of stress. It was concluded that moderate daily stress is associated with a moderate negative effect on sleep sleep efficiency and fragmentation. A slightly stronger effect was seen in the sensitive group. © 2012 European Sleep Research Society.

  12. Parent Report and Actigraphically Defined Sleep in Children with and without Developmental Coordination Disorder; Links with Fatigue and Sleepiness

    Directory of Open Access Journals (Sweden)

    Luci Wiggs

    2016-08-01

    Full Text Available Background: Impaired sleep is associated with negative effects on quality of life and daytime functioning. Higher rates of sleep disturbance are reported in children with various developmental disorders. However, little is known about sleep in children with Developmental Coordination Disorder (DCD, a condition characterized by everyday movement difficulties. Previously, in a preliminary study, we found higher rates of parent-reported sleep disturbance in children with DCD compared to controls. Aims: To examine sleep in DCD using objective measures and to examine links with daytime fatigue and sleepiness. Methods: Two groups (primary and secondary school-aged of 15 children with DCD, plus matched controls, participated. Parent reported child sleep was assessed using the Children’s Sleep Habits Questionnaire and actigraphy provided an objective measure of sleep-wake patterns over one week (including weekdays and weekend. Pediatric Restless Legs Syndrome (RLS Semi-Structured Diagnostic Interview was conducted with each child and parent to capture symptoms of RLS. Aspects of self-rated child functioning were assessed with questionnaires (Pre-sleep Arousal Scale, Pediatric Daytime Sleepiness Scale, PedsQL Multidimensional Fatigue Scale and mothers’ reported thoughts about child sleep with the Maternal Cognitions about Infant Sleep Questionnaire.Results: The DCD groups had greater parent-reported sleep disturbance. Actigraphy results suggested that for secondary aged children with DCD their sleep quality was impaired and there were differences in the timing of sleep compared to controls (including some differences in the variation between weekday and weekend sleep times. The actigraphy of the primary age group with DCD was unremarkable compared to controls. No child in the study met the criteria for RLS. Exploratory analyses suggested that daytime fatigue, aspects of pre-sleep arousal and daytime sleepiness were reported as greater in the DCD

  13. Disrupted sleep without sleep curtailment induces sleepiness and cognitive dysfunction via the tumor necrosis factor-α pathway

    OpenAIRE

    Ramesh Vijay; Nair Deepti; Zhang Shelley X L; Hakim Fahed; Kaushal Navita; Kayali Foaz; Wang Yang; Li Richard C; Carreras Alba; Gozal David

    2012-01-01

    Abstract Background Sleepiness and cognitive dysfunction are recognized as prominent consequences of sleep deprivation. Experimentally induced short-term sleep fragmentation, even in the absence of any reductions in total sleep duration, will lead to the emergence of excessive daytime sleepiness and cognitive impairments in humans. Tumor necrosis factor (TNF)-α has important regulatory effects on sleep, and seems to play a role in the occurrence of excessive daytime sleepiness in children who...

  14. Conjoint influence of mind-wandering and sleepiness on task performance.

    Science.gov (United States)

    Stawarczyk, David; D'Argembeau, Arnaud

    2016-10-01

    Recent research suggests that sleepiness and mind-wandering-the experience of thoughts that are both stimulus-independent and task-unrelated-frequently co-occur and are both associated with poorer cognitive functioning. Whether these two phenomena have distinguishable effects on task performance remains unknown, however. To investigate this question, we used the online experience sampling of mind-wandering episodes and subjective sleepiness during a laboratory task (the Sustained Attention to Response Task; SART), and also assessed mind-wandering frequency and sleep-related disturbances in daily life using self-report questionnaires. The results revealed that the tendency to experience mind-wandering episodes during the SART and daily life was associated with higher levels of daytime sleepiness and sleep-related disturbances. More important, however, mind-wandering and sleepiness were independent predictors of SART performance at both the within- and between-individuals levels. These findings demonstrate that, although mind-wandering and sleepiness frequently co-occur, these two phenomena have distinguishable and additive effects on task performance. (PsycINFO Database Record

  15. Excessive Daytime Sleepiness and Unintended Sleep Episodes Associated with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Fatai Salawu

    2015-01-01

    Full Text Available This article looks at the issues of excessive daytime sleepiness and unintended sleep episodes in patients with Parkinson’s disease (PD and explores the reasons why patients might suffer from these symptoms, and what steps could be taken to manage them. During the last decade, understanding of sleep/wake regulation has increased. Several brainstem nuclei and their communication pathways in the ascending arousing system through the hypothalamus and thalamus to the cortex play key roles in sleep disorders. Insomnia is the most common sleep disorder in PD patients, and excessive daytime sleepiness is also common. Excessive daytime sleepiness affects up to 50% of PD patients and a growing body of research has established this sleep disturbance as a marker of preclinical and premotor PD. It is a frequent and highly persistent feature in PD, with multifactorial underlying pathophysiology. Both age and disease-related disturbances of sleep-wake regulation contribute to hypersomnia in PD. Treatment with dopamine agonists also contribute to excessive daytime sleepiness. Effective management of sleep disturbances and excessive daytime sleepiness can greatly improve the quality of life for patients with PD.

  16. Recent advances in the treatment and management of excessive daytime sleepiness.

    Science.gov (United States)

    Black, Jed; Duntley, Stephen P; Bogan, Richard K; O'Malley, Mary B

    2007-02-01

    Excessive daytime sleepiness (EDS) is a prevalent complaint among patients in psychiatric care. Patients with conditions of EDS have often been misdiagnosed with depression due to their complaints of lack of energy, poor concentration, memory disturbance, and a reduced interest in life. Impaired alertness associated with EDS can be detrimental to a person's quality of life by causing decreased work performance, self-consciousness, low self esteem, and social isolation. Excessive sleepiness is also associated with various health problems, comorbid medical and psychiatric conditions, and fatal accidents occurring after the driver has fallen asleep at the wheel. Contributing factors leading to EDS range from insufficient sleep hours to central nervous system-mediated debilitating hypersomnolence. Circadian rhythm disorders, sleep disorders such as obstructive sleep apnea and narcolepsy, and medications that cause sleepiness may also contribute to symptoms of EDS. Recognition of the symptoms of sleep deprivation is essential, as many such patients do not have a clear awareness of their own sleepiness. Treatment options, depending upon the condition, include light therapy or appropriate airway management techniques such as nasal continuous positive airway pressure (CPAP). Occasionally, wakefulness-promoting medications are necessary, particularly in patients with narcolepsy. In this expert roundtable supplement, Stephen P. Duntley, MD, reviews the definition and prevalence of EDS and discusses the contributing factors and consequences of daytime sleepiness. Next, Richard K. Bogan, MD, FCCP, gives an overview of the differential diagnosis of EDS and the assessment tools available for identifying sleepiness in symptomatic patients. Finally, Mary B. O'Malley, MD, PhD, reviews treatment of EDS, including counseling on sleep hygiene and duration of sleep, mechanical treatments, bright-light therapy, and wake-promoting medications.

  17. Chronic headaches and sleepiness caused by facial soap (containing hydrolyzed wheat proteins)-induced wheat allergy.

    Science.gov (United States)

    Iseki, Chifumi; Kawanami, Toru; Tsunoda, Takahiko; Chinuki, Yuko; Kato, Takeo

    2014-01-01

    A 38-year-old woman was suffering from irregular headaches and sleepiness. She had used soap containing Glupearl 19S (hydrolyzed wheat proteins) every day for approximately one year and had experienced an episode of rash eruption on her face seven months ago. Wheat-specific IgE antibodies were detected in her serum. A Western blot analysis revealed a high titer of IgE antibodies against Glupearl 19S and wheat proteins. The patient was sensitive to these compounds in a skin prick test. After avoiding eating wheat, her headaches and sleepiness disappeared. A hidden food allergy is a possible cause of these symptoms.

  18. Sleep and sleepiness among first-time postpartum parents: a field- and laboratory-based multimethod assessment.

    Science.gov (United States)

    Insana, Salvatore P; Montgomery-Downs, Hawley E

    2013-05-01

    The study aim was to compare sleep, sleepiness, fatigue, and neurobehavioral performance among first-time mothers and fathers during their early postpartum period. Participants were 21 first-time postpartum mother-father dyads (N = 42) and seven childless control dyads (N = 14). Within their natural environment, participants completed 1 week of wrist actigraphy monitoring, along with multi-day self-administered sleepiness, fatigue, and neurobehavioral performance measures. The assessment week was followed by an objective laboratory-based test of sleepiness. Mothers obtained more sleep compared to fathers, but mothers' sleep was more disturbed by awakenings. Fathers had greater objectively measured sleepiness than mothers. Mothers and fathers did not differ on subjectively measured sleep quality, sleepiness, or fatigue; however, mothers had worse neurobehavioral performance than fathers. Compared to control dyads, postpartum parents experienced greater sleep disturbance, sleepiness, and sleepiness-associated impairments. Study results can inform social policy, postpartum sleep intervention development, and research on postpartum family systems and mechanisms that propagate sleepiness.

  19. Sleep-Wake Cycle, Daytime Sleepiness, and Attention Components in Children Attending Preschool in the Morning and Afternoon Shifts

    Science.gov (United States)

    Belísio, Aline S.; Kolodiuk, Fernanda F.; Louzada, Fernando M.; Valdez, Pablo; Azevedo, Carolina V. M.

    2017-01-01

    Children tend to sleep and wake up early and to exhibit daytime sleep episodes. To evaluate the impact of school start times on sleepiness and attention in preschool children, this study compared the temporal patterns of sleep, daytime sleepiness, and the components of attention between children aged 4-6 years that study in the morning (n = 66)…

  20. Sleep-Wake Cycle, Daytime Sleepiness, and Attention Components in Children Attending Preschool in the Morning and Afternoon Shifts

    Science.gov (United States)

    Belísio, Aline S.; Kolodiuk, Fernanda F.; Louzada, Fernando M.; Valdez, Pablo; Azevedo, Carolina V. M.

    2017-01-01

    Children tend to sleep and wake up early and to exhibit daytime sleep episodes. To evaluate the impact of school start times on sleepiness and attention in preschool children, this study compared the temporal patterns of sleep, daytime sleepiness, and the components of attention between children aged 4-6 years that study in the morning (n = 66)…

  1. Insomnia, daytime sleepiness and cardio-cerebrovascular diseases in the elderly: a 6-year prospective study.

    Directory of Open Access Journals (Sweden)

    Isabelle Jaussent

    Full Text Available OBJECTIVE: To examine 1 the associations between history of cardio-cerebrovascular diseases (CVD and insomnia complaints and excessive daytime sleepiness (EDS, and 2 the relationships between sleep complaints and future CVD in persons over 65. METHODS: CVD was assessed at baseline and during two, four, and six-year follow-up in 5494 non-demented subjects. Self-reported insomnia complaints (poor sleep quality, difficulty in initiating sleep, difficulty in maintening sleep, and early morning awakening, EDS and sleep medication use were evaluated at baseline. Logistic regression models and Cox proportional hazard models, with delayed entry and age of participants as the time scale, were adjusted for socio-demographic, lifestyle and clinical variables. RESULTS: At baseline, 748 participants had a past-history of CVD. A past-history of CVD was associated with EDS (OR = 1.28 95%CI = [1.05-1.57] and the number of insomnia complaints (OR = 1.26 95%CI = [1.03-1.55] for 1-2 insomnia complaints; OR = 1.32 95%CI = [1.03-1.71] for ≥3 complaints. In longitudinal analyses, neither the four components of insomnia nor the number of insomnia complaints were significantly associated with first or recurrent CVD events (n = 391 events. EDS was independently associated with future CVD events even after adjusting for prescribed sleep medication and past-history of CVD (HR = 1.35 95%CI = [1.06-1.71]. CONCLUSION: Our results suggest that the relationships between sleep complaints and CVD could be complex. Insomnia complaints are more likely a consequence of CVD, whereas EDS appears to be a determinant of CVD independently of past-history of CVD. EDS screening may thus constitute a means of detecting persons at high risk of CVD.

  2. Obstructive Sleep Apnea With Objective Daytime Sleepiness Is Associated With Hypertension.

    Science.gov (United States)

    Ren, Rong; Li, Yun; Zhang, Jihui; Zhou, Junying; Sun, Yuanfeng; Tan, Lu; Li, Taomei; Wing, Yun-Kwok; Tang, Xiangdong

    2016-11-01

    Subjective daytime sleepiness is considered a significant risk factor of hypertension in patients with obstructive sleep apnea (OSA). In this study, our goal was to examine the joint effect on hypertension of OSA and objective daytime sleepiness measured by the multiple sleep latency test (MSLT). A total of 1338 Chinese patients with OSA and 484 primary snorers were included in the study. All subjects underwent 1 night polysomnography followed by MSLT. The MSLT values were classified into 3 categories: >8 minutes, 5 to 8 minutes, and Hypertension was defined based either on direct blood pressure measures or on diagnosis by a physician. After controlling for confounders, OSA combined with MSLT of 5 to 8 minutes increased the odds of hypertension by 95% (odds ratio, 1.95; 95% confidence interval, 1.10-3.46), whereas OSA combined with MSLT hypertension by 111% (odds ratio, 2.11; 95% confidence interval, 1.22-3.31) compared with primary snorers with MSLT >8 minutes. In stratified analyses, the association of hypertension with MSLT in OSA patients was seen among both sexes, younger ages, both obese and nonobese patients, and patients with and without subjective excessive daytime sleepiness. We conclude that objective daytime sleepiness is associated with hypertension in patients with OSA. © 2016 American Heart Association, Inc.

  3. Armodafinil for Treatment of Excessive Sleepiness Associated With Shift Work Disorder: A Randomized Controlled Study

    OpenAIRE

    Czeisler, Charles A.; Walsh, James K.; Wesnes, Keith A.; Arora, Sanjay; Roth, Thomas

    2009-01-01

    OBJECTIVE: To assess the effect of armodafinil, 150 mg, on the physiologic propensity for sleep and cognitive performance during usual night shift hours in patients with excessive sleepiness associated with chronic (≥3 months) shift work disorder (SWD) of moderate or greater severity.

  4. Daytime Sleepiness, Poor Sleep Quality, Eveningness Chronotype, and Common Mental Disorders among Chilean College Students

    Science.gov (United States)

    Concepcion, Tessa; Barbosa, Clarita; Vélez, Juan Carlos; Pepper, Micah; Andrade, Asterio; Gelaye, Bizu; Yanez, David; Williams, Michelle A.

    2014-01-01

    Objectives: To evaluate whether daytime sleepiness, poor sleep quality, and morningness and eveningness preferences are associated with common mental disorders (CMDs) among college students. Methods: A total of 963 college students completed self-administered questionnaires that collected information about sociodemographic characteristics, sleep…

  5. The Psychosocial Problems of Children with Narcolepsy and Those with Excessive Daytime Sleepiness of Uncertain Origin

    Science.gov (United States)

    Stores, Gregory; Montgomery, Paul; Wiggs, Luci

    2007-01-01

    Background: Narcolepsy is a predominantly rapid eye movement sleep disorder with onset usually in the second decade but often in earlier childhood. Classically it is characterized by combinations of excessive sleepiness especially sleep attacks, cataplexy, hypnagogic hallucinations, and sleep paralysis. The psychosocial effects of this lifelong…

  6. The Psychosocial Problems of Children with Narcolepsy and Those with Excessive Daytime Sleepiness of Uncertain Origin

    Science.gov (United States)

    Stores, Gregory; Montgomery, Paul; Wiggs, Luci

    2007-01-01

    Background: Narcolepsy is a predominantly rapid eye movement sleep disorder with onset usually in the second decade but often in earlier childhood. Classically it is characterized by combinations of excessive sleepiness especially sleep attacks, cataplexy, hypnagogic hallucinations, and sleep paralysis. The psychosocial effects of this lifelong…

  7. Insomnia, Sleepiness, and Depression in Adolescents Living in Residential Care Facilities

    Science.gov (United States)

    Moreau, Vincent; Belanger, Lynda; Begin, Gilles; Morin, Charles M.

    2009-01-01

    The main objective of this study was to document sleep patterns and disturbances reported by youths temporarily living in residential care facilities. A secondary objective was to examine the relationships between sleep disturbances and mood and daytime sleepiness. A self-reported questionnaire on sleep patterns and habits assessing duration,…

  8. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work

    Directory of Open Access Journals (Sweden)

    Juha Liira

    Full Text Available BACKGROUND: Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and quality. OBJECTIVES: To evaluate the effects of pharmacological interventions to reduce sleepiness or to improve alertness at work and decrease sleep disturbances whilst of work, or both, in workers undertaking shift work. METHODS: Search methods: We searched CENTRAL, MEDLINE, EMBASE, PubMed and PsycINFO up to 20 September 2013 and ClinicalTrials.gov up to July 2013. We also screened reference lists of included trials and relevant reviews. Selection criteria: We included all eligible randomised controlled trials (RCTs, including cross-over RCTs, of pharmacological products among workers who were engaged in shift work (including night shifts in their present jobs and who may or may not have had sleep problems. Primary outcomes were sleep length and sleep quality while of work, alertness and sleepiness, or fatigue at work. Data collection and analysis: Two authors independently selected studies, extracted data and assessed risk of bias in included trials. We performed meta-analyses where appropriate. MAIN RESULTS: We included 15 randomised placebo-controlled trials with 718 participants. Nine trials evaluated the effect of melatonin and two the effect of hypnotics for improving sleep problems. One trial assessed the effect of modafinil, two of armodafinil and one examined cafeine plus naps to decrease sleepiness or to increase alertness.

  9. Daytime Sleepiness and Sleep Inadequacy as Risk Factors for Dementia

    OpenAIRE

    Angeliki Tsapanou; Yian Gu; Jennifer Manly; Nicole Schupf; Ming-Xin Tang; Molly Zimmerman; Nikolaos Scarmeas; Yaakov Stern

    2015-01-01

    Background/Aims: To examine the association between self-reported sleep problems and incidence of dementia in community-dwelling elderly people. Methods: 1,041 nondemented participants over 65 years old were examined longitudinally. Sleep problems were estimated using the RAND Medical Outcomes Study Sleep Scale examining sleep disturbance, snoring, sleep short of breath or with a headache, sleep adequacy, and sleep somnolence. Cox regression analysis was used to examine the association betwee...

  10. Improvement in Fatigue during Natalizumab Treatment is Linked to Improvement in Depression and Day-Time Sleepiness

    DEFF Research Database (Denmark)

    Penner, Iris-Katharina; Sivertsdotter, Eva Catharina; Celius, Elisabeth G

    2015-01-01

    BACKGROUND: Fatigue is a frequent symptom in multiple sclerosis (MS) and often interrelated with depression and sleep disorders making symptomatic treatment decisions difficult. In the single-arm, observational phase IV TYNERGY study, relapsing-remitting MS patients showed a clinically meaningful...... of the two latter symptoms and changes in fatigue was analyzed. RESULTS: After 1 year of natalizumab treatment, the majority of patients (>92%) remained stable or improved in total, motor, and cognitive fatigue. Proportion of patients without depression increased by 17% while proportions of mildly depressed...... patients or patients with potential major depression decreased by 5 and 12%, respectively. Proportion of patients classified as not being sleepy increased by 13% while proportions of sleepy and very sleepy patients decreased by 11 and 2%, respectively. Most importantly, improved depression and sleepiness...

  11. Habitual Sleep Duration, Unmet Sleep Need, and Excessive Daytime Sleepiness in Korean Adults

    OpenAIRE

    Hwangbo, Young; Kim, Won-Joo; Chu, Min Kyung; Yun, Chang-ho; Yang, Kwang Ik

    2016-01-01

    Background and Purpose Sleep need differs between individuals, and so the same duration of sleep will lead to sleep insufficiency in some individuals but not others. The aim of this study was to determine the separate and combined associations of both sleep duration and unmet sleep need with excessive daytime sleepiness (EDS) in Korean adults. Methods The participants comprised 2,769 Korean adults aged 19 years or older. They completed questionnaires about their sleep habits over the previous...

  12. Medico-legal aspects of sleep disorders: sleepiness and civil liability.

    Science.gov (United States)

    Ellis, Elizabeth; Grunstein, Ronald R.

    2001-02-01

    Excessive sleepiness is associated with motor vehicle accidents and is responsible for enormous social and financial loss. The specific legal obligations for an individual with a sleep disorder, their employer and those health care practitioners associated with that individual are reviewed. Although there are related implications within the criminal law and in particular criminal negligence, the arguments developed in this paper will be largely confined to the context of the civil liability. The legal concepts of foreseeability and proximity are discussed in the context of sleep-related accidents. The reasoning of a recent Australian High Court judgement is discussed in view of the differences in legal and medical opinion on the extent of foreseeability of accidents as a result of sleepiness. Many countries have legislation designed to protect employees from injury at work and to protect the general public from injury. What is not clear is the extent to which an employer will be required to accept liability for an employee's sleepiness and the duty to monitor the health of their employees. Factors which influence this liability include: the extent to which the implications of the condition is known and understood generally; the extent to which the condition is suspected or identified in an individual employee; the extent of a proper screening and treatment program and the way in which risk management programs have been implemented. Although the issue of sleepiness and civil liability is examined from an Australian legal context, the principles have direct relevance to other legal systems. The authors highlight the degree of uncertainty provided by the common law and statutory provisions, and that decisions rest on the balance of public interests, which mean that many of the current dilemmas facing practitioners may only be solved in the courts.

  13. Armodafinil improves wakefulness and long-term episodic memory in nCPAP-adherent patients with excessive sleepiness associated with obstructive sleep apnea.

    Science.gov (United States)

    Roth, Thomas; Rippon, Gregory A; Arora, Sanjay

    2008-03-01

    Residual excessive sleepiness (ES) and impaired cognition can occur despite effective and regular nasal continuous positive airway pressure (nCPAP) therapy in some patients with obstructive sleep apnea (OSA). A pooled analysis of two 12-week, randomized, double-blind studies in nCPAP-adherent patients with ES associated with OSA evaluated the effect of armodafinil on wakefulness and cognition. Three hundred and ninety-one patients received armodafinil (150 or 250 mg) and 260 patients received placebo once daily for 12 weeks. Efficacy assessments included the Maintenance of Wakefulness Test (MWT), Cognitive Drug Research cognitive performance battery, Epworth Sleepiness Scale, and Brief Fatigue Inventory. Adverse events were monitored. Armodafinil increased mean MWT sleep latency from baseline to final visit by 2.0 min vs a decrease of 1.5 min with placebo (P armodafinil significantly improved quality of episodic secondary memory (P Armodafinil did not adversely affect desired nighttime sleep, and nCPAP use remained high (approximately 7 h/night). Adjunct treatment with armodafinil significantly improved wakefulness, long-term memory, and patients' ability to engage in activities of daily living in nCPAP-adherent individuals with ES associated with OSA. Armodafinil also reduced patient-reported fatigue and was well tolerated.

  14. Daytime Sleepiness, Poor Sleep Quality, Eveningness Chronotype and Common Mental Disorders Among Chilean College Students

    Science.gov (United States)

    Concepcion, Tessa; Barbosa, Clarita; Vélez, Juan Carlos; Pepper, Micah; Andrade, Asterio; Gelaye, Bizu; Yanez, David; Williams, Michelle A.

    2014-01-01

    Objectives To evaluate whether daytime sleepiness, poor sleep quality and morningness and eveningness preferences are associated with common mental disorders (CMDs) among college students. Methods A total of 963 college students completed self-administered questionnaires that collected information about socio-demographic characteristics, sleep quality characteristics, CMDs, and other lifestyle behaviors. Results The prevalence of CMDs was 24.3% (95% CI: 21.5-27.1%) among all students. Prevalence estimates of both excessive daytime sleepiness and poor sleep quality were higher among females (35.4% and 54.4%) than males (22.0% and 45.8%). Cigarette smoking was statistically significantly and positively associated with having CMDs (p=0.034). Excessive daytime sleepiness (OR= 3.65; 95% CI: 2.56-4.91) and poor sleep quality (OR=4.76; 95% CI: 3.11-7.29) were associated with increased odds of CMDs. Conclusion Given the adverse health consequences associated with both sleep disorders and CMDs, improving sleep hygiene among college students is imperative to public health. PMID:24810953

  15. Emerging drugs for common conditions of sleepiness: obstructive sleep apnea and narcolepsy.

    Science.gov (United States)

    Sullivan, Shannon S; Guilleminault, Christian

    2015-01-01

    Obstructive sleep apnea (OSA) and narcolepsy are sleep disorders associated with high prevalence and high symptomatic burden including prominent sleepiness, daytime dysfunction and poor nocturnal sleep. Both have elevated risk of poor health outcomes. Current therapies are often underutilized, cumbersome, costly or associated with residual symptoms. This review covers current available therapies for OSA and narcolepsy as well as discusses areas for potential drug development, and agents in the therapeutic pipeline, including the cannabinoid dronabinol (OSA), the histamine inverse agonist/ antagonist pitolisant (narcolepsy), and stimulants with uncertain and/or multiple activities such as JZP-110 and JZP-386 (narcolepsy, possibly OSA). Finally it addresses new approaches and uses for therapies currently on the market such as the carbonic anhydrase inhibitor acetazolamide (OSA). Both OSA and narcolepsy are conditions of sleepiness for which lifelong treatments are likely to be required. In OSA, while continuous positive airway pressure will likely remain the gold standard therapy for the foreseeable future, there is plenty of room for integrating phenotypes and variants of OSA into therapeutic strategies to lead to better, more personalized disease modification. In narcolepsy, unlike OSA, drug therapy is the current mainstay of treatment. Advances using novel mechanisms to treat targeted symptoms such as sleepiness and/or novel agents that can treat more than one symptom of narcolepsy, hold promise. However, cost, convenience and side effects remain challenges.

  16. Daytime Sleepiness and Parkinson’s Disease: The Contribution of the Multiple Sleep Latency Test

    Directory of Open Access Journals (Sweden)

    Marcelo Ataide

    2014-01-01

    Full Text Available Background. Sleep disorders are major nonmotor manifestations of patients with Parkinson’s disease (PD, and excessive daytime sleepiness (EDS is one of the most common symptoms. Objective. We reviewed a current literature concerning major factors that influence EDS in PD patients, using Multiple Sleep Latency Test (MSLT. Methods. A Medline search found 23 studies. Results. The presence of EDS was observed in 12.7% to 47% in patients without complaints of daytime sleepiness and 47% to 66.7% with complaints of daytime sleepiness. Despite being recognized by several authors, major factors that influence EDS, such as severity of motor symptoms, use of dopaminergic medications, and associated sleep disturbances, presented contradictory data. Conclusions. Available data suggest that the variability of the results may be related to the fact that it was conducted with a small sample size, not counting the neuropathological heterogeneity of the disease. Thus, before carrying out longitudinal studies with significant samples, careful analysis should be done by assigning a specific agent on the responsibility of EDS in PD patients.

  17. Examination of daytime sleepiness and cognitive performance testing in patients with primary insomnia.

    Directory of Open Access Journals (Sweden)

    Hong Liu

    Full Text Available While individuals with insomnia consistently complain of cognitive impairment, previous studies on the effect of insomnia on objective measures of cognitive function have obtained ambiguous results. The relationship between daytime sleepiness and cognitive manifestations in insomnia patients is not clear.Thirty-six primary insomnia patients (PIPs and 26 good sleep controls (GSCs with age and gender matched manner were included in the study. Participants underwent an overnight polysomnography followed by a multiple sleep latency test (MSLT and an examination of the attention network test (ANT. ANT reflected three attentional networks including alerting, orienting and executive control. According to whether accompanied with excessive daytime sleepiness (EDS, the insomnia group were subdivided into PIPs with EDS (n = 12, score on MSLT<10 min and PIPs without EDS (n = 24, score on MSLT≥10 min.PIPs only performed worse on executive control function than GSCs in ANT. PIPs with EDS had longer overall reaction time (RT related to PIPs without EDS. Further analyses with Pearson correlation analysis showed a significant negative correlation between the overall RT and MSLT latency in insomniacs (r = -0.444, p<0.01, whereas no such correlation was found in controls.Results suggest that PIPs do show executive control function deficits compared with GSCs. Daytime sleepiness in terms of MSLT latency was associated with poor cognitive manifestations in patients with insomnia.

  18. Regularity of cardiac rhythm as a marker of sleepiness in sleep disordered breathing.

    Directory of Open Access Journals (Sweden)

    Marc Guaita

    Full Text Available The present study aimed to analyse the autonomic nervous system activity using heart rate variability (HRV to detect sleep disordered breathing (SDB patients with and without excessive daytime sleepiness (EDS before sleep onset.Two groups of 20 patients with different levels of daytime sleepiness -sleepy group, SG; alert group, AG- were selected consecutively from a Maintenance of Wakefulness Test (MWT and Multiple Sleep Latency Test (MSLT research protocol. The first waking 3-min window of RR signal at the beginning of each nap test was considered for the analysis. HRV was measured with traditional linear measures and with time-frequency representations. Non-linear measures -correntropy, CORR; auto-mutual-information function, AMIF- were used to describe the regularity of the RR rhythm. Statistical analysis was performed with non-parametric tests.Non-linear dynamic of the RR rhythm was more regular in the SG than in the AG during the first wakefulness period of MSLT, but not during MWT. AMIF (in high-frequency and in Total band and CORR (in Total band yielded sensitivity > 70%, specificity >75% and an area under ROC curve > 0.80 in classifying SG and AG patients.The regularity of the RR rhythm measured at the beginning of the MSLT could be used to detect SDB patients with and without EDS before the appearance of sleep onset.

  19. [Self-rating scales reveal psychopathy].

    Science.gov (United States)

    Dåderman, A; Lidberg, L

    1998-01-28

    Psychopathy is regarded as a dimensional concept--i.e., a person can be more or less psychopathic. This approach enables psychopathy to be measured with reliable, validated personality scales, and to be related to impairment of serontonergic function in the brain. Several personality inventories are described in the article, especially the Karolinska Scales of Personality, the Zuckerman Sensation Seeking Scales, form V, the Eysenck Personality Questionnaire, including an impulsiveness scale from the IVE (Impulsiveness-Venturesomeness-Empathy) inventory, and the old dimensional scale, the Marke-Nyman Personality Temperament scale based on the personality theory of Henrik Sjöbring. In this way both old and new, and both Swedish and foreign personality concepts are linked together. Personality scales are easy to use and enable better stability and validity of results to be attained.

  20. Sonolência e acidentes automobilísticos Sleepiness and motor vehicle accidents

    Directory of Open Access Journals (Sweden)

    SIMONE FAGONDES CANANI

    2001-03-01

    Full Text Available Objetivo: Este artigo tem por finalidade apresentar uma sucinta revisão sobre as repercussões da sonolência excessiva no desempenho dos motoristas no trânsito, enfatizando a necessidade da maior valorização do tema abordado. Métodos: Revisão bibliográfica da literatura nacional e internacional, abrangendo artigos originais e publicações oficiais da American Thoracic Society e da American Sleep Apnea Association. Resultados: As evidências de que a sonolência é um fator que pode contribuir de forma decisiva para a ocorrência de acidentes automobilísticos são crescentes. As dificuldades com relação à caracterização da sonolência precedendo o acidente são discutidas no texto. Muitas são as causas de sonolência excessiva; felizmente, sua maioria é passível de identificação e manejo adequado. Conclusões: É importante que haja maior entendimento do problema em nosso meio, para que possam ocorrer modificações na abordagem do paciente com sonolência excessiva e também discussões acerca das leis de trânsito vigentes e das obrigações legais do médico com relação a este problema.Objective: The purpose of this article is to present a brief review of the effects of excessive sleepiness on driving performance, and to emphasize the importance of the subject. Methods: Bibliographic review of national and international literature, including original articles and official publications from the American Thoracic Society and the American Sleep Apnea Association. Results: There is growing evidence that excessive sleepiness may be an important factor related to the occurrence of motor vehicle accidents. Difficulties regarding the identification of sleepiness as a preceding factor related to motor vehicle crashes are discussed on the text. There are many causes for excessive sleepiness. Fortunately most of them are easy to recognize and have specific treatment. Conclusions: A better understanding of the problem is fundamental

  1. When the going gets tough: behavioural type-dependent space use in the sleepy lizard changes as the season dries.

    Science.gov (United States)

    Spiegel, Orr; Leu, Stephan T; Sih, Andrew; Godfrey, Stephanie S; Bull, C Michael

    2015-11-22

    Understanding space use remains a major challenge for animal ecology, with implications for species interactions, disease spread, and conservation. Behavioural type (BT) may shape the space use of individuals within animal populations. Bolder or more aggressive individuals tend to be more exploratory and disperse further. Yet, to date we have limited knowledge on how space use other than dispersal depends on BT. To address this question we studied BT-dependent space-use patterns of sleepy lizards (Tiliqua rugosa) in southern Australia. We combined high-resolution global positioning system (GPS) tracking of 72 free-ranging lizards with repeated behavioural assays, and with a survey of the spatial distributions of their food and refuge resources. Bayesian generalized linear mixed models (GLMM) showed that lizards responded to the spatial distribution of resources at the neighbourhood scale and to the intensity of space use by other conspecifics (showing apparent conspecific avoidance). BT (especially aggressiveness) affected space use by lizards and their response to ecological and social factors, in a seasonally dependent manner. Many of these effects and interactions were stronger later in the season when food became scarce and environmental conditions got tougher. For example, refuge and food availability became more important later in the season and unaggressive lizards were more responsive to these predictors. These findings highlight a commonly overlooked source of heterogeneity in animal space use and improve our mechanistic understanding of processes leading to behaviourally driven disease dynamics and social structure.

  2. 日间嗜睡与急性缺血性卒中短期预后的关系%Correlation of Daytime Sleepiness and Acute Ischemic Stroke

    Institute of Scientific and Technical Information of China (English)

    谢子珍; 李常红; 孟晓梅; 于逢春

    2016-01-01

    Objective By analyzing the relationship between daytime sleepiness and neurological function prognosis in patients with acute stroke, to explore the relationship between daytime sleepiness and acute ischemic stroke. Methods Patients with acute ischemic stroke within 48 hours were consecutively enrolled from Beijing Haidian Hospital during June 2015 to September, 2015. And data were collected including demographics, chronic disease history, National Institutes of Health Stroke Scale (NIHSS) on admission and the 14th day, and Epworth Sleepiness Scale (ESS) on admission. ESS 1 month before admission, which is the premorbid ESS, were retrospectively evaluated. The correlation between premorbid ESS with demographics, chronic disease history, NIHSS on admission and the 14th day, delta NIHSS (the result of NIHSS on admission minus NIHSS of the 14th day) and ESS on admission were analyzed. According to premorbid ESS, patients were divided into sleepiness group and non-sleepiness group, compared NIHSS on admission and the 14th day, delta NIHSS and ESS on admission between two groups. Results One hundred and six patients were consecutively enrolled. The results showed that①Premorbid ESS had positive correlation with admission NIHSS, the 14th day NIHSS and admission ESS. Pearson correlation coefifcient were 0.199, 0.276 and 0.407, andP values were 0.041, 0.004 and Conclusion Premorbid daytime sleepiness patients will be more severely on admission and in 14th day, meanwhile their prognosis in the acute phase is worse. The degree of daytime sleepiness will aggravate when ischemic stroke happens.%目的通过分析急性缺血性卒中患者日间嗜睡及急性期神经功能转归情况,探索日间嗜睡与急性缺血性卒中短期预后之间的关系。  方法连续收集2015年6月-2015年9月北京市海淀医院神经内科收治的发病48 h内的住院急性缺血性卒中患者临床资料,包括:人口学特征、既往病史、入院时及发病14 d

  3. Effects of a selective educational system on fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents in Taiwan

    Directory of Open Access Journals (Sweden)

    Chen TY

    2015-03-01

    Full Text Available Tien-Yu Chen,1,2 Yu-Ching Chou,3 Nian-Sheng Tzeng,1,2,4 Hsin-An Chang,1,2,4 Shin-Chang Kuo,1,2,5 Pei-Yin Pan,1,2 Yi-Wei Yeh,1,2,5 Chin-Bin Yeh,1,2 Wei-Chung Mao1,2,6 1Department of Psychiatry, Tri-Service General Hospital, 2School of Medicine, National Defense Medical Center, 3School of Public Health, National Defense Medical Center, 4Student Counseling Center, National Defense Medical Center, 5Graduate Institute of Medical Sciences, National Defense Medical Center, 6Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan, Republic of China Objective: The aim of the study reported here was to clarify the effects of academic pressure on fatigue, sleep problems, daytime sleepiness, and depression among senior high school adolescents in Taiwan. Methods: This cross-sectional study enrolled 757 senior high school adolescents who were classified into four groups: Grade 1 (n=261, Grade 2 (n=228, Grade 3T (n=199; Grade 3 students who had another college entrance test to take, and Grade 3S (n=69; Grade 3 students who had succeeded in their college application. Fatigue, sleep quality, daytime sleepiness, and depression were assessed using the Chinese version of the Multidimensional Fatigue Symptom Inventory – Short Form, Pittsburgh Sleep Quality Index-Taiwan Form, the Chinese version of the Epworth Sleepiness Scale, and the Chinese version of the Beck Depression Inventory®-II (BDI-II, respectively. Results: Physical, emotional, and mental fatigue scores were all higher in higher-grade groups. The Grade 3T (test students had the worst fatigue severity, and the Grade 3S (success students had the least fatigue severity. More than half of the students (60.9% went to bed after 12 am, and they had on average 6.0 hours of sleep per night. More than 30% of the students in Grade 2 (37.3% and Grades 3T/S (30.2%/30.4% possibly had daily sleepiness problems. The students in Grade 3T had the worst BDI-II score (13.27±9.24, and the Grade 3S

  4. Excessive daytime sleepiness and adherence to antihypertensive medications among Blacks: analysis of the counseling African Americans to control hypertension (CAATCH trial

    Directory of Open Access Journals (Sweden)

    Williams NJ

    2014-03-01

    Full Text Available Natasha J Williams,1 Girardin Jean-Louis,1 Abhishek Pandey,2 Joseph Ravenell,1 Carla Boutin-Foster,3 Gbenga Ogedegbe1 1Center for Healthful Behavior Change, Division of Internal Medicine, NYU Medical Center, New York, 2Department of Family Medicine, SUNY Downstate Medical Center, Brooklyn, 3Center of Excellence in Disparities Research, Weill Cornell Medical College, New York, NY, USA Background: Excessive daytime sleepiness (EDS often occurs as a result of insufficient sleep, sleep apnea, illicit substance use, and other medical and psychiatric conditions. This study tested the hypothesis that blacks exhibiting EDS would have poorer self-reported adherence to hypertensive medication using cross-sectional data from the Counseling African-Americans to Control Hypertension (CAATCH trial. Methods: A total of 1,058 hypertensive blacks (average age 57±12 years participated in CAATCH, a randomized controlled trial evaluating the effectiveness of a multilevel intervention for participants who receive care from community health centers in New York City. Data analyzed in this study included baseline sociodemographics, medical history, EDS, and medication adherence. We used the Epworth Sleepiness Scale, with a cutoff score of ≥10, to define EDS. Medication adherence was measured using an abbreviated Morisky Medication Adherence scale, with a score >0 indicating nonadherence. Results: Of the sample, 71% were female, 72% received at least a high school education, 51% reported a history of smoking, and 33% had a history of alcohol consumption. Overall, 27% of the participants exhibited EDS, and 44% of those who exhibited EDS were classified as adherent to prescribed antihypertensive medications. Multivariable logistic regression analysis, adjusting for effects of age, body mass index, sex, education, and smoking and drinking history indicated that participants who exhibited EDS were more than twice as likely to be nonadherent (odds ratio 2.28, 95

  5. Prevalence and risk factors for excessive daytime of sleepiness in rural western Anotolia (Turkey): the role of obesity and metabolic syndrome

    National Research Council Canada - National Science Library

    Günes, Zeynep; Sahbaz, Muazzez; Tuğrul, Emel; Günes, Hakki

    2012-01-01

    The purpose of the present study was to identify risk factors for and prevalence of excessive daytime sleepiness and associations between demographic factors, obesity and metabolic syndrome criteria...

  6. Effects of driver behavior style differences and individual differences on driver sleepiness detection

    Directory of Open Access Journals (Sweden)

    Keyong Li

    2015-04-01

    Full Text Available Driving sleepiness is still a major causes of traffic accidents. Individual drivers, under various conditions, act and respond in different manners. This article presents the attempt of a straight-line driving simulator study that examined the effects of driver behavior style differences and individual differences on driver sleepiness detection which is based on driving performance measures. A total of 15 drivers who were classified into two categories through subjective assessment based on a Driver Behavior Questionnaire participated in driving simulator experiments. A total of 18 detection models, including 15 SE models for each subject, an A model for the aggressive drivers, an NA model for the non-aggressive drivers, and a G model for all experiment participants, were developed using support vector machine method based on driving performance characteristic parameters. The results show that the G model is not suitable for all drivers due to its lower mean accuracy of 69.88% (standard deviation = 7.70% and higher standard deviation. The SE models for each subject show the best detection accuracy performance of 84.26% (standard deviation = 5.38%; however, it is impossible to set up a special detection model for every individual driver. The SD models on different style categories show an accuracy value of 77.54% (standard deviation = 5.78%. The results demonstrate that driver style differences as well as individual differences have great effects on driver sleepiness detection (F = 19.148, p < 0.000.

  7. Chronotype differences in circadian rhythms of temperature, melatonin, and sleepiness as measured in a modified constant routine protocol

    Directory of Open Access Journals (Sweden)

    Leon Lack

    2009-11-01

    Full Text Available Leon Lack, Michelle Bailey, Nicole Lovato, Helen WrightSchool of Psychology, Flinders University, Adelaide, South Australia, AustraliaAbstract: Evening chronotypes typically have sleep patterns timed 2–3 hours later than morning chronotypes. Ambulatory studies have suggested that differences in the timing of underlying circadian rhythms as a cause of the sleep period differences. However, differences in endogenous circadian rhythms are best explored in laboratory protocols such as the constant routine. We used a 27-hour modified constant routine to measure the endogenous core temperature and melatonin circadian rhythms as well as subjective and objective sleepiness from hourly 15-minute sleep opportunities. Ten (8f morning type individuals were compared with 12 (8f evening types. All were young, healthy, good sleepers. The typical sleep onset, arising times, circadian phase markers for temperature and melatonin and objective sleepiness were all 2–3 hours later for the evening types than morning types. However, consistent with past studies the differences for the subjective sleepiness rhythms were much greater (5–9 hours. Therefore, the present study supports the important role of subjective alertness/sleepiness in determining the sleep period differences between morning and evening types and the possible vulnerability of evening types to delayed sleep phase disorder.Keywords: chronotype, constant routine, circadian rhythms, sleep propensity, subjective sleepiness

  8. Aggravation of excessive daytime sleepiness concurrent with aggravation of an injured ascending reticular activating system in a patient with mild traumatic brain injury

    Science.gov (United States)

    Jang, Sung Ho; Kwon, Hyeok Gyu

    2017-01-01

    Abstract Background: We report on a patient who developed aggravation of excessive daytime sleepiness (EDS) concurrent with aggravation of an injured ascending reticular activating system (ARAS) following mild traumatic brain injury (TBI), demonstrated by follow-up diffusion tensor tractographies (DTTs). Methods: A 42-year-old male patient experienced head trauma resulting from flexion-hyperextension injury after collision with another vehicle from behind while stopped at an intersection. The patient lost consciousness for approximately 10 seconds and experienced no post-traumatic amnesia following the accident. The patient's Glasgow Coma Scale score was 15. No specific lesion was observed on the conventional brain MRI performed at 10 weeks after onset. The patient complained of EDS after the head trauma and aggravation of EDS with passage of time. The Epworth Sleepiness Scale indicated abnormality with a score of 12 at 10 weeks after onset (cut-off: 10 points full mark: 24 score) and it was aggravated with a score of 18 at 16 months. Results: On 10-week DTT, decreased neural connectivity of the intralaminar thalamic nucleus to the prefrontal cortex and basal forebrain was observed in both hemispheres. However, no significant abnormality was observed in the dorsal and ventral lower ARAS. On 16-month DTT, the upper portion of the left dorsal lower ARAS showed partial tearing and the ventral lower ARAS showed thinning (both sides) and partial tearing (right side). Conclusions: Aggravation of EDS concurrent with aggravation of an injured ARAS was demonstrated in a patient with mild TBI using DTT. PMID:28121943

  9. Repeated sessions of transcranial direct current stimulation evaluation on fatigue and daytime sleepiness in Parkinson's disease.

    Science.gov (United States)

    Forogh, Bijan; Rafiei, Maryam; Arbabi, Amin; Motamed, Mohammad Reza; Madani, Seyed Pezhman; Sajadi, Simin

    2017-02-01

    Parkinson is a common and disabling disease that affects patient's and career's quality of life. Unfortunately, medications, such as dopaminergic and sedative-hypnotic drugs, as an effective treatment have unwilling side effects. Recently, Transcranial Direct Current Stimulation (tDCS) in conjunction with medication becomes popular as a complementary safe treatment and several studies have proved its effectiveness on controlling motor and specially non-motor aspects of Parkinson's disease. In this randomized double-blind parallel study, 23 patients with Parkinson's disease divided into two groups of real tDCS plus occupational therapy and sham tDCS plus occupational therapy and the effects of therapeutic sessions (eight sessions tDCS with 0.06 mA/cm(2) current, 20 min on dorsolateral prefrontal cortex) were evaluated on fatigue and daytime sleepiness just after therapeutic course and in 3-month follow-up. tDCS had a significant effect on fatigue and no effect on daytime sleepiness reduction in patients with Parkinson's disease. tDCS is an effective and safe complementary treatment on fatigue reduction in Parkinson's disease.

  10. Popular media and 'excessive daytime sleepiness': a study of rhetorical authority in medical sociology.

    Science.gov (United States)

    Kroll-Smith, Steve

    2003-09-01

    Problem sleepiness is emerging as a medical problem in the US and Britain. Though an increasingly salient complaint, clinical medicine is only peripherally involved in the diagnosis and treatment of sleep troubles. Paramount in shaping public perceptions and experiences of sleep are the popular media. The apparent chasm between self-reported sleep troubles and the routine medical gaze is the point of departure for this inquiry. Aided by the idea of rhetorical authority, a case is made for the conspicuous influence of newspapers, magazines and the Internet in shaping a persuasive cultural directive to become conscious of soporific states and their possible deleterious consequences. Attending to this cultural directive, a growing number of people are self-diagnosing with a novel sleep disorder, excessive daytime sleepiness. The increasing significance of popular culture in the creation of medical troubles summons an alternative version of medical sociology. A limited case for this claim is made by revisiting two key ideas in this field: naming diseases and the classic distinction between illness and disease.

