Countermeasures for sleep loss and deprivation

Stanford University Center of Excellence for Sleep Disorders, 401 Quarry Road, Suite 3301, Stanford, CA 94305, USA. .
Current Treatment Options in Neurology (Impact Factor: 1.94). 10/2006; 8(5):361-6. DOI: 10.1007/s11940-006-0025-7
Source: PubMed


Sleep deprivation is ubiquitous and carries profound consequences in terms of personal and public health and safety. There is no substitute for a good night's sleep. Sleep that is optimal in quality and quantity for individuals, factoring in their age and personal sleep requirements, will minimize sleep debt and maximize daytime performance. Therefore, setting aside an adequate amount of time for sleep should be a priority; sleep should not be sacrificed at the expense of other activities of daily living. Nevertheless, there are certain therapeutic countermeasures available for individuals who are unable to obtain adequate sleep because of medical or sleep-related conditions (eg, narcolepsy, obstructive sleep apnea) when excessive daytime sleepiness is the main feature of the condition, or residual sleepiness despite treatment for the main conditions is present. These therapeutic countermeasures may also be considered in situations in which occupational constraints (eg, rotating shift work, military duty) dictate that constant or heightened vigilance is important or critical to work performance, crucial decision making, and/or survival. Exploration of the causes of sleep loss or deprivation, whether it is voluntary, or work or family induced, and/or the effects of a medical or sleep disorder, is a necessary first step in the evaluation of a patient who has significant daytime fatigue or sleepiness. Wake-promoting substances and medications such as caffeine, modafinil, methylphenidate, and dextroamphetamine may be considered in situations in which sleep loss is unavoidable or persists despite treatment of an underlying disorder that is characterized by or associated with daytime fatigue or sleepiness.

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    • "Interventions addressing farmrelated injury need to consider the role of sleep quantity. Any intervention to reduce daytime sleepiness should initially focus on increasing sleep quantity; however, therapeutic countermeasures to reduce daytime sleepiness are available [Driskell and Mullen, 2005; Kushida, 2006]. Our study provides new evidence that seasonal fatigue-related factors are associated with agricultural workrelated injuries among the Saskatchewan farm community. "
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    ABSTRACT: The objective was to examine the relationship between seasonal variations in sleep quantity and work-related injuries on Saskatchewan farms. A cross-sectional analysis of data from the Saskatchewan Farm Injury Cohort Study was conducted. Analyses were restricted to workers, aged ≥16 years. The primary outcome was work-related injury in the last year. Logistic regression models were used to identify associations between sleep quantity and farm injury. After controlling for confounding variables peak production season sleep was not associated with increased odds of injury. However, those obtaining ≤5 hr sleep per night during non-peak production seasons had increased odds of injury (OR 2.42, 95% CI 1.04-5.59) compared with those sleeping ≥7 hr per night. We identified that restricted sleep durations, in certain seasons, placed farmers, and farm workers at risk of injury. Agricultural injury intervention programs need to consider the role of seasonal-related variations in sleep on farm injury.
    American Journal of Industrial Medicine 04/2012; 55(4):367-75. DOI:10.1002/ajim.22003 · 1.74 Impact Factor
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    • "Insufficient sleep can have deleterious effects on personal health, cognitive performance, and safety [1] [2] [3]. "
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    ABSTRACT: Insufficient sleep can adversely affect a variety of cognitive abilities, ranging from simple alertness to higher-order executive functions. Although the effects of sleep loss on mood and cognition are well documented, there have been no controlled studies examining its effects on perceived emotional intelligence (EQ) and constructive thinking, abilities that require the integration of affect and cognition and are central to adaptive functioning. Twenty-six healthy volunteers completed the Bar-On Emotional Quotient Inventory (EQi) and the Constructive Thinking Inventory (CTI) at rested baseline and again after 55.5 and 58 h of continuous wakefulness, respectively. Relative to baseline, sleep deprivation was associated with lower scores on Total EQ (decreased global emotional intelligence), Intrapersonal functioning (reduced self-regard, assertiveness, sense of independence, and self-actualization), Interpersonal functioning (reduced empathy toward others and quality of interpersonal relationships), Stress Management skills (reduced impulse control and difficulty with delay of gratification), and Behavioral Coping (reduced positive thinking and action orientation). Esoteric Thinking (greater reliance on formal superstitions and magical thinking processes) was increased. These findings are consistent with the neurobehavioral model suggesting that sleep loss produces temporary changes in cerebral metabolism, cognition, emotion, and behavior consistent with mild prefrontal lobe dysfunction.
    Sleep Medicine 08/2008; 9(5):517-26. DOI:10.1016/j.sleep.2007.07.003 · 3.15 Impact Factor
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    ABSTRACT: An active cortex is necessary for intact cognitive function. In a sleepy individual, the cerebral cortex is to some extent deactivated; a sleep-deprived person will experience reduced physical and mental activity and productivity, more errors on the job, more risk for motor vehicle accidents, and psychosocial problems. Hormone levels can become imbalanced from excessive daytime sleepiness (EDS), and treatments for conditions unrelated to EDS can be hampered. Whether sleep restriction is voluntary or not, those who experience it habitually are at greater risk of obesity and type 2 diabetes. While an accurate history is necessary to diagnose sleep disorders, all too often a patient's chronic daytime sleepiness is never mentioned. EDS will not show up in most blood chemistries either. It is important that primary care providers ask patients about their sleep and its quality. Other screening tools include questionnaires, which are easily administered and can be sensitive. To determine the basis of EDS, formal sleep studies may be necessary.
    The American journal of managed care 12/2007; 13(6 Suppl):S140-7. · 2.26 Impact Factor
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