  11. Driver sleepiness and risk of motor vehicle crash injuries: a population-based case control study in Fiji (TRIP 12).

    Science.gov (United States)

    Herman, Josephine; Kafoa, Berlin; Wainiqolo, Iris; Robinson, Elizabeth; McCaig, Eddie; Connor, Jennie; Jackson, Rod; Ameratunga, Shanthi

    2014-03-01

    Published studies investigating the role of driver sleepiness in road crashes in low and middle-income countries have largely focused on heavy vehicles. We investigated the contribution of driver sleepiness to four-wheel motor vehicle crashes in Fiji, a middle-income Pacific Island country. The population-based case control study included 131 motor vehicles involved in crashes where at least one person died or was hospitalised (cases) and 752 motor vehicles identified in roadside surveys (controls). An interviewer-administered questionnaire completed by drivers or proxies collected information on potential risks for crashes including sleepiness while driving, and factors that may influence the quantity or quality of sleep. Following adjustment for confounders, there was an almost six-fold increase in the odds of injury-involved crashes for vehicles driven by people who were not fully alert or sleepy (OR 5.7, 95%CI: 2.7, 12.3), or those who reported less than 6 h of sleep during the previous 24 h (OR 5.9, 95%CI: 1.7, 20.9). The population attributable risk for crashes associated with driving while not fully alert or sleepy was 34%, and driving after less than 6 h sleep in the previous 24 h was 9%. Driving by people reporting symptoms suggestive of obstructive sleep apnoea was not significantly associated with crash risk. Driver sleepiness is an important contributor to injury-involved four-wheel motor vehicle crashes in Fiji, highlighting the need for evidence-based strategies to address this poorly characterised risk factor for car crashes in less resourced settings. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Effect of Positive Airway Pressure on Cardiovascular Outcomes in Coronary Artery Disease Patients with Non-Sleepy Obstructive Sleep Apnea : The RICCADSA Randomized Controlled Trial

    NARCIS (Netherlands)

    Peker, Yüksel; Glantz, Helena; Eulenburg, Christine; Wegscheider, Karl; Herlitz, Johan; Thunström, Erik

    2016-01-01

    RATIONALE: Obstructive sleep apnea is common in patients with coronary artery disease, many of whom do not report daytime sleepiness. First-line treatment for symptomatic obstructive sleep apnea is continuous positive airway pressure, but its value in patients without daytime sleepiness is uncertain

  13. The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review

    NARCIS (Netherlands)

    Dewald, J.F.; Meijer, A.M.; Oort, F.J.; Kerkhof, G.A.; Bögels, S.M.

    2010-01-01

    Insufficient sleep, poor sleep quality and sleepiness are common problems in children and adolescents being related to learning, memory and school performance. The associations between sleep quality (k = 16 studies, N = 13,631), sleep duration (k = 17 studies, N = 15,199), sleepiness (k = 17, N =

  14. Effects of continuous positive airway pressure on blood pressure and daytime sleepiness in obstructive sleep apnea patients with coronary heart diseases under optimal medications.

    Science.gov (United States)

    Zhao, Qing; Liu, Zhi-Hong; Luo, Qin; Zhao, Zhi-Hui; Zhang, Hong-Liang; Wang, Yong

    2012-06-01

    Continuous positive airway pressure (CPAP) is an effective therapy for obstructive sleep apnea (OSA). However, for patients who already have OSA and coronary heart diseases (CHD) with optimal medications, whether CPAP can reduce the blood pressure (BP) is not clear. This is a controlled study to evaluate the effects of CPAP on BP in Chinese cohorts with CHD under optimal medications. Twenty-four patients with CHD and moderate to severe OSA were treated with CPAP and standard care for 1 month. Twenty-four matched control patients were only treated with standard care alone. Baseline demographic data as well as sleep study data was recorded in all patients. Office blood pressure, heart rate, Epworth sleepiness scale (ESS) score, and quality of life (SF-36) of the two groups were compared after 1-month treatment. Compared with control group, CPAP treatment markedly reduced the morning diastolic BP (Δ -0.8 ± 6.0 vs. Δ -5.1 ± 6.5, respectively, P = 0.023) and improved ESS scores (Δ -0.5 ± 3.2 vs. Δ -5.2 ± 3.1, P heart rate, and quality of life. CPAP treatment for 1 month was associated with significant reduction in diastolic BP and improvement in ESS score. For patients with moderate to severe OSA and CHD under optimal medications, CPAP treatment leads to effective reduction in diastolic blood pressure and improvement in daytime sleepiness.

  15. Attention following traumatic brain injury: Neuropsychological and driving simulator data, and association with sleep, sleepiness, and fatigue.

    Science.gov (United States)

    Beaulieu-Bonneau, Simon; Fortier-Brochu, Émilie; Ivers, Hans; Morin, Charles M

    2017-03-01

    The objectives of this study were to compare individuals with traumatic brain injury (TBI) and healthy controls on neuropsychological tests of attention and driving simulation performance, and explore their relationships with participants' characteristics, sleep, sleepiness, and fatigue. Participants were 22 adults with moderate or severe TBI (time since injury ≥ one year) and 22 matched controls. They completed three neuropsychological tests of attention, a driving simulator task, night-time polysomnographic recordings, and subjective ratings of sleepiness and fatigue. Results showed that participants with TBI exhibited poorer performance compared to controls on measures tapping speed of information processing and sustained attention, but not on selective attention measures. On the driving simulator task, a greater variability of the vehicle lateral position was observed in the TBI group. Poorer performance on specific subsets of neuropsychological variables was associated with poorer sleep continuity in the TBI group, and with a greater increase in subjective sleepiness in both groups. No significant relationship was found between cognitive performance and fatigue. These findings add to the existing evidence that speed of information processing is still impaired several years after moderate to severe TBI. Sustained attention could also be compromised. Attention seems to be associated with sleep continuity and daytime sleepiness; this interaction needs to be explored further.

  16. Subjective sleepiness and sleep quality in adolescents are related to objective and subjective measures of school performance

    NARCIS (Netherlands)

    Boschloo, Annemarie; Krabbendam, Lydia; Dekker, Sanne; Lee, Nikki; De Groot, Renate; Jolles, Jelle

    2016-01-01

    This study investigated the relation between sleep and school performance in a large sample of 561 adolescents aged 11–18 years. Three subjective measures of sleep were used: sleepiness, sleep quality, and sleep duration. They were compared to three measures of school performance: objective school

  17. Subjective sleepiness and sleep quality in adolescents are related to objective and subjective measures of school performance

    NARCIS (Netherlands)

    Boschloo, A.; Krabbendam, L.; Dekker, S.; Lee, N.; Groot, R. de; Jolles, J.

    2013-01-01

    This study investigated the relation between sleep and school performance in a large sample of 561 adolescents aged 11-18 years. Three subjective measures of sleep were used: sleepiness, sleep quality, and sleep duration. They were compared to three measures of school performance: objective school

  18. Subjective sleepiness and sleep quality in adolescents are related to objective and subjective measures of school performance

    NARCIS (Netherlands)

    Boschloo, A.; Krabbendam, L.; Dekker, S.; Lee, N.; Groot, R. de; Jolles, J.

    2013-01-01

    This study investigated the relation between sleep and school performance in a large sample of 561 adolescents aged 11-18 years. Three subjective measures of sleep were used: sleepiness, sleep quality, and sleep duration. They were compared to three measures of school performance: objective school g

  19. Subjective sleepiness and sleep quality in adolescents are related to objective and subjective measures of school performance

    NARCIS (Netherlands)

    Boschloo, Annemarie; Krabbendam, Lydia; Dekker, Sanne; Lee, Nikki; De Groot, Renate; Jolles, Jelle

    2016-01-01

    This study investigated the relation between sleep and school performance in a large sample of 561 adolescents aged 11–18 years. Three subjective measures of sleep were used: sleepiness, sleep quality, and sleep duration. They were compared to three measures of school performance: objective school g

  20. Discussion of causes and consequences of sleepiness among college students, 2014

    Directory of Open Access Journals (Sweden)

    Wolgast B

    2016-05-01

    Full Text Available Brad WolgastCenter for Counseling and Student Development, University of Delaware, Newark, DE, USAI was recently directed to, “Causes and consequences of sleepiness among college students”, from Hershner and Chervin.1 As a psychologist who specializes in treating college student sleep problems, I was very pleased to see this article. Overall, it is a gem: thorough, well-conceived, and thoughtful. However, I have concerns about two sections. First, on page 74, Hershner and Chervin1 write, “How much sleep a young adult needs is not clearly known, but is thought to be 8 hours.” They then cite Wehr et al2 as well as Van Dongen et al.3 These choices are surprising as reference for the assertion that young adults need approximately 8 hours of sleep.View original paper by Hershner and Chervin.

  1. Daytime Sleepiness Is Associated With Reduced Integration of Temporally Distant Outcomes on the Iowa Gambling Task.

    Science.gov (United States)

    Olson, Elizabeth A; Weber, Mareen; Rauch, Scott L; Killgore, William D S

    2016-01-01

    Sleep deprivation is associated with performance decrements on some measures of executive functioning. For instance, sleep deprivation results in altered decision making on the Iowa Gambling Task. However, it is unclear which component processes of the task may be driving the effect. In this study, Iowa Gambling task performance was decomposed using the Expectancy-Valence model. Recent sleep debt and greater daytime sleepiness were associated with higher scores on the updating parameter, which reflects the extent to which recent experiences are emphasized over remote ones. Findings suggest that the effects of insufficient sleep on IGT performance are due to shortening of the time horizon over which decisions are integrated. These findings may have clinical implications in that individuals with sleep problems may not integrate more temporally distant information when making decisions.

  2. Balancing task focus and relationship building: asking sleepy patients about traffic risk in treatment initiation consultations.

    Science.gov (United States)

    Iversen, Clara; Broström, Anders; Ulander, Martin

    2017-04-24

    The use of traffic risk assessment questions is an understudied area in nursing research. Obstructive sleep apnoea is associated with an increased risk of traffic accidents. Therefore, traffic safety authorities demand adherent continuous positive airway pressure use. Nurses act as coaches to achieve treatment adherence, but they are also obliged to act as state agents by prohibiting obstructive sleep apnoea patients from drowsy driving. To examine how nurses and obstructive sleep apnoea patients manage traffic risk assessment questions in the relation-building context of treatment initiation consultations. To study, in detail, the actual practice of risk assessment, we used conversation analysis of 19 video-recorded initial treatment consultations with nurses and recently diagnosed obstructive sleep apnoea patients. The study received ethical approval from the Central Ethical Review Board in Linköping (registration number 214/231-32) and follows the ethical guidelines for qualitative research. Patients influence how nurses phrase questions about traffic risk by taking a stance to daytime sleepiness prior to the risk question. Nurses ask traffic risk questions in a way that assumes that driving is unproblematic if patients have not previously indicated problems. It may pose a significant problem when nurses, by accepting patients' prior stance when asking about traffic risk, orient to relationship building rather than task focus. To clarify the difference between their two potentially conflicting roles, nurses need to refer to existing laws and official guidelines when they raise the issue of risk in treatment initiation consultations. Nurses should also ask risk assessment questions in a problem-oriented communicative environment. Traffic risk assessment is sensitive yet important, as obstructive sleep apnoea is a highly prevalent problem causing excessive sleepiness. It is essential to acknowledge nurses' double roles with regard to coaching continuous positive

  3. Ready for takeoff? A critical review of armodafinil and modafinil for the treatment of sleepiness associated with jet lag.

    Science.gov (United States)

    McCarty, David E

    2010-01-01

    Jet lag syndrome (JLS) is a clinical syndrome of disrupted nocturnal sleep and daytime neurocognitive impairment which occurs in the context of rapid transmeridian travel. Many strategies for treatment of JLS exist, and include hypnotics to enhance nocturnal sleep, chronotherapeutic approaches (eg, light therapy, melatonin, or gradual schedule shifting), and alerting agents to counter daytime sleepiness. Safety concerns have prompted renewed interest in managing JLS-associated excessive daytime sleepiness (JLSAEDS). Off-label use of the newer alerting agents modafinil and armodafinil is increasing for this indication, often at the specific request of patients. In order to better evaluate the potential risks and benefits of these medications for the management of JLSAEDS, clinicians must be aware of what is known - and still not known. In this article, the pharmacology and pharmacokinetics of modafinil and armodafinil are reviewed, along with evidence for their efficacy in treating sleepiness associated with narcolepsy, obstructive sleep apnea and shift work sleep disorder. Clinical trial data for use of alerting agents in the management of JLSAEDS are limited to one three-day trial involving armodafinil, dosed in the morning to treat JLSAEDS in the setting of eastbound transmeridian travel. This study showed improvement in objective measures of daytime sleepiness at doses of 50 and 150 mg per day. However, global impression of clinical severity of symptom scores only improved on day 1 for those patients receiving 150 mg, and were otherwise not superior to placebo. Consideration for the use of modafinil or armodafinil for the treatment of sleepiness associated with JLS involves careful integration of patient-reported goals, a review of medical contraindications, and an awareness of rare adverse events. More research is needed in order to identify those who are most likely to benefit from this intervention and better define the risk-benefit ratio for this indication.

  4. Laparoscopic Skills and Cognitive Function are not Affected in Surgeons During a Night Shift

    DEFF Research Database (Denmark)

    Amirian, Ilda; Andersen, Lærke T; Rosenberg, Jacob

    2014-01-01

    simulation and the d2 test of attention at 8 a.m. before call and at 4 a.m. on call. Sleep was measured by wrist actigraphy and sleepiness by the Karolinska sleepiness scale. SETTING: Department of Surgery at Herlev Hospital, Denmark. PARTICIPANTS: Overall, 30 interns, residents, and attending surgeons were...... compared with on-call values. The d2 test of attention showed significantly improved values on call compared with before call. CONCLUSION: Sleep deprivation during a 17-hour night shift did not impair surgeons' psychomotor or cognitive performance....

  5. Disrupted sleep without sleep curtailment induces sleepiness and cognitive dysfunction via the tumor necrosis factor-α pathway

    Directory of Open Access Journals (Sweden)

    Ramesh Vijay

    2012-05-01

    Full Text Available Abstract Background Sleepiness and cognitive dysfunction are recognized as prominent consequences of sleep deprivation. Experimentally induced short-term sleep fragmentation, even in the absence of any reductions in total sleep duration, will lead to the emergence of excessive daytime sleepiness and cognitive impairments in humans. Tumor necrosis factor (TNF-α has important regulatory effects on sleep, and seems to play a role in the occurrence of excessive daytime sleepiness in children who have disrupted sleep as a result of obstructive sleep apnea, a condition associated with prominent sleep fragmentation. The aim of this study was to examine role of the TNF-α pathway after long-term sleep fragmentation in mice. Methods The effect of chronic sleep fragmentation during the sleep-predominant period on sleep architecture, sleep latency, cognitive function, behavior, and inflammatory markers was assessed in C57BL/6 J and in mice lacking the TNF-α receptor (double knockout mice. In addition, we also assessed the above parameters in C57BL/6 J mice after injection of a TNF-α neutralizing antibody. Results Mice subjected to chronic sleep fragmentation had preserved sleep duration, sleep state distribution, and cumulative delta frequency power, but also exhibited excessive sleepiness, altered cognitive abilities and mood correlates, reduced cyclic AMP response element-binding protein phosphorylation and transcriptional activity, and increased phosphodiesterase-4 expression, in the absence of AMP kinase-α phosphorylation and ATP changes. Selective increases in cortical expression of TNF-α primarily circumscribed to neurons emerged. Consequently, sleepiness and cognitive dysfunction were absent in TNF-α double receptor knockout mice subjected to sleep fragmentation, and similarly, treatment with a TNF-α neutralizing antibody abrogated sleep fragmentation-induced learning deficits and increases in sleep propensity. Conclusions Taken together

  6. Avaliação da sonolência em estudantes universitários de turnos distintos Evaluación de la somnolencia en estudiantes universitarios de turnos distintos Evaluation of sleepiness in college students from different shifts

    Directory of Open Access Journals (Sweden)

    Danilo de Freitas Araújo

    2012-08-01

    Full Text Available Estudantes de graduação possuem altas chances de apresentar Sonolência Diurna Excessiva, devido aos horários escolares e às demandas acadêmicas. Por isso, pretendeu-se analisar níveis de sonolência de estudantes de turnos distintos. O universo foi constituído por 109 graduandos do turno matutino e 125 do noturno. Utilizou-se a Escala de Sonolência de Epworth. A amostra apresentou média total de 9,38 (DP=4,03, sendo 9,03 (DP=4,01 para o turno matutino e 9,7 (DP=3,93 para o noturno. Foram detectadas diferenças significativas nos níveis de sonolência entre turnos (η² =0,10;p Estudiantes de graduación poseen altas posibilidades de presentar Somnolencia Diurna Excesiva, debido a los horarios escolares y a las demandas académicas. Por eso, se pretendió analizar niveles de somnolencia de estudiantes de turnos distintos. El universo fue constituido por 109 graduandos del turno matutino y 125 del nocturno. Se utilizó la Escala de Somnolencia de Epworth. La muestra presentó promedio total de 9,38 (DP=4,03, siendo 9,03 (DP=4,01 para el turno matutino y 9,7 (DP=3,93 para el nocturno. Fueron detectadas diferencias significativas en los niveles de somnolencia entre turnos (η²=0,10; pUndergraduate students are a population with high chances of developing Excessive Daytime Sleepiness, due to school schedules and academic demands. Our aim was to examine the levels of sleepiness of students belonging to morning and night classes. The universe has consisted of 109 undergraduate students of the morning shift and 125 of the night shift. We have used the Epworth Sleepiness Scale. The sample had an average of 9.38 (SD=4.03, and 9.03 (SD=4.01 for the morning shift and 9.7 (SD=3.93 for the night shift. Statistical analysis showed significant differences in sleepiness between shifts (η²=0,10; p<0,00, and among male subjects and female in the two shifts (η²=0,45; p<0,00. It should therefore be considered the role of academic demands, since they

  7. Long-term efficacy and safety of modafinil (PROVIGIL((R))) for the treatment of excessive daytime sleepiness associated with narcolepsy.

    Science.gov (United States)

    Mitler; Harsh; Hirshkowitz; Guilleminault

    2000-07-01

    Objectives: To assess the long-term efficacy and safety of modafinil in patients with excessive daytime sleepiness (EDS) associated with narcolepsy.Background: Modafinil has been shown to be effective and well tolerated for treating EDS associated with narcolepsy in two large-scale, well-controlled, 9-week clinical trials.Methods: Four hundred and seventy eight adult patients with a diagnosis of narcolepsy who had completed one of two 9-week, double-blind, placebo-controlled, multicenter, clinical trials of modafinil were enrolled in two 40-week, open-label, extension studies. A flexible-dose regimen (i.e. 200, 300, or 400 mg daily) was followed in one study. In the second study, patients received 200 mg/day for 1 week, followed by 400 mg/day for 1 week. Investigators then prescribed either 200- or 400-mg doses for the duration of the study. Efficacy was evaluated using Clinical Global Impression of Change (CGI-C) scores, the Epworth Sleepiness Scale (ESS), and the 36-item Medical Outcomes Study health survey (SF-36). Adverse events were recorded. Data from the two studies were combined.Results: The majority of patients ( approximately 75%) received 400 mg of modafinil daily. Disease severity improved in >80% of patients throughout the 40-week study. At weeks 2, 8, 24, and 40, disease severity was 'much improved' or 'very much improved' in 49, 58, 59, and 58% of patients, respectively. The mean (+/-SEM) ESS score improved significantly from 16.5+/-0.2 at open-label baseline to 12.4+/-0.2 at week 2 and remained at that level through week 40 (PQuality of life scores at weeks 4, 8, 24, and 40 were significantly improved versus open-label baseline scores for six of the eight SF-36 domains (P<0.001). The most common treatment-related adverse events were headache (13%), nervousness (8%), and nausea (5%). Most adverse events were mild to moderate in nature. A total of 341 patients (71%) completed the studies. Forty-three patients (9.0%) discontinued treatment because of

  8. Sleep habits, sleepiness and accidents among truck drivers Hábitos de sono, sonolência e acidentes em caminhoneiros

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    José Carlos Souza

    2005-12-01

    Full Text Available OBJECTIVE: To evaluate the quality of sleep, shift work, alcohol and psychostimulant drug use, and the prevalence of accidents among truck drivers. METHOD: Data were collected using a demographic questionnaire, the Epworth Sleepiness Scale (ESS and the Pittsburgh sleep quality index (PSQI. Statistical analysis was conducted using the Student t, chi-square, Pearson and Fisher tests. RESULTS: 43.2% of the drivers drove over 16 h a day, and 2.9% worked shifts. Mean number of sleep hours/day was 5.97±1.47; 23.8% slept 5; 23 subjects snored more than three times a week (11.1%. Mean ESS was 6.56±4.2; 21.7% had a score >10. In the preceding five years, 27 drivers (13.1% were involved in accidents, 5 of which resulted in injuries and 3 in deaths. CONCLUSION: Results showed a high prevalence of sleep disorders, use of alcohol and psychostimulant drugs, and accidents.OBETIVO: Avaliar a qualidade do sono, trabalho em turnos, consumo de álcool e psicoestimulantes, e a prevalência de acidentes, entre caminhoneiros. MÉTDO: Foram aplicados questionários demográficos, a Escala de Epworth e o Índice de Pittsburgh. A análise estatística foi feita com os testes t de Student, qui-quadrado, Pearson e Fisher. RESULTADOS: 43,2% dirigiam mais que 16 h/dia; 2,9% faziam trabalho por turnos. A média de horas de sono foi 5,97 +/- 1,47. 23,8% dormiam menos de 5 horas. 50,9% faziam uso de bebida alcoólica; usavam cafeína 95,6% e anfetaminas 11,1%. A média do PSQI foi 4,95 +/- 2,56; 35,4% tinham o PSQI maior que 5; 23 sujeitos ressonavam mais que 3 vezes por semana (11,1%. A ESE teve uma média de 6,56 +/- 4,2; 21.7% um escore superior a 10. Nos últimos cinco anos 27 motoristas (13,1% estiveram envolvidos em acidentes, 5 com feridos e 3 com mortos. CONCLUSÃO: Foi alta a prevalência de distúrbios do sono, uso de álcool e estimulantes, e de acidentes.

  9. Association between Screen Viewing Duration and Sleep Duration, Sleep Quality, and Excessive Daytime Sleepiness among Adolescents in Hong Kong

    Directory of Open Access Journals (Sweden)

    Yim Wah Mak

    2014-10-01

    Full Text Available Screen viewing is considered to have adverse impacts on the sleep of adolescents. Although there has been a considerable amount of research on the association between screen viewing and sleep, most studies have focused on specific types of screen viewing devices such as televisions and computers. The present study investigated the duration with which currently prevalent screen viewing devices (including televisions, personal computers, mobile phones, and portable video devices are viewed in relation to sleep duration, sleep quality, and daytime sleepiness among Hong Kong adolescents (N = 762. Television and computer viewing remain prevalent, but were not correlated with sleep variables. Mobile phone viewing was correlated with all sleep variables, while portable video device viewing was shown to be correlated only with daytime sleepiness. The results demonstrated a trend of increase in the prevalence and types of screen viewing and their effects on the sleep patterns of adolescents.

  10. Association between screen viewing duration and sleep duration, sleep quality, and excessive daytime sleepiness among adolescents in Hong Kong.

    Science.gov (United States)

    Mak, Yim Wah; Wu, Cynthia Sau Ting; Hui, Donna Wing Shun; Lam, Siu Ping; Tse, Hei Yin; Yu, Wing Yan; Wong, Ho Ting

    2014-10-28

    Screen viewing is considered to have adverse impacts on the sleep of adolescents. Although there has been a considerable amount of research on the association between screen viewing and sleep, most studies have focused on specific types of screen viewing devices such as televisions and computers. The present study investigated the duration with which currently prevalent screen viewing devices (including televisions, personal computers, mobile phones, and portable video devices) are viewed in relation to sleep duration, sleep quality, and daytime sleepiness among Hong Kong adolescents (N = 762). Television and computer viewing remain prevalent, but were not correlated with sleep variables. Mobile phone viewing was correlated with all sleep variables, while portable video device viewing was shown to be correlated only with daytime sleepiness. The results demonstrated a trend of increase in the prevalence and types of screen viewing and their effects on the sleep patterns of adolescents.

  11. Recovery after prolonged sleep deprivation: residual effects of slow-release caffeine on recovery sleep, sleepiness and cognitive functions.

    Science.gov (United States)

    Beaumont, Maurice; Batéjat, Denise; Coste, Olivier; Doireau, Philippe; Chauffard, Françoise; Enslen, Marc; Lagarde, Didier; Pierard, Christophe

    2005-01-01

    A long work schedule often results in sleep deprivation, sleepiness, impaired performance and fatigue. We investigated the residual effects of slow-release caffeine (SRC) on sleep, sleepiness and cognitive performance during a 42-hour recovery period following a 64-hour continuous wakefulness period in 16 healthy males, according to a double-blind, randomised, placebo-controlled, crossover study. Three hundred milligrams of SRC or placebo was given twice a day at 21:00 and 9:00 during the first 48 h of wakefulness. Recovery sleep was analysed with electroencephalography (EEG) and wrist actigraphy, daytime sleepiness with continuous EEG, sleep latency tests and actigraphy and cognitive functions with computerized tests from the NATO AGARD STRES battery. Both drug groups exhibited almost the same sleep architecture with a rebound of slow-wave sleep during both recovery nights and of REM sleep during the second night. Wakefulness level and cognitive functions were similarly impaired in both groups on the first day of recovery and partially returned to baseline on the second. To conclude, SRC appears to have no unwanted side-effects on recovery sleep, wakefulness and cognitive performance after a long period of sleep deprivation and might therefore be a useful choice over other psychostimulants for a long work schedule.

  12. Associations of excessive sleepiness on duty with sleeping hours and number of days of overnight work among medical residents in Japan.

    Science.gov (United States)

    Wada, Koji; Sakata, Yumi; Theriault, Gilles; Narai, Rie; Yoshino, Yae; Tanaka, Katsutoshi; Aizawa, Yoshiharu

    2007-11-01

    Despite long-standing concerns regarding the effects of working hours on the performance and health of medical residents, and the patients' safety, prior studies have not shown an association of excessive sleepiness with the number of sleeping hours and days of overnight work among medical residents. In August 2005, a questionnaire was mailed to 227 eligible participants at 16 teaching hospitals. The total number of sleeping hours in the last 30 d was estimated from the average number of sleeping hours during regular days and during days with overnight work, and the number of days of overnight work. Multiple logistic regression analysis was used to adjust for potentially associated variables. A total of 149 men and 47 women participated in this study. The participation rate was 86.3%. Among the participants, 55 (28.1%) suffered from excessive sleepiness. Excessive sleepiness was associated with sleeping for less than 150 h in the last 30 d (corrected odds ratio [cOR]=1.57; 95% confidence interval [CI], 1.02-2.16). The number of days of overnight work in the last 30 d showed no association with excessive sleepiness. Excessive sleepiness was also associated with smoking (cOR, 1.65; 95%CI, 1.01-2.32). Medical residents who slept for less than 150 h in the last 30 d and smoked had a significantly higher risk of excessive sleepiness on duty.

  13. Excessive daytime sleepiness in Campo Grande general population, Brazil Sonolência diurna excessiva na população geral de Campo Grande, MS

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    José Carlos Souza

    2002-09-01

    Full Text Available The prevalence of excessive daytime sleepiness (EDS in general population was determined by means of 408 home interviews of adults, in a representative sample of Campo Grande city, Brazil. The random sample was stratified by sex, age and economic social status. EDS was considered in those with indexes 11 or more in the Epworth Sleepiness Scale. Statistics used chi-square, Fisher and Pearson tests; and inferences based on binomial distribution parameters; the significance level was 5% and confidence interval (CI was 95%. The prevalence of EDS was 18.9% of the general population ( SD=1.9%; CI 15.1% to 22.7%. No significant association was found between EDS and the use of hypnotics, nor with insomnia, body mass index, sex, age, years of schooling, economic social status, marital status, occupation and the use of alternative means to improve sleep. When the sample was separated according to sex, only the male group showed significant association between EDS and actual insomnia (p=0.005.Buscou-se a prevalência da sonolência diurna excessiva (SDE com 408 entrevistas domiciliares de adultos, em amostra representativa da população geral da cidade de Campo Grande, MS. A amostragem aleatória foi estratificada por sexo, idade e classe social. Tinham SDE as pessoas com 11 ou mais pontos na Escala de Sonolência Epworth. Usaram-se os testes de qui-quadrado, Fisher, Pearson e inferências com base nos parâmetros da distribuição binomial; nível de significância 5% e intervalo de confiança (IC 95%. Tinham SDE 18,9% da população (dp=1,9%; IC 15,1% a 22,7%; não houve associação significativa entre SDE e uso de hipnóticos, nem insônia, índice de massa corporal, sexo, idade, escolaridade, classe sócio-econômica, estado civil, ocupação e uso de meios alternativos para dormir melhor. Ao serem separados de acordo com sexo, apenas no sexo masculino houve associação significativa entre SDE e presença de insônia (p=0,005.

  14. Drug treatment of patients with insomnia and excessive daytime sleepiness: pharmacokinetic considerations.

    Science.gov (United States)

    Nishino, S; Mignot, E

    1999-10-01

    Insomnia and excessive daytime sleepiness (EDS) are frequently observed conditions in the general public. A national survey in the USA in 1979 indicated that 35% of American adults experience insomnia in the course of a year. The prevalence of EDS varies depending on the survey (0.3 to 13.3%), but a recent study stated that 2.4% of individuals reported that they continually fell asleep at work. These problems are often long term and negatively affect the individuals' quality of life. People with these sleep problems often have difficulties maintaining high levels of productivity at work or pursuing their daily activities; individuals with insomnia lack the feeling of being rested or refreshed in the morning and EDS is unavoidable in most cases. Behavioural therapy has been shown to be effective for many people affected with insomnia and EDS. However, pharmacological treatments using hypnosedatives and central nervous system (CNS) stimulants are usually necessary, and effective, for those with more severe cases. These compounds have thus been widely prescribed in clinical practice (e.g., 2.6% of all adults surveyed used medically prescribed hypnosedatives and 4.5% used over-the-counter drugs to promote sleep). The onset and duration of action of these hypnosedatives and CNS stimulant drugs are important factors to be considered when prescribing these compounds. These factors primarily depend on physicochemical properties (lipid solubility and protein binding), as well as the pharmacokinetic profile (absorption, distribution, elimination and clearance) of the compounds. Significant differences in profile exist amongst hypnosedatives and CNS stimulants, and these differences may account for the observed variations in clinical action and adverse effects during and after treatment. In this review, we will introduce recently obtained knowledge of the pharmacokinetics of hypnosedatives and CNS stimulants and their applications for patients affected with insomnia and EDS.

  15. Are There Differences in Students’ School Success, Biorhythm, and Daytime Sleepiness Depending on Their School Starting Times?

    OpenAIRE

    Milić, Jakov; Kvolik, Ana; Ivković, Martina; Babić Čikeš, Ana; Labak, Irena; Benšić, Mirta; Ilakovac, Vesna; Ništ, Marina; Zibar, Lada; Heffer, Marija

    2014-01-01

    Chronotype is a characteristic of a person in a certain point of one’s lifetime and it slowly changes with age. Adolescents start to go to bed later while schools impose early starting hours, which may become a problem for students who are unable to adapt their circadian rhythm. The aim of this study was to determine if differences in school starting times affect the students’ chronotype, school success, or daytime sleepiness. We tested a total of 1020 students from four high schools in Osije...

  16. Psychomotor Vigilance Performance Predicted by Epworth Sleepiness Scale Scores in an Operational Setting with the United States Navy

    Science.gov (United States)

    2015-01-01

    SHATTUCK and PANAG IOT I S MATSANGAS Operations Research Department, Naval Postgraduate School, Monterey, CA, USA Keywords fatigue, fitness-for-duty...actigraphic devices and were instructed to take the PVT four times per day, before and after standing for each of two daily watch periods. They were also

  17. The association between use of electronic media in bed before going to sleep and insomnia symptoms, daytime sleepiness, morningness, and chronotype.

    Science.gov (United States)

    Fossum, Ingrid Nesdal; Nordnes, Linn Tinnesand; Storemark, Sunniva Straume; Bjorvatn, Bjørn; Pallesen, Ståle

    2014-09-03

    This study investigated whether the use of a television, computer, gaming console, tablet, mobile phone, or audio player in bed before going to sleep was associated with insomnia, daytime sleepiness, morningness, or chronotype. 532 students aged 18-39 were recruited from lectures or via e-mail. Respondents reported the frequency and average duration of their in-bed media use, as well as insomnia symptoms, daytime sleepiness, morningness-eveningness preference and bedtime/rise time on days off. Mean time of media use per night was 46.6 minutes. The results showed that computer usage for playing/surfing/reading was positively associated with insomnia, and negatively associated with morningness. Mobile phone usage for playing/surfing/texting was positively associated with insomnia and chronotype, and negatively associated with morningness. None of the other media devices were related to either of these variables, and no type of media use was related to daytime sleepiness.

  18. An official American Thoracic Society Clinical Practice Guideline: sleep apnea, sleepiness, and driving risk in noncommercial drivers. An update of a 1994 Statement.

    Science.gov (United States)

    Strohl, Kingman P; Brown, Daniel B; Collop, Nancy; George, Charles; Grunstein, Ronald; Han, Fang; Kline, Lawrence; Malhotra, Atul; Pack, Alan; Phillips, Barbara; Rodenstein, Daniel; Schwab, Richard; Weaver, Terri; Wilson, Kevin

    2013-06-01

    Sleepiness may account for up to 20% of crashes on monotonous roads, especially highways. Obstructive sleep apnea (OSA) is the most common medical disorder that causes excessive daytime sleepiness, increasing the risk for drowsy driving two to three times. The purpose of these guidelines is to update the 1994 American Thoracic Society Statement that described the relationships among sleepiness, sleep apnea, and driving risk. A multidisciplinary panel was convened to develop evidence-based clinical practice guidelines for the management of sleepy driving due to OSA. Pragmatic systematic reviews were performed, and the Grading of Recommendations, Assessment, Development, and Evaluation approach was used to formulate and grade the recommendations. Critical outcomes included crash-related mortality and real crashes, whereas important outcomes included near-miss crashes and driving performance. A strong recommendation was made for treatment of confirmed OSA with continuous positive airway pressure to reduce driving risk, rather than no treatment, which was supported by moderate-quality evidence. Weak recommendations were made for expeditious diagnostic evaluation and initiation of treatment and against the use of stimulant medications or empiric continuous positive airway pressure to reduce driving risk. The weak recommendations were supported by very low-quality evidence. Additional suggestions included routinely determining the driving risk, inquiring about additional causes of sleepiness, educating patients about the risks of excessive sleepiness, and encouraging clinicians to become familiar with relevant laws. The recommendations presented in this guideline are based on the current evidence, and will require an update as new evidence and/or technologies becomes available.

  19. Fonoaudiologia e apneia do sono: uma revisão Speech therapy and sleepy apnae: a review

    Directory of Open Access Journals (Sweden)

    Erilucia Pereira Santa Rosa

    2010-10-01

    Full Text Available TEMA: a Síndrome da Apneia/Hipopneia Obstrutiva do Sono (SAHOS é definida pela Academia Americana do Sono como a presença de episódios recorrentes de obstrução parcial ou total das vias aéreas superiores durante o sono e manifesta-se como uma redução (hipopneia ou cessação completa (apneia do fluxo aéreo, apesar da manutenção dos esforços inspiratórios. A SAHOS motiva o chamado ronco crônico, sonolência e caracteriza-se pela parada do fluxo aéreo respiratório por pelo menos, 10 segundos. O diagnóstico é realizado através do exame polissonográfico, que consiste no registro simultâneo de atividades do organismo durante a noite, indicando a quantidade de apneias e hipopneias ocorridos e a gravidade da SAHOS. Para sucesso no tratamento desta desordem é fundamental o diagnóstico preciso e correto e a atuação de uma equipe multidisciplinar, estando inserido nela o fonoaudiólogo. OBJETIVO: analisar, através da literatura a interrrelação da Fonoaudiologia e a SAHOS. CONCLUSÃO: aom o referente estudo, podemos identificar a complexidade da SAHOS e mostrar a importância da atuação fonoaudiológica na terapêutica desses pacientes, para uma melhor qualidade de vida.BACKGROUND: the Apnea syndrome / Obstructive Sleepy Hypopnea (SOHAS is define by the American Academy of Sleep with recurrent presence of episodes of partial or total obstruction in the superior airways during sleep, in addition to showing a reduction (hypopnea or complete stoppage (apnea of airflow, although there is an ongoing maintenance of inspiratory efforts. SOHAS motivates the so-called sleepy chronic snoring and sleepiness to dress up by the stop of airflow by at least 10 seconds. The diagnosis is carried out through polysomnographic examination, which consists of the simultaneous recording of body activities during the night, indicating the number of occurring apneas and hypopneas and SOHAS severity. For the successful of disorder treatment it is

  20. Cansancio y somnolencia en conductores de ómnibus interprovinciales: estudio comparativo entre formalidad e informalidad Fatigue and sleepiness in interprovincial road bus drivers: comparative study between formality and informality

    Directory of Open Access Journals (Sweden)

    Gustavo R. Liendo

    2010-06-01

    non-probabilistic sampling. 100 companies of land transport were included, out of which 17 were formal according to the official registries of the Ministry of Transport and Communications (MTC, the drivers were also classified as formal or informal. The survey included one questionnaire and a Peruvian validated version of the Epworth sleepiness scale. Results. 71 formal drivers and 274 informal drivers participated, all were males. Out of the 134 drivers that worked for the formal companies according to the MTC, only 43 (32% belong to the formal group based on the proposed criteria. 48% (34 of the formal drivers and 43% (118 of the informal sleep less than 7 hours a day. 48% (34 of the formal and 49% (135 of the informal admitted having had an accident or "almost" having had it, the most frequent time of the day was between 01.00 and 04.00 in the morning. The dawn is the period in which both groups feel most tired. 44% (30 of the formal drivers and 54% (144 of the informal ones perform 5 or more night shifts per week. Out of the total of interviewed, 16% (56 had sleepiness. The association with road traffic accidents was similar. Conclusions. The fatigue and sleepiness levels were similar between formal and informal drivers. Companies classified as formal, have a high percentage of informality amongst their drivers.

  1. Scatter Plot Analysis of Excessive Daytime Sleepiness and Severe Disruptive Behavior in Adults with Prader-Willi Syndrome: A Pilot Study

    Science.gov (United States)

    Maas, Anneke P. H. M.; Didden, Robert; Bouts, Lex; Smits, Marcel G.; Curfs, Leopold M. G.

    2009-01-01

    Individuals with Prader-Willi syndrome (PWS) are at risk for excessive daytime sleepiness (EDS) and disruptive behavior. This pilot study explores temporal characteristics of EDS and severe disruptive behavior across time of day and day of week in seven individuals with PWS (aged between 33 and 49 years) of whom five were matched to controls.…

  2. Experimental investigation of the effects of the car driver`s postures on sleepiness; Chakuza shisei ga nemuke ni oyobosu eikyo ni kansuru kenkyu

    Energy Technology Data Exchange (ETDEWEB)

    Komatsudani, M.; Okamura, C. [Toyo Seat Co. Ltd., Hiroshima (Japan); Nishiyama, S. [Hiroshima City Industrial Technology Institute, Hiroshima (Japan); Nozawa, T.; Nishikawa, K. [Matsuda Motor Corp., Hiroshima (Japan); Hori, T.; Hayashi, M. [Hiroshima University, Hiroshima (Japan)

    1998-05-01

    Effects of car driver`s postures on sleepiness were experimentally investigated. For the measurement method of EEG (electroencephalogram), bipolar induction was adopted, to record Cz and Pz using those at left ear as standard by international 10-20 electrode method. In addition, differential potential was recorded between locations of Cz and Pz. The time constant of EEG was set in 0.3 sec. Brain waves were measured for one minute under open and close eye conditions before and after each test as EEG at the rest. For the measurement of EOG (electro-oculograph), vertical and horizontal eye motions were observed. Induced potential change was measured by attaching silver-silver chloride electrode at the time constant 1.5 sec. For the measurement of SPL (skin potential level), the palm of left hand was used as a measuring point and the left front arm was used as a reference point for attaching electrodes. The danger of sleepiness was provided by the boring driving conditions independent of driver`s postures. There was a difference of relaxation time due to the driver`s postures. It was difficult to avoid sleepiness by adjusting the relative angle between seat and seat back. However, it was found that the angle 110deg was most suitable for avoiding sleepiness. 7 refs., 5 figs., 2 tabs.

  3. Effects of epilepsy treatments on sleep architecture and daytime sleepiness: an evidence-based review of objective sleep metrics.

    Science.gov (United States)

    Jain, Sejal V; Glauser, Tracy A

    2014-01-01

    Sleep is considered restorative, and good quantity and quality sleep is required for memory consolidation and synaptic plasticity. Sleep disorders are common in patients with epilepsy. Poor sleep quality or quantity may worsen seizure control. On the other end, seizures and epilepsy may worsen the sleep quality and set a vicious cycle. In addition, antiepileptic drugs have an effect on sleep architecture. We performed a systemic literature review with a goal to evaluate the effect of antiepileptic drugs and nondrug treatments for epilepsy on sleep architecture to help better understand treatment effects, especially in patients with epilepsy and sleep problems. We searched PubMed and identified studies that evaluated objective sleep outcomes for an antiepileptic drug. We also searched for studies with objective sleep outcomes that evaluated other epilepsy treatments such as epilepsy surgery, vagus nerve stimulation, and ketogenic diet. The studies were categorized based on evidence class and study population for an individual antiepileptic drug or treatment. We identified that most antiepileptic drugs and nondrug treatments for epilepsy affect sleep architecture. We identified that gabapentin, tiagabine, pregabalin, clobazam, and carbamazepine reduce sleep latency and/or improve sleep efficiency. Phenobarbital, valproic acid, and higher-dose levetiracetam aggravate daytime sleepiness, whereas topiramate and zonisamide do not. Vagus nerve stimulation reduces daytime sleepiness, and ketogenic diet improves slow-wave sleep. Epilepsy surgery may improve nocturnal sleep only in a subgroup of patients with improved seizure frequency. Further studies are needed to evaluate the dose-dependent sleep effects of antiepileptic drugs and nondrug treatments independent of the improvement of epilepsy, and to identify if these changes are clinically significant. Wiley Periodicals, Inc. © 2013 International League Against Epilepsy.

  4. Vigilance on the civil flight deck: incidence of sleepiness and sleep during long-haul flights and associated changes in physiological parameters.

    Science.gov (United States)

    Wright, N; McGown, A

    2001-01-15

    The study investigated sleepiness and sleep in aircrew during long-haul flights. The objectives were to identify loss of alertness and to recommend a practical approach to the design of an alerting system to be used by aircrew to prevent involuntary sleep. The flights were between London and Miami, covering both day- and night-time sectors, each with a duration of approximately 9 h. The subjects were 12 British Airways pilots. Various physiological variables were measured that could potentially be used to indicate the presence of drowsiness and involuntary sleep: brain electrical activity (electroencephalogram, EEG), eye movements via the electro-oculogram (EOG), wrist activity, head movements and galvanic skin resistance. The EEG and EOG identified sleepiness and sleep, as well as being potential measures on which to base an alarm system. Ten pilots either slept or showed evidence of sleepiness as assessed by the EEG and EOG. Many of the episodes of sleepiness lasted alarm system to prevent involuntary sleep. Skin resistance is considered to be unsuitable, however, being related in a more general way to fatigue rather than to sleep episodes. The optimal way to monitor the onset of sleep would be to measure eye movements; however, this is not feasible in the flight deck environment at the present time due to the intrusive nature of the recording methodology. Wrist activity is therefore recommended as the basis of an alertness alarm. Such a device would alert the pilot after approximately 4-5 min of wrist inactivity, since this duration has been shown by the present study to be associated with sleep. The possibility that sleep inertia (reduced alertness immediately after awakening from sleep) could follow periods of sleep lasting 5 min needs to be considered. The findings reported here might be applicable to other occupational environments where fatigue and sleepiness are known to occur.

  5. Measurement of narcolepsy symptoms: The Narcolepsy Severity Scale.

    Science.gov (United States)

    Dauvilliers, Yves; Beziat, Severine; Pesenti, Carole; Lopez, Regis; Barateau, Lucie; Carlander, Bertrand; Luca, Gianina; Tafti, Mehdi; Morin, Charles M; Billiard, Michel; Jaussent, Isabelle

    2017-04-04

    To validate the Narcolepsy Severity Scale (NSS), a brief clinical instrument to evaluate the severity and consequences of symptoms in patients with narcolepsy type 1 (NT1). A 15-item scale to assess the frequency and severity of excessive daytime sleepiness, cataplexy, hypnagogic hallucinations, sleep paralysis, and disrupted nighttime sleep was developed and validated by sleep experts with patients' feedback. Seventy untreated and 146 treated adult patients with NT1 were evaluated and completed the NSS in a single reference sleep center. The NSS psychometric properties, score changes with treatment, and convergent validity with other clinical parameters were assessed. The NSS showed good psychometric properties with significant item-total score correlations. The factor analysis indicated a 3-factor solution with good reliability, expressed by satisfactory Cronbach α values. The NSS total score temporal stability was good. Significant NSS score differences were observed between untreated and treated patients (dependent sample, 41 patients before and after sleep therapy; independent sample, 29 drug-free and 105 treated patients). Scores were lower in the treated populations (10-point difference between groups), without ceiling effect. Significant correlations were found among NSS total score and daytime sleepiness (Epworth Sleepiness Scale, Mean Sleep Latency Test), depressive symptoms, and health-related quality of life. The NSS can be considered a reliable and valid clinical tool for the quantification of narcolepsy symptoms to monitor and optimize narcolepsy management. © 2017 American Academy of Neurology.

  6. Força muscular respiratória e capacidade funcional em idosas hipertensas com sonolência diurna excessiva Respiratory muscle strength and physical fitness in hypertensive elderly women with excessive daytime sleepiness

    Directory of Open Access Journals (Sweden)

    Rafaela Pedrosa

    2010-06-01

    Physical Activity Questionnaire; degree of EDS, by the Epworth Sleepiness Scale; sleep quality, by the Pittsburgh Sleep Quality Index; and intensity of snoring by the Stanford Snoring Scale. Both groups were homogenous as to anthropometric and hypertension features and were statistically compared as to sleep parameters, maximal respiratory pressures, level of physical activity, and FC. Significant differences were found in sleep quality (p=0.03, showing very poor sleep quality of the group hypertension with EDS; but no significant differences were found as to maximal respiratory pressures, or at the FC tests. Hence the strength of respiratory muscles is not altered due to the presence of EDS in elderly hypertensive women and sleepiness does not seem to interfere in functional capacity.

  7. The Effect of Armodafinil on Patient-Reported Functioning and Quality of Life in Patients With Excessive Sleepiness Associated With Shift Work Disorder: A Randomized, Double-Blind, Placebo-Controlled Trial

    OpenAIRE

    Erman, Milton K.; Yang, Ronghua; Seiden, David J.

    2012-01-01

    Objective: To examine whether treatment with armodafinil for 6 weeks affected patient-reported overall functioning and daily quality of life compared with placebo in patients with excessive sleepiness associated with shift work disorder.

  8. Sleep architecture of consolidated and split sleep due to the dawn (Fajr prayer among Muslims and its impact on daytime sleepiness

    Directory of Open Access Journals (Sweden)

    Ahmed S BaHammam

    2012-01-01

    Full Text Available Background: Muslims are required to wake up early to pray (Fajr at dawn (approximately one and one-half hours before sunrise. Some Muslims wake up to pray Fajr and then sleep until it is time to work (split sleep, whereas others sleep continuously (consolidated sleep until work time and pray Fajr upon awakening. Aim: To objectively assess sleep architecture and daytime sleepiness in consolidated and split sleep due to the Fajr prayer. Setting and Design: A cross-sectional, single-center observational study in eight healthy male subjects with a mean age of 32.0 ± 2.4 years. Methods: The participants spent three nights in the Sleep Disorders Center (SDC at King Khalid University Hospital, where they participated in the study, which included (1 a medical checkup and an adaptation night, (2 a consolidated sleep night, and (3 a split-sleep night. Polysomnography (PSG was conducted in the SDC following the standard protocol. Participants went to bed at 11:30 PM and woke up at 7:00 AM in the consolidated sleep protocol. In the split-sleep protocol, participants went to bed at 11:30 PM, woke up at 3:30 AM for 45 minutes, went back to bed at 4:15 AM, and finally woke up at 7:45 AM. PSG was followed by a multiple sleep latency test to assess the daytime sleepiness of the participants. Results: There were no differences in sleep efficiency, the distribution of sleep stages, or daytime sleepiness between the two protocols. Conclusion: No differences were detected in sleep architecture or daytime sleepiness in the consolidated and split-sleep schedules when the total sleep duration was maintained.

  9. Sleep architecture of consolidated and split sleep due to the dawn (Fajr) prayer among Muslims and its impact on daytime sleepiness

    OpenAIRE

    BaHammam, Ahmed S.; Sharif, Munir M.; D Warren Spence; Pandi-Perumal, Seithikurippu R.

    2012-01-01

    Background: Muslims are required to wake up early to pray (Fajr) at dawn (approximately one and one-half hours before sunrise). Some Muslims wake up to pray Fajr and then sleep until it is time to work (split sleep), whereas others sleep continuously (consolidated sleep) until work time and pray Fajr upon awakening. Aim: To objectively assess sleep architecture and daytime sleepiness in consolidated and split sleep due to the Fajr prayer. Setting and Design: A cross-sectional, single-...

  10. Armodafinil improves wakefulness and long-term episodic memory in nCPAP-adherent patients with excessive sleepiness associated with obstructive sleep apnea

    OpenAIRE

    Roth, Thomas; Rippon, Gregory A.; Arora, Sanjay

    2007-01-01

    Residual excessive sleepiness (ES) and impaired cognition can occur despite effective and regular nasal continuous positive airway pressure (nCPAP) therapy in some patients with obstructive sleep apnea (OSA). A pooled analysis of two 12-week, randomized, double-blind studies in nCPAP-adherent patients with ES associated with OSA evaluated the effect of armodafinil on wakefulness and cognition. Three hundred and ninety-one patients received armodafinil (150 or 250 mg) and 260 patients received...

  11. Sleep Apnea, Sleep Debt and Daytime Sleepiness Are Independently Associated with Road Accidents. A Cross-Sectional Study on Truck Drivers

    OpenAIRE

    Garbarino, Sergio; Durando, Paolo; Guglielmi, Ottavia; Dini, Guglielmo; Bersi, Francesca; Fornarino, Stefania; Toletone, Alessandra; Chiorri, Carlo; Magnavita, Nicola

    2016-01-01

    Background Recent research has found evidence of an association between motor vehicle accidents (MVAs) or near miss accidents (NMAs), and excessive daytime sleepiness (EDS) or its main medical cause, Obstructive Sleep Apnea (OSA). However, EDS can also be due to non-medical factors, such as sleep debt (SD), which is common among professional truck drivers. On the opposite side, rest breaks and naps are known to protect against accidents. Study Objectives To investigate the association of OSA,...

  12. Fremlæggelse af projekt med Epworth søvnighedsskema, opgørelse af data fra 2009-2014: "Prevalence of excessive daytime sleepiness in patients treated with orthognathic surgery"

    DEFF Research Database (Denmark)

    Linderup, Mette Werner

    Fremlæggelse af projekt med Epworth søvnighedsskema, opgørelse af data fra 2009-2014: "Prevalence of excessive daytime sleepiness in patients treated with orthognathic surgery"......Fremlæggelse af projekt med Epworth søvnighedsskema, opgørelse af data fra 2009-2014: "Prevalence of excessive daytime sleepiness in patients treated with orthognathic surgery"...

  13. Risk of obstructive sleep apnea with daytime sleepiness is associated with liver damage in non-morbidly obese patients with nonalcoholic fatty liver disease.

    Directory of Open Access Journals (Sweden)

    Edoardo Alessandro Pulixi

    Full Text Available BACKGROUND: A high prevalence of obstructive sleep apnea syndrome (OSAS has been reported in severely obese patients with nonalcoholic fatty liver disease (NAFLD, but few studies have evaluated OSAS in non-morbidly obese NAFLD patients. AIMS: To determine the prevalence of risk for OSAS with or without daytime sleepiness in non-morbidly obese patients with NAFLD and evaluate the association with the severity of liver damage. METHODS: We considered 159 consecutive patients with histological NAFLD and body mass index (BMI 1; 9/13, 69% vs. 39/146, 27%; p = 0.003. At multivariate logistic regression analysis, OSAS with sleepiness was strongly associated with NASH and fibrosis>1 independently of known clinical risk factors such as age, gender, BMI, diabetes, and ALT levels (OR 7.1, 95% c.i. 1.7-51, p = 0.005 and OR 14.0, 95% c.i. 3.5-70, p = 0.0002, respectively. CONCLUSIONS: A proportion of NAFLD patients without severe obesity is at risk for OSAS with daytime sleepiness, which is associated with the severity of liver damage independently of body mass and other cofactors.

  14. The impact of daytime sleepiness on the school performance of college students with attention deficit hyperactivity disorder (ADHD): a prospective longitudinal study.

    Science.gov (United States)

    Langberg, Joshua M; Dvorsky, Melissa R; Becker, Stephen P; Molitor, Stephen J

    2014-06-01

    This prospective longitudinal study evaluated the impact of daytime sleepiness on the school performance of 62 college students diagnosed comprehensively with attention deficit hyperactivity disorder. The primary goal of the study was to determine if self-reported daytime sleepiness rated at the beginning of the academic year could predict academic and overall functioning at the end of the academic year while also considering potentially important covariates, including symptoms of inattention, hyperactivity and impulsivity, medication status and whether or not students lived at home or on-campus. Self-reported daytime sleepiness predicted longitudinally school maladjustment, overall functional impairment and the number of D and F grades (i.e. poor and failing) students received in courses above and beyond both self- and parent-report of symptoms, but did not predict overall grade point average. Living at home served as a protective factor and was associated with less school maladjustment and overall impairment. Gender was the only significant predictor in the overall grade point average model, with female gender associated with higher overall grades. The implications of these findings for monitoring and treatment of sleep disturbances in college students with attention deficit hyperactivity disorder are discussed.

  15. DISTRIBUTION ANALYSIS OF ENLARGED CELLS DERIVED FROM GROUPER SLEEPY DISEASE IRIDOVIRUS (GSDIV INFECTED HUMPBACK GROUPER Cromileptes altivelis

    Directory of Open Access Journals (Sweden)

    Indah Mastuti

    2012-06-01

    Full Text Available Characteristic of Megalocytivirus infection has been known to produce formation of inclusion body bearing cells (IBCs on internals organs of fish predominantly on spleen and kidney. Megalocytivirus that infected grouper is known as Grouper Sleepy Disease Iridovirus (GSDIV. This study was conducted to answer the effect of entry sites of GSDIV on distribution of enlarged cells formed on the internal organs of humpback grouper Cromileptes altivelis. Enlarged cells were observed histologically under the light microscope on spleen, head kidney, trunk kidney, liver, gill, heart, stomach, intestine, muscle and brain. Entry sites were designated to intramuscularly injection, intraperitoneally injection, dipped gill and inoculum added feed. Enlarged cells were formed on spleen, head kidney, trunk kidney, liver, gill, heart, stomach, muscle, except on intestine and brain. All the entry sites resulted in formation of enlarged cells on spleen, head kidney, trunk kidney, liver, heart. Spleen and head kidney were the most frequent observed organ. These results suggested that distribution of enlarged cells were not affected by the entry site of GSDIV.

  16. THE EFFECTS OF CRUDE RECOMBINANT VIRAL PROTEIN VACCINES AGAINST GROUPER SLEEPY DISEASE IRIDOVIRUS (GSDIV ON HUMPBACK GROUPER (Cromileptes altivelis

    Directory of Open Access Journals (Sweden)

    Ketut Mahardika

    2015-12-01

    Full Text Available Infection of Megalocytivirus cause serious mass mortality in marine fish in South East Asian countries. The aim of this study was to produce recombinant of GSDIV capsid protein and its protection to humpback grouper Cromileptes altivelis against grouper sleepy disease iridovirus (GSDIV. A major capsid protein (MCP was selected for use as a crude subunit vaccines. This gene target (MCP was inserted to the protein expression system vector of pET SUMO and cloned in cells bacteria Escherichia coli strain BL-21. The MCP was succeded to be induced using 1 mM of IPTG. Results of protein analysis using MALDI TOF-TOF indicated that the MCP has measurement of 49.566 kDa with PI index of 6.00, and contained 453 amino acids. BLAST homology analysis exhibited that the amino acid sequence of the MCP showed high similarity with MCP of Red Sea Bream Iridovirus (RSIV. E. coli expressing MCP protein was inactivated using 0.03% formalin overnight and washed using PBS. The inactivated E. coli as a crude subunit vaccine was then injected intramuscularly to humpback grouper juveniles. Subsequently, the juveniles were challenged tested with GSDIV. The juveniles vaccinated with the MCP recombinant bacteria showed significantly higher survival rates than control those vaccinated with PBS. Thus, the MCP fusion protein is considered as a potential vaccine against GSDIV infections in grouper.

  17. The influence of sleep deprivation and oscillating motion on sleepiness, motion sickness, and cognitive and motor performance.

    Science.gov (United States)

    Kaplan, Janna; Ventura, Joel; Bakshi, Avijit; Pierobon, Alberto; Lackner, James R; DiZio, Paul

    2017-01-01

    Our goal was to determine how sleep deprivation, nauseogenic motion, and a combination of motion and sleep deprivation affect cognitive vigilance, visual-spatial perception, motor learning and retention, and balance. We exposed four groups of subjects to different combinations of normal 8h sleep or 4h sleep for two nights combined with testing under stationary conditions or during 0.28Hz horizontal linear oscillation. On the two days following controlled sleep, all subjects underwent four test sessions per day that included evaluations of fatigue, motion sickness, vigilance, perceptual discrimination, perceptual learning, motor performance and learning, and balance. Sleep loss and exposure to linear oscillation had additive or multiplicative relationships to sleepiness, motion sickness severity, decreases in vigilance and in perceptual discrimination and learning. Sleep loss also decelerated the rate of adaptation to motion sickness over repeated sessions. Sleep loss degraded the capacity to compensate for novel robotically induced perturbations of reaching movements but did not adversely affect adaptive recovery of accurate reaching. Overall, tasks requiring substantial attention to cognitive and motor demands were degraded more than tasks that were more automatic. Our findings indicate that predicting performance needs to take into account in addition to sleep loss, the attentional demands and novelty of tasks, the motion environment in which individuals will be performing and their prior susceptibility to motion sickness during exposure to provocative motion stimulation. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Microcurrent Stimulation at Shenmen Acupoint Facilitates EEG Associated with Sleepiness and Positive Mood: A Randomized Controlled Electrophysiological Study

    Directory of Open Access Journals (Sweden)

    Mei-chun Cheung

    2015-01-01

    Full Text Available To examine the electrophysiological effects of microcurrent stimulation at the Shenmen acupoint, 40 healthy normal subjects were randomly assigned to a placebo group (sham stimulation and an experimental group (bilateral electrocutaneous stimulation at the Shenmen. The following two electroencephalographic indicators were used to measure brain activity. (1 Arousal level was measured with reference to log-transformed absolute alpha power and power source and analyzed using low-resolution electromagnetic tomography and (2 frontal alpha asymmetry was used as an indicator of mood. After real stimulation for 10 minutes, absolute alpha power was globally reduced in the experimental group, particularly in the anterior and centrotemporal regions of the brain. This indicates a decline in the brain activity associated with arousal. Moreover, the reduction was more prominent in the left frontal region, as compared to the right frontal region, resulting in significant increase from negative to positive frontal alpha asymmetry scores and reflecting an increase in the brain activity associated with enhanced mood. However, the placebo group exhibited no significant changes in two indicators after sham stimulation. This study provides initial electrophysiological evidence of changes in brain activity associated with reduced arousal (and thus greater sleepiness and enhanced mood after microcurrent stimulation at the Shenmen acupoint.

  19. Sonolência excessiva diurna na população geral de um município brasileiro Excessive daytime sleepiness in the general population of Brazilian city

    Directory of Open Access Journals (Sweden)

    José Carlos Souza

    2008-01-01

    Full Text Available OBJETIVO: Buscou-se avaliar a prevalência da sonolência excessiva diurna (SED na população geral de um município brasileiro. MÉTODO: Foram feitas 198 entrevistas domiciliares entre os adultos, em amostra representativa da população geral de Ribeirão do Largo, BA. A amostragem foi aleatória simples. Tinham SED as pessoas com 11 ou mais pontos na Escala de Sonolência de Epworth (ESE. Usaram-se os testes de qui-quadrado, Fisher e ANOVA; nível de significância 5%. RESULTADOS: Tinham SED 21,5% da população (DP = 2,9%; IC 15,8% a 27,2%; não houve associação significativa entre SED e idade (p = 0,924, nem IMC (p = 0,197, sexo (p = 0,095, instrução (p = 0,700, estado civil (p = 0,414 e uso de hipnóticos (p = 0,176. Houve associação com o despertar precoce (p = 0,046. CONCLUSÃO: Foi alta a prevalência de SED na população estudada.OBJECTIVE: To assess the prevalence of excessive daytime sleepiness (ESD in general population of a Brazilian city. METHODS: It was determined by means of 198 home interviews of adults, in a representative sample of Ribeirão do Largo city, Brazil. The random sample was simple. ESD was considered in those with index 11 or more in the Epworth Sleepiness Scale (ESS. Statistics used chi-square, Fisher and ANOVA; the significance level was 5%. RESULTS: The prevalence of ESD was 21.5% of population (SD = 2.9%; CI 15.8%-27.2%. No significant association was found between ESD and age (p=0.924, nor with body mass index (p=0.197, sex (p=0.095, schooling (p=0,700, marital status (p=0.414 and the use of hypnotics (p=0.176. There was significant association with early awakening (p=0.046. CONCLUSION: There was a high prevalence of ESD in the population.

  20. QUANTITATIVE HISTOPATHOLOGICAL ANALYSIS OF ENLARGED CELLS DERIVED FROM HUMPBACK GROUPER, Cromileptes altivelis INFECTED WITH GROUPER SLEEPY DISEASE IRIDOVIRUS (GSDIV

    Directory of Open Access Journals (Sweden)

    Indah Mastuti

    2010-12-01

    Full Text Available Pathognomonic sign of grouper sleepy disease iridovirus (GSDIV was proposed to be the formation of enlarged cells and necrotic cells, in which under electron microscope, it is revealed to be the inclusion body bearing cells (IBCs and necrotic cells containing GSDIV viral particles. Spleen and kidney tissues are the major sites for formation of enlarged cells. This paper described the result of histopatological analysis of enlarged cells found in the spleen and kidney of moribund fish after GSDIV challenge. A pathogenicity test was conducted on fish stocked in two tanks for infected groups and the other two tanks for uninfected control groups (15 fish per tank. The infected groups were injected intramuscularly with 0.1 ml of the viral inoculum. The uninfected groups were injected with the same amount of EMEM-2. The GSDIV-infected humpback grouper began to die after 6 days post infection and all died after 7 dpi, excluding one fish which had survived until the end of experimental infection periods (93% to 100% mortality. All of the diseased fish showed massive formation of enlarged cells in their spleen, head kidney and trunk kidney. The largest number of enlarged cells was observed on head kidneys and subsequently followed by spleens, trunk kidney (2.0-200.3/field of view. This result suggested that the number of enlarged cells in the affected organs was not the direct factor that led to the mortality of fish.

  1. High indoor CO2 concentrations in an office environment increases the transcutaneous CO2 level and sleepiness during cognitive work.

    Science.gov (United States)

    Vehviläinen, Tommi; Lindholm, Harri; Rintamäki, Hannu; Pääkkönen, Rauno; Hirvonen, Ari; Niemi, Olli; Vinha, Juha

    2016-01-01

    The purpose of this study is to perform a multiparametric analysis on the environmental factors, the physiological stress reactions in the body, the measured alertness, and the subjective symptoms during simulated office work. Volunteer male subjects were monitored during three 4-hr work meetings in an office room, both in a ventilated and a non-ventilated environment. The environmental parameters measured included CO(2), temperature, and relative humidity. The physiological test battery consisted of measuring autonomic nervous system functions, salivary stress hormones, blood's CO(2)- content and oxygen saturation, skin temperatures, thermal sensations, vigilance, and sleepiness. The study shows that we can see physiological changes caused by high CO(2) concentration. The findings support the view that low or moderate level increases in concentration of CO(2) in indoor air might cause elevation in the blood's transcutaneously assessed CO(2). The observed findings are higher CO(2) concentrations in tissues, changes in heart rate variation, and an increase of peripheral blood circulation during exposure to elevated CO(2) concentration. The subjective parameters and symptoms support the physiological findings. This study shows that a high concentration of CO(2) in indoor air seem to be one parameter causing physiological effects, which can decrease the facility user's functional ability. The correct amount of ventilation with relation to the number of people using the facility, functional air distribution, and regular breaks can counteract the decrease in functional ability. The findings of the study suggest that merely increasing ventilation is not necessarily a rational solution from a technical-economical viewpoint. Instead or in addition, more comprehensive, anthropocentric planning of space is needed as well as instructions and new kinds of reference values for the design and realization of office environments.

  2. Sustained attention to response task (SART) shows impaired vigilance in a spectrum of disorders of excessive daytime sleepiness.

    Science.gov (United States)

    Van Schie, Mojca K M; Thijs, Roland D; Fronczek, Rolf; Middelkoop, Huub A M; Lammers, Gert Jan; Van Dijk, J Gert

    2012-08-01

    The sustained attention to response task comprises withholding key presses to one in nine of 225 target stimuli; it proved to be a sensitive measure of vigilance in a small group of narcoleptics. We studied sustained attention to response task results in 96 patients from a tertiary narcolepsy referral centre. Diagnoses according to ICSD-2 criteria were narcolepsy with (n=42) and without cataplexy (n=5), idiopathic hypersomnia without long sleep time (n=37), and obstructive sleep apnoea syndrome (n=12). The sustained attention to response task was administered prior to each of five multiple sleep latency test sessions. Analysis concerned error rates, mean reaction time, reaction time variability and post-error slowing, as well as the correlation of sustained attention to response task results with mean latency of the multiple sleep latency test and possible time of day influences. Median sustained attention to response task error scores ranged from 8.4 to 11.1, and mean reaction times from 332 to 366ms. Sustained attention to response task error score and mean reaction time did not differ significantly between patient groups. Sustained attention to response task error score did not correlate with multiple sleep latency test sleep latency. Reaction time was more variable as the error score was higher. Sustained attention to response task error score was highest for the first session. We conclude that a high sustained attention to response task error rate reflects vigilance impairment in excessive daytime sleepiness irrespective of its cause. The sustained attention to response task and the multiple sleep latency test reflect different aspects of sleep/wakefulness and are complementary.

  3. Effects of obstructive sleep apnea syndrome on pilot's sleepiness, mood and subjective quality of life%阻塞性睡眠呼吸暂停综合征对飞行员睡眠、情绪和主观生活质量的影响

    Institute of Scientific and Technical Information of China (English)

    余昳; 谭昌金; 张瞿璐; 武强; 濮捷; 杨长亮

    2011-01-01

    目的 探讨阻塞性睡眠呼吸暂停综合征(obstructive sleep apnea syndrome,OSAS)对飞行员白天过度嗜睡(excessive daytime sleepiness,EDS)、情绪状态和主观生活质量(subjective quality of life,QOF)的影响.方法 对经多导睡眠仪(polysomnography,PSG)监测诊断的54例OSAS飞行员和30例正常飞行员做人体测量、记录Epworth嗜睡量表评分(Epworth sleepiness scale,ESS)、睡眠呼吸暂停生活质量指数(calgary sleep apnea quality of life index,SAQLI)和Zung抑郁自评量表(Zung self-rated depression scale,SDS),将所获资料进行描述和均数比较.结果 OSAS飞行员中76.6%超重,20.3%肥胖;28.1%存有白天嗜睡,对日常工作及生活有明显影响;41.7%的患者抑郁,抑郁症状与白天嗜睡及疲劳有明显关系.比较正常飞行员和不同程度OSAS飞行员的体质指数、颈围、呼吸暂停低通气指数(sleep apnea hypopnea index,AHI)、ESS、SAQLI和SDS评分,差异均有统计学意义(F=6.28~270.29,P<0.01);进一步分析发现,SAQLI和AHI在正常和轻度患者之间差异有统计学意义(P<0.01),ESS在正常和轻度患者之间差异无统计学意义(P>0.05),而在正常和中重度患者之间差异有统计学意义(P<0.01).本研究12例OSAS歼击机飞行员中9例轻度,3例中度,经减轻体重,复测PSG参数和ESS评分正常,均飞行合格;42例OSAS运输机飞行员中13例轻度,飞行合格;15例中度,经减轻体重,PSG参数和ESS评分正常,飞行合格;14例重度,其中8例经减轻体重症状好转飞行合格,6例尚在治疗中.结论 OSAS飞行员常伴有白天过度嗜睡和抑郁情绪,其主观生活质量较正常者明显下降.中度及重度OSAS飞行员应进行干预治疗.%Objective To suggest intervention by investigating the effects of obstructive sleep apnea syndrome(OSAS) on pilot's sleepiness,mood and subjective quality of life.Methods Fiftyfour pilots,who were diagnosed as OSAS by polysomnography (PSG

  4. Prevalence of Excessive Daytime Sleepiness and Associated Factors in 3085 University Teachers and Staffs in Kunming%昆明市3085名高校教职工白天过度嗜睡患病率及其相关影响因素研究

    Institute of Scientific and Technical Information of China (English)

    王耶盈; 孙霞; 曹宇; 李永霞

    2013-01-01

    Objective To investigate the prevalence of excessive daytime sleepiness and explore the associated factors in university teachers and staffs in Kunming.Methods Epworth sleepiness scale was used as the tool of diagnosis. We consecutively collected the data of teachers and staffs on duty in Yunnan Nationalities University,Yunnan Agricultural University,Yunnan Normal University,Kunming Medical University and Yunnan University of Finance and Economics within 8 months.Results The prevalence of excessive daytime sleepiness in university teachers and staffs was 12.45%, the prevalence of male was 16.82% and female was 7.70%, respectively. The results of Logistic regression showed that the main associated factors of excessive daytime sleepiness were male (OR=1.898),age (30 years and less was as control group,the ORs of 31-40 year group, 41-50 years group and more than 51 years group were 1.480, 2.366 and 2.719, respectively), family history of snoring (OR=3.371), consumption sedative (OR=1.815), memory failing (OR=2.044), dizzy and feeble (OR=2. 076),choking (OR=2.143),report apnea (OR=2.684),etc. Conclusions The prevalence of excessive daytime sleepiness is high in the university teachers and staffs that can partially represent the residents of Kunming city. The associated factors of excessive daytime sleepiness hint that excessive daytime sleepiness may be caused by sleep apnea/hyperpnoea syndrome in the sample population,hence the people with excessive sleepiness need further sleep monitoring .%目的调查昆明市高校教职工白天嗜睡现患率并探讨其相关影响因素.方法使用Epworth嗜睡量表为研究工具,连续8个月收集昆明市5所高校(云南民族大学、云南农业大学、云南师范大学、昆明医科大学、云南财经大学)在岗教职工相关信息.结果高校教职工白天过度嗜睡现患率为12.45%,其中男性现患率为16.82%,女性现患率为7.70%.Logistic回归分析结果显示白天过度

  5. Experience with the use of modafinil in the treatment of narcolepsy in a outpatient facility specialized in diurnal excessive sleepiness in São Paulo

    Directory of Open Access Journals (Sweden)

    Nilce Sanny Costa da Silva Behrens

    2014-03-01

    Full Text Available Narcolepsy is a chronic neurological disease characterized by diurnal excessive sleepiness and catapleaxy. It affects 1 in every 2000 to 4000 individuals with personal, social and familiar significant repercussions. The treatment of narcolepsy is mainly based on the use of stimulants for the control of the diurnal excessive sleepiness, in conjunction with behavioral measures and sleep hygiene. Among the stimulants, modafinil has presently been the drug of choice for the treatment of the diurnal excessive sleepiness in patients with narcolepsy. In the worldwide experience, its use is better tolerated and the majority of its side effects is considered light or moderate. However, the clinical use in Brazil was initiated at the end of 2008, with little experience on the narcolepsy population of this country. In this context, the objective of this study was the evaluation of the use of modafinil, verifying the indication of use, causes for discontinuation, daily dosage, efficiency of the treatment in a patient sample of narcoleptics consulted in a specialized center in Brazil. In this study, modafinil was effective for the control of the symptoms related do narcolepsy in 66% of the studied patients. The side effects such as headache, parestesias and diarrhea were the main reasons for the discontinuation of treatment with modafinil. It is important to clinically follow up the patients for a long period to evaluate symptomatology, control of use, tolerability and re-evaluation of the more effective therapeutic dosage able to control narcolepsy. Due to its high cost and clinical benefits, this drug should be on the government׳s list of free drugs for the treatment of these patients.

  6. Cortical and Subcortical Grey and White Matter Atrophy in Myotonic Dystrophies Type 1 and 2 Is Associated with Cognitive Impairment, Depression and Daytime Sleepiness

    Science.gov (United States)

    Prehn, Christian; Krogias, Christos; Schneider, Ruth; Klein, Jan; Gold, Ralf; Lukas, Carsten

    2015-01-01

    Objectives Central nervous system involvement is one important clinical aspect of myotonic dystrophy type 1 and 2 (DM1 and DM2). We assessed CNS involvement DM1 and DM2 by 3T MRI and correlated clinical and neuocognitive symptoms with brain volumetry and voxel-based morphometry (VBM). Methods 12 patients with juvenile or classical DM1 and 16 adult DM2 patients underwent 3T MRI, a thorough neurological and neuropsychological examination and scoring of depression and daytime sleepiness. Volumes of brain, ventricles, cerebellum, brainstem, cervical cord, lesion load and VBM results of the patient groups were compared to 33 matched healthy subjects. Results Clinical symptoms were depression (more pronounced in DM2), excessive daytime sleepiness (more pronounced in DM1), reduced attention and flexibility of thinking, and deficits of short-term memory and visuo-spatial abilities in both patient groups. Both groups showed ventricular enlargement and supratentorial GM and WM atrophy, with prevalence for more GM atrophy and involvement of the motor system in DM1 and more WM reduction and affection of limbic structures in DM2. White matter was reduced in DM1 in the splenium of the corpus callosum and in left-hemispheric WM adjacent to the pre- and post-central gyrus. In DM2, the bilateral cingulate gyrus and subgyral medio-frontal and primary somato-sensory WM was affected. Significant structural-functional correlations of morphological MRI findings (global volumetry and VBM) with clinical findings were found for reduced flexibility of thinking and atrophy of the left secondary visual cortex in DM1 and of distinct subcortical brain structures in DM2. In DM2, depression was associated with brainstem atrophy, Daytime sleepiness correlated with volume decrease in the middle cerebellar peduncles, pons/midbrain and the right medio-frontal cortex. Conclusion GM and WM atrophy was significant in DM1 and DM2. Specific functional-structural associations related morphological changes

  7. The viability of an ecologically valid chronic sleep restriction and circadian timing protocol: An examination of sample attrition, compliance, and effectiveness at impacting sleepiness and mood

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    Drummond, Sean P. A.; McElroy, Todd

    2017-01-01

    Chronic sleep restriction (SR) increases sleepiness, negatively impacts mood, and impairs a variety of cognitive performance measures. The vast majority of work establishing these effects are tightly controlled in-lab experimental studies. Examining commonly-experienced levels of SR in naturalistic settings is more difficult and generally involves observational methods, rather than active manipulations of sleep. The same is true for analyzing behavioral and cognitive outcomes at circadian unfavorable times. The current study tested the ability of an at-home protocol to manipulate sleep schedules (i.e., impose SR), as well as create a mismatch between a subject’s circadian preference and time of testing. Viability of the protocol was assessed via completion, compliance with the SR, and success at manipulating sleepiness and mood. An online survey was completed by 3630 individuals to assess initial eligibility, 256 agreed via email response to participate in the 3-week study, 221 showed for the initial in-person session, and 184 completed the protocol (175 with complete data). The protocol consisted of 1 week at-home SR (5-6 hours in bed/night), 1 week wash-out, and 1 week well-rested (WR: 8-9 hours in bed/night). Sleep was monitored with actigraphy, diary, and call-ins. Risk management strategies were implemented for subject safety. At the end of each experimental week, subjects reported sleepiness and mood ratings. Protocol completion was 83%, with lower depression scores, higher anxiety scores, and morning session assignment predicting completion. Compliance with the sleep schedule was also very good. Subjects spent approximately 2 hours less time in bed/night and obtained an average of 1.5 hours less nightly sleep during SR, relative to WR, with 82% of subjects obtaining at least 60 minutes less average nightly sleep. Sleepiness and mood were impacted as expected by SR. These findings show the viability of studying experimental chronic sleep restriction outside

  8. Rating scales and questionnaires for assessment of sleep disorders in Parkinson's disease: what they inform about?

    Science.gov (United States)

    Zea-Sevilla, María Ascensión; Martínez-Martín, Pablo

    2014-08-01

    Sleep disorders are very prevalent in Parkinson's disease (PD) and include a diversity of disturbances. Rating scales and questionnaires are widely used to assess the presence and severity of the sleep disorders. The objective is to review rating scales and questionnaires used for assessment of sleep disorders in PD. To this purpose, a description and update of the sleep scales reviewed by the ad hoc Movement Disorder Society task force (MDS-TF) and other sleep disorder assessments was performed. Two specific (Parkinson's Disease Sleep Scale and Scales for Outcomes in PD Sleep) and two generic scales (Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale) were "Recommended" by the MDS-TF as they were used in PD patients, by researchers others than their developers and properly validated. Two other generic scales (Inappropriate Sleep Composite Score and Stanford Sleepiness Scale), "Suggested" due to incomplete validation, are also reviewed. Other instruments included in this review are three comprehensive PD-specific instruments for assessing multiple domains in addition to sleep problems (e.g., Non-Motor Symptoms Questionnaire, Non-Motor Symptoms Scale, MDS-UPDRS), and three generic instruments focused on particular disturbances (e.g., International Restless Legs Syndrome Study Group Rating Scale, REM behavioral disorders questionnaires), although these latter lack formal validation in PD populations. The "Recommended" instruments cover satisfactorily the needs for screening and evaluation of the nocturnal sleep disorders and daytime sleepiness in PD patients. It would be convenient to validate or complete the validation in PD populations of those instruments that cannot be recommended due to the lack of information on their clinimetric attributes.

  9. Are Sleepy Students Learning?

    Science.gov (United States)

    Willingham, Daniel T.

    2013-01-01

    Cognitive science is an interdisciplinary field of researchers from psychology, neuroscience, linguistics, philosophy, computer science, and anthropology who seek to understand the mind. This paper considers findings from this field that are strong and clear enough to merit classroom application. Although many teachers and parents worry that high…

  10. 早期帕金森病患者日间过度思睡的相关因素分析%Analysis of excessive daytime sleepiness of patients with Parkinson disease at early stage

    Institute of Scientific and Technical Information of China (English)

    娄凡; 李明; 任艳

    2012-01-01

    Objective To evaluate the excessive daylime sleepiness ( EDS) and total quality of nocturnal sleep of palienls with Parkinson's disease ( PD) at early slage and analyse their clinical characlerlics and relaled factors. Methods 76 conseculive palienls with idiopalhic PD in our palient-clinic and 70 age and sex matched healthy controls were participated in subjective evaluation. Trough face-to-face inlerview assessmenls were performed by using Pittsburgh Sleep Qualily Index(PQSI)& Epworth sleepiness scale(ESS) , unified Parkinson's disease raling scale Part Ⅲ ( UPDRS- Ⅲ ) , Hamilton Depression Rating Scale ( HAMD ) , and mino-mental state examination( MMSE ) to respectively evaluate the sleep quality,movement function,depression and cognition state. The relationship between EDS and age,sex,duration of disease,MMSE score,UPDRS-Ⅲ ,HAMD score,dopaminergic agonists,daily dose of L dopa, Restless leg syndrome ( RLS) and REM behavior disorder ( RBD) was evaluated by Multi-factor togistic. Results The total ESS score in the patients with PD at early stage (6. 14 ± 1.02) was significantly higher than healthy group(4. 14 ± 1. 13 ) ( P = 0. 003 ) . Multi-factor togistic showed that EDS of patients with PD at early stage was related to dopaminergic agonists, RBD, PQSI score and RLS, but not related to age, sex, duration of disease, MMSE sore, UPDRS Ⅲ , HAMD score or daily dose of L-dopa. Conclusions EDS are more common in patients with PD at early stage, and this may be related to the usage of dopaminergic agonists, the quality of nocturnal sleep, parasomnias and pathological changes of PD itself.%目的 评价早期帕金森病患者(PD)日间过度思睡(EDS)情况,分析其相关影响因素.方法 选取我院PD患者72例及年龄与之相匹配的正常对照组68例,采用爱泼沃斯思睡量表(ESS)、匹兹堡睡眠指数量表(PQSI)对其日间及夜间睡眠情况进行评价.对PD患者采用统一PD评定量表--运动检查(UPDRS-Ⅲ)、汉密尔顿抑

  11. Armodafinil versus Modafinil in Patients of Excessive Sleepiness Associated with Shift Work Sleep Disorder: A Randomized Double Blind Multicentric Clinical Trial.

    Science.gov (United States)

    Tembe, D V; Dhavale, A; Desai, H; Mane, D N; Raut, S K; Dhingra, G; Sardesai, U; Saoji, S; Rohra, M; Shinde, V G; Padsalge, M; Paliwal, A; Abbasi, K; Devnani, P; Papinwar, S; Phadke, S; Mehta, H; Bhailume, V

    2011-01-01

    Aim. To compare the efficacy and safety of armodafinil, the R-enantiomer of modafinil, with modafinil in patients of shift work sleep disorder (SWSD). Material and Methods. This was a 12-week, randomized, comparative, double-blind, multicentric, parallel-group study in 211 patients of SWSD, receiving armodafinil (150 mg) or modafinil (200 mg) one hour prior to the night shift. Outcome Measures. Efficacy was assessed by change in stanford sleepiness score (SSS) by at least 2 grades (responder) and global assessment for efficacy. Safety was assessed by incidence of adverse events, change in laboratory parameters, ECG, and global assessment of tolerability. Results. Both modafinil and armodafinil significantly improved sleepiness mean grades as compared to baseline (P armodafinil (72.12%) and modafinil (74.29%) were comparable (P = .76). Adverse event incidences were comparable. Conclusion. Armodafinil was found to be safe and effective in the treatment of SWSD in Indian patients. The study did not demonstrate any difference in efficacy and safety of armodafinil 150 mg and modafinil 200 mg.

  12. Armodafinil versus Modafinil in Patients of Excessive Sleepiness Associated with Shift Work Sleep Disorder: A Randomized Double Blind Multicentric Clinical Trial

    Directory of Open Access Journals (Sweden)

    D. V. Tembe

    2011-01-01

    Full Text Available Aim. To compare the efficacy and safety of armodafinil, the R-enantiomer of modafinil, with modafinil in patients of shift work sleep disorder (SWSD. Material and Methods. This was a 12-week, randomized, comparative, double-blind, multicentric, parallel-group study in 211 patients of SWSD, receiving armodafinil (150 mg or modafinil (200 mg one hour prior to the night shift. Outcome Measures. Efficacy was assessed by change in stanford sleepiness score (SSS by at least 2 grades (responder and global assessment for efficacy. Safety was assessed by incidence of adverse events, change in laboratory parameters, ECG, and global assessment of tolerability. Results. Both modafinil and armodafinil significantly improved sleepiness mean grades as compared to baseline (<.0001. Responder rates with armodafinil (72.12% and modafinil (74.29% were comparable (=.76. Adverse event incidences were comparable. Conclusion. Armodafinil was found to be safe and effective in the treatment of SWSD in Indian patients. The study did not demonstrate any difference in efficacy and safety of armodafinil 150 mg and modafinil 200 mg.

  13. Scales, scales and more scales.

    Science.gov (United States)

    Weitzenhoffer, Andre M

    2002-01-01

    This article examines the nature, uses, and limitations of the large variety of existing, so-called, hypnosis scales; that is, instruments that have been proposed for the assessment of hypnotic behavior. Although the major aim of most of the scales ostensively seems to be to assess several aspects of hypnotic states, they are found generally to say little about these and much more about responses to suggestions. The greatest application of these scales is to be found in research, but they also have a limited place in clinical work.

  14. Effects of Shift Work on the Postural and Psychomotor Performance of Night Workers.

    Directory of Open Access Journals (Sweden)

    Fernanda Veruska Narciso

    Full Text Available The purpose of the study was to investigate the effects of shift work on the psychomotor and postural performance of night workers. The study included 20 polysomnography technicians working schedule of 12-h night shift by 36-h off. On the first day of protocol, the body mass and height were measured, and an actigraph was placed on the wrist of each participant. On the second day of protocol, sleepiness by Karolinska Sleepiness Scale, postural control by force platform (30 seconds and psychomotor performance by Psychomotor Vigilance Task (10 minutes were measured before and after 12-h night work. Results showed that after 12-h night work, sleepiness increased by 59% (p<0.001, postural control variables increased by 9% (p = 0.048, and 14% (p = 0.006. Mean reaction time, and the number of lapses of attention increased by 13% (p = 0.006 and 425% (p = 0.015, respectively, but the mean reciprocal reaction time decreased by 7%. In addition, there were correlations between sleepiness and postural control variables with opened eyes (r = 0.616, 95% confidence interval [CI] = 0.361-0.815; r = 0.538; 95% CI = 0.280-0.748 and closed eyes (r = 0.557; 95% CI = 0.304-0.764, r = 0497; 95% CI = 0.325-0.715 and a pronounced effect of sleepiness on postural sway (R2 = 0.393; 95% CI = 0.001-0.03. Therefore, 12-h night work system and sleepiness showed a negative impact in postural and psychomotor vigilance performance of night workers. As unexpected, the force platform was feasibility to detect sleepiness in this population, underscoring the possibility of using this method in the workplace to prevent occupational injuries and accidents.

  15. Ultrastructure of developmental stages of Hemolivia mariae (Apicomplexa: Haemogregarinidae), natural parasite of the Australian sleepy lizard, in experimentally infected deviant hosts.

    Science.gov (United States)

    Paperna, I; Smallridge, C J

    2001-01-01

    Mabuya vitatta (Olivier) (Scincidae) and Agama stellio (L.) (Agamidae) were infected with Hemolivia mariae Smallridge et Paperna, 1997 by ingestion of tick viscera from Amblyomma limbatum Neumann, fed as nymphs on naturally infected Australian sleepy lizards, Tiliqua rugosa Gray. The unnatural infection apparently interfered with the developmental schedule of the parasites. Transmission electron microscopic images of merogonic stages were obtained, as well as images of early developing gametocytes. Tissue and intraerythrocytic meronts were bound by a hardened wall. Intraerythrocytic gametocytes were lodged in a parasitophorous vacuole, which was filled with granular material, and were bound by a two-membrane wall. Small and large osmiophilic bodies were located in a sub-pellicular position. With differentiation, the wall membranes tightened with the parasitophorous vacuole wall, and the osmiophilic bodies disappeared. The outer parasite membrane consolidated into a thick encasing with distinct sutures. Late infection in A. stellio comprised gametocytes only.

  16. [Epworth drowsiness scale value in obstructive sleep apnea syndrome].

    Science.gov (United States)

    Uribe Echevarría, E M; Alvarez, D; Giobellina, R; Uribe Echevarría, A M

    2000-01-01

    Hypersomnia is one of the most consulted symptoms among patients evaluated at sleep disorder centers and it is frequently related to obstructive sleep apnea syndrome (OSAS). Our hypothesis is that Epworth sleepiness scale (ESS) is the parameter with the greatest predictive value in the OSAS diagnosis. We compared patients with OSAS diagnosis to a control group. In both groups we compared ESS with body mass index (BMI), neck circumference (NC), waist perimeter (WP). Anthropometric index (BMI, NC and WC), were similar in both groups (p < 0.10). When we analyzed ESS, a score greater than 10 was observed in the OSAS group, with a significant difference between groups (p < 0.001). Epworth sleepiness scale yielded 60% of sensibility, 82% of specificity and a positive predictive value of 85%. The negative predictive value was 52%. Confidence index was 70%. The relationship between OSAS and ESS scale was significant (Pearson Chi-Square value 7.5). Odds Ratio for apneas was 15 and its confidence interval was lower than 1.5 and upper than 141. We conclude that with ESS score exceeding 10 points OSAS should be suspected.

  17. Effects of sleep/wake history and circadian phase on proposed pilot fatigue safety performance indicators.

    Science.gov (United States)

    Gander, Philippa H; Mulrine, Hannah M; van den Berg, Margo J; Smith, A Alexander T; Signal, T Leigh; Wu, Lora J; Belenky, Gregory

    2015-02-01

    The Karolinska Sleepiness Scale and Samn-Perelli fatigue ratings, and psychomotor vigilance task performance are proposed as measures for monitoring commercial pilot fatigue. In laboratory studies, they are sensitive to sleep/wake history and circadian phase. The present analyses examined whether they reliably reflect sleep/wake history and circadian phase during transmeridian flight operations. Data were combined from four studies (237 pilots, 730 out-and-back flights between 13 city pairs, 1-3-day layovers). Sleep was monitored (wrist actigraphy, logbooks) before, during and after trips. On duty days, sleepiness, fatigue and mean response speed were measured pre-flight and at the top of the descent. Mixed-model analysis of variance examined associations between these measures and sleep/wake history, after controlling for operational factors. Circadian phase was approximated by local (domicile) time in the city where each trip began and ended. More sleep in the 24 h prior to duty was associated with lower pre-flight sleepiness and fatigue and faster response speed. Sleepiness and fatigue were greater before flights departing during the domicile night and early morning. At the top of the descent, pilots felt less sleepy and fatigued after more in-flight sleep and less time awake. Flights arriving in the early-mid-morning (domicile time) had greater sleepiness and fatigue and slower response speeds than flights arriving later. Subjective ratings showed expected associations with sleep/wake history and circadian phase. The response speed showed expected circadian variation but was not associated with sleep/wake history at the top of the descent. This may reflect moderate levels of fatigue at this time and/or atypically fast responses among pilots.

  18. An analysis of clinical characteristics and factors in Parkinson's disease patients with excessive daytime sleepiness%伴日间嗜睡帕金森病患者的临床特征及其影响因素分析

    Institute of Scientific and Technical Information of China (English)

    龚艳; 刘春风

    2016-01-01

    Objective To explore the clinical characteristics and prognostic factors in patients with Parkinson's disease (PD) and excessive daytime sleepiness (EDS) and to identify whether EDS could influence the sleep architecture and sleep apnea-related parameters.Methods A total of 130 PD patients were eligible and enrolled in the study.By the Epworth sleepiness scale (ESS),patients were divided into the EDS group (ESS ≥ 10) with 61 patients and the non-EDS group (ESS < 10) with 69 patients.All underwent a video-polysomnography (PSG).Clinical characteristics were mainly evaluated by the unified Parkinson's disease rating scale (UPDRS) and the Hoehn-Yahr(H-Y) stage.while other related scales were applied for evaluating depression,cognitive function,quality of sleep and quality of life.Results A total of 61 patients (46.92%) were diagnosed as EDS (ESS≥ 10).Compared to the non-EDS group,the EDS group had significantly higher score of HAMD,UPDRS Ⅰ and UPDRS Ⅱ,and significantly lower score of MoCA and PDQ (all P < 0.05).Non-conditional logistic regression analysis showed that the scores of HAMD and UPDRS Ⅰ were the main prognostic factors for EDS.Significantly decreased sleep latency (SL) was found in the EDS group by PSG (P =0.008).The score of ESS was showed to be correlated with the scores of HAMD,MoCA,UPDRS Ⅰ,UPDRS Ⅱ,PDQ and SL.Conclusions PD patients with EDS have more severe depression and cognitive dysfunction and worse quality of life.Sleep structure is altered in those patients with decreased sleep latency.Mental status is closely associated with EDS,but not sleep apnea.%目的 分析伴日间嗜睡(EDS)的帕金森病(PD)患者的临床特征及其影响因素,并探讨EDS对PD患者的睡眠结构和呼吸事件的影响.方法 本研究共纳入130例PD患者,根据Epworth 嗜睡量表,将其分为日间嗜睡组(EDS组)(Epworth嗜睡量表评分≥10分,61例)和无日间嗜睡组(non-EDS组,Epworth嗜睡量表评分<10分,69例).所有患者

  19. Maintenance of wakefulness with lisdexamfetamine dimesylate, compared with placebo and armodafinil in healthy adult males undergoing acute sleep loss.

    Science.gov (United States)

    Gasior, Maria; Freeman, Jon; Zammit, Gary; Donnelly, Patricia; Gao, Joseph; Ferreira-Cornwell, Maria Celeste; Roth, Thomas

    2014-12-01

    This study evaluated daytime alertness and performance with lisdexamfetamine dimesylate during acute sleep loss. In a randomized, double-blind study in healthy adult men (n = 135) undergoing 24-hour sleep loss, the alerting effects of single oral lisdexamfetamine dimesylate doses (20, 50, or 70 mg) were compared with a placebo and an active control (armodafinil 250 mg). Primary end point was mean unequivocal sleep latency on the 30-minute maintenance of wakefulness test taken every 2 hours from midnight to 8:00 A.M. Secondary end points included the Karolinska sleepiness scale and psychomotor vigilance task. Safety assessments included treatment-emergent adverse events (TEAEs) and vital signs. Least squares mean (SE) maintenance of wakefulness test unequivocal sleep latency (in minutes) was longer with lisdexamfetamine dimesylate 20, 50, and 70 mg, or armodafinil 250 mg (23.3 [1.10], 27.9 [0.64], 29.3 [0.44], or 27.6 [0.63], respectively) versus placebo (15.3 [1.00]; P armodafinil (P = 0.0351) and armodafinil versus lisdexamfetamine dimesylate 20 mg (P = 0.0014). On Karolinska sleepiness scale, lisdexamfetamine dimesylate 50 and 70 mg improved estimated sleepiness versus placebo (P ≤ 0.0002) and armodafinil (P ≤ 0.03). Active treatments improved psychomotor vigilance task performance versus placebo (P armodafinil (7.4% each) versus placebo (3.7%). Small mean increases in vital signs were observed with lisdexamfetamine dimesylate and armodafinil. In sleep-deprived healthy men, alertness was greater with lisdexamfetamine dimesylate and armodafinil versus placebo on the primary end point. Studies are needed in clinical populations and using longer durations of administration.

  20. Armodafinil and modafinil in patients with excessive sleepiness associated with shift work disorder: a pharmacokinetic/pharmacodynamic model for predicting and comparing their concentration-effect relationships.

    Science.gov (United States)

    Darwish, Mona; Bond, Mary; Ezzet, Farkad

    2012-09-01

    Armodafinil, the longer lasting R-isomer of racemic modafinil, improves wakefulness in patients with excessive sleepiness associated with shift work disorder (SWD). Pharmacokinetic studies suggest that armodafinil achieves higher plasma concentrations than modafinil late in a dose interval following equal oral doses. Pooled Multiple Sleep Latency Test (MSLT) data from 2 randomized, double-blind, placebo-controlled trials in 463 patients with SWD, 1 with armodafinil 150 mg/d and 1 with modafinil 200 mg/d (both administered around 2200 h before night shifts), were used to build a pharmacokinetic/pharmacodynamic model. Predicted plasma drug concentrations were obtained by developing and applying a population pharmacokinetic model using nonlinear mixed-effects modeling. Armodafinil 200 mg produced a plasma concentration above the EC(50) (4.6 µg/mL) for 9 hours, whereas modafinil 200 mg did not exceed the EC(50). Consequently, armodafinil produced greater increases in predicted placebo-subtracted MSLT times of 0.5-1 minute (up to 10 hours after dosing) compared with modafinil. On a milligram-to-milligram basis, armodafinil 200 mg consistently increased wakefulness more than modafinil 200 mg, including times late in the 8-hour shift.

  1. Correlations between subjective and objective features of nocturnal sleep and excessive diurnal sleepiness in patients with narcolepsy Correlação entre as características objetivas e subjetivas do sono noturno e a hipersonolência diurna em pacientes narcolepticos

    Directory of Open Access Journals (Sweden)

    Ulises Jiménez-Correa

    2009-12-01

    Full Text Available OBJECTIVE: To determine the correlations between excessive daytime sleepiness (EDS, assessed by the Epworth sleepiness scale (ESS, and the multiple sleep latency test (MSLT and nocturnal sleep architecture features, clinical symptoms of narcolepsy (CSN and subjective sleep quality (SSQ in patients with narcolepsy. METHOD: Twenty three untreated patients were studied and compared with a matched control group. Diagnosis of narcolepsy was carried out employing a clinical interview, a polysomnographic (PSG record, and an MSLT. RESULTS: Subjective number of awakenings was the SSQ indicator that best correlated with EDS (ESS and MSLT. Regarding clinical features, diurnal tiredness and sleep paralysis correlated with ESS values. Increase in ESS was related with decrease in total sleep time, SWS, and sleep onset latency. On the other hand, increase in MSLT was related with decrease in SWS. CONCLUSION: These data suggest that EDS in patients with narcolepsy could be impaired by disturbed nocturnal sleep.OBJETIVO: Determinar as correlações entre hipersonolência, avaliada pela escala de sonolência Epworth (ESE e o teste múltiplo de latência do sono (TMLS com a arquitetura do sono (AS, sintomas e qualidade subjetiva do sono em pacientes narcolepticos. MÉTODO: Comparou-se um grupo de vinte e tres pacientes narcolepticos sem tratamento com grupo controle. O diagnóstico de narcolepsia foi realizado por uma entrevista clinica, polissonografia e o TMLS. RESULTADOS: O número subjetivo de despertares foi o indicador com maior relação com a hipersonolência, o cansaço diurno e a paralisia do sono também foi correlacionados com a ESE.O aumento do índice na ESE foi correlacionado com uma diminuição do tempo total do sono, no sono de ondas lentas (SOL e com a latência para o início do sono. O incremento na TMLS foi relacionado com diminuição do SOL. CONCLUSÃO: Os dados sugerem que a hipersonolência diurna em pacientes portadores de narcolepsia

  2. Resting-State fMRI Functional Connectivity Is Associated with Sleepiness, Imagery, and Discontinuity of Mind

    Science.gov (United States)

    Chen, Gang; den Braber, Anouk; van ‘t Ent, Dennis; Boomsma, Dorret I.; Mansvelder, Huibert D.; de Geus, Eco; Van Someren, Eus J. W.; Linkenkaer-Hansen, Klaus

    2015-01-01

    Resting-state functional magnetic resonance imaging (rs-fMRI) is widely used to investigate the functional architecture of the healthy human brain and how it is affected by learning, lifelong development, brain disorders or pharmacological intervention. Non-sensory experiences are prevalent during rest and must arise from ongoing brain activity, yet little is known about this relationship. Here, we used two runs of rs-fMRI both immediately followed by the Amsterdam Resting-State Questionnaire (ARSQ) to investigate the relationship between functional connectivity within ten large-scale functional brain networks and ten dimensions of thoughts and feelings experienced during the scan in 106 healthy participants. We identified 11 positive associations between brain-network functional connectivity and ARSQ dimensions. ‘Sleepiness’ exhibited significant associations with functional connectivity within Visual, Sensorimotor and Default Mode networks. Similar associations were observed for ‘Visual Thought’ and ‘Discontinuity of Mind’, which may relate to variation in imagery and thought control mediated by arousal fluctuations. Our findings show that self-reports of thoughts and feelings experienced during a rs-fMRI scan help understand the functional significance of variations in functional connectivity, which should be of special relevance to clinical studies. PMID:26540239

  3. Sleep Apnea, Sleep Debt and Daytime Sleepiness Are Independently Associated with Road Accidents. A Cross-Sectional Study on Truck Drivers

    Science.gov (United States)

    Guglielmi, Ottavia; Dini, Guglielmo; Bersi, Francesca; Fornarino, Stefania; Toletone, Alessandra; Chiorri, Carlo

    2016-01-01

    Background Recent research has found evidence of an association between motor vehicle accidents (MVAs) or near miss accidents (NMAs), and excessive daytime sleepiness (EDS) or its main medical cause, Obstructive Sleep Apnea (OSA). However, EDS can also be due to non-medical factors, such as sleep debt (SD), which is common among professional truck drivers. On the opposite side, rest breaks and naps are known to protect against accidents. Study Objectives To investigate the association of OSA, SD, EDS, rest breaks and naps, with the occurrence of MVAs and NMAs in a large sample of truck drivers. Methods 949 male truck drivers took part in a cross-sectional medical examination and were asked to complete a questionnaire about sleep and waking habits, risk factors for OSA and EDS. Results MVAs and NMAs were reported by 34.8% and 9.2% of participants, respectively. MVAs were significantly predicted by OSA (OR = 2.32 CI95% = 1.68–3.20), SD (OR = 1.45 CI95% = 1.29–1.63), EDS (OR = 1.73 CI95% = 1.15–2.61) and prevented by naps (OR = 0.59 CI95% = 0.44–0.79) or rest breaks (OR = 0.63 CI95% = 0.45–0.89). NMAs were significantly predicted by OSA (OR = 2.39 CI95% = 1.47–3.87) and SD (OR = 1.49 CI95% = 1.27–1.76) and prevented by naps (OR = 0.52 CI95% = 0.32–0.85) or rest breaks (OR = 0.49 CI95% = 0.29–0.82). Conclusions When OSA, SD or EDS are present, the risk of MVAs or NMAs in truck drivers is severely increased. Taking a rest break or a nap appear to be protective against accidents. PMID:27902703

  4. Night shift fatigue among anaesthesia trainees at a major metropolitan teaching hospital.

    Science.gov (United States)

    Lancman, B M

    2016-05-01

    Night shifts expose anaesthesia trainees to the risk of fatigue and, potentially, fatigue-related performance impairment. This study examined the workload, fatigue and coping strategies of anaesthesia trainees during night shifts. A blinded survey-based study was undertaken at a major single centre metropolitan teaching hospital in Australia. All ten anaesthesia trainees who worked night shifts participated. The survey collected data on duration of night shifts, workload, and sleep patterns. Fatigue was assessed using the Karolinska Sleepiness Scale (KSS). There were 93 night shifts generating data out of a potential 165. Trainees tended to sleep an increasing amount before their shift as the nights progressed from 1 to 5. Night 1 was identified as an 'at risk' night due to the amount of time spent awake before arriving at work (32% awake for U+003E8 hours); on all other nights trainees were most likely to have slept 6-8 hours. The KSS demonstrated an increase in sleepiness of 3 to 4 points on the scale from commencement to conclusion of a night shift. The Night 1 conclusion sleepiness was markedly worse than any other night with 42% falling into an 'at-risk' category. The findings demonstrate fatigue and inadequate sleep in anaesthesia trainees during night shifts in a major metropolitan teaching hospital. The data obtained may help administrators prepare safer rosters, and junior staff develop improved strategies to reduce the likelihood of fatigue.

  5. Large-Scale Brain Network Coupling Predicts Total Sleep Deprivation Effects on Cognitive Capacity.

    Directory of Open Access Journals (Sweden)

    Yu Lei

    Full Text Available Interactions between large-scale brain networks have received most attention in the study of cognitive dysfunction of human brain. In this paper, we aimed to test the hypothesis that the coupling strength of large-scale brain networks will reflect the pressure for sleep and will predict cognitive performance, referred to as sleep pressure index (SPI. Fourteen healthy subjects underwent this within-subject functional magnetic resonance imaging (fMRI study during rested wakefulness (RW and after 36 h of total sleep deprivation (TSD. Self-reported scores of sleepiness were higher for TSD than for RW. A subsequent working memory (WM task showed that WM performance was lower after 36 h of TSD. Moreover, SPI was developed based on the coupling strength of salience network (SN and default mode network (DMN. Significant increase of SPI was observed after 36 h of TSD, suggesting stronger pressure for sleep. In addition, SPI was significantly correlated with both the visual analogue scale score of sleepiness and the WM performance. These results showed that alterations in SN-DMN coupling might be critical in cognitive alterations that underlie the lapse after TSD. Further studies may validate the SPI as a potential clinical biomarker to assess the impact of sleep deprivation.

  6. Working night shifts affects surgeons' biological rhythm

    DEFF Research Database (Denmark)

    Amirian, Ilda; Andersen, Lærke T; Rosenberg, Jacob

    2015-01-01

    BACKGROUND: Chronic sleep deprivation combined with work during the night is known to affect performance and compromise residents' own safety. The aim of this study was to examine markers of circadian rhythm and the sleep-wake cycle in surgeons working night shifts. METHODS: Surgeons were monitored...... prospectively for 4 days: pre call, on call, post call day 1 (PC1), and post call day 2 (PC2). The urinary metabolite of melatonin and cortisol in saliva were measured to assess the circadian rhythm. Sleep and activity were measured by actigraphy. Subjective measures were assessed by the Karolinska Sleepiness...... Scale and Visual Analog Scale of fatigue, general well-being, and sleep quality. RESULTS: For both metabolite of melatonin and cortisol, a significant difference (P sleep time during the day on call...

  7. Acute effects of alcohol on sleep are mediated by components of homeostatic sleep regulatory system: An Editorial Highlight for 'Lesions of the basal forebrain cholinergic neurons attenuates sleepiness and adenosine after alcohol consumption' on page 710.

    Science.gov (United States)

    Alam, Md Noor; McGinty, Dennis

    2017-09-01

    Alcohol causes adenosine buildup, which inhibits wake-active neurons via adenosine A1 receptors thus disinhibiting sleep active neurons and also stimulates sleep-active neurons via A2A receptors, causing sleep. This editorial highlights the study entitled, "Lesions of the basal forebrain cholinergic neurons attenuates sleepiness and adenosine after alcohol consumption" by Sharma and colleagues. They report that the wake-promoting basal forebrain (BF) cholinergic neurons play a crucial role in mediating acute alcohol-induced sleep via adenosinergic signaling. © 2017 International Society for Neurochemistry.

  8. Estudo da capacidade de manter o alerta em pacientes com fibromialgia por meio do teste da manutenção da vigília Degree of daytime sleepiness in patients with fibromyalgia through the awakefulness maintenance test

    Directory of Open Access Journals (Sweden)

    Djalma Gomes Ribeiro Sobrinho

    2008-02-01

    Full Text Available OBJETIVO: Avaliar, de forma objetiva, a capacidade de manter o alerta em pacientes com fibromialgia por meio do teste da manutenção da vigília (TMV. MÉTODO: Foi realizado um estudo caso-controle de 15 pacientes com diagnóstico de fibromialgia com pelo menos 11 de 18 pontos dolorosos e dor difusa nos últimos três meses. O grupo-controle foi constituído de 15 indivíduos hígidos pareados por idade e sexo, selecionados seqüencialmente. Os participantes responderam à escala de sonolência de Epworth e foram submetidos ao TMV. Foram realizadas quatro captações, cada uma com duração mínima de 20 minutos e com intervalo de duas horas. Considerou-se como normal a latência para o início do sono maior do que 20 minutos, e patológica a latência menor que 11 minutos. RESULTADOS: O grupo com fibromialgia apresentou significante redução da latência para o início do sono no TMV, comparado ao grupo-controle 9,9 ± 4,6 e 14,9 ± 5,1, respectivamente, p = 0,01, sendo que em 66,7% dos casos o resultado foi patológico, em comparação com 26,7% no grupo-controle (p = 0,03. Não se observou correlação entre o resultado do TMV e a idade dos pacientes ou a pontuação na escala de sonolência de Epworth. CONCLUSÃO: Neste estudo-piloto, pacientes com fibromialgia apresentam redução da latência do sono no TMV.OBJECTIVE: To assess in an objective way the degree of alertness in patients with fibromyalgia through the Maintenance Wakefulness Test ( MWT. METHOD: Fifteen patients with fibromyalgia and 15 age and sex- matched healthy controls were sequentially selected. The inclusion criteria for fibromyalgia were the presence of at least 11 of the 18 tender points and diffuse pain during three months prior to evaluation. All participants answered the Epworth Sleepiness Scale (ESS and underwent four 20 minutes sessions of MWT scheduled at 2-hour intervals. Mean sleep latency higher than 20 minutes or lower than 10 minutes was considered normal or

  9. Pharmacokinetics of armodafinil and modafinil after single and multiple doses in patients with excessive sleepiness associated with treated obstructive sleep apnea: a randomized, open-label, crossover study.

    Science.gov (United States)

    Darwish, Mona; Kirby, Mary; D'Andrea, Denise M; Yang, Ronghua; Hellriegel, Edward T; Robertson, Philmore

    2010-11-01

    Armodafinil (the R-isomer of racemic modafinil) and modafinil are wakefulness-promoting medications for excessive sleepiness associated with treated obstructive sleep apnea (OSA). The R-isomer of racemic modafinil has a half-life of approximately15 hours; the S-isomer has a half-life of 4 to 5 hours. The R-and S-isomers are equipotent, producing equivalent pharmacologic activity at equal concentrations. The aim of this work was to compare the pharmacokinetic profiles of armodafinil (R-modafinil) and modafinil (racemic mixture with equal quantities of R- and S-isomers) at equal doses in patients with residual excessive sleepiness associated with continuous positive airway pressure-treated OSA. This open-label study was conducted at 5 US centers from July 2008 to March 2009. Patients were randomized to 1 of 2 crossover administration sequences, ABCD or BADC, where A was a single armodafinil 200-mg dose, B was a single modafinil 200-mg dose, C was multiple daily modafinil 200-mg doses, and D was multiple daily armodafinil 200-mg doses. During multiple-dose administration, patients received 100 mg once daily for days 1 and 2, and 200 mg once daily for days 3 through 10. The pharmacokinetic parameters of principal interest for assessing the bioequivalence of armodafinil and modafinil were maximum concentration at 7 to 11 hours after dosing and the concentration-versus-time curve for this period. Analysis was performed via achiral high-performance liquid chromatography with ultraviolet detection using blood samples obtained over 72 hours after single-dose administration and over 24 hours after the multiple-dose regimen. For post hoc evaluation of bioequivalence, 90% CI values were also constructed for the geometric mean ratios of armodafinil to modafinil. Tolerability was assessed by the reported adverse events, clinical laboratory testing, vital sign measurements, ECGs, and physical exams. The study population was 83.3% male (35/42) and 76.2% white (32/42) with a mean

  10. Psychometric properties of the Adolescent Sleep Hygiene Scale.

    Science.gov (United States)

    Storfer-Isser, Amy; Lebourgeois, Monique K; Harsh, John; Tompsett, Carolyn J; Redline, Susan

    2013-12-01

    This study evaluated the psychometric properties of the Adolescent Sleep Hygiene Scale (ASHS), a self-report measure assessing sleep practices theoretically important for optimal sleep. Data were collected on a community sample of 514 adolescents (16-19; 17.7 ± 0.4 years; 50% female) participating in the late adolescent examination of a longitudinal study on sleep and health. Sleep hygiene and daytime sleepiness were obtained from adolescent reports, behavior from caretaker reports, and sleep-wake estimation on weekdays from wrist actigraphy. Confirmatory factor analysis indicated the empirical and conceptually based factor structure were similar for six of the eight proposed sleep hygiene domains. Internal consistency of the revised scale (ASHSr) was α = 0.84; subscale alphas were: physiological: α = 0.60; behavioural arousal: α = 0.62; cognitive/emotional: α = 0.81; sleep environment: α = 0.61; sleep stability: α = 0.68; daytime sleep: α = 0.78. Sleep hygiene scores were associated positively with sleep duration (r = 0.16) and sleep efficiency (r = 0.12) and negatively with daytime sleepiness (r = -0.26). Results of extreme-groups analyses comparing ASHSr scores in the lowest and highest quintile provided further evidence for concurrent validity. Correlations between sleep hygiene scores and caretaker reports of school competence, internalizing and externalizing behaviours provided support for convergent validity. These findings indicate that the ASHSr has satisfactory psychometric properties for a research instrument and is a useful research tool for assessing sleep hygiene in adolescents. © 2013 European Sleep Research Society.

  11. Prehospital management and fluid resuscitation in hypotensive trauma patients admitted to Karolinska University Hospital in Stockholm.

    Science.gov (United States)

    Talving, Peep; Pålstedt, Joakim; Riddez, Louis

    2005-01-01

    Few previous studies have been conducted on the prehospital management of hypotensive trauma patients in Stockholm County. The aim of this study was to describe the prehospital management of hypotensive trauma patients admitted to the largest trauma center in Sweden, and to assess whether prehospital trauma life support (PHTLS) guidelines have been implemented regarding prehospital time intervals and fluid therapy. In addition, the effects of the age, type of injury, injury severity, prehospital time interval, blood pressure, and fluid therapy on outcome were investigated. This is a retrospective, descriptive study on consecutive, hypotensive trauma patients (systolic blood pressure or = 15 years) recruited, the median age was 35.5 years (range: 27-55 years) and 77 patients (75%) had suffered blunt injury. The predominant trauma mechanisms were falls between levels (24%) and motor vehicle crashes (22%) with an ISS of 28.5 (range: 16-50). The on-scene time interval was 19 minutes (range: 12-24 minutes). Fluid therapy was initiated at the scene of injury in the majority of patients (73%) regardless of the type of injury (77 blunt [75%] / 25 penetrating [25%]) or injury severity (ISS: 0-20; 21-40; 41-75). Age (odds ratio (OR) = 1.04), male gender (OR = 3.2), ISS 21-40 (OR = 13.6), and ISS >40 (OR = 43.6) were the significant factors affecting outcome in the exact logistic regression analysis. The time interval at the scene of injury exceeded PHTLS guidelines. The vast majority of the hypotensive trauma patients were fluid-resuscitated on-scene regardless of the type, mechanism, or severity of injury. A predefined fluid resuscitation regimen is not employed in hypotensive trauma victims with different types of injuries. The outcome was worsened by male gender, progressive age, and ISS > 20 in the exact multiple regression analysis.

  12. Effect Of Vibration On Occupant Driving Performances Measured By Simulated Driving

    Directory of Open Access Journals (Sweden)

    Amzar Azizan

    2015-08-01

    Full Text Available Although the performance of vehicle driver has been well investigated in many types of environments however drowsy driving caused by vibration has received far less attention. Experiment procedures comprised of two 10-minutes simulated driving sessions in no-vibration condition and with-vibration condition. In with-vibration condition volunteers were exposed to a Gaussian random vibration with 1-15 Hz frequency bandwidth at 0.2 ms-2 r.m.s. for 30-minutes. A deviation in lane position and vehicle speed were recorded and analyzed. Volunteers have also rated their subjective drowsiness by giving score using Karolinska Sleepiness Scale KSS every 5-minutes interval. Strong evidence of driving impairment following 30-minutes exposure to vibration were found significant in all volunteers p 0.05.

  13. Effect of topical application of melatonin cream 12.5% on cognitive parameters

    DEFF Research Database (Denmark)

    Scheuer, Cecilie; Pommergaard, Hans-Christian; Rosenberg, Jacob

    2016-01-01

    have never been investigated. Objectives The aim of this study was to assess the degree of cognitive dysfunction when using melatonin cream as full body topical application. METHODS: In a randomized, placebo-controlled, double-blind crossover study in healthy volunteers, the degree of cognitive...... dysfunction when using cream containing 12.5% melatonin as full body application was assessed. A group of ten volunteers had melatonin cream 12.5% applied on 80% of their body surface area, and degree of cognitive dysfunction was assessed using a test battery consisting of Karolinska sleepiness scale (KSS...... application of melatonin cream on a full body surface area. The results support that melatonin is a safe drug for dermal application even in a high dosage....

  14. Effect of Daylight on Melatonin and Subjective General Health Factors in Elderly People

    Directory of Open Access Journals (Sweden)

    Zohre KARAMI

    2016-05-01

    Full Text Available Background: This paper investigated the effect of daylight on morning and night melatonin, subjective general health using GHQ questionnaire, sleepiness and alertness on elderly who lived in nursing houses.Methods: Nineteen nursing home residents participated voluntarily. They exposed to daylight from 9 to 10 a.m. and from 4 to 5 p.m. for 6 wk. The level of melatonin in the morning and at night was measured. General health of all participants was evaluated using General Health Questionnaire (GHQ as well.Results: Daylight exposure significantly affected morning melatonin from 25.39 pg/ml to 59.77 pg/ml (P=0.001 and night melatonin were changed from 40.30pg/ml to 34.41pg/ml (P=0.081. Mean score of general health changed 36.31 to 29.89 (P=0.003. Karolinska Sleepiness Scale (KSS and Visual Analogue Scale (VAS showed increase sleepiness and decrease alertness from 3:00 to 7:00 a.m. Sleepiness decreased and alertness increased during 1:00 p.m. and 20:00 p.m.Conclusions: Daylight exposure could delay sleep phase and correction of circadian rhythm in elderly. Anxiety and insomnia could be improved with daylight exposure. It suggests that elders should be exposed to scheduled daylight in morning and evening for prevention and improvement of mental disorders. Adequate light should be provided for elder’s homes and nursing house.  Keywords: Daylight, Melatonin, Health, Circadian rhythm, Elderly, Iran

  15. Scale and scaling in soils

    Science.gov (United States)

    Scale is recognized as a central concept in the description of the hierarchical organization of our world. Pressing environmental and societal problems such require an understanding of how processes operate at different scales, and how they can be linked across scales. Soil science as many other dis...

  16. Helicity scalings

    Energy Technology Data Exchange (ETDEWEB)

    Plunian, F [ISTerre, CNRS, Universite Joseph Fourier, Grenoble (France); Lessinnes, T; Carati, D [Physique Statistique et Plasmas, Universite Libre de Bruxelles (Belgium); Stepanov, R, E-mail: Franck.Plunian@ujf-grenoble.fr [Institute of Continuous Media Mechanics of the Russian Academy of Science, Perm (Russian Federation)

    2011-12-22

    Using a helical shell model of turbulence, Chen et al. (2003) showed that both helicity and energy dissipate at the Kolmogorov scale, independently from any helicity input. This is in contradiction with a previous paper by Ditlevsen and Giuliani (2001) in which, using a GOY shell model of turbulence, they found that helicity dissipates at a scale larger than the Kolmogorov scale, and does depend on the helicity input. In a recent paper by Lessinnes et al. (2011), we showed that this discrepancy is due to the fact that in the GOY shell model only one helical mode (+ or -) is present at each scale instead of both modes in the helical shell model. Then, using the GOY model, the near cancellation of the helicity flux between the + and - modes cannot occur at small scales, as it should be in true turbulence. We review the main results with a focus on the numerical procedure needed to obtain accurate statistics.

  17. Framing scales and scaling frames

    NARCIS (Netherlands)

    Lieshout, van M.; Dewulf, A.; Aarts, M.N.C.; Termeer, C.J.A.M.

    2009-01-01

    Policy problems are not just out there. Actors highlight different aspects of a situation as problematic and situate the problem on different scales. In this study we will analyse the way actors apply scales in their talk (or texts) to frame the complex decision-making process of the establishment o

  18. Similarity Scaling

    Science.gov (United States)

    Schnack, Dalton D.

    In Lecture 10, we introduced a non-dimensional parameter called the Lundquist number, denoted by S. This is just one of many non-dimensional parameters that can appear in the formulations of both hydrodynamics and MHD. These generally express the ratio of the time scale associated with some dissipative process to the time scale associated with either wave propagation or transport by flow. These are important because they define regions in parameter space that separate flows with different physical characteristics. All flows that have the same non-dimensional parameters behave in the same way. This property is called similarity scaling.

  19. Planck Scale to Hubble Scale

    CERN Document Server

    Sidharth, B G

    1998-01-01

    Within the context of the usual semi classical investigation of Planck scale Schwarzchild Black Holes, as in Quantum Gravity, and later attempts at a full Quantum Mechanical description in terms of a Kerr-Newman metric including the spinorial behaviour, we attempt to present a formulation that extends from the Planck scale to the Hubble scale. In the process the so called large number coincidences as also the hitherto inexplicable relations between the pion mass and the Hubble Constant, pointed out by Weinberg, turn out to be natural consequences in a consistent description.

  20. Scaling down

    Directory of Open Access Journals (Sweden)

    Ronald L Breiger

    2015-11-01

    Full Text Available While “scaling up” is a lively topic in network science and Big Data analysis today, my purpose in this essay is to articulate an alternative problem, that of “scaling down,” which I believe will also require increased attention in coming years. “Scaling down” is the problem of how macro-level features of Big Data affect, shape, and evoke lower-level features and processes. I identify four aspects of this problem: the extent to which findings from studies of Facebook and other Big-Data platforms apply to human behavior at the scale of church suppers and department politics where we spend much of our lives; the extent to which the mathematics of scaling might be consistent with behavioral principles, moving beyond a “universal” theory of networks to the study of variation within and between networks; and how a large social field, including its history and culture, shapes the typical representations, interactions, and strategies at local levels in a text or social network.

  1. Scale interactions

    Science.gov (United States)

    Snow, John T.

    Since the time of the first world war, investigation of synoptic processes has been a major focus of atmospheric research. These are the physical processes that drive the continuously evolving pattern of high and low pressure centers and attendant frontal boundaries that are to be seen on continental-scale weather maps. This effort has been motivated both by a spirit of scientific inquiry and by a desire to improve operational weather forecasting by national meteorological services. These national services in turn have supported the development of a global observational network that provides the data required for both operational and research purposes. As a consequence of this research, there now exists a reasonable physical understanding of many of the phenomena found at this synoptic scale. This understanding is reflected in the numerical weather forecast models used by the national services. These have shown significant skill in predicting the evolution of synoptic-scale features for periods extending out to five days.

  2. Scale Holography

    CERN Document Server

    Cembranos, Jose A R; Garay, Luis J

    2016-01-01

    We present a new correspondence between a d-dimensional dynamical system and a whole family of (d+1)-dimensional systems. This new scale-holographic relation is built by the explicit introduction of a dimensionful constant which determines the size of the additional dimension. Scale holography is particularly useful for studying non-local theories, since the equivalent dual system on the higher dimensional manifold can be made to be local, as we illustrate with the specific example of the p-adic string.

  3. Cansancio y somnolencia durante el desempeño laboral de los conductores interprovinciales: experiencia peruana y planteamiento de propuestas Tiredness and sleepiness in rural bus drivers during their job performance: Peruvian experience and proposals

    Directory of Open Access Journals (Sweden)

    Jorge Rey de Castro

    2010-06-01

    Full Text Available La información indica que los accidentes de tránsito causados por somnolencia o cansancio de los conductores de ómnibus son frecuentes en nuestro país. Un conductor que se duerme durante la conducción no puede realizar maniobras evasivas para evitar colisiones o despistes, siendo el resultado de este tipo de accidentes, gran número de víctimas y la destrucción de infraestructura. En este artículo se discute la información original publicada en Perú hasta la actualidad y plantea propuestas generales para enfrentar el problema.The information indicates that the traffic accidents caused by bus drivers’ sleepiness or tiredness are frequent in our country. A driver that falls asleep while driving cannot perform evasive maneuvers in order to avoid crashes or getting off the track, being the result of this kind of accidents a great number of victims and infrastructure destruction. In this article we discuss the original data published in Peru up to date and make general proposals to face the problem.

  4. Effect of brief sleep hygiene education for workers of an information technology company.

    Science.gov (United States)

    Kakinuma, Mitsuru; Takahashi, Masaya; Kato, Noritada; Aratake, Yutaka; Watanabe, Mayumi; Ishikawa, Yumi; Kojima, Reiko; Shibaoka, Michi; Tanaka, Katsutoshi

    2010-01-01

    To investigate the effects of sleep hygiene education for workers of an information technology (IT) company, we conducted a controlled clinical trial providing 581 workers one-hour sleep hygiene education. The contents of the sleep hygiene education program were a review of sleep habits, provide sleep hygiene education, and the establishment of sleep habit goals. A self-report questionnaire was used to measure outcomes including the Pittsburgh Sleep Quality Index (PSQI), Karolinska Sleepiness Scale (KSS), Checklist Individual Strength (CIS), Center for Epidemiologic Studies for Depression (CES-D), and mean sleep duration on weekdays before and 4 wk after the intervention. A total of 391 participants were included in the analysis, with 214 participants in the sleep hygiene education group and 177 in the waiting list group. KSS score at 2 P.M. decreased by 0.42 points in the sleep hygiene education group, but increased by 0.08 points in the waiting list group, showing a significant effect size of 0.50 (95%CI, -0.97 to -0.04, psleep hygiene education may improve afternoon sleepiness at work, but not sleep at night for IT workers.

  5. Drowsiness discrimination in an overnight driving simulation on the basis of RR and QT intervals

    Directory of Open Access Journals (Sweden)

    Heinze Christian

    2017-09-01

    Full Text Available We examined if ECG-based features are discrimi-native towards drowsiness. Twenty-five volunteers (19–32 years completed 7×40 minutes of monotonous overnight driving simulation, designed to induce drowsiness. ECG (512 s-1 was recorded continuously; subjective ratings of drowsiness on the Karolinska sleepiness scale (KSS were polled every five minutes. ECG recordings were divided into 5-min segments, each associated with the mean of one self- and two observer-KSS ratings. Those mean KSS values were binarized to obtain two classes not drowsy and drowsy. The Q-, R- and T-waves in the recordings were detected; R-peak positions were manually reviewed; the Q- and T-detection method was tested against the manual annotations of Physio-net’s QT database. Power spectral densities of RR intervals (RR-PSD and quantiles of the empirical distribution of heart-rate corrected QTc intervals were estimated. Support-vector machines and random-holdout cross-validation were used for the estimation of the classification error. Using either RR-PSD or QTc features yielded mean test errors of 79.3 ± 0.3 % and 82.7 ± 0.5 %, respectively. Merging RR and QTc features improved the accuracy to 88.3 ± 0.2 %. QTc intervals of the class drowsy were generally prolonged com-pared to not drowsy. Our findings indicate that the inclusion of QT intervals contribute to the discrimination of driver sleepiness.

  6. Age-Related Reduction in Daytime Sleep Propensity and Nocturnal Slow Wave Sleep

    Science.gov (United States)

    Dijk, Derk-Jan; Groeger, John A.; Stanley, Neil; Deacon, Stephen

    2010-01-01

    Objective: To investigate whether age-related and experimental reductions in SWS and sleep continuity are associated with increased daytime sleep propensity. Methods: Assessment of daytime sleep propensity under baseline conditions and following experimental disruption of SWS. Healthy young (20-30 y, n = 44), middle-aged (40-55 y, n = 35) and older (66-83 y, n = 31) men and women, completed a 2-way parallel group study. After an 8-h baseline sleep episode, subjects were randomized to 2 nights with selective SWS disruption by acoustic stimuli, or without disruption, followed by 1 recovery night. Objective and subjective sleep propensity were assessed using the Multiple Sleep Latency Test (MSLT) and the Karolinska Sleepiness Scale (KSS). Findings: During baseline sleep, SWS decreased (P sleep propensity, sleep continuity, and SWS. In contrast, experimental disruption of SWS leads to an increase in daytime sleep propensity. The age-related decline in SWS and reduction in daytime sleep propensity may reflect a lessening in homeostatic sleep requirement. Healthy older adults without sleep disorders can expect to be less sleepy during the daytime than young adults. Citation: Dijk DJ; Groeger JA; Stanley N; Deacon S. Age-related reduction in daytime sleep propensity and nocturnal slow wave sleep. SLEEP 2010;33(2):211-223. PMID:20175405

  7. Nuclear scales

    Energy Technology Data Exchange (ETDEWEB)

    Friar, J.L.

    1998-12-01

    Nuclear scales are discussed from the nuclear physics viewpoint. The conventional nuclear potential is characterized as a black box that interpolates nucleon-nucleon (NN) data, while being constrained by the best possible theoretical input. The latter consists of the longer-range parts of the NN force (e.g., OPEP, TPEP, the {pi}-{gamma} force), which can be calculated using chiral perturbation theory and gauged using modern phase-shift analyses. The shorter-range parts of the force are effectively parameterized by moments of the interaction that are independent of the details of the force model, in analogy to chiral perturbation theory. Results of GFMC calculations in light nuclei are interpreted in terms of fundamental scales, which are in good agreement with expectations from chiral effective field theories. Problems with spin-orbit-type observables are noted.

  8. Nuclear Scales

    CERN Document Server

    Friar, J L

    1998-01-01

    Nuclear scales are discussed from the nuclear physics viewpoint. The conventional nuclear potential is characterized as a black box that interpolates nucleon-nucleon (NN) data, while being constrained by the best possible theoretical input. The latter consists of the longer-range parts of the NN force (e.g., OPEP, TPEP, the $\\pi$-$\\gamma$ force), which can be calculated using chiral perturbation theory and gauged using modern phase-shift analyses. The shorter-range parts of the force are effectively parameterized by moments of the interaction that are independent of the details of the force model, in analogy to chiral perturbation theory. Results of GFMC calculations in light nuclei are interpreted in terms of fundamental scales, which are in good agreement with expectations from chiral effective field theories. Problems with spin-orbit-type observables are noted.

  9. Scaling CMOS

    Directory of Open Access Journals (Sweden)

    G.A Brown

    2004-01-01

    Full Text Available The scaling of silicon integrated circuits to smaller physical dimensions became a primary activity of advanced device development almost as soon as the basic technology was established. The importance and persistence of this activity is rooted in the confluence of two of the strongest drives governing the business; the push for greater device performance, measured in terms of switching speed, and the desire for greater manufacturing profitability, dependent upon reduced cost per good device built.

  10. Sonolência excessiva diurna e depressão: causas, implicações clínicas e manejo terapêutico Excessive daytime sleepiness and depression: causes, clinical implications, and therapeutic management

    Directory of Open Access Journals (Sweden)

    Sarah Laxhmi Chellappa

    2009-01-01

    Full Text Available A sonolência excessiva diurna (SED é frequentemente associada à depressão, e as possíveis relações entre as duas afecções são numerosas. A SED pode ocorrer devido a insônia ou hiperssonia. A sintomatologia da depressão inclui, notadamente, a insônia e a consequente SED, que podem ser, em alguns casos, sintomas residuais após a resposta ao tratamento antidepressivo. Paralelamente, a insônia e a sonolência diurna podem, inclusive, ser efeitos colaterais de curta ou longa duração do manejo terapêutico antidepressivo. Independente de a SED ser um sintoma de um quadro depressivo atual, sintoma residual de depressão prévia ou efeito colateral de medicação antidepressiva, faz-se necessária uma adequada avaliação clínica da SED na depressão. A fim de discorrer sobre as atuais evidências das investigações da SED na depressão, foi feito um levantamento da literatura médica nos bancos de dados ISI, MEDLINE e SciELO, compreendendo-se o período de 1990 a 2007. Apesar de os mecanismos responsáveis pela relação entre a sonolência diurna e a depressão serem complexos e entrelaçados, a avaliação compreensiva desse transtorno do sono desempenha um papel fundamental na predição de respostas ao manejo terapêutico, recaídas e modelos etiológicos da depressão.Excessive daytime sleepiness (EDS is often related to depression, and there are several possible relationships between them. EDS can usually occur due to either insomnia or hypersomnia. The symptomatology of depression prominently includes insomnia and the resultant EDS, which may, in such cases, be residual symptoms as a response to antidepressant treatment. Furthermore, insomnia and daytime sleepiness may be short- or long-term side effects of antidepressant treatment as well. The clinical assessment of depression should adequately address whether EDS is a symptom of current depression, a prior depression residual symptom, or a side effect of antidepressant

  11. Influence of gender on psychomotor vigilance task performance by adolescents

    Directory of Open Access Journals (Sweden)

    F. Beijamini

    2008-08-01

    Full Text Available During adolescence, the sleep phase delay associated with early school times increases daytime sleepiness and reduces psychomotor performance. Some studies have shown an effect of gender on psychomotor performance in adults and children. Males present faster reaction times (RT compared with females. The aim of the present study was to evaluate the influence of gender on Palm psychomotor vigilance task (PVT performance in adolescents. Thirty-four adolescents (19 girls, 13 to 16 years old attending morning school classes of a public school in Curitiba, PR, Brazil, participated in the study. Sleep patterns were measured using actigraphy and sleepiness data were accessed with the Karolinska Sleepiness Scale (KSS. KSS and PVT measurements were collected at two times in the morning (8:00 and 11:00 h. The data were compared using one-way ANOVA, considering gender as a factor. ANOVA indicated that gender did not affect sleep patterns and subjective somnolence; however, a statistically significant effect of gender was detected for PVT performance. Boys presented faster RT (RT-PVT1: 345.51 ms, F = 6.08, P < 0.05; RT-PVT2: 343.30 ms, F = 6.35, P < 0.05 and fewer lapses (lapses-PVT1: 8.71, F = 4.45, P < 0.05; lapses-PVT2: 7.82, F = 7.06, P < 0.05 compared with girls (RT-PVT1: 402.96; RT-PVT2: 415.70; lapses-PVT1: 16.33; lapses-PVT2: 17.80. These results showed that this effect of gender, already reported in adults and children, is also observed in adolescents. The influence of gender should be taken into account in studies that use Palm PVT to evaluate psychomotor performance in this age range.

  12. Molecular scale

    Directory of Open Access Journals (Sweden)

    Christopher H. Childers

    2016-03-01

    Full Text Available This manuscript demonstrates the molecular scale cure rate dependence of di-functional epoxide based thermoset polymers cured with amines. A series of cure heating ramp rates were used to determine the influence of ramp rate on the glass transition temperature (Tg and sub-Tg transitions and the average free volume hole size in these systems. The networks were comprised of 3,3′-diaminodiphenyl sulfone (33DDS and diglycidyl ether of bisphenol F (DGEBF and were cured at ramp rates ranging from 0.5 to 20 °C/min. Differential scanning calorimetry (DSC and NIR spectroscopy were used to explore the cure ramp rate dependence of the polymer network growth, whereas broadband dielectric spectroscopy (BDS and free volume hole size measurements were used to interrogate networks’ molecular level structural variations upon curing at variable heating ramp rates. It was found that although the Tg of the polymer matrices was similar, the NIR and DSC measurements revealed a strong correlation for how these networks grow in relation to the cure heating ramp rate. The free volume analysis and BDS results for the cured samples suggest differences in the molecular architecture of the matrix polymers due to cure heating rate dependence.

  13. desirability scale

    Directory of Open Access Journals (Sweden)

    Alejandro C. Cosentino

    2008-01-01

    Full Text Available La deseabilidad social es la necesidad de los sujetos de obtener aprobación respondiendo de un modo culturalmente aceptable y apropiado. Uno de los instrumentos más utilizado para medirla es la Marlowe-Crowne Social Desirability Scale (MCSDS, desarrollada por los autores en 1960. Es de frecuente aplicación en diversos tipos de estudios de diferentes áreas de la Psicología y la Medicina. Resulta adecuada tanto para estimar sesgos de respuestas en un sentido socialmente deseable como para operacionalizar constructos psicológicos, tales como de necesidad de aprobación o de defensividad. Es la medida estándar para discriminar entre los estilos de respuesta al estrés del modelo de Weinberger, Schwartz y Davidson (1979. A lo largo del tiempo, diversos autores le han realizado modificaciones tales como: cambios de formato de administración, abreviaciones, traducciones y adaptaciones a diversas culturas. En este estudio se describe el desarrollo de la Escala de Deseabilidad Social de Crowne y Marlowe (EDSCM que es una adaptación argentina de la escala completa MCSDS en su formato original de papel y lápiz. Los datos obtenidos a través de diferentes muestras (estudiantes universitarios, adultos y solicitantes de empleos respaldan que la EDSCM posee adecuadas confiabilidad y validez de constructo, como lo demuestra el estudio de su validez convergente, validez divergente, validez por técnica de instrucciones diferenciales y validez de grupos conocidos. Se sugiere el uso de la EDSCM para investigaciones en diferentes áreas de Psicología y Medicina en poblaciones argentinas.

  14. Allogeneic Hematopoietic Stem Cell Transplantation in the Treatment of Human C1q Deficiency: The Karolinska Experience.

    Science.gov (United States)

    Olsson, Richard F; Hagelberg, Stefan; Schiller, Bodil; Ringdén, Olle; Truedsson, Lennart; Åhlin, Anders

    2016-06-01

    Human C1q deficiency is associated with systemic lupus erythematosus (SLE) and increased susceptibility to severe bacterial infections. These patients require extensive medical therapy and some develop treatment-resistant disease. Because C1q is produced by monocytes, it has been speculated that allogeneic hematopoietic stem cell transplantation (allo-HSCT) may cure this disorder. We have so far treated 5 patients with C1q deficiency. In 3 cases, SLE symptoms remained relatively mild after the start of medical therapy, but 2 patients developed treatment-resistant SLE, and we decided to pursue treatment with allo-HSCT. For this purpose, we chose a conditioning regimen composed of treosulfan (14 g/m) and fludarabine (30 mg/m) started on day -6 and given for 3 and 5 consecutive days, respectively. Thymoglobulin was given at a cumulative dose of 8 mg/kg, and graft-versus-host disease prophylaxis was composed of cyclosporine and methotrexate. A 9-year-old boy and a 12-year-old girl with refractory SLE restored C1q production after allo-HSCT. This resulted in normal functional properties of the classical complement pathway followed by reduced severity of SLE symptoms. The boy developed posttransplant lymphoproliferative disease, which resolved after treatment with rituximab and donor lymphocyte infusion. Unfortunately, donor lymphocyte infusion induced severe cortisone-resistant gastrointestinal graft-versus-host disease, and the patient died from multiple organ failure 4 months after transplantation. The girl is doing well 33 months after transplantation, and clinically, all signs of SLE have resolved. Allo-HSCT can cure SLE in human C1q deficiency and should be considered early in subjects resistant to medical therapy.

  15. Excessive daytime sleepiness of the Brazilian emperor Dom Pedro II probably due to sleep apnea syndrome Sonolência diurna excessiva de Dom Pedro II do Brasil devida provavelmente à síndrome de apnéia do sono

    Directory of Open Access Journals (Sweden)

    Rubens Reimão

    2008-01-01

    Full Text Available OBJECTIVE: To show that the obstructive sleep apnea syndrome (OSAS was the probable cause of D. Pedro II's excessive daytime sleepiness. METHOD: Research of historical documents and bibliographical. RESULTS: The excessive daytime sleepiness of D. Pedro II (1825-1891 was well known and bitterly criticized behavior by oppositionist magazines; it was also recognized by his peers. He would fall asleep in public places such as the theater and while attending lectures. As a youth, he was of normal complexion, putting on weight (obesity at middle years. CONCLUSION: The possibility of this diagnosis is particularly relevant in this case because it points to an organic cause for D. Pedro II daytime naps and excessive daytime sleepiness. It could be the result of OSAS and not "disinterest" as erroneously assumed at that time.OBJETIVO: Evidenciar a síndrome de apnéia do sono tipo obstrutivo (SASO como provável causa da sonolência diurna excessiva de D. Pedro II. MÉTODO: Pesquisa de documentos históricos e bibliográfica. RESULTADOS: A sonolência diurna excessiva de D. Pedro II (1825-1891 era bem conhecida e criticada enfaticamente pelas revistas oposicionistas, era também reconhecida pelos seus pares. Ele adormecia em lugares públicos como no teatro e ao assistir aulas. Como jovem ele tinha compleição normal, ganhando peso (obesidade na meia idade. CONCLUSÃO: A possibilidade deste diagnóstico é particularmente relevante neste caso porque aponta para uma causa orgânica para os cochilos diurnos e a sonolência diurna excessiva. Pode se dever à SASO e não ao "desinteresse" como erroneamente admitido naquela época.

  16. Development of a Scale for Assessing Three Aspects of Sleep: Regularity, Quality, and Quantity.

    Science.gov (United States)

    Matsumoto, Yuuki; Ishitake, Tatsuya; Uchimura, Naohisa; Ishida, Tetsuya; Morimatsu, Yoshitaka; Hoshiko, Michiko; Mori, Mihoko; Kushino, Nanae

    2013-07-12

    Objectives: It is difficult to assess sleep habits using one factor (i.e., sleep duration) alone. Regularity and quality of sleep have to be considered to assess sleep accurately. However, to our knowledge there is no scale which scores the three factors simultaneously. The purpose of this study was to inspect the reliability and validity (content, construct, and discriminant validity) of a scale we developed to screen for poor sleep habits. This scale was constructed to assess three aspects of sleep: regularity, quality, and quantity. Methods: Subjects were 563 day workers (370 men and 193 women; average age = 40.4 yr) from the manufacturing and service industries. We created a 21-item questionnaire (7 items for each of 3 factors) based on earlier studies and discussions with specialists. Reliability and construct validity of the questionnaire were assessed through item and factor analyses and Cronbach's alpha. In addition, subjects' scores were using principal component analysis, and subjects were classified according to their scores through a cluster analysis. We compared lifestyles, daytime sleepiness, stress, and chronic disease among the subjects to examine the instrument's discriminant validity. Results: Although our analysis revealed 6 items were invalid, the questionnaire assessed the three factors (regularity, quality and quantity) as expected: Cronbach's alpha was 0.744, 0.757, and 0.548, respectively. Two of the 7 quantity items were identified as assessing regularity instead, but all other items performed as expected. Four items measuring insomnia (disturbance of sleep induction, disturbance of sound sleep, nocturnal awakening, and early morning awakening) included constant burden as a quality factor. Chi-squared tests showed that the ratio of participants who took good care of their health and had less stress and daytime sleepiness was significantly high in the highest-scoring group, while the ratio of people reporting stress and chronic disease was

  17. TV and Sex Make Americans Sleepy

    Institute of Scientific and Technical Information of China (English)

    朱吉利

    2001-01-01

    本文让我们窥见了美国的“隐私”一隅。在美国失眠者不在少数,他们有什么安然入梦之良策?似乎男女各有招数: For women, reading came in as the best way to fall asleep, followed by watching TV and prayer or meditation(冥想). Men favored TV viewing and sex——although women also acknowledged the sleep-inducing powers of sex. When asked if sex before bed helped them fall asleep, three quarters of respondents said it did.】

  18. Religious attitude scale: scale development and validation

    OpenAIRE

    Üzeyir Ok

    2011-01-01

    In this paper a scale of religious attitude (in an Islamic tradition) was constructed and its metric properties were introduced on the basis of its tests on two different samples (ns=930 and 388) of university students. It was found that the scale, which was named as Ok-Religious Attitude Scale, recorded high alpha scores (.81 and .91). Both explanatory and confirmatory factor analyses confirm that the scale with its four subscales (cognitive, emotional, behavioural and relational) form an id...

  19. Rating of daytime and nighttime symptoms in RLS: validation of the RLS-6 scale of restless legs syndrome/Willis-Ekbom disease.

    Science.gov (United States)

    Kohnen, Ralf; Martinez-Martin, Pablo; Benes, Heike; Trenkwalder, Claudia; Högl, Birgit; Dunkl, Elmar; Walters, Arthur S

    2016-04-01

    The International Restless Legs Scale (IRLS) is the most widely used of the scales rating the severity of restless legs syndrome/Willis-Ekbom disease (RLS/WED). It has been well validated and is the primary end point for most of the therapeutic and nontherapeutic studies of RLS/WED. It has excellent psychometric properties, although it does not capture the severity of RLS under a wide variety of circumstances and times of day. Moreover, the IRLS has a large placebo effect. The Restless Legs Syndrome-6 Scale (RLS-6), however, takes another potentially valuable approach. Six items are rated on a 0-10 scale from no symptoms at 0 to very severe at 10. In addition to questions on satisfaction with sleep and sleepiness, the scale rates the severity of RLS for the past week under four separate circumstances: while falling asleep, during the night, during the day while sitting or lying, and during the day when moving around. The purpose of the current study is to report the validation of the RLS-6 under baseline and therapeutic conditions. The RLS-6 seems to be an acceptable, reliable, precise, valid, and responsive instrument for the assessment of RLS severity in a specific and pragmatic manner. At present, we view the RLS-6 not as a replacement for the IRLS but as a supplement, as each scale provides information not captured by the other. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  20. Assessment of fatigue using the Identity- Consequence Fatigue Scale in patients with lung cancer

    Directory of Open Access Journals (Sweden)

    Ingrid Correia Nogueira

    Full Text Available ABSTRACT Objective: To evaluate the properties of the Identity-Consequence Fatigue Scale (ICFS in patients with lung cancer (LC, assessing the intensity of fatigue and associated factors. Methods: This was a cross-sectional study involving LC patients, treated at a teaching hospital in Brazil, who completed the ICFS. Patients with chronic heart disease (CHD and healthy controls, matched for age and gender, also completed the scale. Initially, a Brazilian Portuguese-language version of the ICFS was administered to 50 LC patients by two independent interviewers; to test for reproducibility, it was readministered to those same patients. At baseline, the LC patients were submitted to spirometry and the six-minute walk test, as well as completing the Epworth Sleepiness Scale (ESS, Hospital Anxiety and Depression Scale (HADS, Medical Outcomes Study 36-item Short-Form Health Survey (SF-36, and Fatigue Severity Scale (FSS. Inflammatory status was assessed by blood C-reactive protein (CRP levels. To validate the ICFS, we assessed the correlations of its scores with those variables. Results: The sample comprised 50 patients in each group (LC, CHD, and control. In the LC group, the intraclass correlation coefficients for intra-rater and inter-rater reliability regarding ICFS summary variables ranged from 0.94 to 0.76 and from 0.94 to 0.79, respectively. The ICFS presented excellent internal consistency, and Bland-Altman plots showed good test-retest reliability. The ICFS correlated significantly with FSS, HADS, and SF-36 scores, as well as with CRP levels. Mean ICFS scores in the LC group differed significantly from those in the CHD and control groups. Conclusions: The ICFS is a valid, reliable instrument for evaluating LC patients, in whom depression, quality of life, and CRP levels seem to be significantly associated with fatigue.

  1. Scaling: An Items Module

    Science.gov (United States)

    Tong, Ye; Kolen, Michael J.

    2010-01-01

    "Scaling" is the process of constructing a score scale that associates numbers or other ordered indicators with the performance of examinees. Scaling typically is conducted to aid users in interpreting test results. This module describes different types of raw scores and scale scores, illustrates how to incorporate various sources of…

  2. Raters & Rating Scales.

    Science.gov (United States)

    Lopez, Winifred A.; Stone, Mark H.

    1998-01-01

    The first article in this section, "Rating Scales and Shared Meaning," by Winifred A. Lopez, discusses the analysis of rating scale data. The second article, "Rating Scale Categories: Dichotomy, Double Dichotomy, and the Number Two," by Mark H. Stone, argues that dichotomies in rating scales are more useful than multiple ratings. (SLD)

  3. Scaling of Metabolic Scaling within Physical Limits

    Directory of Open Access Journals (Sweden)

    Douglas S. Glazier

    2014-10-01

    Full Text Available Both the slope and elevation of scaling relationships between log metabolic rate and log body size vary taxonomically and in relation to physiological or developmental state, ecological lifestyle and environmental conditions. Here I discuss how the recently proposed metabolic-level boundaries hypothesis (MLBH provides a useful conceptual framework for explaining and predicting much, but not all of this variation. This hypothesis is based on three major assumptions: (1 various processes related to body volume and surface area exert state-dependent effects on the scaling slope for metabolic rate in relation to body mass; (2 the elevation and slope of metabolic scaling relationships are linked; and (3 both intrinsic (anatomical, biochemical and physiological and extrinsic (ecological factors can affect metabolic scaling. According to the MLBH, the diversity of metabolic scaling relationships occurs within physical boundary limits related to body volume and surface area. Within these limits, specific metabolic scaling slopes can be predicted from the metabolic level (or scaling elevation of a species or group of species. In essence, metabolic scaling itself scales with metabolic level, which is in turn contingent on various intrinsic and extrinsic conditions operating in physiological or evolutionary time. The MLBH represents a “meta-mechanism” or collection of multiple, specific mechanisms that have contingent, state-dependent effects. As such, the MLBH is Darwinian in approach (the theory of natural selection is also meta-mechanistic, in contrast to currently influential metabolic scaling theory that is Newtonian in approach (i.e., based on unitary deterministic laws. Furthermore, the MLBH can be viewed as part of a more general theory that includes other mechanisms that may also affect metabolic scaling.

  4. Atomic Scale Plasmonic Switch

    OpenAIRE

    Emboras, A.; Niegemann, J.; Ma, P.; Haffner, C; Pedersen, A.; Luisier, M.; Hafner, C.; Schimmel, T.; Leuthold, J.

    2016-01-01

    The atom sets an ultimate scaling limit to Moore’s law in the electronics industry. While electronics research already explores atomic scales devices, photonics research still deals with devices at the micrometer scale. Here we demonstrate that photonic scaling, similar to electronics, is only limited by the atom. More precisely, we introduce an electrically controlled plasmonic switch operating at the atomic scale. The switch allows for fast and reproducible switching by means of the relocat...

  5. The self-morningness/eveningness (Self-ME): An extremely concise and totally subjective assessment of diurnal preference.

    Science.gov (United States)

    Turco, M; Corrias, M; Chiaromanni, F; Bano, M; Salamanca, M; Caccin, L; Merkel, C; Amodio, P; Romualdi, C; De Pittà, C; Costa, R; Montagnese, S

    2015-01-01

    The assessment of diurnal preference, or the preferred timing of sleep and activity, is generally based on comprehensive questionnaires such as the Horne-Östberg (HÖ). The aim of the present study was to assess the reliability of a subject's self-classification as extremely morning (Self-MM), more morning than evening (Self-M), more evening than morning (Self-E) or extremely evening (Self-EE) type, based on the last question of the HÖ (Self-ME). A convenience sample of 461 subjects [23.8 ± 4.7 years; 322 females] completed a full sleep-wake assessment, including diurnal preference (HÖ), night sleep quality (Pittsburgh Sleep Quality Index, PSQI), daytime sleepiness (Karolinska Sleepiness Scale, KSS), and habitual sleep-wake timing (12 d sleep diaries; n = 296). Significant differences in HÖ total score were observed between Self-ME classes, with each class being significantly different from neighboring classes (p Self-ME classes. Such differences were maintained when sleep-wake habits were analysed separately on work and free days, and also in a smaller group of 67 subjects who completed the Self-ME as a stand-alone rather than as part of the original questionnaire. Significant differences were observed in the time-course of subjective sleepiness by Self-ME class in both the large and the small group, with Self-MM and Self-M subjects being significantly more alert in the morning and sleepier in the evening hours compared with their Self-E and Self-EE counterparts. Finally, significant differences were observed in night sleep quality between Self-ME classes, with Self-EE/Self-E subjects sleeping worse than their Self-MM/Self-M counterparts, and averaging just over the abnormality PSQI threshold of 5. In conclusion, young, healthy adults can define their diurnal preference based on a single question (Self-ME) in a way that reflects their sleep-wake timing, their sleepiness levels over the daytime hours, and their night sleep quality. Validation of

  6. Blue-Enriched White Light Enhances Physiological Arousal But Not Behavioral Performance during Simulated Driving at Early Night

    Science.gov (United States)

    Rodríguez-Morilla, Beatriz; Madrid, Juan A.; Molina, Enrique; Correa, Angel

    2017-01-01

    Vigilance usually deteriorates over prolonged driving at non-optimal times of day. Exposure to blue-enriched light has shown to enhance arousal, leading to behavioral benefits in some cognitive tasks. However, the cognitive effects of long-wavelength light have been less studied and its effects on driving performance remained to be addressed. We tested the effects of a blue-enriched white light (BWL) and a long-wavelength orange light (OL) vs. a control condition of dim light on subjective, physiological and behavioral measures at 21:45 h. Neurobehavioral tests included the Karolinska Sleepiness Scale and subjective mood scale, recording of distal-proximal temperature gradient (DPG, as index of physiological arousal), accuracy in simulated driving and reaction time in the auditory psychomotor vigilance task. The results showed that BWL decreased the DPG (reflecting enhanced arousal), while it did not improve reaction time or driving performance. Instead, blue light produced larger driving errors than OL, while performance in OL was stable along time on task. These data suggest that physiological arousal induced by light does not necessarily imply cognitive improvement. Indeed, excessive arousal might deteriorate accuracy in complex tasks requiring precision, such as driving. PMID:28690558

  7. Depressão, ansiedade e sonolência diurna em cuidadores primários de crianças com paralisia cerebral Depresión, ansiedad y somnolencia diurna en cuidadores primarios de niños con parálisis cerebral Depression, anxiety and daytime sleepiness of primary caregivers of children with cerebral palsy

    Directory of Open Access Journals (Sweden)

    Catherine Marx

    2011-12-01

    Beck, ansiedad estado-rasgo y Epworth, respectivamente. RESULTADOS: La mayoría de los entrevistados eran madres con bajo nivel socioeconómico. Los que se autoevaluaron ansiosos y depresivos presentaron resultados comprobatorios de ansiedad y depresión con los inventarios de estado-rasgo y Beck para los cuidadores de niños con parálisis cerebral. Los niveles de somnolencia diurna excesiva estuvieron estadísticamente relacionados a los elevados niveles de depresión. El comprometimiento neurológico de los niños no influenció los resultados sobre los cuidadores. CONCLUSIONES: Depresión, ansiedad y problemas relacionados al sueño son comunes en cuidadores de niños con parálisis cerebral. El nivel de funcionalidad neurológica del niño no influencia los resultados.OBJECTIVE: To evaluate depression, anxiety and excessive daytime sleepiness (EDS levels in primary caregivers of children with cerebral palsy (CCP and to trace the relationships with their socioeconomic conditions and child neurological characteristics, as compared with caregivers of typical children (CTC. METHODS: 45 CCP and 50 CTC were randomly chosen and answered a semi-structured questionnaire. We evaluated EDS on the Epworth scale. Beck depression inventory (BDI and the state-trait anxiety inventory (STAI identified depressive and anxious symptoms, respectively. RESULTS: The majority of subjects were mothers with low socioeconomic level. Self-perception of anxiety and depressive symptoms of CCP were confirmed through BDI and STAI. EDS was statistically related to high levels of depression. Children's disabilities did not influence the results. CONCLUSIONS: Depression, anxiety symptoms and sleep disruption were common in CCP. Child functional level did not influence the results.

  8. On Quantitative Rorschach Scales.

    Science.gov (United States)

    Haggard, Ernest A.

    1978-01-01

    Two types of quantitative Rorschach scales are discussed: first, those based on the response categories of content, location, and the determinants, and second, global scales based on the subject's responses to all ten stimulus cards. (Author/JKS)

  9. Saturation and geometrical scaling

    CERN Document Server

    Praszalowicz, Michal

    2016-01-01

    We discuss emergence of geometrical scaling as a consequence of the nonlinear evolution equations of QCD, which generate a new dynamical scale, known as the saturation momentum: Qs. In the kinematical region where no other energy scales exist, particle spectra exhibit geometrical scaling (GS), i.e. they depend on the ratio pT=Qs, and the energy dependence enters solely through the energy dependence of the saturation momentum. We confront the hypothesis of GS in different systems with experimental data.

  10. Scale Space Hierarchy

    NARCIS (Netherlands)

    Kuijper, Arjan; Florack, L.M.J.; Viergever, M.A.

    2002-01-01

    We investigate the deep structure of a scale space image. We concentrate on scale space critical points - points with vanishing gradient with respect to both spatial and scale direction. We show that these points are always saddle points. They turn out to be extremely useful, since the iso-intensity

  11. In-flight sleep, pilot fatigue and Psychomotor Vigilance Task performance on ultra-long range versus long range flights.

    Science.gov (United States)

    Gander, Philippa H; Signal, T Leigh; van den Berg, Margo J; Mulrine, Hannah M; Jay, Sarah M; Jim Mangie, Captain

    2013-12-01

    This study evaluated whether pilot fatigue was greater on ultra-long range (ULR) trips (flights >16 h on 10% of trips in a 90-day period) than on long range (LR) trips. The within-subjects design controlled for crew complement, pattern of in-flight breaks, flight direction and departure time. Thirty male Captains (mean age = 54.5 years) and 40 male First officers (mean age = 48.0 years) were monitored on commercial passenger flights (Boeing 777 aircraft). Sleep was monitored (actigraphy, duty/sleep diaries) from 3 days before the first study trip to 3 days after the second study trip. Karolinska Sleepiness Scale, Samn-Perelli fatigue ratings and a 5-min Psychomotor Vigilance Task were completed before, during and after every flight. Total sleep in the 24 h before outbound flights and before inbound flights after 2-day layovers was comparable for ULR and LR flights. All pilots slept on all flights. For each additional hour of flight time, they obtained an estimated additional 12.3 min of sleep. Estimated mean total sleep was longer on ULR flights (3 h 53 min) than LR flights (3 h 15 min; P(F) = 0.0004). Sleepiness ratings were lower and mean reaction speed was faster at the end of ULR flights. Findings suggest that additional in-flight sleep mitigated fatigue effectively on longer flights. Further research is needed to clarify the contributions to fatigue of in-flight sleep versus time awake at top of descent. The study design was limited to eastward outbound flights with two Captains and two First Officers. Caution must be exercised when extrapolating to different operations.

  12. Classifying performance impairment in response to sleep loss using pattern recognition algorithms on single session testing.

    Science.gov (United States)

    St Hilaire, Melissa A; Sullivan, Jason P; Anderson, Clare; Cohen, Daniel A; Barger, Laura K; Lockley, Steven W; Klerman, Elizabeth B

    2013-01-01

    There is currently no "gold standard" marker of cognitive performance impairment resulting from sleep loss. We utilized pattern recognition algorithms to determine which features of data collected under controlled laboratory conditions could most reliably identify cognitive performance impairment in response to sleep loss using data from only one testing session, such as would occur in the "real world" or field conditions. A training set for testing the pattern recognition algorithms was developed using objective Psychomotor Vigilance Task (PVT) and subjective Karolinska Sleepiness Scale (KSS) data collected from laboratory studies during which subjects were sleep deprived for 26-52h. The algorithm was then tested in data from both laboratory and field experiments. The pattern recognition algorithm was able to identify performance impairment with a single testing session in individuals studied under laboratory conditions using PVT, KSS, length of time awake and time of day information with sensitivity and specificity as high as 82%. When this algorithm was tested on data collected under real-world conditions from individuals whose data were not in the training set, accuracy of predictions for individuals categorized with low performance impairment were as high as 98%. Predictions for medium and severe performance impairment were less accurate. We conclude that pattern recognition algorithms may be a promising method for identifying performance impairment in individuals using only current information about the individual's behavior. Single testing features (e.g., number of PVT lapses) with high correlation with performance impairment in the laboratory setting may not be the best indicators of performance impairment under real-world conditions. Pattern recognition algorithms should be further tested for their ability to be used in conjunction with other assessments of sleepiness in real-world conditions to quantify performance impairment in response to sleep loss.

  13. Scaling of differential equations

    CERN Document Server

    Langtangen, Hans Petter

    2016-01-01

    The book serves both as a reference for various scaled models with corresponding dimensionless numbers, and as a resource for learning the art of scaling. A special feature of the book is the emphasis on how to create software for scaled models, based on existing software for unscaled models. Scaling (or non-dimensionalization) is a mathematical technique that greatly simplifies the setting of input parameters in numerical simulations. Moreover, scaling enhances the understanding of how different physical processes interact in a differential equation model. Compared to the existing literature, where the topic of scaling is frequently encountered, but very often in only a brief and shallow setting, the present book gives much more thorough explanations of how to reason about finding the right scales. This process is highly problem dependent, and therefore the book features a lot of worked examples, from very simple ODEs to systems of PDEs, especially from fluid mechanics. The text is easily accessible and exam...

  14. Scale and scaling in agronomy and environmental sciences

    Science.gov (United States)

    Scale is of paramount importance in environmental studies, engineering, and design. The unique course covers the following topics: scale and scaling, methods and theories, scaling in soils and other porous media, scaling in plants and crops; scaling in landscapes and watersheds, and scaling in agro...

  15. Universal scalings of universal scaling exponents

    Energy Technology Data Exchange (ETDEWEB)

    Llave, Rafael de la [Department of Mathematics, University of Texas, Austin, TX 78712 (United States); Olvera, Arturo [IIMAS-UNAM, FENOMEC, Apdo. Postal 20-726, Mexico DF 01000 (Mexico); Petrov, Nikola P [Department of Mathematics, University of Oklahoma, Norman, OK 73019 (United States)

    2007-06-08

    In the last decades, renormalization group (RG) ideas have been applied to describe universal properties of different routes to chaos (quasi-periodic, period doubling or tripling, Siegel disc boundaries, etc). Each of the RG theories leads to universal scaling exponents which are related to the action of certain RG operators. The goal of this announcement is to show that there is a principle that organizes many of these scaling exponents. We give numerical evidence that the exponents of different routes to chaos satisfy approximately some arithmetic relations. These relations are determined by combinatorial properties of the route and become exact in an appropriate limit. (fast track communication)

  16. Fusion of Optimized Indicators from Advanced Driver Assistance Systems (ADAS for Driver Drowsiness Detection

    Directory of Open Access Journals (Sweden)

    Iván G. Daza

    2014-01-01

    Full Text Available This paper presents a non-intrusive approach for monitoring driver drowsiness using the fusion of several optimized indicators based on driver physical and driving performance measures, obtained from ADAS (Advanced Driver Assistant Systems in simulated conditions. The paper is focused on real-time drowsiness detection technology rather than on long-term sleep/awake regulation prediction technology. We have developed our own vision system in order to obtain robust and optimized driver indicators able to be used in simulators and future real environments. These indicators are principally based on driver physical and driving performance skills. The fusion of several indicators, proposed in the literature, is evaluated using a neural network and a stochastic optimization method to obtain the best combination. We propose a new method for ground-truth generation based on a supervised Karolinska Sleepiness Scale (KSS. An extensive evaluation of indicators, derived from trials over a third generation simulator with several test subjects during different driving sessions, was performed. The main conclusions about the performance of single indicators and the best combinations of them are included, as well as the future works derived from this study.

  17. Fusion of optimized indicators from Advanced Driver Assistance Systems (ADAS) for driver drowsiness detection.

    Science.gov (United States)

    Daza, Iván García; Bergasa, Luis Miguel; Bronte, Sebastián; Yebes, Jose Javier; Almazán, Javier; Arroyo, Roberto

    2014-01-09

    This paper presents a non-intrusive approach for monitoring driver drowsiness using the fusion of several optimized indicators based on driver physical and driving performance measures, obtained from ADAS (Advanced Driver Assistant Systems) in simulated conditions. The paper is focused on real-time drowsiness detection technology rather than on long-term sleep/awake regulation prediction technology. We have developed our own vision system in order to obtain robust and optimized driver indicators able to be used in simulators and future real environments. These indicators are principally based on driver physical and driving performance skills. The fusion of several indicators, proposed in the literature, is evaluated using a neural network and a stochastic optimization method to obtain the best combination. We propose a new method for ground-truth generation based on a supervised Karolinska Sleepiness Scale (KSS). An extensive evaluation of indicators, derived from trials over a third generation simulator with several test subjects during different driving sessions, was performed. The main conclusions about the performance of single indicators and the best combinations of them are included, as well as the future works derived from this study.

  18. Driving Drowsiness Detection Using Fusion of Electroencephalography, Electrooculography, and Driving Quality Signals.

    Science.gov (United States)

    Noori, Seyed Mohammad Reza; Mikaeili, Mohammad

    2016-01-01

    This study investigates the detection of the drowsiness state (DS) for future application such as in the reduction of the road traffic accidents. The electroencephalography, electrooculography, driving quality, and Karolinska sleepiness scale data of 7 males during approximately 20 h of sleep deprivation were recorded. To reduce the eye blink artifact, an automatic mechanism based on the independent component analysis method and Higuchi's fractal dimension has been applied. After recordings, for selecting the best subset of features, a new combined method, called class separability feature selection-sequential feature selection, has been developed. This method reduces the time of calculations from 6807 to 2096 s (by 69.21%) while the classification accuracy remains relatively unchanged. For diagnosis of the DS and classification of the state, a new approach based on a self-organized map network is used. First, using the data obtained from two classes of awareness state (AS) and DS, the network achieved an accuracy of 76.51 ± 3.43%. Using data from three classes of AS, AS/DS (passing from awareness to drowsiness), and DS to the network, an accuracy of 62.70 ± 3.65% was achieved. It is suggested that the DS during driving is detectable with an unsupervised network.

  19. Effect of topical application of melatonin cream 12.5% on cognitive parameters: A randomized, placebo-controlled, double-blind crossover study in healthy volunteers.

    Science.gov (United States)

    Scheuer, Cecilie; Pommergaard, Hans-Christian; Rosenberg, Jacob; Gögenur, Ismail

    2016-11-01

    Skin cancer is an increasing problem in modern dermatology. Earlier studies have shown protective effects against ultraviolet radiation (UVR)-induced skin damage by topical treatment with melatonin. However, the potential sedative effects of full body topical application of melatonin have never been investigated. Objectives The aim of this study was to assess the degree of cognitive dysfunction when using melatonin cream as full body topical application. In a randomized, placebo-controlled, double-blind crossover study in healthy volunteers, the degree of cognitive dysfunction when using cream containing 12.5% melatonin as full body application was assessed. A group of ten volunteers had melatonin cream 12.5% applied on 80% of their body surface area, and degree of cognitive dysfunction was assessed using a test battery consisting of Karolinska sleepiness scale (KSS), Finger tapping test (FTT) and Continuous Reaction time (CRT). No significant effects on cognitive parameters were found. However, great inter-individual variations on cognitive parameters were observed. This study was the first to assess degree of cognitive dysfunction resulting from application of melatonin cream on a full body surface area. The results support that melatonin is a safe drug for dermal application even in a high dosage.

  20. Parabolic scaling beams.

    Science.gov (United States)

    Gao, Nan; Xie, Changqing

    2014-06-15

    We generalize the concept of diffraction free beams to parabolic scaling beams (PSBs), whose normalized intensity scales parabolically during propagation. These beams are nondiffracting in the circular parabolic coordinate systems, and all the diffraction free beams of Durnin's type have counterparts as PSBs. Parabolic scaling Bessel beams with Gaussian apodization are investigated in detail, their nonparaxial extrapolations are derived, and experimental results agree well with theoretical predictions.

  1. Maximum likely scale estimation

    DEFF Research Database (Denmark)

    Loog, Marco; Pedersen, Kim Steenstrup; Markussen, Bo

    2005-01-01

    A maximum likelihood local scale estimation principle is presented. An actual implementation of the estimation principle uses second order moments of multiple measurements at a fixed location in the image. These measurements consist of Gaussian derivatives possibly taken at several scales and/or ...

  2. Genome-Scale Models

    DEFF Research Database (Denmark)

    Bergdahl, Basti; Sonnenschein, Nikolaus; Machado, Daniel

    2016-01-01

    An introduction to genome-scale models, how to build and use them, will be given in this chapter. Genome-scale models have become an important part of systems biology and metabolic engineering, and are increasingly used in research, both in academica and in industry, both for modeling chemical pr...

  3. Universities Scale Like Cities

    CERN Document Server

    van Raan, Anthony F J

    2012-01-01

    Recent studies of urban scaling show that important socioeconomic city characteristics such as wealth and innovation capacity exhibit a nonlinear, particularly a power law scaling with population size. These nonlinear effects are common to all cities, with similar power law exponents. These findings mean that the larger the city, the more disproportionally they are places of wealth and innovation. Local properties of cities cause a deviation from the expected behavior as predicted by the power law scaling. In this paper we demonstrate that universities show a similar behavior as cities in the distribution of the gross university income in terms of total number of citations over size in terms of total number of publications. Moreover, the power law exponents for university scaling are comparable to those for urban scaling. We find that deviations from the expected behavior can indeed be explained by specific local properties of universities, particularly the field-specific composition of a university, and its ...

  4. The career distress scale

    DEFF Research Database (Denmark)

    Creed, Peter; Hood, Michelle; Praskova, Anna

    2016-01-01

    Career distress is a common and painful outcome of many negative career experiences, such as career indecision, career compromise, and discovering career barriers. However, there are very few scales devised to assess career distress, and the two existing scales identified have psychometric...... weaknesses. The absence of a practical, validated scale to assess this construct restricts research related to career distress and limits practitioners who need to assess and treat it. Using a sample of 226 young adults (mean age 20.5 years), we employed item response theory to assess 12 existing career......, which we combined into a scale labelled the Career Distress Scale, demonstrated excellent psychometric properties, meaning that both researchers and practitioners can use it with confidence, although continued validation is required, including testing its relationship to other nomological net variables...

  5. Parallel Computing in SCALE

    Energy Technology Data Exchange (ETDEWEB)

    DeHart, Mark D [ORNL; Williams, Mark L [ORNL; Bowman, Stephen M [ORNL

    2010-01-01

    The SCALE computational architecture has remained basically the same since its inception 30 years ago, although constituent modules and capabilities have changed significantly. This SCALE concept was intended to provide a framework whereby independent codes can be linked to provide a more comprehensive capability than possible with the individual programs - allowing flexibility to address a wide variety of applications. However, the current system was designed originally for mainframe computers with a single CPU and with significantly less memory than today's personal computers. It has been recognized that the present SCALE computation system could be restructured to take advantage of modern hardware and software capabilities, while retaining many of the modular features of the present system. Preliminary work is being done to define specifications and capabilities for a more advanced computational architecture. This paper describes the state of current SCALE development activities and plans for future development. With the release of SCALE 6.1 in 2010, a new phase of evolutionary development will be available to SCALE users within the TRITON and NEWT modules. The SCALE (Standardized Computer Analyses for Licensing Evaluation) code system developed by Oak Ridge National Laboratory (ORNL) provides a comprehensive and integrated package of codes and nuclear data for a wide range of applications in criticality safety, reactor physics, shielding, isotopic depletion and decay, and sensitivity/uncertainty (S/U) analysis. Over the last three years, since the release of version 5.1 in 2006, several important new codes have been introduced within SCALE, and significant advances applied to existing codes. Many of these new features became available with the release of SCALE 6.0 in early 2009. However, beginning with SCALE 6.1, a first generation of parallel computing is being introduced. In addition to near-term improvements, a plan for longer term SCALE enhancement

  6. Scaling the universe

    CERN Document Server

    Frankel, Norman E

    2014-01-01

    A model is presented for the origin of the large scale structure of the universe and their Mass-Radius scaling law. The physics is conventional, orthodox, but it is used to fashion a highly unorthodox model of the origin of the galaxies, their groups, clusters, super-clusters, and great walls. The scaling law fits the observational results and the model offers new suggestions and predictions. These include a largest, a supreme, cosmic structure, and possible implications for the recently observed pressing cosmological anomalies.

  7. Scaling the Universe

    Science.gov (United States)

    Frankel, Norman E.

    2014-04-01

    A model is presented for the origin of the large scale structure of the universe and their Mass-Radius scaling law. The physics is conventional, orthodox, but it is used to fashion a highly unorthodox model of the origin of the galaxies, their groups, clusters, super-clusters, and great walls. The scaling law fits the observational results and the model offers new suggestions and predictions. These include a largest, a supreme, cosmic structure, and possible implications for the recently observed pressing cosmological anomalies.

  8. Small scale optics

    CERN Document Server

    Yupapin, Preecha

    2013-01-01

    The behavior of light in small scale optics or nano/micro optical devices has shown promising results, which can be used for basic and applied research, especially in nanoelectronics. Small Scale Optics presents the use of optical nonlinear behaviors for spins, antennae, and whispering gallery modes within micro/nano devices and circuits, which can be used in many applications. This book proposes a new design for a small scale optical device-a microring resonator device. Most chapters are based on the proposed device, which uses a configuration know as a PANDA ring resonator. Analytical and nu

  9. Maximum likely scale estimation

    DEFF Research Database (Denmark)

    Loog, Marco; Pedersen, Kim Steenstrup; Markussen, Bo

    2005-01-01

    A maximum likelihood local scale estimation principle is presented. An actual implementation of the estimation principle uses second order moments of multiple measurements at a fixed location in the image. These measurements consist of Gaussian derivatives possibly taken at several scales and....../or having different derivative orders. Although the principle is applicable to a wide variety of image models, the main focus here is on the Brownian model and its use for scale selection in natural images. Furthermore, in the examples provided, the simplifying assumption is made that the behavior...... of the measurements is completely characterized by all moments up to second order....

  10. ON BANDLIMITED SCALING FUNCTION

    Institute of Scientific and Technical Information of China (English)

    Wei Chen; Qiao Yang; Wei-jun Jiang; Si-long Peng

    2002-01-01

    This paper discuss band-limited scaling function, especially on the interval band case and three interval bands case, its relationship to oversampling property and weakly translation invariance are also studied. At the end, we propose an open problem.

  11. Small-scale Biorefining

    NARCIS (Netherlands)

    Visser, de C.L.M.; Ree, van R.

    2016-01-01

    One promising way to accelerate the market implementation of integrated biorefineries is to promote small (regional) biorefinery initiatives. Small-scale biorefineries require relatively low initial investments, and therefore are often lacking the financing problems that larger facilities face. They

  12. Allometric Scaling of Countries

    CERN Document Server

    Zhang, Jiang

    2010-01-01

    As huge complex systems consisting of geographic regions, natural resources, people and economic entities, countries follow the allometric scaling law which is ubiquitous in ecological, urban systems. We systematically investigated the allometric scaling relationships between a large number of macroscopic properties and geographic (area), demographic (population) and economic (GDP, gross domestic production) sizes of countries respectively. We found that most of the economic, trade, energy consumption, communication related properties have significant super-linear (the exponent is larger than 1) or nearly linear allometric scaling relations with GDP. Meanwhile, the geographic (arable area, natural resources, etc.), demographic(labor force, military age population, etc.) and transportation-related properties (road length, airports) have significant and sub-linear (the exponent is smaller than 1) allometric scaling relations with area. Several differences of power law relations with respect to population betwee...

  13. Scaling Foreign Exchange Volatility

    OpenAIRE

    Jonathan Batten; Craig Ellis

    2001-01-01

    When asset returns are normally distributed the risk of an asset over a long return interval may be estimated by scaling the risk from shorter return intervals. While it is well known that asset returns are not normally distributed a key empirical question concerns the effect that scaling the volatility of dependent processes will have on the pricing of related financial assets. This study provides an insight into this issue by investigating the return properties of the most important currenc...

  14. SMALL SCALE MORPHODYNAMICAL MODELLING

    Institute of Scientific and Technical Information of China (English)

    D. Ditschke; O. Gothel; H. Weilbeer

    2001-01-01

    Long term morphological simulations using complete coupled models lead to very time consuming computations. Latteux (1995) presented modelling techniques developed for tidal current situations in order to reduce the computational effort. In this paper the applicability of such methods to small scale problems is investigated. It is pointed out that these methods can be transferred to small scale problems using the periodicity of the vortex shedding process.

  15. Atomic Scale Plasmonic Switch.

    Science.gov (United States)

    Emboras, Alexandros; Niegemann, Jens; Ma, Ping; Haffner, Christian; Pedersen, Andreas; Luisier, Mathieu; Hafner, Christian; Schimmel, Thomas; Leuthold, Juerg

    2016-01-13

    The atom sets an ultimate scaling limit to Moore's law in the electronics industry. While electronics research already explores atomic scales devices, photonics research still deals with devices at the micrometer scale. Here we demonstrate that photonic scaling, similar to electronics, is only limited by the atom. More precisely, we introduce an electrically controlled plasmonic switch operating at the atomic scale. The switch allows for fast and reproducible switching by means of the relocation of an individual or, at most, a few atoms in a plasmonic cavity. Depending on the location of the atom either of two distinct plasmonic cavity resonance states are supported. Experimental results show reversible digital optical switching with an extinction ratio of 9.2 dB and operation at room temperature up to MHz with femtojoule (fJ) power consumption for a single switch operation. This demonstration of an integrated quantum device allowing to control photons at the atomic level opens intriguing perspectives for a fully integrated and highly scalable chip platform, a platform where optics, electronics, and memory may be controlled at the single-atom level.

  16. Universities scale like cities.

    Directory of Open Access Journals (Sweden)

    Anthony F J van Raan

    Full Text Available Recent studies of urban scaling show that important socioeconomic city characteristics such as wealth and innovation capacity exhibit a nonlinear, particularly a power law scaling with population size. These nonlinear effects are common to all cities, with similar power law exponents. These findings mean that the larger the city, the more disproportionally they are places of wealth and innovation. Local properties of cities cause a deviation from the expected behavior as predicted by the power law scaling. In this paper we demonstrate that universities show a similar behavior as cities in the distribution of the 'gross university income' in terms of total number of citations over 'size' in terms of total number of publications. Moreover, the power law exponents for university scaling are comparable to those for urban scaling. We find that deviations from the expected behavior can indeed be explained by specific local properties of universities, particularly the field-specific composition of a university, and its quality in terms of field-normalized citation impact. By studying both the set of the 500 largest universities worldwide and a specific subset of these 500 universities--the top-100 European universities--we are also able to distinguish between properties of universities with as well as without selection of one specific local property, the quality of a university in terms of its average field-normalized citation impact. It also reveals an interesting observation concerning the working of a crucial property in networked systems, preferential attachment.

  17. Cardinal scales for health evaluation

    DEFF Research Database (Denmark)

    Harvey, Charles; Østerdal, Lars Peter Raahave

    2010-01-01

    Policy studies often evaluate health for an individual or for a population by using measurement scales that are ordinal scales or expected-utility scales. This paper develops scales of a different type, commonly called cardinal scales, that measure changes in health. Also, we argue that cardinal ...

  18. 无侵入测量指标的驾驶疲劳检测性能评估%Evaluating Performance of Non-intrusive Indicators on Drowsy Driving Detection

    Institute of Scientific and Technical Information of China (English)

    胥川; 王雪松; 陈小鸿

    2014-01-01

    为了准确检测驾驶疲劳状态,利用高仿真度驾驶模拟器进行模拟实验,采集了驾驶行为和眼动数据,并进行了主观疲劳程度调查.在此基础上,设计了23种无侵入检测指标,从与疲劳的相关性、二元检测性能、对道路线形的敏感性和个体一致性4方面,评估了指标的性能并按综合性能排序.研究结果表明:眼闭合时间比例与主观疲劳程度(Karolinska sleepiness scale,KSS)的相关性最高,为0.443;二元检测性能最好的是眼闭合时间比例和车道偏移标准差;眼动指标在曲-直路段的变化幅度均低于20%;当KSS为7时,除车中心越线时间比例外,其余指标均存在显著的个体差异;综合性能最高的指标依次为车道偏移标准差、闭眼时间比例和越线期间横向平均速度.%To detect the drowsiness state of the driver more accurately,a high-fidelity driving simulator was adopted to collect the driving behavior and eye movement data of drivers, and questionnaires were used to collect their subjective sleepiness scales. Based on these data,23 non-intrusive indicators were developed. The indicators were evaluated from the aspects of their correlation with drowsiness,binary classification performance,sensitivity to road alignment,and individual homogeneity;and then ranked in terms of comprehensive performance. The results show that the percentage of eyelid closure time (PERCLOS)has the highest correlation (0. 443)with the Karolinska sleepiness scale (KSS ). The best binary classification performance of eye movement and driving indicators lies on PERCLOS and the lateral position standard deviation (LPSD ). For eye movement indicators,the difference between straight line and curve is lower than 20%. When KSS is 7,all the indicators show significant individual difference except the percentage of lane crossing time of vehicle center. The top three non-intrusive indicators with the best

  19. Scaled-Free Objects

    CERN Document Server

    Grilliette, Will

    2010-01-01

    Several functional analysts and C*-algebraists have been moving toward a categorical means of understanding normed objects. In this work, I address a primary issue with adapting these abstract concepts to functional analytic settings, the lack of free objects. Using a new object, called a "crutched set", and associated categories, I devise generalized construction of normed objects as a left adjoint functor to a natural forgetful functor. Further, the universal property in each case yields a "scaled-free" mapping property, which extends previous notions of `"free" normed objects. In particular, I construct the following types of scaled-free objects: Banach spaces, Banach algebras, C*-algebras, operator spaces, and operator algebras. In subsequent papers, this scaled-free property, coupled with the associated functorial results, will give rise to a new view of presentation theory for C*-algebras, which inherits many properties and constructions from its algebraic counterpart.

  20. No-Scale Inflation

    CERN Document Server

    Ellis, John; Nanopoulos, Dimitri V.; Olive, Keith A.

    2016-01-01

    Supersymmetry is the most natural framework for physics above the TeV scale, and the corresponding framework for early-Universe cosmology, including inflation, is supergravity. No-scale supergravity emerges from generic string compactifications and yields a non-negative potential, and is therefore a plausible framework for constructing models of inflation. No-scale inflation yields naturally predictions similar to those of the Starobinsky model based on $R + R^2$ gravity, with a tilted spectrum of scalar perturbations: $n_s \\sim 0.96$, and small values of the tensor-to-scalar perturbation ratio $r < 0.1$, as favoured by Planck and other data on the cosmic microwave background (CMB). Detailed measurements of the CMB may provide insights into the embedding of inflation within string theory as well as its links to collider physics.

  1. Wavelets, vibrations and scalings

    CERN Document Server

    Meyer, Yves

    1997-01-01

    Physicists and mathematicians are intensely studying fractal sets of fractal curves. Mandelbrot advocated modeling of real-life signals by fractal or multifractal functions. One example is fractional Brownian motion, where large-scale behavior is related to a corresponding infrared divergence. Self-similarities and scaling laws play a key role in this new area. There is a widely accepted belief that wavelet analysis should provide the best available tool to unveil such scaling laws. And orthonormal wavelet bases are the only existing bases which are structurally invariant through dyadic dilations. This book discusses the relevance of wavelet analysis to problems in which self-similarities are important. Among the conclusions drawn are the following: 1) A weak form of self-similarity can be given a simple characterization through size estimates on wavelet coefficients, and 2) Wavelet bases can be tuned in order to provide a sharper characterization of this self-similarity. A pioneer of the wavelet "saga", Meye...

  2. Rolling at small scales

    DEFF Research Database (Denmark)

    Nielsen, Kim L.; Niordson, Christian F.; Hutchinson, John W.

    2016-01-01

    The rolling process is widely used in the metal forming industry and has been so for many years. However, the process has attracted renewed interest as it recently has been adapted to very small scales where conventional plasticity theory cannot accurately predict the material response. It is well....... Metals are known to be stronger when large strain gradients appear over a few microns; hence, the forces involved in the rolling process are expected to increase relatively at these smaller scales. In the present numerical analysis, a steady-state modeling technique that enables convergence without...... dealing with the transient response period is employed. This allows for a comprehensive parameter study. Coulomb friction, including a stick-slip condition, is used as a first approximation. It is found that length scale effects increase both the forces applied to the roll, the roll torque, and thus...

  3. Urban Scaling in Europe

    CERN Document Server

    Bettencourt, Luis M A

    2015-01-01

    Over the last decades, in disciplines as diverse as economics, geography, and complex systems, a perspective has arisen proposing that many properties of cities are quantitatively predictable due to agglomeration or scaling effects. Using new harmonized definitions for functional urban areas, we examine to what extent these ideas apply to European cities. We show that while most large urban systems in Western Europe (France, Germany, Italy, Spain, UK) approximately agree with theoretical expectations, the small number of cities in each nation and their natural variability preclude drawing strong conclusions. We demonstrate how this problem can be overcome so that cities from different urban systems can be pooled together to construct larger datasets. This leads to a simple statistical procedure to identify urban scaling relations, which then clearly emerge as a property of European cities. We compare the predictions of urban scaling to Zipf's law for the size distribution of cities and show that while the for...

  4. Scaled Sparse Linear Regression

    CERN Document Server

    Sun, Tingni

    2011-01-01

    Scaled sparse linear regression jointly estimates the regression coefficients and noise level in a linear model. It chooses an equilibrium with a sparse regression method by iteratively estimating the noise level via the mean residual squares and scaling the penalty in proportion to the estimated noise level. The iterative algorithm costs nearly nothing beyond the computation of a path of the sparse regression estimator for penalty levels above a threshold. For the scaled Lasso, the algorithm is a gradient descent in a convex minimization of a penalized joint loss function for the regression coefficients and noise level. Under mild regularity conditions, we prove that the method yields simultaneously an estimator for the noise level and an estimated coefficient vector in the Lasso path satisfying certain oracle inequalities for the estimation of the noise level, prediction, and the estimation of regression coefficients. These oracle inequalities provide sufficient conditions for the consistency and asymptotic...

  5. Scaling up Telemedicine

    DEFF Research Database (Denmark)

    Christensen, Jannie Kristine Bang; Nielsen, Jeppe Agger; Gustafsson, Jeppe

    Although the processes of innovation have attracted attention of an increasing number of scholars, its political dynamics remains underexplored. Against this backdrop, this paper examines political behavior as critical aspects of the process of scaling up innovations. We revisit the concepts...... telemedicine project through simultaneous translation and theorization efforts in a cross-sectorial, politicized social context. Although we focus on upscaling as a bottom up process (from pilot to large scale), we argue that translation and theorization, and associated political behavior occurs in a broader...... through negotiating, mobilizing coalitions, and legitimacy building. To illustrate and further develop this conceptualization, we build on insights from a longitudinal case study (2008-2014) and provide a rich empirical account of how a Danish telemedicine pilot was transformed into a large-scale...

  6. Elders Health Empowerment Scale

    Science.gov (United States)

    2014-01-01

    Introduction: Empowerment refers to patient skills that allow them to become primary decision-makers in control of daily self-management of health problems. As important the concept as it is, particularly for elders with chronic diseases, few available instruments have been validated for use with Spanish speaking people. Objective: Translate and adapt the Health Empowerment Scale (HES) for a Spanish-speaking older adults sample and perform its psychometric validation. Methods: The HES was adapted based on the Diabetes Empowerment Scale-Short Form. Where "diabetes" was mentioned in the original tool, it was replaced with "health" terms to cover all kinds of conditions that could affect health empowerment. Statistical and Psychometric Analyses were conducted on 648 urban-dwelling seniors. Results: The HES had an acceptable internal consistency with a Cronbach's α of 0.89. The convergent validity was supported by significant Pearson's Coefficient correlations between the HES total and item scores and the General Self Efficacy Scale (r= 0.77), Swedish Rheumatic Disease Empowerment Scale (r= 0.69) and Making Decisions Empowerment Scale (r= 0.70). Construct validity was evaluated using item analysis, half-split test and corrected item to total correlation coefficients; with good internal consistency (α> 0.8). The content validity was supported by Scale and Item Content Validity Index of 0.98 and 1.0, respectively. Conclusions: HES had acceptable face validity and reliability coefficients; which added to its ease administration and users' unbiased comprehension, could set it as a suitable tool in evaluating elder's outpatient empowerment-based medical education programs. PMID:25767307

  7. Global Scale Impacts

    CERN Document Server

    Asphaug, Erik; Jutzi, Martin

    2015-01-01

    Global scale impacts modify the physical or thermal state of a substantial fraction of a target asteroid. Specific effects include accretion, family formation, reshaping, mixing and layering, shock and frictional heating, fragmentation, material compaction, dilatation, stripping of mantle and crust, and seismic degradation. Deciphering the complicated record of global scale impacts, in asteroids and meteorites, will lead us to understand the original planet-forming process and its resultant populations, and their evolution in time as collisions became faster and fewer. We provide a brief overview of these ideas, and an introduction to models.

  8. Irreversibility time scale.

    Science.gov (United States)

    Gallavotti, G

    2006-06-01

    Entropy creation rate is introduced for a system interacting with thermostats (i.e., for a system subject to internal conservative forces interacting with "external" thermostats via conservative forces) and a fluctuation theorem for it is proved. As an application, a time scale is introduced, to be interpreted as the time over which irreversibility becomes manifest in a process leading from an initial to a final stationary state of a mechanical system in a general nonequilibrium context. The time scale is evaluated in a few examples, including the classical Joule-Thompson process (gas expansion in a vacuum).

  9. The career distress scale

    DEFF Research Database (Denmark)

    Creed, Peter; Hood, Michelle; Praskova, Anna

    2016-01-01

    weaknesses. The absence of a practical, validated scale to assess this construct restricts research related to career distress and limits practitioners who need to assess and treat it. Using a sample of 226 young adults (mean age 20.5 years), we employed item response theory to assess 12 existing career...

  10. Symbolic Multidimensional Scaling

    NARCIS (Netherlands)

    P.J.F. Groenen (Patrick); Y. Terada

    2015-01-01

    markdownabstract__Abstract__ Multidimensional scaling (MDS) is a technique that visualizes dissimilarities between pairs of objects as distances between points in a low dimensional space. In symbolic MDS, a dissimilarity is not just a value but can represent an interval or even a histogram. Here, w

  11. LARGE SCALE GLAZED

    DEFF Research Database (Denmark)

    Bache, Anja Margrethe

    2010-01-01

    WORLD FAMOUS ARCHITECTS CHALLENGE TODAY THE EXPOSURE OF CONCRETE IN THEIR ARCHITECTURE. IT IS MY HOPE TO BE ABLE TO COMPLEMENT THESE. I TRY TO DEVELOP NEW AESTHETIC POTENTIALS FOR THE CONCRETE AND CERAMICS, IN LARGE SCALES THAT HAS NOT BEEN SEEN BEFORE IN THE CERAMIC AREA. IT IS EXPECTED TO RESULT...

  12. Scaling the Salary Heights.

    Science.gov (United States)

    McNamee, Mike

    1986-01-01

    Federal cutbacks have created new demand for fund-raisers everywhere. Educational fund-raisers are thinking about "pay for performance"--incentive-based pay plans that can help them retain, reward, and motivate talented fund raisers within the tight pay scales common at colleges and universities. (MLW)

  13. Vineland Adaptive Behavior Scales.

    Science.gov (United States)

    Icabone, Dona G.

    1999-01-01

    This article describes the Vineland Adaptive Behavior Scales, a general assessment of personal and social sufficiency of individuals from birth through adulthood to determine areas of strength and weakness. The instrument assesses communication, daily living skills, socialization, and motor skills. Its administration, standardization, reliability,…

  14. The Spiritual Competency Scale

    Science.gov (United States)

    Robertson, Linda A.

    2010-01-01

    This study describes the development of the Spiritual Competency Scale, which was based on the Association for Spiritual, Ethical and Religious Values in Counseling's original Spiritual Competencies. Participants were 662 counseling students from religiously based and secular universities nationwide. Exploratory factor analysis revealed a 22-item,…

  15. Is this scaling nonlinear?

    CERN Document Server

    Leitao, J C; Gerlach, M; Altmann, E G

    2016-01-01

    One of the most celebrated findings in complex systems in the last decade is that different indexes y (e.g., patents) scale nonlinearly with the population~x of the cities in which they appear, i.e., $y\\sim x^\\beta, \\beta \

  16. Scaling School Turnaround

    Science.gov (United States)

    Herman, Rebecca

    2012-01-01

    This article explores the research on turning around low performing schools to summarize what we know, what we don't know, and what this means for scaling school turnaround efforts. "School turnaround" is defined here as quick, dramatic gains in academic achievement for persistently low performing schools. The article first considers the…

  17. Supergranulation Scale Connection Simulations

    CERN Document Server

    Stein, R F; Georgobiani, D; Benson, D; Schaffenberger, W

    2008-01-01

    Results of realistic simulations of solar surface convection on the scale of supergranules (96 Mm wide by 20 Mm deep) are presented. The simulations cover only 10% of the geometric depth of the solar convection zone, but half its pressure scale heights. They include the hydrogen, first and most of the second helium ionization zones. The horizontal velocity spectrum is a power law and the horizontal size of the dominant convective cells increases with increasing depth. Convection is driven by buoyancy work which is largest close to the surface, but significant over the entire domain. Close to the surface buoyancy driving is balanced by the divergence of the kinetic energy flux, but deeper down it is balanced by dissipation. The damping length of the turbulent kinetic energy is 4 pressure scale heights. The mass mixing length is 1.8 scale heights. Two thirds of the area is upflowing fluid except very close to the surface. The internal (ionization) energy flux is the largest contributor to the convective flux fo...

  18. Allometric scaling of countries

    Science.gov (United States)

    Zhang, Jiang; Yu, Tongkui

    2010-11-01

    As huge complex systems consisting of geographic regions, natural resources, people and economic entities, countries follow the allometric scaling law which is ubiquitous in ecological, and urban systems. We systematically investigated the allometric scaling relationships between a large number of macroscopic properties and geographic (area), demographic (population) and economic (GDP, gross domestic production) sizes of countries respectively. We found that most of the economic, trade, energy consumption, communication related properties have significant super-linear (the exponent is larger than 1) or nearly linear allometric scaling relations with the GDP. Meanwhile, the geographic (arable area, natural resources, etc.), demographic (labor force, military age population, etc.) and transportation-related properties (road length, airports) have significant and sub-linear (the exponent is smaller than 1) allometric scaling relations with area. Several differences of power law relations with respect to the population between countries and cities were pointed out. First, population increases sub-linearly with area in countries. Second, the GDP increases linearly in countries but not super-linearly as in cities. Finally, electricity or oil consumption per capita increases with population faster than cities.

  19. Gravo-Aeroelastic Scaling for Extreme-Scale Wind Turbines

    Energy Technology Data Exchange (ETDEWEB)

    Fingersh, Lee J [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Loth, Eric [University of Virginia; Kaminski, Meghan [University of Virginia; Qin, Chao [University of Virginia; Griffith, D. Todd [Sandia National Laboratories

    2017-06-09

    A scaling methodology is described in the present paper for extreme-scale wind turbines (rated at 10 MW or more) that allow their sub-scale turbines to capture their key blade dynamics and aeroelastic deflections. For extreme-scale turbines, such deflections and dynamics can be substantial and are primarily driven by centrifugal, thrust and gravity forces as well as the net torque. Each of these are in turn a function of various wind conditions, including turbulence levels that cause shear, veer, and gust loads. The 13.2 MW rated SNL100-03 rotor design, having a blade length of 100-meters, is herein scaled to the CART3 wind turbine at NREL using 25% geometric scaling and blade mass and wind speed scaled by gravo-aeroelastic constraints. In order to mimic the ultralight structure on the advanced concept extreme-scale design the scaling results indicate that the gravo-aeroelastically scaled blades for the CART3 are be three times lighter and 25% longer than the current CART3 blades. A benefit of this scaling approach is that the scaled wind speeds needed for testing are reduced (in this case by a factor of two), allowing testing under extreme gust conditions to be much more easily achieved. Most importantly, this scaling approach can investigate extreme-scale concepts including dynamic behaviors and aeroelastic deflections (including flutter) at an extremely small fraction of the full-scale cost.

  20. The Conscientious Responders Scale

    Directory of Open Access Journals (Sweden)

    Zdravko Marjanovic

    2014-07-01

    Full Text Available This investigation introduces a novel tool for identifying conscientious responders (CRs and random responders (RRs in psychological inventory data. The Conscientious Responders Scale (CRS is a five-item validity measure that uses instructional items to identify responders. Because each item instructs responders exactly how to answer that particular item, each response can be scored as either correct or incorrect. Given the long odds of answering a CRS item correctly by chance alone on a 7-point scale (14.29%, we reasoned that RRs would answer most items incorrectly, whereas CRs would answer them correctly. This rationale was evaluated in two experiments in which CRs’ CRS scores were compared against RRs’ scores. As predicted, results showed large differences in CRS scores across responder groups. Moreover, the CRS correctly classified responders as either conscientious or random with greater than 93% accuracy. Implications for the reliability and effectiveness of the CRS are discussed.

  1. An Elastica Arm Scale

    CERN Document Server

    Bosi, F; Corso, F Dal; Bigoni, D

    2015-01-01

    The concept of 'deformable arm scale' (completely different from a traditional rigid arm balance) is theoretically introduced and experimentally validated. The idea is not intuitive, but is the result of nonlinear equilibrium kinematics of rods inducing configurational forces, so that deflection of the arms becomes necessary for the equilibrium, which would be impossible for a rigid system. In particular, the rigid arms of usual scales are replaced by a flexible elastic lamina, free of sliding in a frictionless and inclined sliding sleeve, which can reach a unique equilibrium configuration when two vertical dead loads are applied. Prototypes realized to demonstrate the feasibility of the system show a high accuracy in the measure of load within a certain range of use. It is finally shown that the presented results are strongly related to snaking of confined beams, with implications on locomotion of serpents, plumbing, and smart oil drilling.

  2. Evolution of Scale Worms

    DEFF Research Database (Denmark)

    Gonzalez, Brett Christopher

    of adaptability and convergent evolution between relatively closely related scale worms. While some morphological and behavioral modifications in cave polynoids reflected troglomorphism, other modifications like eye loss were found to stem from a common ancestor inhabiting the deep sea, further corroborating...... the deep sea ancestry of scale worm cave fauna. In conclusion, while morphological characterization across Aphroditiformia appears deceptively easy due to the presence of elytra, convergent evolution during multiple early radiations across wide ranging habitats have confounded our ability to reconstruct......) caves, and the interstitium, recovering six monophyletic clades within Aphroditiformia: Acoetidae, Aphroditidae, Eulepethidae, Iphionidae, Polynoidae, and Sigalionidae (inclusive of the former ‘Pisionidae’ and ‘Pholoidae’), respectively. Tracing of morphological character evolution showed a high degree...

  3. Scaling macroscopic aquatic locomotion

    Science.gov (United States)

    Gazzola, Mattia; Argentina, Mederic; Mahadevan, Lakshminarayanan

    2014-11-01

    Inertial aquatic swimmers that use undulatory gaits range in length L from a few millimeters to 30 meters, across a wide array of biological taxa. Using elementary hydrodynamic arguments, we uncover a unifying mechanistic principle characterizing their locomotion by deriving a scaling relation that links swimming speed U to body kinematics (tail beat amplitude A and frequency ω) and fluid properties (kinematic viscosity ν). This principle can be simply couched as the power law Re ~ Swα , where Re = UL / ν >> 1 and Sw = ωAL / ν , with α = 4 / 3 for laminar flows, and α = 1 for turbulent flows. Existing data from over 1000 measurements on fish, amphibians, larvae, reptiles, mammals and birds, as well as direct numerical simulations are consistent with our scaling. We interpret our results as the consequence of the convergence of aquatic gaits to the performance limits imposed by hydrodynamics.

  4. Perceived prominence and scale types

    DEFF Research Database (Denmark)

    Tøndering, John; Jensen, Christian

    2005-01-01

    Three different scales which have been used to measure perceived prominence are evaluated in a perceptual experiment. Average scores of raters using a multi-level (31-point) scale, a simple binary (2-point) scale and an intermediate 4-point scale are almost identical. The potentially finer gradat...

  5. The Unintentional Procrastination Scale

    OpenAIRE

    Fernie, BA; Bharucha, Z; Nikčević, AV; Spada, MM

    2016-01-01

    © 2016 The Author(s)Procrastination refers to the delay or postponement of a task or decision and is often conceptualised as a failure of self-regulation. Recent research has suggested that procrastination could be delineated into two domains: intentional and unintentional. In this two-study paper, we aimed to develop a measure of unintentional procrastination (named the Unintentional Procrastination Scale or the ‘UPS’) and test whether this would be a stronger marker of psychopathology than ...

  6. Extreme Scale Visual Analytics

    Energy Technology Data Exchange (ETDEWEB)

    Steed, Chad A [ORNL; Potok, Thomas E [ORNL; Pullum, Laura L [ORNL; Ramanathan, Arvind [ORNL; Shipman, Galen M [ORNL; Thornton, Peter E [ORNL; Potok, Thomas E [ORNL

    2013-01-01

    Given the scale and complexity of today s data, visual analytics is rapidly becoming a necessity rather than an option for comprehensive exploratory analysis. In this paper, we provide an overview of three applications of visual analytics for addressing the challenges of analyzing climate, text streams, and biosurveilance data. These systems feature varying levels of interaction and high performance computing technology integration to permit exploratory analysis of large and complex data of global significance.

  7. The Chinese Politeness Scale

    Institute of Scientific and Technical Information of China (English)

    王喜凤

    2012-01-01

    In order to make sense of what is said in an interaction,we have to look at various factors which relate to social distance and closeness.Generally,these factors include the specific situation language takes place,the relative status of the two participants,the message being delivered and finally the age of the participants.In this article,the Chinese Politeness Scale,based on Chinese social values and tradition,will be explained and demonstrated in detail.

  8. EARTHQUAKE SCALING PARADOX

    Institute of Scientific and Technical Information of China (English)

    WU ZHONG-LIANG

    2001-01-01

    Two measures of earthquakes, the seismic moment and the broadband radiated energy, show completely different scaling relations. For shallow earthquakes worldwide from January 1987 to December 1998, the frequency distribution of the seismic moment shows a clear kink between moderate and large earthquakes, as revealed by previous works. But the frequency distribution of the broadband radiated energy shows a single power law, a classical Gutenberg-Richter relation. This inconsistency raises a paradox in the self-organized criticality model of earthquakes.

  9. Scaling up Copy Detection

    OpenAIRE

    Li, Xian; Dong, Xin Luna; Lyons, Kenneth B.; Meng, Weiyi; Srivastava, Divesh

    2015-01-01

    Recent research shows that copying is prevalent for Deep-Web data and considering copying can significantly improve truth finding from conflicting values. However, existing copy detection techniques do not scale for large sizes and numbers of data sources, so truth finding can be slowed down by one to two orders of magnitude compared with the corresponding techniques that do not consider copying. In this paper, we study {\\em how to improve scalability of copy detection on structured data}. Ou...

  10. Micro-Scale Thermoacoustics

    Science.gov (United States)

    Offner, Avshalom; Ramon, Guy Z.

    2016-11-01

    Thermoacoustic phenomena - conversion of heat to acoustic oscillations - may be harnessed for construction of reliable, practically maintenance-free engines and heat pumps. Specifically, miniaturization of thermoacoustic devices holds great promise for cooling of micro-electronic components. However, as devices size is pushed down to micro-meter scale it is expected that non-negligible slip effects will exist at the solid-fluid interface. Accordingly, new theoretical models for thermoacoustic engines and heat pumps were derived, accounting for a slip boundary condition. These models are essential for the design process of micro-scale thermoacoustic devices that will operate under ultrasonic frequencies. Stability curves for engines - representing the onset of self-sustained oscillations - were calculated with both no-slip and slip boundary conditions, revealing improvement in the performance of engines with slip at the resonance frequency range applicable for micro-scale devices. Maximum achievable temperature differences curves for thermoacoustic heat pumps were calculated, revealing the negative effect of slip on the ability to pump heat up a temperature gradient. The authors acknowledge the support from the Nancy and Stephen Grand Technion Energy Program (GTEP).

  11. H2@Scale Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ruth, Mark

    2017-07-12

    'H2@Scale' is a concept based on the opportunity for hydrogen to act as an intermediate between energy sources and uses. Hydrogen has the potential to be used like the primary intermediate in use today, electricity, because it too is fungible. This presentation summarizes the H2@Scale analysis efforts performed during the first third of 2017. Results of technical potential uses and supply options are summarized and show that the technical potential demand for hydrogen is 60 million metric tons per year and that the U.S. has sufficient domestic resources to meet that demand. A high level infrastructure analysis is also presented that shows an 85% increase in energy on the grid if all hydrogen is produced from grid electricity. However, a preliminary spatial assessment shows that supply is sufficient in most counties across the U.S. The presentation also shows plans for analysis of the economic potential for the H2@Scale concept. Those plans involve developing supply and demand curves for potential hydrogen generation options and as compared to other options for use of that hydrogen.

  12. Tournament Satisfaction Scale (TOSS

    Directory of Open Access Journals (Sweden)

    Kubilay Öcal

    2016-04-01

    Full Text Available Increasing in the popularity of regional sport tourism addresses the consumers to measure satisfaction of participants in order to provide high quality product or services. The literature declares the strong need of a reliable and valid scale in the area of sport tourism. For that purpose this paper describes the process of developing Tournament Satisfaction Scale (TOSS that can be used to asses athletes’ perception of satisfaction through sport tournaments. An item pool with 33 items was developed by literature reviews and interviews with experts in the area of sport tourism, sport management and coaching. Exploratory Factor Analysis with Maximum Likelihood extraction method and oblique rotation (direct oblimin was carried out by using the data obtained from 278 athletes in various sport branches participated in a tournament as a regional sport tourist. Exploratory Factor Analysis results yielded one factor with 22 items over .50 factor loading. The 22-item TOSS was found to explain 40.3% of the variance in tournament satisfaction. Cronbach alpha coefficient is 0.93 for TOSS indicating satisfactory reliability evidence. Overall, it can be concluded that the scale is reliable and valid tool for evaluating tournament satisfaction from the perceptions of athletes. In this way coaches, team managers, and tournament organizers would possible to obtain important clues about their performances.

  13. Mechanism for salt scaling

    Science.gov (United States)

    Valenza, John J., II

    Salt scaling is superficial damage caused by freezing a saline solution on the surface of a cementitious body. The damage consists of the removal of small chips or flakes of binder. The discovery of this phenomenon in the early 1950's prompted hundreds of experimental studies, which clearly elucidated the characteristics of this damage. In particular it was shown that a pessimum salt concentration exists, where a moderate salt concentration (˜3%) results in the most damage. Despite the numerous studies, the mechanism responsible for salt scaling has not been identified. In this work it is shown that salt scaling is a result of the large thermal expansion mismatch between ice and the cementitious body, and that the mechanism responsible for damage is analogous to glue-spalling. When ice forms on a cementitious body a bi-material composite is formed. The thermal expansion coefficient of the ice is ˜5 times that of the underlying body, so when the temperature of the composite is lowered below the melting point, the ice goes into tension. Once this stress exceeds the strength of the ice, cracks initiate in the ice and propagate into the surface of the cementitious body, removing a flake of material. The glue-spall mechanism accounts for all of the characteristics of salt scaling. In particular, a theoretical analysis is presented which shows that the pessimum concentration is a consequence of the effect of brine pockets on the mechanical properties of ice, and that the damage morphology is accounted for by fracture mechanics. Finally, empirical evidence is presented that proves that the glue-small mechanism is the primary cause of salt scaling. The primary experimental tool used in this study is a novel warping experiment, where a pool of liquid is formed on top of a thin (˜3 mm) plate of cement paste. Stresses in the plate, including thermal expansion mismatch, result in warping of the plate, which is easily detected. This technique revealed the existence of

  14. Nestedness across biological scales

    Science.gov (United States)

    Marquitti, Flavia M. D.; Raimundo, Rafael L. G.; Sebastián-González, Esther; Coltri, Patricia P.; Perez, S. Ivan; Brandt, Débora Y. C.; Nunes, Kelly; Daura-Jorge, Fábio G.; Floeter, Sergio R.; Guimarães, Paulo R.

    2017-01-01

    Biological networks pervade nature. They describe systems throughout all levels of biological organization, from molecules regulating metabolism to species interactions that shape ecosystem dynamics. The network thinking revealed recurrent organizational patterns in complex biological systems, such as the formation of semi-independent groups of connected elements (modularity) and non-random distributions of interactions among elements. Other structural patterns, such as nestedness, have been primarily assessed in ecological networks formed by two non-overlapping sets of elements; information on its occurrence on other levels of organization is lacking. Nestedness occurs when interactions of less connected elements form proper subsets of the interactions of more connected elements. Only recently these properties began to be appreciated in one-mode networks (where all elements can interact) which describe a much wider variety of biological phenomena. Here, we compute nestedness in a diverse collection of one-mode networked systems from six different levels of biological organization depicting gene and protein interactions, complex phenotypes, animal societies, metapopulations, food webs and vertebrate metacommunities. Our findings suggest that nestedness emerge independently of interaction type or biological scale and reveal that disparate systems can share nested organization features characterized by inclusive subsets of interacting elements with decreasing connectedness. We primarily explore the implications of a nested structure for each of these studied systems, then theorize on how nested networks are assembled. We hypothesize that nestedness emerges across scales due to processes that, although system-dependent, may share a general compromise between two features: specificity (the number of interactions the elements of the system can have) and affinity (how these elements can be connected to each other). Our findings suggesting occurrence of nestedness

  15. (Re)scaling identities

    DEFF Research Database (Denmark)

    Koefoed, Lasse Martin; Simonsen, Kirsten

    2012-01-01

    This article draws attention to life as an ‘internal stranger’ in the city, the nation and other spatial formations. It explores the habitability of the different spatial formations and the possibilities of identification for ethnic minority groups. Drawing on research on citizens in Copenhagen...... and identification is ambivalence in affiliation to the Danish nation expressing the discrepancy between feeling Danish and not being recognized as a full member of the Danish imagined community. This emotional ambivalence gives rise to what we call jumping scale in identification and a search for alternative spaces...

  16. Scaling Big Data Cleansing

    KAUST Repository

    Khayyat, Zuhair

    2017-07-31

    Data cleansing approaches have usually focused on detecting and fixing errors with little attention to big data scaling. This presents a serious impediment since identify- ing and repairing dirty data often involves processing huge input datasets, handling sophisticated error discovery approaches and managing huge arbitrary errors. With large datasets, error detection becomes overly expensive and complicated especially when considering user-defined functions. Furthermore, a distinctive algorithm is de- sired to optimize inequality joins in sophisticated error discovery rather than na ̈ıvely parallelizing them. Also, when repairing large errors, their skewed distribution may obstruct effective error repairs. In this dissertation, I present solutions to overcome the above three problems in scaling data cleansing. First, I present BigDansing as a general system to tackle efficiency, scalability, and ease-of-use issues in data cleansing for Big Data. It automatically parallelizes the user’s code on top of general-purpose distributed platforms. Its programming inter- face allows users to express data quality rules independently from the requirements of parallel and distributed environments. Without sacrificing their quality, BigDans- ing also enables parallel execution of serial repair algorithms by exploiting the graph representation of discovered errors. The experimental results show that BigDansing outperforms existing baselines up to more than two orders of magnitude. Although BigDansing scales cleansing jobs, it still lacks the ability to handle sophisticated error discovery requiring inequality joins. Therefore, I developed IEJoin as an algorithm for fast inequality joins. It is based on sorted arrays and space efficient bit-arrays to reduce the problem’s search space. By comparing IEJoin against well- known optimizations, I show that it is more scalable, and several orders of magnitude faster. BigDansing depends on vertex-centric graph systems, i.e., Pregel

  17. Scaling CouchDB

    CERN Document Server

    Holt, Bradley

    2011-01-01

    This practical guide offers a short course on scaling CouchDB to meet the capacity needs of your distributed application. Through a series of scenario-based examples, this book lets you explore several methods for creating a system that can accommodate growth and meet expected demand. In the process, you learn about several tools that can help you with replication, load balancing, clustering, and load testing and monitoring. Apply performance tips for tuning your databaseReplicate data, using Futon and CouchDB's RESTful interfaceDistribute CouchDB's workload through load balancingLearn option

  18. Scales on the scalp

    Directory of Open Access Journals (Sweden)

    Jamil A

    2013-05-01

    Full Text Available A five-year-old boy presented with a six-week history of scales, flaking and crusting of the scalp. He had mild pruritus but no pain. He did not have a history of atopy and there were no pets at home. Examination of the scalp showed thick, yellowish dry crusts on the vertex and parietal areas and the hair was adhered to the scalp in clumps. There was non-scarring alopecia and mild erythema (Figure 1 & 2. There was no cervical or occipital lymphadenopathy. The patient’s nails and skin in other parts of the body were normal.

  19. Soil organic carbon across scales.

    Science.gov (United States)

    O'Rourke, Sharon M; Angers, Denis A; Holden, Nicholas M; McBratney, Alex B

    2015-10-01

    Mechanistic understanding of scale effects is important for interpreting the processes that control the global carbon cycle. Greater attention should be given to scale in soil organic carbon (SOC) science so that we can devise better policy to protect/enhance existing SOC stocks and ensure sustainable use of soils. Global issues such as climate change require consideration of SOC stock changes at the global and biosphere scale, but human interaction occurs at the landscape scale, with consequences at the pedon, aggregate and particle scales. This review evaluates our understanding of SOC across all these scales in the context of the processes involved in SOC cycling at each scale and with emphasis on stabilizing SOC. Current synergy between science and policy is explored at each scale to determine how well each is represented in the management of SOC. An outline of how SOC might be integrated into a framework of soil security is examined. We conclude that SOC processes at the biosphere to biome scales are not well understood. Instead, SOC has come to be viewed as a large-scale pool subjects to carbon flux. Better understanding exists for SOC processes operating at the scales of the pedon, aggregate and particle. At the landscape scale, the influence of large- and small-scale processes has the greatest interaction and is exposed to the greatest modification through agricultural management. Policy implemented at regional or national scale tends to focus at the landscape scale without due consideration of the larger scale factors controlling SOC or the impacts of policy for SOC at the smaller SOC scales. What is required is a framework that can be integrated across a continuum of scales to optimize SOC management.

  20. Small scale sanitation technologies.

    Science.gov (United States)

    Green, W; Ho, G

    2005-01-01

    Small scale systems can improve the sustainability of sanitation systems as they more easily close the water and nutrient loops. They also provide alternate solutions to centrally managed large scale infrastructures. Appropriate sanitation provision can improve the lives of people with inadequate sanitation through health benefits, reuse products as well as reduce ecological impacts. In the literature there seems to be no compilation of a wide range of available onsite sanitation systems around the world that encompasses black and greywater treatment plus stand-alone dry and urine separation toilet systems. Seventy technologies have been identified and classified according to the different waste source streams. Sub-classification based on major treatment methods included aerobic digestion, composting and vermicomposting, anaerobic digestion, sand/soil/peat filtration and constructed wetlands. Potential users or suppliers of sanitation systems can choose from wide range of technologies available and examine the different treatment principles used in the technologies. Sanitation systems need to be selected according to the local social, economic and environmental conditions and should aim to be sustainable.

  1. Returns to Scale and Economies of Scale: Further Observations.

    Science.gov (United States)

    Gelles, Gregory M.; Mitchell, Douglas W.

    1996-01-01

    Maintains that most economics textbooks continue to repeat past mistakes concerning returns to scale and economies of scale under assumptions of constant and nonconstant input prices. Provides an adaptation for a calculus-based intermediate microeconomics class that demonstrates the pointwise relationship between returns to scale and economies of…

  2. Tera Scale Remnants of Unification and Supersymmetry at Planck Scale

    CERN Document Server

    Kawamura, Yoshiharu

    2013-01-01

    We predict new particles at the Tera scale based on the assumptions that the standard model gauge interactions are unified around the gravitational scale with a big desert and new particles originate from hypermultiplets as remnants of supersymmetry, and propose a theoretical framework at the Tera scale and beyond, that has predictability.

  3. A Validity Scale for the Sharp Consumer Satisfaction Scales.

    Science.gov (United States)

    Tanner, Barry A.; Stacy, Webb, Jr.

    1985-01-01

    A validity scale for the Sharp Consumer Satisfaction Scale was developed and used in experiments to assess patients' satisfaction with community mental health centers. The scale discriminated between clients who offered suggestions and those who did not. It also improved researcher's ability to predict true scores from obtained scores. (DWH)

  4. Karolinske psychodynamic profile (KAPP)

    DEFF Research Database (Denmark)

    Mathiesen, Birgit Bork; Søgaard, Ulf

    2006-01-01

    psykologiske testmetoder, assesment, Karolinska psychodynamic profile (KAPP), psykodynamisk profil......psykologiske testmetoder, assesment, Karolinska psychodynamic profile (KAPP), psykodynamisk profil...

  5. Earthquake impact scale

    Science.gov (United States)

    Wald, D.J.; Jaiswal, K.S.; Marano, K.D.; Bausch, D.

    2011-01-01

    With the advent of the USGS prompt assessment of global earthquakes for response (PAGER) system, which rapidly assesses earthquake impacts, U.S. and international earthquake responders are reconsidering their automatic alert and activation levels and response procedures. To help facilitate rapid and appropriate earthquake response, an Earthquake Impact Scale (EIS) is proposed on the basis of two complementary criteria. On the basis of the estimated cost of damage, one is most suitable for domestic events; the other, on the basis of estimated ranges of fatalities, is generally more appropriate for global events, particularly in developing countries. Simple thresholds, derived from the systematic analysis of past earthquake impact and associated response levels, are quite effective in communicating predicted impact and response needed after an event through alerts of green (little or no impact), yellow (regional impact and response), orange (national-scale impact and response), and red (international response). Corresponding fatality thresholds for yellow, orange, and red alert levels are 1, 100, and 1,000, respectively. For damage impact, yellow, orange, and red thresholds are triggered by estimated losses reaching $1M, $100M, and $1B, respectively. The rationale for a dual approach to earthquake alerting stems from the recognition that relatively high fatalities, injuries, and homelessness predominate in countries in which local building practices typically lend themselves to high collapse and casualty rates, and these impacts lend to prioritization for international response. In contrast, financial and overall societal impacts often trigger the level of response in regions or countries in which prevalent earthquake resistant construction practices greatly reduce building collapse and resulting fatalities. Any newly devised alert, whether economic- or casualty-based, should be intuitive and consistent with established lexicons and procedures. Useful alerts should

  6. Sonolência diurna excessiva pós-traumatismo de crânio: associação com movimentos periódicos de pernas e distúrbio de comportamento do sono REM: relato de caso Excessive daytime sleepiness after traumatic brain injury: association with periodic limb movements and REM behavior disorder: case report

    Directory of Open Access Journals (Sweden)

    Raimundo Nonato D. Rodrigues

    2002-09-01

    Full Text Available Um homem de 52 anos, procurou o Hospital. Universitário de Brasília com queixa de sono agitado. Sua esposa relatava, desde há cerca de 10 anos, intensa movimentação de membros e agressividade em meio a sonhos violentos. Desde então apresentava sonolência diurna excessiva. Havia relato de traumatismo de crânio há 34 anos e coma de 2 meses de duração. A vídeo-polissonografia revelou comportamento agressivo e agitado durante o sono REM, e movimentos periódicos de pernas. Havia importante sonolência diurna no teste de latências de sono. Foi instituído tratamento com levodopa-benzerazida 100/25 mg à noite. Após 10 semanas de evolução, houve melhora da movimentação noturna global, e desaparecimento dos episódios ligados a sonhos de conteúdo violento. Este caso nos permite analisar a associação entre trauma craniano e alterações nas vias dopaminérgicas (movimentos periódicos das pernas e distúrbio de comportamento do sono REM e revisar a importância dos distúrbios na produção de hipocretina hipotalâmica na fisiopatologia desse quadro clínico.A 52 year-old male patient, had complaint of "restless sleep". His wife informed that for the past ten years the patient had presented intense and aggressive body movements, and sometimes, violent dreams. The patient also complained of excessive daytime sleepiness. His relevant previous medical history included a traumatic brain injury at the age of 28 which left him in coma for two months. A video-polysomnography showed periodic leg movements and, during REM sleep, aggressive and agitated behaviour. The multiple sleep latency test revealed extremely short latencies. Initially, he was treated with levodopa-benzerazide, 100/25 mg, 2 hours before bedtime. After 10 weeks his overnight behaviour pattern improved and leg movements diminished. This case supports the hypothesis of an association between cranial trauma and alterations in the dopaminergic pathways represented by periodic

  7. Northeast Snowfall Impact Scale (NESIS)

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — While the Fujita and Saffir-Simpson Scales characterize tornadoes and hurricanes respectively, there is no widely used scale to classify snowstorms. The Northeast...

  8. Scaling Equation for Invariant Measure

    Institute of Scientific and Technical Information of China (English)

    LIU Shi-Kuo; FU Zun-Tao; LIU Shi-Da; REN Kui

    2003-01-01

    An iterated function system (IFS) is constructed. It is shown that the invariant measure of IFS satisfies the same equation as scaling equation for wavelet transform (WT). Obviously, IFS and scaling equation of WT both have contraction mapping principle.

  9. ScaleUp America Communities

    Data.gov (United States)

    Small Business Administration — SBA’s new ScaleUp America Initiative is designed to help small firms with high potential “scale up” and grow their businesses so that they will provide more jobs and...

  10. Assessment of fatigue using the Identity-Consequence Fatigue Scale in patients with lung cancer.

    Science.gov (United States)

    Nogueira, Ingrid Correia; Araújo, Amanda Souza; Morano, Maria Tereza; Cavalcante, Antonio George; Bruin, Pedro Felipe de; Paddison, Johana Susan; Silva, Guilherme Pinheiro da; Pereira, Eanes Delgado

    2017-01-01

    To evaluate the properties of the Identity-Consequence Fatigue Scale (ICFS) in patients with lung cancer (LC), assessing the intensity of fatigue and associated factors. This was a cross-sectional study involving LC patients, treated at a teaching hospital in Brazil, who completed the ICFS. Patients with chronic heart disease (CHD) and healthy controls, matched for age and gender, also completed the scale. Initially, a Brazilian Portuguese-language version of the ICFS was administered to 50 LC patients by two independent interviewers; to test for reproducibility, it was readministered to those same patients. At baseline, the LC patients were submitted to spirometry and the six-minute walk test, as well as completing the Epworth Sleepiness Scale (ESS), Hospital Anxiety and Depression Scale (HADS), Medical Outcomes Study 36-item Short-Form Health Survey (SF-36), and Fatigue Severity Scale (FSS). Inflammatory status was assessed by blood C-reactive protein (CRP) levels. To validate the ICFS, we assessed the correlations of its scores with those variables. The sample comprised 50 patients in each group (LC, CHD, and control). In the LC group, the intraclass correlation coefficients for intra-rater and inter-rater reliability regarding ICFS summary variables ranged from 0.94 to 0.76 and from 0.94 to 0.79, respectively. The ICFS presented excellent internal consistency, and Bland-Altman plots showed good test-retest reliability. The ICFS correlated significantly with FSS, HADS, and SF-36 scores, as well as with CRP levels. Mean ICFS scores in the LC group differed significantly from those in the CHD and control groups. The ICFS is a valid, reliable instrument for evaluating LC patients, in whom depression, quality of life, and CRP levels seem to be significantly associated with fatigue. Avaliar as propriedades da Escala de Identificação e Consequências da Fadiga (EICF) em pacientes com câncer de pulmão (CP), analisando a intensidade da fadiga e fatores associados

  11. Scale setting in lattice QCD

    Energy Technology Data Exchange (ETDEWEB)

    Sommer, Rainer [DESY, Zeuthen (Germany). John von Neumann-Inst. fuer Computing NIC

    2014-02-15

    The principles of scale setting in lattice QCD as well as the advantages and disadvantages of various commonly used scales are discussed. After listing criteria for good scales, I concentrate on the main presently used ones with an emphasis on scales derived from the Yang-Mills gradient flow. For these I discuss discretisation errors, statistical precision and mass effects. A short review on numerical results also brings me to an unpleasant disagreement which remains to be explained.

  12. Indian scales and inventories.

    Science.gov (United States)

    Venkatesan, S

    2010-01-01

    This conceptual, perspective and review paper on Indian scales and inventories begins with clarification on the historical and contemporary meanings of psychometry before linking itself to the burgeoning field of clinimetrics in their applications to the practice of clinical psychology and psychiatry. Clinimetrics is explained as a changing paradigm in the design, administration, and interpretation of quantitative tests, techniques or procedures applied to measurement of clinical variables, traits and processes. As an illustrative sample, this article assembles a bibliographic survey of about 105 out of 2582 research papers (4.07%) scanned through 51 back dated volumes covering 185 issues related to clinimetry as reviewed across a span of over fifty years (1958-2009) in the Indian Journal of Psychiatry. A content analysis of the contributions across distinct categories of mental measurements is explained before linkages are proposed for future directions along these lines.

  13. Biological scaling and physics

    Indian Academy of Sciences (India)

    A R P Rau

    2002-09-01

    Kleiber’s law in biology states that the specific metabolic rate (metabolic rate per unit mass) scales as -1/4 in terms of the mass of the organism. A long-standing puzzle is the (- 1/4) power in place of the usual expectation of (- 1/3) based on the surface to volume ratio in three-dimensions. While recent papers by physicists have focused exclusively on geometry in attempting to explain the puzzle, we consider here a specific law of physics that governs fluid flow to show how the (- 1/4) power arises under certain conditions. More generally, such a line of approach that identifies a specific physical law as involved and then examines the implications of a power law may illuminate better the role of physics in biology.

  14. Scaling MongoDB

    CERN Document Server

    Chodorow, Kristina

    2011-01-01

    Create a MongoDB cluster that will to grow to meet the needs of your application. With this short and concise book, you'll get guidelines for setting up and using clusters to store a large volume of data, and learn how to access the data efficiently. In the process, you'll understand how to make your application work with a distributed database system. Scaling MongoDB will help you: Set up a MongoDB cluster through shardingWork with a cluster to query and update dataOperate, monitor, and backup your clusterPlan your application to deal with outages By following the advice in this book, you'l

  15. Multi Scale Modelling

    Energy Technology Data Exchange (ETDEWEB)

    Huemmer, Matthias [AREVA NP GmbH, Paul-Gossen Strasse 100, Erlangen (Germany)

    2008-07-01

    The safety of the Reactor Pressure Vessels (RPV) must be assured and demonstrated by safety assessments against brittle fracture according to the codes and standards. In addition to these deterministic methods, researchers developed statistic methods, so called local approach (LA) models, to predict specimen or component failure. These models transfer the microscopic fracture events to the macro scale by means of Weibull stresses and therefore can describe the fracture behavior more accurate. This paper will propose a recently developed LA model. After the calibration of the model parameters the wide applicability of the model will be demonstrated. Therefore a large number of computations, based on 3D finite element simulations, have been conducted, containing different specimen types and materials in unirradiated and irradiated condition. Comparison of the experimental data with the predictions attained by means of the LA model shows that the fracture behavior can be well described. (authors)

  16. Biological scaling and physics.

    Science.gov (United States)

    Rau, A R P

    2002-09-01

    Kleiber's law in biology states that the specific metabolic rate (metabolic rate per unit mass) scales as M- 1/4 in terms of the mass M of the organism. A long-standing puzzle is the (- 1/4) power in place of the usual expectation of (- 1/3) based on the surface to volume ratio in three-dimensions. While recent papers by physicists have focused exclusively on geometry in attempting to explain the puzzle, we consider here a specific law of physics that governs fluid flow to show how the (- 1/4) power arises under certain conditions. More generally, such a line of approach that identifies a specific physical law as involved and then examines the implications of a power law may illuminate better the role of physics in biology.

  17. Large Scale Solar Heating

    DEFF Research Database (Denmark)

    Heller, Alfred

    2001-01-01

    The main objective of the research was to evaluate large-scale solar heating connected to district heating (CSDHP), to build up a simulation tool and to demonstrate the application of the simulation tool for design studies and on a local energy planning case. The evaluation was mainly carried out...... model is designed and validated on the Marstal case. Applying the Danish Reference Year, a design tool is presented. The simulation tool is used for proposals for application of alternative designs, including high-performance solar collector types (trough solar collectors, vaccum pipe collectors......). Simulation programs are proposed as control supporting tool for daily operation and performance prediction of central solar heating plants. Finaly the CSHP technolgy is put into persepctive with respect to alternatives and a short discussion on the barries and breakthrough of the technology are given....

  18. The Children's Loneliness Scale.

    Science.gov (United States)

    Maes, Marlies; Van den Noortgate, Wim; Vanhalst, Janne; Beyers, Wim; Goossens, Luc

    2017-03-01

    The present study examined the factor structure and construct validity of the Children's Loneliness Scale (CLS), a popular measure of childhood loneliness, in Belgian children. Analyses were conducted on two samples of fifth and sixth graders in Belgium, for a total of 1,069 children. A single-factor structure proved superior to alternative solutions proposed in the literature, when taking item wording into account. Construct validity was shown by substantial associations with related constructs, based on both self-reported (e.g., depressive symptoms and low social self-esteem), and peer-reported variables (e.g., victimization). Furthermore, a significant association was found between the CLS and a peer-reported measure of loneliness. Collectively, these findings provide a solid foundation for the continuing use of the CLS as a measure of childhood loneliness.

  19. Excitable Scale Free Networks

    CERN Document Server

    Copelli, Mauro

    2007-01-01

    When a simple excitable system is continuously stimulated by a Poissonian external source, the response function (mean activity versus stimulus rate) generally shows a linear saturating shape. This is experimentally verified in some classes of sensory neurons, which accordingly present a small dynamic range (defined as the interval of stimulus intensity which can be appropriately coded by the mean activity of the excitable element), usually about one or two decades only. The brain, on the other hand, can handle a significantly broader range of stimulus intensity, and a collective phenomenon involving the interaction among excitable neurons has been suggested to account for the enhancement of the dynamic range. Since the role of the pattern of such interactions is still unclear, here we investigate the performance of a scale-free (SF) network topology in this dynamic range problem. Specifically, we study the transfer function of disordered SF networks of excitable Greenberg-Hastings cellular automata. We obser...

  20. An ordinal metrical scale built on a fuzzy nominal scale

    Science.gov (United States)

    Benoit, E.

    2010-07-01

    The Measurement theory defines a measurement as a mapping from a set of empirical property manifestations to a set of abstract property values called symbols. The ordinal metrical scales were introduced within the context of Psychophysics as a way to solve the problem of multidimensional scaling. Usually the distances used to define such scales are based on the hypothesis that symbols are vectors of numbers and that each component is expressed on an interval scale or a ratio scale. In a recent paper was introduced a distance-based scale that represents manifestations from an empirical world with fuzzy subsets of lexical terms. This approach supposes only the existence of a fuzzy nominal scale and allows a choice into a wider set of distances to build the ordinal metrical scales. This paper focuses on the knowledge source used to choose a scale definition and takes metrical scales built on fuzzy nominal scale as example. Then it opens a discussion on the reality of some distances in the empirical world.

  1. Jensen's Functionals on Time Scales

    Directory of Open Access Journals (Sweden)

    Matloob Anwar

    2012-01-01

    Full Text Available We consider Jensen’s functionals on time scales and discuss its properties and applications. Further, we define weighted generalized and power means on time scales. By applying the properties of Jensen’s functionals on these means, we obtain several refinements and converses of Hölder’s inequality on time scales.

  2. Study of Adherent Oxide Scales

    Science.gov (United States)

    1987-09-14

    oxide scale-metal interface, thereby improving scale adherence. Because the reactive elements which improve scale adherence (yttrium, hafnium , etc...temperature range, the chromium in the alloy lowers the sulfur activity greater than that of aluminium . Despite this ability of chromium to reduce sulfur

  3. Coma scales: a historical review

    Directory of Open Access Journals (Sweden)

    Ana Luisa Bordini

    2010-12-01

    Full Text Available OBJECTIVE: To describe the most important coma scales developed in the last fifty years. METHOD: A review of the literature between 1969 and 2009 in the Medline and Scielo databases was carried out using the following keywords: coma scales, coma, disorders of consciousness, coma score and levels of coma. RESULTS: Five main scales were found in chronological order: the Jouvet coma scale, the Moscow coma scale, the Glasgow coma scale (GCS, the Bozza-Marrubini scale and the FOUR score (Full Outline of UnResponsiveness, as well as other scales that have had less impact and are rarely used outside their country of origin. DISCUSSION: Of the five main scales, the GCS is by far the most widely used. It is easy to apply and very suitable for cases of traumatic brain injury (TBI. However, it has shortcomings, such as the fact that the speech component in intubated patients cannot be tested. While the Jouvet scale is quite sensitive, particularly for levels of consciousness closer to normal levels, it is difficult to use. The Moscow scale has good predictive value but is little used by the medical community. The FOUR score is easy to apply and provides more neurological details than the Glasgow scale.

  4. Narcolepsy beyond sleepiness : endocrine, metabolic and other aspects

    NARCIS (Netherlands)

    Donjacour, Claire Elisabeth Henrica Maria

    2014-01-01

    The thesis contains a large study in which eight male hypocretin deficient narcolepsy with cataplexy patients and eight matched controls were enrolled. Blood was sampled before and on the 5th day of SXB administration. SXB was taken 2 times 3g per night for 5 consecutive nights. Both groups underwen

  5. Excessive daytime sleepiness among patients with metabolic syndrome

    Directory of Open Access Journals (Sweden)

    Adel Salah Bediwy

    2016-01-01

    Conclusions: Other explanations of EDS in subjects with metabolic syndrome can be related to obesity, depression, or diabetes rather than to sleep apnea. Subjects with metabolic syndrome should be screened for EDS regardless of sleep apnea.

  6. TV and Sex Make Americans Sleepy Frorn Reuters

    Institute of Scientific and Technical Information of China (English)

    朱吉利

    2001-01-01

    @@ [选注者言:本文让我们窥见了美国的"隐私”一隅.在美国失眠者不在少数,他 们有什么安然入梦之良策?似乎男女各有招数: For women, reading came in as the best way to fall asleep, followed by watching TV and prayer or meditation (冥想). Men favored TV viewing and sex --although women also acknowledged the sleep - inducing powers of sex. When asked if sex before bed helped them fall asleep, three quarters of respondents said it did.

  7. Plasma L-Tryptophan Levels, Subjective Sleepiness and Daytime Sleep.

    Science.gov (United States)

    1980-09-01

    hydroxylase enzyme at the first step in the serotonin synthetic pathway is not saturated (Friedman et al, 1972). The availability of the amino acid...changes in rats after parachloro- phenylalanine (PCPA). Wyatt’s work (Wyatt et al, 1970) showing 1-tryptophan effects on sleep in subjects pretreated with...tryptophan hydroxylase in midbrain of the rat. Science 166: 1274-76. Brezinova, V., Loudon, J., and Oswald, I. 1972. Tryptophan and sleep. Lancet 2: 1086-87

  8. Sleep complaints and daytime sleepiness among pharmaceutical students in Tripoli

    OpenAIRE

    2012-01-01

    Background: The effect of sleep difficulties has achieved a great deal of attention recently, with university students considered as a homogenized population, particularly affected by sleep habits.Aim: The objective of this study was to investigate whether Libyan college students experience sleep disturbance during their academic programmes. Methods: A cross-sectional survey was conducted in the college of Pharmacy, Tripoli University, during February 2010. A total of 201 students, including ...

  9. The Fundamental Scale of Descriptions

    CERN Document Server

    Febres, Gerardo

    2014-01-01

    The complexity of a system description is a function of the entropy of its symbolic description. Prior to computing the entropy of the system description, an observation scale has to be assumed. In natural language texts, typical scales are binary, characters, and words. However, considering languages as structures built around certain preconceived set of symbols, like words or characters, is only a presumption. This study depicts the notion of the Description Fundamental Scale as a set of symbols which serves to analyze the essence a language structure. The concept of Fundamental Scale is tested using English and MIDI music texts by means of an algorithm developed to search for a set of symbols, which minimizes the system observed entropy, and therefore best expresses the fundamental scale of the language employed. Test results show that it is possible to find the Fundamental Scale of some languages. The concept of Fundamental Scale, and the method for its determination, emerges as an interesting tool to fac...

  10. Scale-aware shape manipulation

    Institute of Scientific and Technical Information of China (English)

    Zheng LIU; Wei-ming WANG; Xiu-ping LIU; Li-gang LIU

    2014-01-01

    A novel representation of a triangular mesh surface using a set of scale-invariant measures is proposed. The measures consist of angles of the triangles (triangle angles) and dihedral angles along the edges (edge angles) which are scale and rigidity independent. The vertex coordinates for a mesh give its scale-invariant measures, unique up to scale, rotation, and translation. Based on the representation of mesh using scale-invariant measures, a two-step iterative deformation algorithm is proposed, which can arbitrarily edit the mesh through simple handles interaction. The algorithm can explicitly preserve the local geometric details as much as possible in different scales even under severe editing operations including rotation, scaling, and shearing. The efficiency and robustness of the proposed algorithm are demonstrated by examples.

  11. Solar system to scale

    Science.gov (United States)

    Gerwig López, Susanne

    2016-04-01

    One of the most important successes in astronomical observations has been to determine the limit of the Solar System. It is said that the first man able to measure the distance Earth-Sun with only a very slight mistake, in the second century BC, was the wise Greek man Aristarco de Samos. Thanks to Newtońs law of universal gravitation, it was possible to measure, with a little margin of error, the distances between the Sun and the planets. Twelve-year old students are very interested in everything related to the universe. However, it seems too difficult to imagine and understand the real distances among the different celestial bodies. To learn the differences among the inner and outer planets and how far away the outer ones are, I have considered to make my pupils work on the sizes and the distances in our solar system constructing it to scale. The purpose is to reproduce our solar system to scale on a cardboard. The procedure is very easy and simple. Students of first year of ESO (12 year-old) receive the instructions in a sheet of paper (things they need: a black cardboard, a pair of scissors, colored pencils, a ruler, adhesive tape, glue, the photocopies of the planets and satellites, the measurements they have to use). In another photocopy they get the pictures of the edge of the sun, the planets, dwarf planets and some satellites, which they have to color, cut and stick on the cardboard. This activity is planned for both Spanish and bilingual learning students as a science project. Depending on the group, they will receive these instructions in Spanish or in English. When the time is over, the students bring their works on their cardboard to the class. They obtain a final mark: passing, good or excellent, depending on the accuracy of the measurements, the position of all the celestial bodies, the asteroids belts, personal contributions, etc. If any of the students has not followed the instructions they get the chance to remake it again properly, in order not

  12. Scaling of structural failure

    Energy Technology Data Exchange (ETDEWEB)

    Bazant, Z.P. [Northwestern Univ., Evanston, IL (United States); Chen, Er-Ping [Sandia National Lab., Albuquerque, NM (United States)

    1997-01-01

    This article attempts to review the progress achieved in the understanding of scaling and size effect in the failure of structures. Particular emphasis is placed on quasibrittle materials for which the size effect is complicated. Attention is focused on three main types of size effects, namely the statistical size effect due to randomness of strength, the energy release size effect, and the possible size effect due to fractality of fracture or microcracks. Definitive conclusions on the applicability of these theories are drawn. Subsequently, the article discusses the application of the known size effect law for the measurement of material fracture properties, and the modeling of the size effect by the cohesive crack model, nonlocal finite element models and discrete element models. Extensions to compression failure and to the rate-dependent material behavior are also outlined. The damage constitutive law needed for describing a microcracked material in the fracture process zone is discussed. Various applications to quasibrittle materials, including concrete, sea ice, fiber composites, rocks and ceramics are presented.

  13. Large scale tracking algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, Ross L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Love, Joshua Alan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Melgaard, David Kennett [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Karelitz, David B. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Pitts, Todd Alan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Zollweg, Joshua David [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Anderson, Dylan Z. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Nandy, Prabal [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Whitlow, Gary L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bender, Daniel A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Byrne, Raymond Harry [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2015-01-01

    Low signal-to-noise data processing algorithms for improved detection, tracking, discrimination and situational threat assessment are a key research challenge. As sensor technologies progress, the number of pixels will increase signi cantly. This will result in increased resolution, which could improve object discrimination, but unfortunately, will also result in a significant increase in the number of potential targets to track. Many tracking techniques, like multi-hypothesis trackers, suffer from a combinatorial explosion as the number of potential targets increase. As the resolution increases, the phenomenology applied towards detection algorithms also changes. For low resolution sensors, "blob" tracking is the norm. For higher resolution data, additional information may be employed in the detection and classfication steps. The most challenging scenarios are those where the targets cannot be fully resolved, yet must be tracked and distinguished for neighboring closely spaced objects. Tracking vehicles in an urban environment is an example of such a challenging scenario. This report evaluates several potential tracking algorithms for large-scale tracking in an urban environment.

  14. Large scale tracking algorithms.

    Energy Technology Data Exchange (ETDEWEB)

    Hansen, Ross L.; Love, Joshua Alan; Melgaard, David Kennett; Karelitz, David B.; Pitts, Todd Alan; Zollweg, Joshua David; Anderson, Dylan Z.; Nandy, Prabal; Whitlow, Gary L.; Bender, Daniel A.; Byrne, Raymond Harry

    2015-01-01

    Low signal-to-noise data processing algorithms for improved detection, tracking, discrimination and situational threat assessment are a key research challenge. As sensor technologies progress, the number of pixels will increase signi cantly. This will result in increased resolution, which could improve object discrimination, but unfortunately, will also result in a significant increase in the number of potential targets to track. Many tracking techniques, like multi-hypothesis trackers, suffer from a combinatorial explosion as the number of potential targets increase. As the resolution increases, the phenomenology applied towards detection algorithms also changes. For low resolution sensors, "blob" tracking is the norm. For higher resolution data, additional information may be employed in the detection and classfication steps. The most challenging scenarios are those where the targets cannot be fully resolved, yet must be tracked and distinguished for neighboring closely spaced objects. Tracking vehicles in an urban environment is an example of such a challenging scenario. This report evaluates several potential tracking algorithms for large-scale tracking in an urban environment.

  15. Transition from large-scale to small-scale dynamo.

    Science.gov (United States)

    Ponty, Y; Plunian, F

    2011-04-15

    The dynamo equations are solved numerically with a helical forcing corresponding to the Roberts flow. In the fully turbulent regime the flow behaves as a Roberts flow on long time scales, plus turbulent fluctuations at short time scales. The dynamo onset is controlled by the long time scales of the flow, in agreement with the former Karlsruhe experimental results. The dynamo mechanism is governed by a generalized α effect, which includes both the usual α effect and turbulent diffusion, plus all higher order effects. Beyond the onset we find that this generalized α effect scales as O(Rm(-1)), suggesting the takeover of small-scale dynamo action. This is confirmed by simulations in which dynamo occurs even if the large-scale field is artificially suppressed.

  16. Large scale-small scale duality and cosmological constant

    CERN Document Server

    Darabi, F

    1999-01-01

    We study a model of quantum cosmology originating from a classical model of gravitation where a self interacting scalar field is coupled to gravity with the metric undergoing a signature transition. We show that there are dual classical signature changing solutions, one at large scales and the other at small scales. It is possible to fine-tune the physics in both scales with an infinitesimal effective cosmological constant.

  17. Scaling Effects on Materials Tribology: From Macro to Micro Scale

    Science.gov (United States)

    Stoyanov, Pantcho; Chromik, Richard R.

    2017-01-01

    The tribological study of materials inherently involves the interaction of surface asperities at the micro to nanoscopic length scales. This is the case for large scale engineering applications with sliding contacts, where the real area of contact is made up of small contacting asperities that make up only a fraction of the apparent area of contact. This is why researchers have sought to create idealized experiments of single asperity contacts in the field of nanotribology. At the same time, small scale engineering structures known as micro- and nano-electromechanical systems (MEMS and NEMS) have been developed, where the apparent area of contact approaches the length scale of the asperities, meaning the real area of contact for these devices may be only a few asperities. This is essentially the field of microtribology, where the contact size and/or forces involved have pushed the nature of the interaction between two surfaces towards the regime where the scale of the interaction approaches that of the natural length scale of the features on the surface. This paper provides a review of microtribology with the purpose to understand how tribological processes are different at the smaller length scales compared to macrotribology. Studies of the interfacial phenomena at the macroscopic length scales (e.g., using in situ tribometry) will be discussed and correlated with new findings and methodologies at the micro-length scale. PMID:28772909

  18. Cryptic individual scaling relationships and the evolution of morphological scaling.

    Science.gov (United States)

    Dreyer, Austin P; Saleh Ziabari, Omid; Swanson, Eli M; Chawla, Akshita; Frankino, W Anthony; Shingleton, Alexander W

    2016-08-01

    Morphological scaling relationships between organ and body size-also known as allometries-describe the shape of a species, and the evolution of such scaling relationships is central to the generation of morphological diversity. Despite extensive modeling and empirical tests, however, the modes of selection that generate changes in scaling remain largely unknown. Here, we mathematically model the evolution of the group-level scaling as an emergent property of individual-level variation in the developmental mechanisms that regulate trait and body size. We show that these mechanisms generate a "cryptic individual scaling relationship" unique to each genotype in a population, which determines body and trait size expressed by each individual, depending on developmental nutrition. We find that populations may have identical population-level allometries but very different underlying patterns of cryptic individual scaling relationships. Consequently, two populations with apparently the same morphological scaling relationship may respond very differently to the same form of selection. By focusing on the developmental mechanisms that regulate trait size and the patterns of cryptic individual scaling relationships they produce, our approach reveals the forms of selection that should be most effective in altering morphological scaling, and directs researcher attention on the actual, hitherto overlooked, targets of selection.

  19. Environmental complexity across scales: mechanism, scaling and the phenomenological fallacy

    Science.gov (United States)

    Lovejoy, Shaun

    2015-04-01

    Ever since Van Leeuwenhoek used a microscope to discover "new worlds in a drop of water" we have become used to the idea that "zooming in" - whether in space or in time - will reveal new processes, new phenomena. Yet in the natural environment - geosystems - this is often wrong. For example, in the temporal domain, a recent publication has shown that from hours to hundreds of millions of years the conventional scale bound view of atmospheric variability was wrong by a factor of over a quadrillion (10**15). Mandelbrot challenged the "scale bound" ideology and proposed that many natural systems - including many geosystems - were instead better treated as fractal systems in which the same basic mechanism acts over potentially huge ranges of scale. However, in its original form Mandelbrot's isotropic scaling (self-similar) idea turned out to be too naïve: geosystems are typically anisotropic so that shapes and morphologies (e.g. of clouds landmasses) are not the same at different resolutions. However it turns out that the scaling idea often still applies on condition that the notion of scale is generalized appropriately (using the framework of Generalized Scale Invariance). The overall result is that unique processes, unique dynamical mechanisms may act over huge ranges of scale even though the morphologies systematically change with scale. Therefore the common practice of inferring mechanism from shapes, forms, morphologies is unjustified, the "phenomenological fallacy". We give examples of the phenomenological fallacy drawn from diverse areas of geoscience.

  20. Integrating Local Scale Drainage Measures in Meso Scale Catchment Modelling

    Directory of Open Access Journals (Sweden)

    Sandra Hellmers

    2017-01-01

    Full Text Available This article presents a methodology to optimize the integration of local scale drainage measures in catchment modelling. The methodology enables to zoom into the processes (physically, spatially and temporally where detailed physical based computation is required and to zoom out where lumped conceptualized approaches are applied. It allows the definition of parameters and computation procedures on different spatial and temporal scales. Three methods are developed to integrate features of local scale drainage measures in catchment modelling: (1 different types of local drainage measures are spatially integrated in catchment modelling by a data mapping; (2 interlinked drainage features between data objects are enabled on the meso, local and micro scale; (3 a method for modelling multiple interlinked layers on the micro scale is developed. For the computation of flow routing on the meso scale, the results of the local scale measures are aggregated according to their contributing inlet in the network structure. The implementation of the methods is realized in a semi-distributed rainfall-runoff model. The implemented micro scale approach is validated with a laboratory physical model to confirm the credibility of the model. A study of a river catchment of 88 km2 illustrated the applicability of the model on the regional scale.

  1. The Scales of Injustice

    Directory of Open Access Journals (Sweden)

    Charles Blattberg

    2008-02-01

    Full Text Available This paper criticises four major approaches to criminal law – consequentialism, retributivism, abolitionism, and “mixed” pluralism – each of which, in its own fashion, affirms the celebrated emblem of the “scales of justice.” The argument is that there is a better way of dealing with the tensions that often arise between the various legal purposes than by merely balancing them against each other. It consists, essentially, of striving to genuinely reconcile those purposes, a goal which is shown to require taking a new, “patriotic” approach to law. Le présent article porte une critique à quatre approches majeures en droit pénal : le conséquentialisme, le rétributivisme, l’abolitionnisme et le pluralisme « mixte. » Toutes ces approches se rangent, chacune à leur manière, sous le célèbre emblème des « échelles de justice. » L’argument est qu’il existe une meilleure façon de faire face aux tensions qui opposent les multiples objectifs judiciaires plutôt que de comparer le poids des uns contre le poids des autres. Il s’agit essentiellement de s’efforcer à réaliser une authentique réconciliation de ces objectifs. Il apparaîtra que pour y parvenir il est nécessaire d’avoir recours à une nouvelle approche du droit, une approche précisément « patriotique. »

  2. Industrial scale gene synthesis.

    Science.gov (United States)

    Notka, Frank; Liss, Michael; Wagner, Ralf

    2011-01-01

    The most recent developments in the area of deep DNA sequencing and downstream quantitative and functional analysis are rapidly adding a new dimension to understanding biochemical pathways and metabolic interdependencies. These increasing insights pave the way to designing new strategies that address public needs, including environmental applications and therapeutic inventions, or novel cell factories for sustainable and reconcilable energy or chemicals sources. Adding yet another level is building upon nonnaturally occurring networks and pathways. Recent developments in synthetic biology have created economic and reliable options for designing and synthesizing genes, operons, and eventually complete genomes. Meanwhile, high-throughput design and synthesis of extremely comprehensive DNA sequences have evolved into an enabling technology already indispensable in various life science sectors today. Here, we describe the industrial perspective of modern gene synthesis and its relationship with synthetic biology. Gene synthesis contributed significantly to the emergence of synthetic biology by not only providing the genetic material in high quality and quantity but also enabling its assembly, according to engineering design principles, in a standardized format. Synthetic biology on the other hand, added the need for assembling complex circuits and large complexes, thus fostering the development of appropriate methods and expanding the scope of applications. Synthetic biology has also stimulated interdisciplinary collaboration as well as integration of the broader public by addressing socioeconomic, philosophical, ethical, political, and legal opportunities and concerns. The demand-driven technological achievements of gene synthesis and the implemented processes are exemplified by an industrial setting of large-scale gene synthesis, describing production from order to delivery.

  3. H2@Scale Workshop Report

    Energy Technology Data Exchange (ETDEWEB)

    Pivovar, Bryan

    2017-03-31

    Final report from the H2@Scale Workshop held November 16-17, 2016, at the National Renewable Energy Laboratory in Golden, Colorado. The U.S. Department of Energy's National Renewable Energy Laboratory hosted a technology workshop to identify the current barriers and research needs of the H2@Scale concept. H2@Scale is a concept regarding the potential for wide-scale impact of hydrogen produced from diverse domestic resources to enhance U.S. energy security and enable growth of innovative technologies and domestic industries. Feedback received from a diverse set of stakeholders at the workshop will guide the development of an H2@Scale roadmap for research, development, and early stage demonstration activities that can enable hydrogen as an energy carrier at a national scale.

  4. Plague and climate: scales matter.

    Directory of Open Access Journals (Sweden)

    Tamara Ben-Ari

    2011-09-01

    Full Text Available Plague is enzootic in wildlife populations of small mammals in central and eastern Asia, Africa, South and North America, and has been recognized recently as a reemerging threat to humans. Its causative agent Yersinia pestis relies on wild rodent hosts and flea vectors for its maintenance in nature. Climate influences all three components (i.e., bacteria, vectors, and hosts of the plague system and is a likely factor to explain some of plague's variability from small and regional to large scales. Here, we review effects of climate variables on plague hosts and vectors from individual or population scales to studies on the whole plague system at a large scale. Upscaled versions of small-scale processes are often invoked to explain plague variability in time and space at larger scales, presumably because similar scale-independent mechanisms underlie these relationships. This linearity assumption is discussed in the light of recent research that suggests some of its limitations.

  5. Plague and climate: scales matter.

    Science.gov (United States)

    Ben-Ari, Tamara; Ben Ari, Tamara; Neerinckx, Simon; Gage, Kenneth L; Kreppel, Katharina; Laudisoit, Anne; Leirs, Herwig; Stenseth, Nils Chr

    2011-09-01

    Plague is enzootic in wildlife populations of small mammals in central and eastern Asia, Africa, South and North America, and has been recognized recently as a reemerging threat to humans. Its causative agent Yersinia pestis relies on wild rodent hosts and flea vectors for its maintenance in nature. Climate influences all three components (i.e., bacteria, vectors, and hosts) of the plague system and is a likely factor to explain some of plague's variability from small and regional to large scales. Here, we review effects of climate variables on plague hosts and vectors from individual or population scales to studies on the whole plague system at a large scale. Upscaled versions of small-scale processes are often invoked to explain plague variability in time and space at larger scales, presumably because similar scale-independent mechanisms underlie these relationships. This linearity assumption is discussed in the light of recent research that suggests some of its limitations.

  6. International Symposia on Scale Modeling

    CERN Document Server

    Ito, Akihiko; Nakamura, Yuji; Kuwana, Kazunori

    2015-01-01

    This volume thoroughly covers scale modeling and serves as the definitive source of information on scale modeling as a powerful simplifying and clarifying tool used by scientists and engineers across many disciplines. The book elucidates techniques used when it would be too expensive, or too difficult, to test a system of interest in the field. Topics addressed in the current edition include scale modeling to study weather systems, diffusion of pollution in air or water, chemical process in 3-D turbulent flow, multiphase combustion, flame propagation, biological systems, behavior of materials at nano- and micro-scales, and many more. This is an ideal book for students, both graduate and undergraduate, as well as engineers and scientists interested in the latest developments in scale modeling. This book also: Enables readers to evaluate essential and salient aspects of profoundly complex systems, mechanisms, and phenomena at scale Offers engineers and designers a new point of view, liberating creative and inno...

  7. Plague and Climate: Scales Matter

    Science.gov (United States)

    Ben Ari, Tamara; Neerinckx, Simon; Gage, Kenneth L.; Kreppel, Katharina; Laudisoit, Anne; Leirs, Herwig; Stenseth, Nils Chr.

    2011-01-01

    Plague is enzootic in wildlife populations of small mammals in central and eastern Asia, Africa, South and North America, and has been recognized recently as a reemerging threat to humans. Its causative agent Yersinia pestis relies on wild rodent hosts and flea vectors for its maintenance in nature. Climate influences all three components (i.e., bacteria, vectors, and hosts) of the plague system and is a likely factor to explain some of plague's variability from small and regional to large scales. Here, we review effects of climate variables on plague hosts and vectors from individual or population scales to studies on the whole plague system at a large scale. Upscaled versions of small-scale processes are often invoked to explain plague variability in time and space at larger scales, presumably because similar scale-independent mechanisms underlie these relationships. This linearity assumption is discussed in the light of recent research that suggests some of its limitations. PMID:21949648

  8. Discrete implementations of scale transform

    Science.gov (United States)

    Djurdjanovic, Dragan; Williams, William J.; Koh, Christopher K.

    1999-11-01

    Scale as a physical quantity is a recently developed concept. The scale transform can be viewed as a special case of the more general Mellin transform and its mathematical properties are very applicable in the analysis and interpretation of the signals subject to scale changes. A number of single-dimensional applications of scale concept have been made in speech analysis, processing of biological signals, machine vibration analysis and other areas. Recently, the scale transform was also applied in multi-dimensional signal processing and used for image filtering and denoising. Discrete implementation of the scale transform can be carried out using logarithmic sampling and the well-known fast Fourier transform. Nevertheless, in the case of the uniformly sampled signals, this implementation involves resampling. An algorithm not involving resampling of the uniformly sampled signals has been derived too. In this paper, a modification of the later algorithm for discrete implementation of the direct scale transform is presented. In addition, similar concept was used to improve a recently introduced discrete implementation of the inverse scale transform. Estimation of the absolute discretization errors showed that the modified algorithms have a desirable property of yielding a smaller region of possible error magnitudes. Experimental results are obtained using artificial signals as well as signals evoked from the temporomandibular joint. In addition, discrete implementations for the separable two-dimensional direct and inverse scale transforms are derived. Experiments with image restoration and scaling through two-dimensional scale domain using the novel implementation of the separable two-dimensional scale transform pair are presented.

  9. Fundamental Scaling Laws in Nanophotonics

    OpenAIRE

    Ke Liu; Shuai Sun; Arka Majumdar; Volker J. Sorger

    2016-01-01

    The success of information technology has clearly demonstrated that miniaturization often leads to unprecedented performance, and unanticipated applications. This hypothesis of “smaller-is-better” has motivated optical engineers to build various nanophotonic devices, although an understanding leading to fundamental scaling behavior for this new class of devices is missing. Here we analyze scaling laws for optoelectronic devices operating at micro and nanometer length-scale. We show that optoe...

  10. Electroweak scale neutrinos and Higgses

    CERN Document Server

    Aranda, Alfredo

    2009-01-01

    We present two different models with electroweak scale right-handed neutrinos. One of the models is created under the constraint that any addition to the Standard Model must not introduce new higher scales. The model contains right-handed neutrinos with electroweak scale masses and a lepton number violating singlet scalar field. The scalar phenomenology is also presented. The second model is a triplet Higgs model where again the right-handed neutrinos have electroweak scale masses. In this case the model has a rich scalar phenomenology and in particular we present the analysis involving the doubly charged Higgs.

  11. Extended scaling in high dimensions

    Science.gov (United States)

    Berche, B.; Chatelain, C.; Dhall, C.; Kenna, R.; Low, R.; Walter, J.-C.

    2008-11-01

    We apply and test the recently proposed 'extended scaling' scheme in an analysis of the magnetic susceptibility of Ising systems above the upper critical dimension. The data are obtained by Monte Carlo simulations using both the conventional Wolff cluster algorithm and the Prokof'ev-Svistunov worm algorithm. As already observed for other models, extended scaling is shown to extend the high-temperature critical scaling regime over a range of temperatures much wider than that achieved conventionally. It allows for an accurate determination of leading and sub-leading scaling indices, critical temperatures and amplitudes of the confluent corrections.

  12. Natural Scales in Geographical Patterns

    Science.gov (United States)

    Menezes, Telmo; Roth, Camille

    2017-04-01

    Human mobility is known to be distributed across several orders of magnitude of physical distances, which makes it generally difficult to endogenously find or define typical and meaningful scales. Relevant analyses, from movements to geographical partitions, seem to be relative to some ad-hoc scale, or no scale at all. Relying on geotagged data collected from photo-sharing social media, we apply community detection to movement networks constrained by increasing percentiles of the distance distribution. Using a simple parameter-free discontinuity detection algorithm, we discover clear phase transitions in the community partition space. The detection of these phases constitutes the first objective method of characterising endogenous, natural scales of human movement. Our study covers nine regions, ranging from cities to countries of various sizes and a transnational area. For all regions, the number of natural scales is remarkably low (2 or 3). Further, our results hint at scale-related behaviours rather than scale-related users. The partitions of the natural scales allow us to draw discrete multi-scale geographical boundaries, potentially capable of providing key insights in fields such as epidemiology or cultural contagion where the introduction of spatial boundaries is pivotal.

  13. Natural Scales in Geographical Patterns

    Science.gov (United States)

    Menezes, Telmo; Roth, Camille

    2017-01-01

    Human mobility is known to be distributed across several orders of magnitude of physical distances, which makes it generally difficult to endogenously find or define typical and meaningful scales. Relevant analyses, from movements to geographical partitions, seem to be relative to some ad-hoc scale, or no scale at all. Relying on geotagged data collected from photo-sharing social media, we apply community detection to movement networks constrained by increasing percentiles of the distance distribution. Using a simple parameter-free discontinuity detection algorithm, we discover clear phase transitions in the community partition space. The detection of these phases constitutes the first objective method of characterising endogenous, natural scales of human movement. Our study covers nine regions, ranging from cities to countries of various sizes and a transnational area. For all regions, the number of natural scales is remarkably low (2 or 3). Further, our results hint at scale-related behaviours rather than scale-related users. The partitions of the natural scales allow us to draw discrete multi-scale geographical boundaries, potentially capable of providing key insights in fields such as epidemiology or cultural contagion where the introduction of spatial boundaries is pivotal. PMID:28374825

  14. Drift Scale THM Model

    Energy Technology Data Exchange (ETDEWEB)

    J. Rutqvist

    2004-10-07

    This model report documents the drift scale coupled thermal-hydrological-mechanical (THM) processes model development and presents simulations of the THM behavior in fractured rock close to emplacement drifts. The modeling and analyses are used to evaluate the impact of THM processes on permeability and flow in the near-field of the emplacement drifts. The results from this report are used to assess the importance of THM processes on seepage and support in the model reports ''Seepage Model for PA Including Drift Collapse'' and ''Abstraction of Drift Seepage'', and to support arguments for exclusion of features, events, and processes (FEPs) in the analysis reports ''Features, Events, and Processes in Unsaturated Zone Flow and Transport and Features, Events, and Processes: Disruptive Events''. The total system performance assessment (TSPA) calculations do not use any output from this report. Specifically, the coupled THM process model is applied to simulate the impact of THM processes on hydrologic properties (permeability and capillary strength) and flow in the near-field rock around a heat-releasing emplacement drift. The heat generated by the decay of radioactive waste results in elevated rock temperatures for thousands of years after waste emplacement. Depending on the thermal load, these temperatures are high enough to cause boiling conditions in the rock, resulting in water redistribution and altered flow paths. These temperatures will also cause thermal expansion of the rock, with the potential of opening or closing fractures and thus changing fracture permeability in the near-field. Understanding the THM coupled processes is important for the performance of the repository because the thermally induced permeability changes potentially effect the magnitude and spatial distribution of percolation flux in the vicinity of the drift, and hence the seepage of water into the drift. This is important because

  15. Ultra-Large-Scale Systems: Scale Changes Everything

    Science.gov (United States)

    2008-03-06

    Statistical Mechanics, Complexity Networks Are Everywhere Recurring “scale free” structure • internet & yeast protein structures Analogous dynamics...Design • Design Representation and Analysis • Assimilation • Determining and Managing Requirements 43 Ultra-Large-Scale Systems Linda Northrop: March

  16. Relating urban scaling, fundamental allometry, and density scaling

    CERN Document Server

    Rybski, Diego

    2016-01-01

    We study the connection between urban scaling, fundamental allometry (between city population and city area), and per capita vs.\\ population density scaling. From simple analytical derivations we obtain the relation between the 3 involved exponents. We discuss particular cases and ranges of the exponents which we illustrate in a "phase diagram". As we show, the results are consistent with previous work.

  17. From dynamical scaling to local scale-invariance: a tutorial

    CERN Document Server

    Henkel, Malte

    2016-01-01

    Dynamical scaling arises naturally in various many-body systems far from equilibrium. After a short historical overview, the elements of possible extensions of dynamical scaling to a local scale-invariance will be introduced. Schr\\"odinger-invariance, the most simple example of local scale-invariance, will be introduced as a dynamical symmetry in the Edwards-Wilkinson universality class of interface growth. The Lie algebra construction, its representations and the Bargman superselection rules will be combined with non-equilibrium Janssen-de Dominicis field-theory to produce explicit predictions for responses and correlators, which can be compared to the results of explicit model studies. At the next level, the study of non-stationary states requires to go over, from Schr\\"odinger-invariance, to ageing-invariance. The ageing algebra admits new representations, which acts as dynamical symmetries on more general equations, and imply that each non-equilibrium scaling operator is characterised by two distinct, ind...

  18. Scaling properties of small-scale fluctuations in magnetohydrodynamic turbulence

    CERN Document Server

    Perez, J C; Boldyrev, S; Cattaneo, F

    2014-01-01

    Magnetohydrodynamic (MHD) turbulence in the majority of natural systems, including the interstellar medium, the solar corona, and the solar wind, has Reynolds numbers far exceeding the Reynolds numbers achievable in numerical experiments. Much attention is therefore drawn to the universal scaling properties of small-scale fluctuations, which can be reliably measured in the simulations and then extrapolated to astrophysical scales. However, in contrast with hydrodynamic turbulence, where the universal structure of the inertial and dissipation intervals is described by the Kolmogorov self-similarity, the scaling for MHD turbulence cannot be established based solely on dimensional arguments due to the presence of an intrinsic velocity scale -- the Alfven velocity. In this Letter, we demonstrate that the Kolmogorov first self-similarity hypothesis cannot be formulated for MHD turbulence in the same way it is formulated for the hydrodynamic case. Besides profound consequences for the analytical consideration, this...

  19. Large-scale data analytics

    CERN Document Server

    Gkoulalas-Divanis, Aris

    2014-01-01

    Provides cutting-edge research in large-scale data analytics from diverse scientific areas Surveys varied subject areas and reports on individual results of research in the field Shares many tips and insights into large-scale data analytics from authors and editors with long-term experience and specialization in the field

  20. Very Large Scale Integration (VLSI).

    Science.gov (United States)

    Yeaman, Andrew R. J.

    Very Large Scale Integration (VLSI), the state-of-the-art production techniques for computer chips, promises such powerful, inexpensive computing that, in the future, people will be able to communicate with computer devices in natural language or even speech. However, before full-scale VLSI implementation can occur, certain salient factors must be…

  1. Metric scales for emotion measurement

    Directory of Open Access Journals (Sweden)

    Martin Junge

    2016-09-01

    Full Text Available The scale quality of indirect and direct scalings of the intensity of emotional experiences was investigated from the perspective of representational measurement theory. Study 1 focused on sensory pleasantness and disgust, Study 2 on surprise and amusement, and Study 3 on relief and disappointment. In each study, the emotion intensities elicited by a set of stimuli were estimated using Ordinal Difference Scaling, an indirect probabilistic scaling method based on graded pair comparisons. The obtained scale values were used to select test cases for the quadruple axiom, a central axiom of difference measurement. A parametric bootstrap test was used to decide whether the participants’ difference judgments systematically violated the axiom. Most participants passed this test. The indirect scalings of these participants were then linearly correlated with their direct emotion intensity ratings to determine whether they agreed with them up to measurement error, and hence might be metric as well. The majority of the participants did not pass this test. The findings suggest that Ordinal Difference Scaling allows to measure emotion intensity on a metric scale level for most participants. As a consequence, quantitative emotion theories become amenable to empirical test on the individual level using indirect measurements of emotional experience.

  2. Spiritual Competency Scale: Further Analysis

    Science.gov (United States)

    Dailey, Stephanie F.; Robertson, Linda A.; Gill, Carman S.

    2015-01-01

    This article describes a follow-up analysis of the Spiritual Competency Scale, which initially validated ASERVIC's (Association for Spiritual, Ethical and Religious Values in Counseling) spiritual competencies. The study examined whether the factor structure of the Spiritual Competency Scale would be supported by participants (i.e., ASERVIC…

  3. On the Geologic Time Scale

    NARCIS (Netherlands)

    Gradstein, F.M.; Ogg, J.G.; Hilgen, F.J.

    2012-01-01

    This report summarizes the international divisions and ages in the Geologic Time Scale, published in 2012 (GTS2012). Since 2004, when GTS2004 was detailed, major developments have taken place that directly bear and have considerable impact on the intricate science of geologic time scaling. Precam br

  4. Voice, Schooling, Inequality, and Scale

    Science.gov (United States)

    Collins, James

    2013-01-01

    The rich studies in this collection show that the investigation of voice requires analysis of "recognition" across layered spatial-temporal and sociolinguistic scales. I argue that the concepts of voice, recognition, and scale provide insight into contemporary educational inequality and that their study benefits, in turn, from paying attention to…

  5. Spiritual Competency Scale: Further Analysis

    Science.gov (United States)

    Dailey, Stephanie F.; Robertson, Linda A.; Gill, Carman S.

    2015-01-01

    This article describes a follow-up analysis of the Spiritual Competency Scale, which initially validated ASERVIC's (Association for Spiritual, Ethical and Religious Values in Counseling) spiritual competencies. The study examined whether the factor structure of the Spiritual Competency Scale would be supported by participants (i.e., ASERVIC…

  6. A Scale of Mobbing Impacts

    Science.gov (United States)

    Yaman, Erkan

    2012-01-01

    The aim of this research was to develop the Mobbing Impacts Scale and to examine its validity and reliability analyses. The sample of study consisted of 509 teachers from Sakarya. In this study construct validity, internal consistency, test-retest reliabilities and item analysis of the scale were examined. As a result of factor analysis for…

  7. SCALING AND 4-QUARK FRAGMENTATION

    NARCIS (Netherlands)

    SCHOLTEN, O; BOSVELD, GD

    1991-01-01

    The conditions for a scaling behaviour from the fragmentation process leading to slow protons are discussed- The scaling referred to implies that the fragmentation functions depend on the light-cone momentum fraction only. It is shown that differences in the fragmentation functions for valence- and

  8. Entanglement scaling in lattice systems

    Energy Technology Data Exchange (ETDEWEB)

    Audenaert, K M R [Institute for Mathematical Sciences, Imperial College London, 53 Prince' s Gate, Exhibition Road, London SW7 2PG (United Kingdom); Cramer, M [QOLS, Blackett Laboratory, Imperial College London, Prince Consort Road, London SW7 2BW (United Kingdom); Eisert, J [Institute for Mathematical Sciences, Imperial College London, 53 Prince' s Gate, Exhibition Road, London SW7 2PG (United Kingdom); Plenio, M B [Institute for Mathematical Sciences, Imperial College London, 53 Prince' s Gate, Exhibition Road, London SW7 2PG (United Kingdom)

    2007-05-15

    We review some recent rigorous results on scaling laws of entanglement properties in quantum many body systems. More specifically, we study the entanglement of a region with its surrounding and determine its scaling behaviour with its size for systems in the ground and thermal states of bosonic and fermionic lattice systems. A theorem connecting entanglement between a region and the rest of the lattice with the surface area of the boundary between the two regions is presented for non-critical systems in arbitrary spatial dimensions. The entanglement scaling in the field limit exhibits a peculiar difference between fermionic and bosonic systems. In one-spatial dimension a logarithmic divergence is recovered for both bosonic and fermionic systems. In two spatial dimensions in the setting of half-spaces however we observe strict area scaling for bosonic systems and a multiplicative logarithmic correction to such an area scaling in fermionic systems. Similar questions may be posed and answered in classical systems.

  9. Multi-scale brain networks

    CERN Document Server

    Betzel, Richard F

    2016-01-01

    The network architecture of the human brain has become a feature of increasing interest to the neuroscientific community, largely because of its potential to illuminate human cognition, its variation over development and aging, and its alteration in disease or injury. Traditional tools and approaches to study this architecture have largely focused on single scales -- of topology, time, and space. Expanding beyond this narrow view, we focus this review on pertinent questions and novel methodological advances for the multi-scale brain. We separate our exposition into content related to multi-scale topological structure, multi-scale temporal structure, and multi-scale spatial structure. In each case, we recount empirical evidence for such structures, survey network-based methodological approaches to reveal these structures, and outline current frontiers and open questions. Although predominantly peppered with examples from human neuroimaging, we hope that this account will offer an accessible guide to any neuros...

  10. Scale effect on overland flow connectivity, at the interill scale

    Science.gov (United States)

    Penuela Fernandez, A.; Bielders, C.; Javaux, M.

    2012-04-01

    The relative surface connection function (RSC) was proposed by Antoine et al. (2009) as a functional indicator of runoff flow connectivity. For a given area, it expresses the percentage of the surface connected to the outlet (C) as a function of the degree of filling of the depression storage. This function explicitly integrates the flow network at the soil surface and hence provides essential information regarding the flow paths' connectivity. It has been shown that this function could help improve the modeling of the hydrogram at the square meter scale, yet it is unknown how the scale affects the RSC function, and whether and how it can be extrapolated to other scales. The main objective of this research is to study the scale effect on overland flow connectivity (RSC function). For this purpose, digital elevation data of a real field (9 x 3 m) and three synthetic fields (6 x 6 m) with contrasting hydrological responses was used, and the RSC function was calculated at different scales by changing the length (L) or width (l) of the field. Border effects were observed for the smaller scales. In most of cases, for L or l smaller than 750mm, increasing L or l, resulted in a strong increase or decrease of the maximum depression storage, respectively. There was no scale effect on the RSC function when changing l. On the contrary, a remarkable scale effect was observed in the RSC function when changing L. In general, for a given degree of filling of the depression storage, C decreased as L increased. This change in C was inversely proportional to the change in L. This observation applied only up to approx. 50-70% (depending on the hydrological response of the field) of filling of depression storage, after which no correlation was found between C and L. The results of this study help identify the critical scale to study overland flow connectivity. At scales larger than the critical scale, the RSC function showed a great potential to be extrapolated to other scales.

  11. Scale effect on overland flow connectivity at the plot scale

    Science.gov (United States)

    Peñuela, A.; Javaux, M.; Bielders, C. L.

    2013-01-01

    A major challenge in present-day hydrological sciences is to enhance the performance of existing distributed hydrological models through a better description of subgrid processes, in particular the subgrid connectivity of flow paths. The Relative Surface Connection (RSC) function was proposed by Antoine et al. (2009) as a functional indicator of runoff flow connectivity. For a given area, it expresses the percentage of the surface connected to the outflow boundary (C) as a function of the degree of filling of the depression storage. This function explicitly integrates the flow network at the soil surface and hence provides essential information regarding the flow paths' connectivity. It has been shown that this function could help improve the modeling of the hydrograph at the square meter scale, yet it is unknown how the scale affects the RSC function, and whether and how it can be extrapolated to other scales. The main objective of this research is to study the scale effect on overland flow connectivity (RSC function). For this purpose, digital elevation data of a real field (9 × 3 m) and three synthetic fields (6 × 6 m) with contrasting hydrological responses were used, and the RSC function was calculated at different scales by changing the length (l) or width (w) of the field. To different extents depending on the microtopography, border effects were observed for the smaller scales when decreasing l or w, which resulted in a strong decrease or increase of the maximum depression storage, respectively. There was no scale effect on the RSC function when changing w, but a remarkable scale effect was observed in the RSC function when changing l. In general, for a given degree of filling of the depression storage, C decreased as l increased, the change in C being inversely proportional to the change in l. However, this observation applied only up to approx. 50-70% (depending on the hydrological response of the field) of filling of depression storage, after which no

  12. Scale effect on overland flow connectivity at the plot scale

    Directory of Open Access Journals (Sweden)

    A. Peñuela

    2012-06-01

    Full Text Available A major challenge in present-day hydrological sciences is to enhance the performance of existing distributed hydrological models through a better description of subgrid processes, in particular the subgrid connectivity of flow paths. The relative surface connection function (RSC was proposed by Antoine et al. (2009 as a functional indicator of runoff flow connectivity. For a given area, it expresses the percentage of the surface connected to the outflow boundary (C as a function of the degree of filling of the depression storage. This function explicitly integrates the flow network at the soil surface and hence provides essential information regarding the flow paths' connectivity. It has been shown that this function could help improve the modeling of the hydrogram at the square meter scale, yet it is unknown how the scale affects the RSC function, and whether and how it can be extrapolated to other scales. The main objective of this research is to study the scale effect on overland flow connectivity (RSC function. For this purpose, digital elevation data of a real field (9 × 3 m and three synthetic fields (6 × 6 m with contrasting hydrological responses were used, and the RSC function was calculated at different scales by changing the length (l or width (w of the field. Border effects, at different extents depending on the microtopography, were observed for the smaller scales, when decreasing l or w, which resulted in a strong decrease or increase of the maximum depression storage, respectively. There was no scale effect on the RSC function when changing w. On the contrary, a remarkable scale effect was observed in the RSC function when changing l. In general, for a given degree of filling of the depression storage, C decreased as l increased. This change in C was inversely proportional to the change in l. This observation applied only up to approx. 50–70

  13. Effect Of Vibration Amplitude Level On Seated Occupant Reaction Time

    Directory of Open Access Journals (Sweden)

    Amzar Azizan

    2015-08-01

    Full Text Available The past decade has seen the rapid development of vibration comfort in the automotive industry. However little attention has been paid to vibration drowsiness. Eighteen male volunteers were recruited for this experiment. Before commencing the experiment total transmitted acceleration measured at interfaces between the seat cushion and seatback to human body was adjusted to become 0.2 ms-2 r.m.s and 0.4 ms-2 r.m.s for each volunteer. Seated volunteers were exposed to Gaussian random vibration with frequency band 1-15 Hz at two level of amplitude low vibration amplitude and medium vibration amplitude for 20-minutes in separate days. For the purpose of drowsiness measurement volunteers were asked to complete 10-minutes PVT test before and after vibration exposure and rate their subjective drowsiness by giving score using Karolinska Sleepiness Scale KSS before vibration every 5-minutes interval and following 20-minutes of vibration exposure. Strong evidence of drowsiness was found as there was a significant increase in reaction time and number of lapse following exposure to vibration in both conditions. However the effect is more apparent in medium vibration amplitude. A steady increase of drowsiness level can also be observed in KSS in all volunteers. However no significant differences were found in KSS between low vibration amplitude and medium vibration amplitude. The results of this investigation suggest that exposure to vibration has an adverse effect on human alertness level and more pronounced at higher vibration amplitude. Taken together these findings suggest a role of vibration in promoting drowsiness especially at higher vibration amplitude.

  14. Sleep and recovery in physicians on night call: a longitudinal field study

    Directory of Open Access Journals (Sweden)

    Malmberg Birgitta

    2010-08-01

    Full Text Available Abstract Background It is well known that physicians' night-call duty may cause impaired performance and adverse effects on subjective health, but there is limited knowledge about effects on sleep duration and recovery time. In recent years occupational stress and impaired well-being among anaesthesiologists have been frequently reported for in the scientific literature. Given their main focus on handling patients with life-threatening conditions, when on call, one might expect sleep and recovery to be negatively affected by work, especially in this specialist group. The aim of the present study was to examine whether a 16-hour night-call schedule allowed for sufficient recovery in anaesthesiologists compared with other physician specialists handling less life-threatening conditions, when on call. Methods Sleep, monitored by actigraphy and Karolinska Sleep Diary/Sleepiness Scale on one night after daytime work, one night call, the following first and second nights post-call, and a Saturday night, was compared between 15 anaesthesiologists and 17 paediatricians and ear, nose, and throat surgeons. Results Recovery patterns over the days after night call did not differ between groups, but between days. Mean night sleep for all physicians was 3 hours when on call, 7 h both nights post-call and Saturday, and 6 h after daytime work (p Conclusions Despite considerable sleep loss during work on night call, and unexpectedly short sleep after ordinary day work, the physicians' self-reports indicate full recovery after two nights' sleep. We conclude that these 16-hour night duties were compatible with a short-term recovery in both physician groups, but the limited sleep duration in general still implies a long-term health concern. These results may contribute to the establishment of safe working hours for night-call duty in physicians and other health-care workers.

  15. A comparison of blue light and caffeine effects on cognitive function and alertness in humans.

    Directory of Open Access Journals (Sweden)

    C Martyn Beaven

    Full Text Available The alerting effects of both caffeine and short wavelength (blue light have been consistently reported. The ability of blue light to enhance alertness and cognitive function via non-image forming neuropathways have been suggested as a non-pharmacological countermeasure for drowsiness across a range of occupational settings. Here we compare and contrast the alerting and psychomotor effects of 240 mg of caffeine and a 1-h dose of ~40 lx blue light in a non-athletic population. Twenty-one healthy subjects performed a computer-based psychomotor vigilance test before and after each of four randomly assigned trial conditions performed on different days: white light/placebo; white light/240 mg caffeine; blue light/placebo; blue light/240 mg caffeine. The Karolinska Sleepiness Scale was used to assess subjective measures of alertness. Both the caffeine only and blue light only conditions enhanced accuracy in a visual reaction test requiring a decision and an additive effect was observed with respect to the fastest reaction times. However, in a test of executive function, where a distraction was included, caffeine exerted a negative effect on accuracy. Furthermore, the blue light only condition consistently outperformed caffeine when both congruent and incongruent distractions were presented. The visual reactions in the absence of a decision or distraction were also enhanced in the blue light only condition and this effect was most prominent in the blue-eyed participants. Overall, blue light and caffeine demonstrated distinct effects on aspects of psychomotor function and have the potential to positively influence a range of settings where cognitive function and alertness are important. Specifically, despite the widespread use of caffeine in competitive sporting environments, the possible impact of blue light has received no research attention.

  16. A comparison of blue light and caffeine effects on cognitive function and alertness in humans.

    Science.gov (United States)

    Beaven, C Martyn; Ekström, Johan

    2013-01-01

    The alerting effects of both caffeine and short wavelength (blue) light have been consistently reported. The ability of blue light to enhance alertness and cognitive function via non-image forming neuropathways have been suggested as a non-pharmacological countermeasure for drowsiness across a range of occupational settings. Here we compare and contrast the alerting and psychomotor effects of 240 mg of caffeine and a 1-h dose of ~40 lx blue light in a non-athletic population. Twenty-one healthy subjects performed a computer-based psychomotor vigilance test before and after each of four randomly assigned trial conditions performed on different days: white light/placebo; white light/240 mg caffeine; blue light/placebo; blue light/240 mg caffeine. The Karolinska Sleepiness Scale was used to assess subjective measures of alertness. Both the caffeine only and blue light only conditions enhanced accuracy in a visual reaction test requiring a decision and an additive effect was observed with respect to the fastest reaction times. However, in a test of executive function, where a distraction was included, caffeine exerted a negative effect on accuracy. Furthermore, the blue light only condition consistently outperformed caffeine when both congruent and incongruent distractions were presented. The visual reactions in the absence of a decision or distraction were also enhanced in the blue light only condition and this effect was most prominent in the blue-eyed participants. Overall, blue light and caffeine demonstrated distinct effects on aspects of psychomotor function and have the potential to positively influence a range of settings where cognitive function and alertness are important. Specifically, despite the widespread use of caffeine in competitive sporting environments, the possible impact of blue light has received no research attention.

  17. A Randomized, Double-Blind, Single-Dose, Placebo-Controlled, Multicenter, Polysomnographic Study of Gabapentin in Transient Insomnia Induced by Sleep Phase Advance

    Science.gov (United States)

    Rosenberg, Russell P.; Hull, Steven G.; Lankford, D. Alan; Mayleben, David W.; Seiden, David J.; Furey, Sandy A.; Jayawardena, Shyamalie; Roth, Thomas

    2014-01-01

    Study Objectives: To evaluate the effects of single doses of gabapentin 250 and 500 mg on polysomnographic (PSG) and participant-reported sleep measures in a 5-h phase advance insomnia model. Methods: Adults reporting occasional disturbed sleep received gabapentin 500 mg (n = 125), 250 mg (n = 125), or placebo (n = 127) 30 min prior to bedtime and were in bed from 17:00 to 01:00, ∼5 h before their habitual bedtime. Sleep was assessed by PSG, post-sleep questionnaire, and the Karolinska Sleep Diary (KSD). Next-day residual effects (Digit Symbol Substitution Test [DSST] and Stanford Sleepiness Scale [SSS]) and tolerability were assessed. Results: Demographics were comparable among groups. Among PSG endpoints, wake after sleep onset (primary endpoint) (135.7 [placebo], 100.7 [250 mg], and 73.2 [500 mg] min) was significantly lower and total sleep time (TST) (311.4, 356.5, and 378.7 min) significantly greater in both gabapentin groups versus placebo. Latency to persistent sleep was not significantly different among groups. Percent slow wave sleep (12.6%, 15.4%, and 17.0%, respectively) was significantly greater and percent stage 1 (15.1%, 11.8%, and 10.8%, respectively) significantly lower relative to placebo. Gabapentin was associated with significantly higher values of KSD Sleep Quality Index and reported TST versus placebo; no other reported outcomes were significant. Neither gabapentin dose produced evidence of next-day residual effects as measured by DSST and SSS. Adverse events were infrequent (Rosenberg RP, Hull SG, Lankford DA, Mayleben DW, Seiden DJ, Furey SA, Jayawardena S, Roth T. A randomized, double-blind, single-dose, placebo-controlled, multicenter, polysomnographic study of gabapentin in transient insomnia induced by sleep phase advance. J Clin Sleep Med 2014;10(10):1093-1100. PMID:25317090

  18. Cognitive consequences of sleep deprivation, shiftwork, and heat exposure for underground miners.

    Science.gov (United States)

    Legault, Glenn; Clement, Alexandra; Kenny, Glen P; Hardcastle, Stephen; Keller, Nancy

    2017-01-01

    Sleep deprivation, abnormal sleep patterns arising from working rotating shifts, and exposure to high ambient temperatures contribute to physical and cognitive dysfunction. We examined the effects of these on 19 (41.5 ± 5.1 years) male underground miners. Data were collected for 28 to 30 consecutive days such that the participants experienced their full rotating shift schedule, including days off. Objective measures of sleep quality (actigraphy), attentional capacity (psychomotor vigilance task), core body temperature (visceral pill), executive function (BRIEF-A) and subjective measures of fatigue (Karolinska and Epworth Sleepiness scales) were obtained over the 28-30 day period. Non-parametric analyses (χ(2), Wilcoxen Signed ranks) were used to determine differences between shift types and days off. Z-tests were used to compare sample data to population norms. These revealed that the participants experienced poor quality of sleep relative to age-matched norms irrespective of the shift being worked or if the participant was on a scheduled day off [30-39 year olds: z = -14.62, p sleep prior to beginning work compared to their days off or night shift; however, no differences in total sleep time between when participants worked day or night shifts were observed [χ(2) (2, n = 18) = 13.44, p sleep deprived. The cognitive consequences of this poor sleep were most pronounced during night shift when their attentional capacity declined rapidly over the course of the night shift.

  19. Generic Dynamic Scaling in Kinetic Roughening

    OpenAIRE

    Ramasco, José J.; López, Juan M.; Rodríguez, Miguel A.

    2000-01-01

    We study the dynamic scaling hypothesis in invariant surface growth. We show that the existence of power-law scaling of the correlation functions (scale invariance) does not determine a unique dynamic scaling form of the correlation functions, which leads to the different anomalous forms of scaling recently observed in growth models. We derive all the existing forms of anomalous dynamic scaling from a new generic scaling ansatz. The different scaling forms are subclasses of this generic scali...

  20. A Figurine and its Scale, a Scale and its Figurine

    Directory of Open Access Journals (Sweden)

    Fotis Ifantidis

    2015-05-01

    Full Text Available I was taught to think of archaeological photography as faceless, a to-scale and accurate depiction of ancient artefacts and sites but these rules only apply to one part of archaeological photography, the 'official' one.

  1. Gelation on the microscopic scale

    Science.gov (United States)

    Oppong, Felix K.; Coussot, P.; de Bruyn, John R.

    2008-08-01

    Particle-tracking methods are used to study gelation in a colloidal suspension of Laponite clay particles. We track the motion of small fluorescent polystyrene spheres added to the suspension, and obtain the micron-scale viscous and elastic moduli of the material from their mean-squared displacement. The fluorescent spheres move subdiffusively due to the microstructure of the suspension, with the diffusive exponent decreasing from close to one at early times to near zero as the material gels. The particle-tracking data show that the system becomes more heterogeneous on the microscopic scale as gelation proceeds. We also determine the bulk-scale moduli using small-amplitude oscillatory shear rheometry. Both the macroscopic and microscopic moduli increase with time, and on both scales we observe a transition from a primarily viscous fluid to an elastic gel. We find that the gel point, determined as the time at which the viscous and elastic moduli are equal, is length-scale dependent—gelation occurs earlier on the bulk scale than on the microscopic scale.

  2. Scaling limits of a model for selection at two scales

    Science.gov (United States)

    Luo, Shishi; Mattingly, Jonathan C.

    2017-04-01

    The dynamics of a population undergoing selection is a central topic in evolutionary biology. This question is particularly intriguing in the case where selective forces act in opposing directions at two population scales. For example, a fast-replicating virus strain outcompetes slower-replicating strains at the within-host scale. However, if the fast-replicating strain causes host morbidity and is less frequently transmitted, it can be outcompeted by slower-replicating strains at the between-host scale. Here we consider a stochastic ball-and-urn process which models this type of phenomenon. We prove the weak convergence of this process under two natural scalings. The first scaling leads to a deterministic nonlinear integro-partial differential equation on the interval [0,1] with dependence on a single parameter, λ. We show that the fixed points of this differential equation are Beta distributions and that their stability depends on λ and the behavior of the initial data around 1. The second scaling leads to a measure-valued Fleming–Viot process, an infinite dimensional stochastic process that is frequently associated with a population genetics.

  3. From dynamical scaling to local scale-invariance: a tutorial

    Science.gov (United States)

    Henkel, Malte

    2017-03-01

    Dynamical scaling arises naturally in various many-body systems far from equilibrium. After a short historical overview, the elements of possible extensions of dynamical scaling to a local scale-invariance will be introduced. Schrödinger-invariance, the most simple example of local scale-invariance, will be introduced as a dynamical symmetry in the Edwards-Wilkinson universality class of interface growth. The Lie algebra construction, its representations and the Bargman superselection rules will be combined with non-equilibrium Janssen-de Dominicis field-theory to produce explicit predictions for responses and correlators, which can be compared to the results of explicit model studies. At the next level, the study of non-stationary states requires to go over, from Schrödinger-invariance, to ageing-invariance. The ageing algebra admits new representations, which acts as dynamical symmetries on more general equations, and imply that each non-equilibrium scaling operator is characterised by two distinct, independent scaling dimensions. Tests of ageing-invariance are described, in the Glauber-Ising and spherical models of a phase-ordering ferromagnet and the Arcetri model of interface growth.

  4. Generic maximum likely scale selection

    DEFF Research Database (Denmark)

    Pedersen, Kim Steenstrup; Loog, Marco; Markussen, Bo

    2007-01-01

    The fundamental problem of local scale selection is addressed by means of a novel principle, which is based on maximum likelihood estimation. The principle is generally applicable to a broad variety of image models and descriptors, and provides a generic scale estimation methodology. The focus...... on second order moments of multiple measurements outputs at a fixed location. These measurements, which reflect local image structure, consist in the cases considered here of Gaussian derivatives taken at several scales and/or having different derivative orders....

  5. Rotated and Scaled Alamouti Coding

    CERN Document Server

    Willems, Frans M J

    2008-01-01

    Repetition-based retransmission is used in Alamouti-modulation [1998] for $2\\times 2$ MIMO systems. We propose to use instead of ordinary repetition so-called "scaled repetition" together with rotation. It is shown that the rotated and scaled Alamouti code has a hard-decision performance which is only slightly worse than that of the Golden code [2005], the best known $2\\times 2$ space-time code. Decoding the Golden code requires an exhaustive search over all codewords, while our rotated and scaled Alamouti code can be decoded with an acceptable complexity however.

  6. Japanese large-scale interferometers

    CERN Document Server

    Kuroda, K; Miyoki, S; Ishizuka, H; Taylor, C T; Yamamoto, K; Miyakawa, O; Fujimoto, M K; Kawamura, S; Takahashi, R; Yamazaki, T; Arai, K; Tatsumi, D; Ueda, A; Fukushima, M; Sato, S; Shintomi, T; Yamamoto, A; Suzuki, T; Saitô, Y; Haruyama, T; Sato, N; Higashi, Y; Uchiyama, T; Tomaru, T; Tsubono, K; Ando, M; Takamori, A; Numata, K; Ueda, K I; Yoneda, H; Nakagawa, K; Musha, M; Mio, N; Moriwaki, S; Somiya, K; Araya, A; Kanda, N; Telada, S; Sasaki, M; Tagoshi, H; Nakamura, T; Tanaka, T; Ohara, K

    2002-01-01

    The objective of the TAMA 300 interferometer was to develop advanced technologies for kilometre scale interferometers and to observe gravitational wave events in nearby galaxies. It was designed as a power-recycled Fabry-Perot-Michelson interferometer and was intended as a step towards a final interferometer in Japan. The present successful status of TAMA is presented. TAMA forms a basis for LCGT (large-scale cryogenic gravitational wave telescope), a 3 km scale cryogenic interferometer to be built in the Kamioka mine in Japan, implementing cryogenic mirror techniques. The plan of LCGT is schematically described along with its associated R and D.

  7. Sleep restriction may lead to disruption in physiological attention and reaction time

    Directory of Open Access Journals (Sweden)

    Arbind Kumar Choudhary

    2016-07-01

    Full Text Available Sleepiness is the condition where for some reason fails to go into a sleep state and will have difficulty in remaining awake even while carrying out activities. Sleep restriction occurs when an individual fails to get enough sleep due to high work demands. The mechanism between sleep restriction and underlying brain physiology deficits is not well assumed. The objective of the present study was to investigate the mental attention (P300 and reaction time [visual (VRT and auditory (ART] among night watchmen, at subsequent; first (1st day, fourth (4th day and seventh (7th day of restricted sleep period. After exclusion and inclusion criteria, the study was performed among 50 watchmen (age=18–35 years (n=50 after providing written informed consent and divided into two group. Group I-(Normal sleep (n=28 working in day time and used to have normal sleep in night (≥8 h; Group II-(Restricted sleep (n=22 - working in night time and used to have less sleep in night (≤3 h. Statistical significance between the different groups was determined by the independent student ʻtʼ test and the significance level was fixed at p≤0.05. We observed that among all normal and restricted sleep watchmen there was not any significant variation in Karolinska Sleepiness Scale (KSS score, VRT and ART, along with latency and amplitude of P300 on 1st day of restricted sleep. However at subsequent on 4th day and 7th day of restricted sleep, there was significant increase in (KSSscore, and prolongation of VRT and ART as well as alteration in latency and amplitude of P300 wave in restricted sleep watchmen when compare to normal sleep watchmen. The present finding concludes that loss of sleep has major impact in dynamic change in mental attention and reaction time among watchmen employed in night shift. Professional regulations and work schedules should integrate sleep schedules before and during the work period as an essential dimension for their healthy life.

  8. Sleep restriction may lead to disruption in physiological attention and reaction time.

    Science.gov (United States)

    Choudhary, Arbind Kumar; Kishanrao, Sadawarte Sahebrao; Dadarao Dhanvijay, Anup Kumar; Alam, Tanwir

    2016-01-01

    Sleepiness is the condition where for some reason fails to go into a sleep state and will have difficulty in remaining awake even while carrying out activities. Sleep restriction occurs when an individual fails to get enough sleep due to high work demands. The mechanism between sleep restriction and underlying brain physiology deficits is not well assumed. The objective of the present study was to investigate the mental attention (P300) and reaction time [visual (VRT) and auditory (ART)] among night watchmen, at subsequent; first (1st) day, fourth (4th) day and seventh (7th) day of restricted sleep period. After exclusion and inclusion criteria, the study was performed among 50 watchmen (age=18-35 years) (n=50) after providing written informed consent and divided into two group. Group I-(Normal sleep) (n=28) working in day time and used to have normal sleep in night (≥8 h); Group II-(Restricted sleep) (n=22) - working in night time and used to have less sleep in night (≤3 h). Statistical significance between the different groups was determined by the independent student 't' test and the significance level was fixed at p≤0.05. We observed that among all normal and restricted sleep watchmen there was not any significant variation in Karolinska Sleepiness Scale (KSS) score, VRT and ART, along with latency and amplitude of P300 on 1st day of restricted sleep. However at subsequent on 4th day and 7th day of restricted sleep, there was significant increase in (KSS)score, and prolongation of VRT and ART as well as alteration in latency and amplitude of P300 wave in restricted sleep watchmen when compare to normal sleep watchmen. The present finding concludes that loss of sleep has major impact in dynamic change in mental attention and reaction time among watchmen employed in night shift. Professional regulations and work schedules should integrate sleep schedules before and during the work period as an essential dimension for their healthy life.

  9. Physical capability scale: psychometric testing.

    Science.gov (United States)

    Resnick, Barbara; Boltz, Marie; Galik, Elizabeth; Wells, Chris

    2013-02-01

    The purpose of this study was to describe the psychometric testing of the Basic Physical Capability Scale. The study was a secondary data analysis of combined data sets from three studies. Study participants included 93 older adults, recruited from 2 acute-care settings and 110 older adults living in long-term care facilities. Rasch analysis was used for the testing of the measurement model. There was some support for construct validity based on the fit of the items to the scale across both samples. In addition, there was support for hypothesis testing as physical function was significantly associated with physical capability. There was evidence for internal consistency (Alpha coefficients of .77-.83) and interrater reliability based on an intraclass correlation of .81. This study provided preliminary support for the reliability and validity of the Basic Physical Capability Scale, and guidance for scale revisions and continued use.

  10. Pilot Scale Advanced Fogging Demonstration

    Energy Technology Data Exchange (ETDEWEB)

    Demmer, Rick L. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Fox, Don T. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Archiblad, Kip E. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-01-01

    Experiments in 2006 developed a useful fog solution using three different chemical constituents. Optimization of the fog recipe and use of commercially available equipment were identified as needs that had not been addressed. During 2012 development work it was noted that low concentrations of the components hampered coverage and drying in the United Kingdom’s National Nuclear Laboratory’s testing much more so than was evident in the 2006 tests. In fiscal year 2014 the Idaho National Laboratory undertook a systematic optimization of the fogging formulation and conducted a non-radioactive, pilot scale demonstration using commercially available fogging equipment. While not as sophisticated as the equipment used in earlier testing, the new approach is much less expensive and readily available for smaller scale operations. Pilot scale testing was important to validate new equipment of an appropriate scale, optimize the chemistry of the fogging solution, and to realize the conceptual approach.

  11. Fluid dynamics: Swimming across scales

    Science.gov (United States)

    Baumgart, Johannes; Friedrich, Benjamin M.

    2014-10-01

    The myriad creatures that inhabit the waters of our planet all swim using different mechanisms. Now, a simple relation links key physical observables of underwater locomotion, on scales ranging from millimetres to tens of metres.

  12. Hidden scale invariance of metals

    DEFF Research Database (Denmark)

    Hummel, Felix; Kresse, Georg; Dyre, Jeppe C.

    2015-01-01

    available. Hidden scale invariance is demonstrated in detail for magnesium by showing invariance of structure and dynamics. Computed melting curves of period three metals follow curves with invariance (isomorphs). The experimental structure factor of magnesium is predicted by assuming scale invariant...... of metals making the condensed part of the thermodynamic phase diagram effectively one dimensional with respect to structure and dynamics. DFT computed density scaling exponents, related to the Grüneisen parameter, are in good agreement with experimental values for the 16 elements where reliable data were......Density functional theory (DFT) calculations of 58 liquid elements at their triple point show that most metals exhibit near proportionality between the thermal fluctuations of the virial and the potential energy in the isochoric ensemble. This demonstrates a general “hidden” scale invariance...

  13. Local Scale Invariance and Inflation

    CERN Document Server

    Singh, Naveen K

    2016-01-01

    We study the inflation and the cosmological perturbations generated during the inflation in a local scale invariant model. The local scale invariant model introduces a vector field $S_{\\mu}$ in this theory. In this paper, for simplicity, we consider the temporal part of the vector field $S_t$. We show that the temporal part is associated with the slow roll parameter of scalar field. Due to local scale invariance, we have a gauge degree of freedom. In a particular gauge, we show that the local scale invariance provides sufficient number of e-foldings for the inflation. Finally, we estimate the power spectrum of scalar perturbation in terms of the parameters of the theory.

  14. Scale locality of magnetohydrodynamic turbulence.

    Science.gov (United States)

    Aluie, Hussein; Eyink, Gregory L

    2010-02-26

    We investigate the scale locality of cascades of conserved invariants at high kinetic and magnetic Reynold's numbers in the "inertial-inductive range" of magnetohydrodynamic (MHD) turbulence, where velocity and magnetic field increments exhibit suitable power-law scaling. We prove that fluxes of total energy and cross helicity-or, equivalently, fluxes of Elsässer energies-are dominated by the contributions of local triads. Flux of magnetic helicity may be dominated by nonlocal triads. The magnetic stretching term may also be dominated by nonlocal triads, but we prove that it can convert energy only between velocity and magnetic modes at comparable scales. We explain the disagreement with numerical studies that have claimed conversion nonlocally between disparate scales. We present supporting data from a 1024{3} simulation of forced MHD turbulence.

  15. Dimensional scaling in chemical physics

    CERN Document Server

    Avery, John; Goscinski, Osvaldo

    1993-01-01

    Dimensional scaling offers a new approach to quantum dynamical correlations. This is the first book dealing with dimensional scaling methods in the quantum theory of atoms and molecules. Appropriately, it is a multiauthor production, derived chiefly from papers presented at a workshop held in June 1991 at the Ørsted Institute in Copenhagen. Although focused on dimensional scaling, the volume includes contributions on other unorthodox methods for treating nonseparable dynamical problems and electronic correlation. In shaping the book, the editors serve three needs: an introductory tutorial for this still fledgling field; a guide to the literature; and an inventory of current research results and prospects. Part I treats basic aspects of dimensional scaling. Addressed to readers entirely unfamiliar with the subject, it provides both a qualitative overview, and a tour of elementary quantum mechanics. Part II surveys the research frontier. The eight chapters exemplify current techniques and outline results. Part...

  16. Fluctuation scaling in point processes

    CERN Document Server

    Koyama, Shinsuke

    2014-01-01

    Fluctuation scaling has universally been observed in a wide variety of phenomena. For time series describing sequences of events, it can be expressed as power function relationship between the variance and the mean of either the inter-event interval or counting statistics, depending on the measurement variables. In this article, fluctuation scaling for series of events is formulated for the first time, in which the scaling exponents in the inter-event interval and counting statistics are related. It is also shown that a simple mechanism consisting of first-passage time to a threshold for Ornstein-Uhlenbeck processes explains fluctuation scaling with various exponents depending on the subthreshold dynamics. A possible implication of the results is discussed in terms of characterizing `intrinsic' variability of neuronal discharges.

  17. Scaling of exploding pusher targets

    Energy Technology Data Exchange (ETDEWEB)

    Nuckolls, J.H.

    1977-08-22

    A theory of exploding pusher laser pusher targets is compared to results of LASNEX calculations and to Livermore experiments. A scaling relationship is described which predicts the optimum target/pulse combinations as a function of the laser power.

  18. Scaling of graphene integrated circuits

    Science.gov (United States)

    Bianchi, Massimiliano; Guerriero, Erica; Fiocco, Marco; Alberti, Ruggero; Polloni, Laura; Behnam, Ashkan; Carrion, Enrique A.; Pop, Eric; Sordan, Roman

    2015-04-01

    The influence of transistor size reduction (scaling) on the speed of realistic multi-stage integrated circuits (ICs) represents the main performance metric of a given transistor technology. Despite extensive interest in graphene electronics, scaling efforts have so far focused on individual transistors rather than multi-stage ICs. Here we study the scaling of graphene ICs based on transistors from 3.3 to 0.5 μm gate lengths and with different channel widths, access lengths, and lead thicknesses. The shortest gate delay of 31 ps per stage was obtained in sub-micron graphene ROs oscillating at 4.3 GHz, which is the highest oscillation frequency obtained in any strictly low-dimensional material to date. We also derived the fundamental Johnson limit, showing that scaled graphene ICs could be used at high frequencies in applications with small voltage swing.The influence of transistor size reduction (scaling) on the speed of realistic multi-stage integrated circuits (ICs) represents the main performance metric of a given transistor technology. Despite extensive interest in graphene electronics, scaling efforts have so far focused on individual transistors rather than multi-stage ICs. Here we study the scaling of graphene ICs based on transistors from 3.3 to 0.5 μm gate lengths and with different channel widths, access lengths, and lead thicknesses. The shortest gate delay of 31 ps per stage was obtained in sub-micron graphene ROs oscillating at 4.3 GHz, which is the highest oscillation frequency obtained in any strictly low-dimensional material to date. We also derived the fundamental Johnson limit, showing that scaled graphene ICs could be used at high frequencies in applications with small voltage swing. Electronic supplementary information (ESI) available: Discussions on the cutoff frequency fT, the maximum frequency of oscillation fmax, and the intrinsic gate delay CV/I. See DOI: 10.1039/c5nr01126d

  19. Scale issues in remote sensing

    CERN Document Server

    Weng, Qihao

    2014-01-01

    This book provides up-to-date developments, methods, and techniques in the field of GIS and remote sensing and features articles from internationally renowned authorities on three interrelated perspectives of scaling issues: scale in land surface properties, land surface patterns, and land surface processes. The book is ideal as a professional reference for practicing geographic information scientists and remote sensing engineers as well as a supplemental reading for graduate level students.

  20. Two-Dimensional Vernier Scale

    Science.gov (United States)

    Juday, Richard D.

    1992-01-01

    Modified vernier scale gives accurate two-dimensional coordinates from maps, drawings, or cathode-ray-tube displays. Movable circular overlay rests on fixed rectangular-grid overlay. Pitch of circles nine-tenths that of grid and, for greatest accuracy, radii of circles large compared with pitch of grid. Scale enables user to interpolate between finest divisions of regularly spaced rule simply by observing which mark on auxiliary vernier rule aligns with mark on primary rule.

  1. Normalization of emotion control scale

    Directory of Open Access Journals (Sweden)

    Hojatoolah Tahmasebian

    2014-09-01

    Full Text Available Background: Emotion control skill teaches the individuals how to identify their emotions and how to express and control them in various situations. The aim of this study was to normalize and measure the internal and external validity and reliability of emotion control test. Methods: This standardization study was carried out on a statistical society, including all pupils, students, teachers, nurses and university professors in Kermanshah in 2012, using Williams’ emotion control scale. The subjects included 1,500 (810 females and 690 males people who were selected by stratified random sampling. Williams (1997 emotion control scale, was used to collect the required data. Emotional Control Scale is a tool for measuring the degree of control people have over their emotions. This scale has four subscales, including anger, depressed mood, anxiety and positive affect. The collected data were analyzed by SPSS software using correlation and Cronbach's alpha tests. Results: The results of internal consistency of the questionnaire reported by Cronbach's alpha indicated an acceptable internal consistency for emotional control scale, and the correlation between the subscales of the test and between the items of the questionnaire was significant at 0.01 confidence level. Conclusion: The validity of emotion control scale among the pupils, students, teachers, nurses and teachers in Iran has an acceptable range, and the test itemswere correlated with each other, thereby making them appropriate for measuring emotion control.

  2. Fundamental Scaling Laws in Nanophotonics

    Science.gov (United States)

    Liu, Ke; Sun, Shuai; Majumdar, Arka; Sorger, Volker J.

    2016-11-01

    The success of information technology has clearly demonstrated that miniaturization often leads to unprecedented performance, and unanticipated applications. This hypothesis of “smaller-is-better” has motivated optical engineers to build various nanophotonic devices, although an understanding leading to fundamental scaling behavior for this new class of devices is missing. Here we analyze scaling laws for optoelectronic devices operating at micro and nanometer length-scale. We show that optoelectronic device performance scales non-monotonically with device length due to the various device tradeoffs, and analyze how both optical and electrical constrains influence device power consumption and operating speed. Specifically, we investigate the direct influence of scaling on the performance of four classes of photonic devices, namely laser sources, electro-optic modulators, photodetectors, and all-optical switches based on three types of optical resonators; microring, Fabry-Perot cavity, and plasmonic metal nanoparticle. Results show that while microrings and Fabry-Perot cavities can outperform plasmonic cavities at larger length-scales, they stop working when the device length drops below 100 nanometers, due to insufficient functionality such as feedback (laser), index-modulation (modulator), absorption (detector) or field density (optical switch). Our results provide a detailed understanding of the limits of nanophotonics, towards establishing an opto-electronics roadmap, akin to the International Technology Roadmap for Semiconductors.

  3. Fundamental Scaling Laws in Nanophotonics.

    Science.gov (United States)

    Liu, Ke; Sun, Shuai; Majumdar, Arka; Sorger, Volker J

    2016-11-21

    The success of information technology has clearly demonstrated that miniaturization often leads to unprecedented performance, and unanticipated applications. This hypothesis of "smaller-is-better" has motivated optical engineers to build various nanophotonic devices, although an understanding leading to fundamental scaling behavior for this new class of devices is missing. Here we analyze scaling laws for optoelectronic devices operating at micro and nanometer length-scale. We show that optoelectronic device performance scales non-monotonically with device length due to the various device tradeoffs, and analyze how both optical and electrical constrains influence device power consumption and operating speed. Specifically, we investigate the direct influence of scaling on the performance of four classes of photonic devices, namely laser sources, electro-optic modulators, photodetectors, and all-optical switches based on three types of optical resonators; microring, Fabry-Perot cavity, and plasmonic metal nanoparticle. Results show that while microrings and Fabry-Perot cavities can outperform plasmonic cavities at larger length-scales, they stop working when the device length drops below 100 nanometers, due to insufficient functionality such as feedback (laser), index-modulation (modulator), absorption (detector) or field density (optical switch). Our results provide a detailed understanding of the limits of nanophotonics, towards establishing an opto-electronics roadmap, akin to the International Technology Roadmap for Semiconductors.

  4. Scale Of Fermion Mass Generation

    CERN Document Server

    Niczyporuk, J M

    2002-01-01

    Unitarity of longitudinal weak vector boson scattering implies an upper bound on the scale of electroweak symmetry breaking, Λ EWSB ≡ 8pv ≈ 1 TeV. Appelquist and Chanowitz have derived an analogous upper bound on the scale of fermion mass generation, proportional to v 2/mf, by considering the scattering of same-helicity fermions into pairs of longitudinal weak vector bosons in a theory without a standard Higgs boson. We show that there is no upper bound, beyond that on the scale of electroweak symmetry breaking, in such a theory. This result is obtained by considering the same process, but with a large number of longitudinal weak vector bosons in the final state. We further argue that there is no scale of (Dirac) fermion mass generation in the standard model. In contrast, there is an upper bound on the scale of Majorana-neutrino mass generation, given by ΛMaj ≡ 4πv2/m ν. In general, the upper bound on the scale of fermion mass generation depend...

  5. Chemical Measurement and Fluctuation Scaling.

    Science.gov (United States)

    Hanley, Quentin S

    2016-12-20

    Fluctuation scaling reports on all processes producing a data set. Some fluctuation scaling relationships, such as the Horwitz curve, follow exponential dispersion models which have useful properties. The mean-variance method applied to Poisson distributed data is a special case of these properties allowing the gain of a system to be measured. Here, a general method is described for investigating gain (G), dispersion (β), and process (α) in any system whose fluctuation scaling follows a simple exponential dispersion model, a segmented exponential dispersion model, or complex scaling following such a model locally. When gain and dispersion cannot be obtained directly, relative parameters, GR and βR, may be used. The method was demonstrated on data sets conforming to simple, segmented, and complex scaling. These included mass, fluorescence intensity, and absorbance measurements and specifications for classes of calibration weights. Changes in gain, dispersion, and process were observed in the scaling of these data sets in response to instrument parameters, photon fluxes, mathematical processing, and calibration weight class. The process parameter which limits the type of statistical process that can be invoked to explain a data set typically exhibited 0 4 possible. With two exceptions, calibration weight class definitions only affected β. Adjusting photomultiplier voltage while measuring fluorescence intensity changed all three parameters (0 < α < 0.8; 0 < βR < 3; 0 < GR < 4.1). The method provides a framework for calibrating and interpreting uncertainty in chemical measurement allowing robust comparison of specific instruments, conditions, and methods.

  6. Feasibility of scaling from pilot to process scale.

    Science.gov (United States)

    Ignatova, Svetlana; Wood, Philip; Hawes, David; Janaway, Lee; Keay, David; Sutherland, Ian

    2007-06-01

    The pharmaceutical industry is looking for new technology that is easy to scale up from analytical to process scale and is cheap and reliable to operate. Large scale counter-current chromatography is an emerging technology that could provide this advance, but little was known about the key variables affecting scale-up. This paper investigates two such variables: the rotor radius and the tubing bore. The effect of rotor radius was studied using identical: length, beta-value, helix angle and tubing bore coils for rotors of different radii (50 mm, 110 mm and 300 mm). The effect of bore was researched using identical: length, helix angle and mean beta-value coils on the Maxi-DE centrifuge (R=300 mm). The rotor radius results show that there is very little difference in retention and resolution as rotor radius increases at constant bore. The tubing bore results show that good retention is maintained as bore increases and resolution only decrease slightly, but at the highest bore (17.5 mm) resolution can be maintained at very high flow rates making it possible for process scale centrifuges to be designed with throughputs exceeding 25 kg/day.

  7. Non-Suicidal Self-Injury and Interpersonal Violence in Suicide Attempters.

    Science.gov (United States)

    Sahlin, Hanna; Moberg, Tomas; Hirvikoski, Tatja; Jokinen, Jussi

    2015-01-01

    The current study compared characteristics of suicidal behavior and interpersonal violence in suicide attempters with and without a history of non-suicidal self-injury (NSSI). A total of 100 suicide attempters were assessed with Karolinska Interpersonal Violence Scale (KIVS) and Karolinska Suicide History Interview concerning interpersonal violence and NSSI. There was a high degree of comorbid NSSI in suicide attempters (44%). Suicide attempters with NSSI-history reported more interpersonal violence as adults and more severe suicidal behavior compared to suicide attempters without NSSI. Comorbid NSSI was related to severity of suicidal behavior in a gender specific manner. Comorbid NSSI in suicide attempters may increase suicide and violence risk.

  8. On the scaling of small-scale jet noise to large scale

    Science.gov (United States)

    Soderman, Paul T.; Allen, Christopher S.

    1992-01-01

    An examination was made of several published jet noise studies for the purpose of evaluating scale effects important to the simulation of jet aeroacoustics. Several studies confirmed that small conical jets, one as small as 59 mm diameter, could be used to correctly simulate the overall or perceived noise level (PNL) noise of large jets dominated by mixing noise. However, the detailed acoustic spectra of large jets are more difficult to simulate because of the lack of broad-band turbulence spectra in small jets. One study indicated that a jet Reynolds number of 5 x 10(exp 6) based on exhaust diameter enabled the generation of broad-band noise representative of large jet mixing noise. Jet suppressor aeroacoustics is even more difficult to simulate at small scale because of the small mixer nozzles with flows sensitive to Reynolds number. Likewise, one study showed incorrect ejector mixing and entrainment using a small-scale, short ejector that led to poor acoustic scaling. Conversely, fairly good results were found with a longer ejector and, in a different study, with a 32-chute suppressor nozzle. Finally, it was found that small-scale aeroacoustic resonance produced by jets impacting ground boards does not reproduce at large scale.

  9. Scale Construction: Motivation and Relationship Scale in Education

    Directory of Open Access Journals (Sweden)

    Yunus Emre Demir

    2016-01-01

    Full Text Available The aim of this study is to analyze the validity and reliability of the Turkish version of Motivation and Relationship Scale (MRS, (Raufelder , Drury , Jagenow , Hoferichter & Bukowski , 2013.Participants were 526 students of secondary school. The results of confirmatory factor analysis described that the 21 items loaded three factor and the three-dimensional model was well fit (x2= 640.04, sd= 185, RMSEA= .068, NNFI= .90, CFI = .91, IFI=.91,SRMR=079, GFI= .90,AGFI=.87. Overall findings demonstrated that this scale is a valid and indicates that the adapted MRS is a valid instrument for measuring secondary school children’s motivation in Turkey.

  10. Scaling laws of Rydberg excitons

    Science.gov (United States)

    Heckötter, J.; Freitag, M.; Fröhlich, D.; Aßmann, M.; Bayer, M.; Semina, M. A.; Glazov, M. M.

    2017-09-01

    Rydberg atoms have attracted considerable interest due to their huge interaction among each other and with external fields. They demonstrate characteristic scaling laws in dependence on the principal quantum number n for features such as the magnetic field for level crossing or the electric field of dissociation. Recently, the observation of excitons in highly excited states has allowed studying Rydberg physics in cuprous oxide crystals. Fundamentally different insights may be expected for Rydberg excitons, as the crystal environment and associated symmetry reduction compared to vacuum give not only optical access to many more states within an exciton multiplet but also extend the Hamiltonian for describing the exciton beyond the hydrogen model. Here we study experimentally and theoretically the scaling of several parameters of Rydberg excitons with n , for some of which we indeed find laws different from those of atoms. For others we find identical scaling laws with n , even though their origin may be distinctly different from the atomic case. At zero field the energy splitting of a particular multiplet n scales as n-3 due to crystal-specific terms in the Hamiltonian, e.g., from the valence band structure. From absorption spectra in magnetic field we find for the first crossing of levels with adjacent principal quantum numbers a Br∝n-4 dependence of the resonance field strength, Br, due to the dominant paramagnetic term unlike for atoms for which the diamagnetic contribution is decisive, resulting in a Br∝n-6 dependence. By contrast, the resonance electric field strength shows a scaling as Er∝n-5 as for Rydberg atoms. Also similar to atoms with the exception of hydrogen we observe anticrossings between states belonging to multiplets with different principal quantum numbers at these resonances. The energy splittings at the avoided crossings scale roughly as n-4, again due to crystal specific features in the exciton Hamiltonian. The data also allow us to

  11. Featured Invention: Laser Scaling Device

    Science.gov (United States)

    Dunn, Carol Anne

    2008-01-01

    In September 2003, NASA signed a nonexclusive license agreement with Armor Forensics, a subsidiary of Armor Holdings, Inc., for the laser scaling device under the Innovative Partnerships Program. Coupled with a measuring program, also developed by NASA, the unit provides crime scene investigators with the ability to shoot photographs at scale without having to physically enter the scene, analyzing details such as bloodspatter patterns and graffiti. This ability keeps the scene's components intact and pristine for the collection of information and evidence. The laser scaling device elegantly solved a pressing problem for NASA's shuttle operations team and also provided industry with a useful tool. For NASA, the laser scaling device is still used to measure divots or damage to the shuttle's external tank and other structures around the launchpad. When the invention also met similar needs within industry, the Innovative Partnerships Program provided information to Armor Forensics for licensing and marketing the laser scaling device. Jeff Kohler, technology transfer agent at Kennedy, added, "We also invited a representative from the FBI's special photography unit to Kennedy to meet with Armor Forensics and the innovator. Eventually the FBI ended up purchasing some units. Armor Forensics is also beginning to receive interest from DoD [Department of Defense] for use in military crime scene investigations overseas."

  12. Definition of a nucleophilicity scale.

    Science.gov (United States)

    Jaramillo, Paula; Pérez, Patricia; Contreras, Renato; Tiznado, William; Fuentealba, Patricio

    2006-07-06

    This work deals with exploring some empirical scales of nucleophilicity. We have started evaluating the experimental indices of nucleophilicity proposed by Legon and Millen on the basis of the measure of the force constants derived from vibrational frequencies using a probe dipole H-X (X = F,CN). The correlation among some theoretical parameters with this experimental scale has been evaluated. The theoretical parameters have been chosen as the minimum of the electrostatic potential V(min), the binding energy (BE) between the nucleophile and the H-X dipole, and the electrostatic potential measured at the position of the hydrogen atom V(H) when the complex nucleophile and dipole H-X is in the equilibrium geometry. All of them present good correlations with the experimental nucleophilicity scale. In addition, the BEs of the nucleophiles with two other Lewis acids (one hard, BF(3), and the other soft, BH(3)) have been evaluated. The results suggest that the Legon and Millen nucleophilicity scale and the electrostatic potential derived scales can describe in good approximation the reactivity order of the nucleophiles only when the interactions with a probe electrophile is of the hard-hard type. For a covalent interaction that is orbital controlled, a new nucleophilicity index using information of the frontier orbitals of both, the nucleophile and the electrophile has been proposed.

  13. Scales of Natural Flood Management

    Science.gov (United States)

    Nicholson, Alex; Quinn, Paul; Owen, Gareth; Hetherington, David; Piedra Lara, Miguel; O'Donnell, Greg

    2016-04-01

    The scientific field of Natural flood Management (NFM) is receiving much attention and is now widely seen as a valid solution to sustainably manage flood risk whilst offering significant multiple benefits. However, few examples exist looking at NFM on a large scale (>10km2). Well-implemented NFM has the effect of restoring more natural catchment hydrological and sedimentological processes, which in turn can have significant flood risk and WFD benefits for catchment waterbodies. These catchment scale improvements in-turn allow more 'natural' processes to be returned to rivers and streams, creating a more resilient system. Although certain NFM interventions may appear distant and disconnected from main stem waterbodies, they will undoubtedly be contributing to WFD at the catchment waterbody scale. This paper offers examples of NFM, and explains how they can be maximised through practical design across many scales (from feature up to the whole catchment). New tools to assist in the selection of measures and their location, and to appreciate firstly, the flooding benefit at the local catchment scale and then show a Flood Impact Model that can best reflect the impacts of local changes further downstream. The tools will be discussed in the context of our most recent experiences on NFM projects including river catchments in the north east of England and in Scotland. This work has encouraged a more integrated approach to flood management planning that can use both traditional and novel NFM strategies in an effective and convincing way.

  14. Allometric scaling in-vitro

    Science.gov (United States)

    Ahluwalia, Arti

    2017-02-01

    About two decades ago, West and coworkers established a model which predicts that metabolic rate follows a three quarter power relationship with the mass of an organism, based on the premise that tissues are supplied nutrients through a fractal distribution network. Quarter power scaling is widely considered a universal law of biology and it is generally accepted that were in-vitro cultures to obey allometric metabolic scaling, they would have more predictive potential and could, for instance, provide a viable substitute for animals in research. This paper outlines a theoretical and computational framework for establishing quarter power scaling in three-dimensional spherical constructs in-vitro, starting where fractal distribution ends. Allometric scaling in non-vascular spherical tissue constructs was assessed using models of Michaelis Menten oxygen consumption and diffusion. The models demonstrate that physiological scaling is maintained when about 5 to 60% of the construct is exposed to oxygen concentrations less than the Michaelis Menten constant, with a significant concentration gradient in the sphere. The results have important implications for the design of downscaled in-vitro systems with physiological relevance.

  15. Visions of Atomic Scale Tomography

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, T. F. [Cameca Instruments; Miller, Michael K [ORNL; Rajan, Krishna [Iowa State University; Ringer, S. P. [University of Sydney, Australia

    2012-01-01

    A microscope, by definition, provides structural and analytical information about objects that are too small to see with the unaided eye. From the very first microscope, efforts to improve its capabilities and push them to ever-finer length scales have been pursued. In this context, it would seem that the concept of an ultimate microscope would have received much attention by now; but has it really ever been defined? Human knowledge extends to structures on a scale much finer than atoms, so it might seem that a proton-scale microscope or a quark-scale microscope would be the ultimate. However, we argue that an atomic-scale microscope is the ultimate for the following reason: the smallest building block for either synthetic structures or natural structures is the atom. Indeed, humans and nature both engineer structures with atoms, not quarks. So far as we know, all building blocks (atoms) of a given type are identical; it is the assembly of the building blocks that makes a useful structure. Thus, would a microscope that determines the position and identity of every atom in a structure with high precision and for large volumes be the ultimate microscope? We argue, yes. In this article, we consider how it could be built, and we ponder the answer to the equally important follow-on questions: who would care if it is built, and what could be achieved with it?

  16. 30 CFR 56.3202 - Scaling tools.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Scaling tools. 56.3202 Section 56.3202 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-SURFACE METAL AND NONMETAL MINES Ground Control Scaling and Support § 56.3202 Scaling tools. Where manual scaling is performed, a scaling bar shall be provided. This...

  17. 30 CFR 57.3202 - Scaling tools.

    Science.gov (United States)

    2010-07-01

    ... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Scaling tools. 57.3202 Section 57.3202 Mineral... HEALTH SAFETY AND HEALTH STANDARDS-UNDERGROUND METAL AND NONMETAL MINES Ground Control Scaling and Support-Surface and Underground § 57.3202 Scaling tools. Where manual scaling is performed, a scaling...

  18. Large Scale Dynamos in Stars

    Science.gov (United States)

    Vishniac, Ethan T.

    2015-01-01

    We show that a differentially rotating conducting fluid automatically creates a magnetic helicity flux with components along the rotation axis and in the direction of the local vorticity. This drives a rapid growth in the local density of current helicity, which in turn drives a large scale dynamo. The dynamo growth rate derived from this process is not constant, but depends inversely on the large scale magnetic field strength. This dynamo saturates when buoyant losses of magnetic flux compete with the large scale dynamo, providing a simple prediction for magnetic field strength as a function of Rossby number in stars. Increasing anisotropy in the turbulence produces a decreasing magnetic helicity flux, which explains the flattening of the B/Rossby number relation at low Rossby numbers. We also show that the kinetic helicity is always a subdominant effect. There is no kinematic dynamo in real stars.

  19. The Satisfaction With Life Scale.

    Science.gov (United States)

    Diener, E; Emmons, R A; Larsen, R J; Griffin, S

    1985-02-01

    This article reports the development and validation of a scale to measure global life satisfaction, the Satisfaction With Life Scale (SWLS). Among the various components of subjective well-being, the SWLS is narrowly focused to assess global life satisfaction and does not tap related constructs such as positive affect or loneliness. The SWLS is shown to have favorable psychometric properties, including high internal consistency and high temporal reliability. Scores on the SWLS correlate moderately to highly with other measures of subjective well-being, and correlate predictably with specific personality characteristics. It is noted that the SWLS is Suited for use with different age groups, and other potential uses of the scale are discussed.

  20. Hidden scale in quantum mechanics

    CERN Document Server

    Giri, Pulak Ranjan

    2007-01-01

    We show that the intriguing localization of a free particle wave-packet is possible due to a hidden scale present in the system. Self-adjoint extensions (SAE) is responsible for introducing this scale in quantum mechanical models through the nontrivial boundary conditions. We discuss a couple of classically scale invariant free particle systems to illustrate the issue. In this context it has been shown that a free quantum particle moving on a full line may have localized wave-packet around the origin. As a generalization, it has also been shown that particles moving on a portion of a plane or on a portion of a three dimensional space can have unusual localized wave-packet.