Optimisation d’une sieste en milieu professionnel : Apport des techniques d’optimisation du potentiel (TOP) pour l’approfondissement du sommeil
Abstract and Figures
Objectif
L’objectif de cette etude est d’evaluer l’efficacite d’une contre-mesure apportee par des techniques militaires pour optimiser la sieste de volontaires sains sur leur lieu de travail. Plus particulierement, l’efficacite sur la latence d’endormissement et sur la profondeur du sommeil d’une sieste accompagnee par des suggestions hypnotiques, dans le cadre d’un programme d’optimisation du potentiel (TOP), en comparaison a une sieste « sans TOP » a ete investiguee.
Methodes
Onze volontaires sains (9H et 2F, 37–52 ans) equipes d’une PSG miniaturisee (3 EEG : F3, C3, O1), 1 EOG et 1 EMG se pretent a 2 conditions de siestes : 4 siestes « sans TOP » de 30 min et 4 siestes de 30 min accompagnees d’un programme TOP.
Resultats
Le pourcentage de temps total de sommeil, le % de temps passe en N2 et le % de temps passe en N3 augmentent respectivement de 11, 11 et 8 % lorsque la seance est dirigee par un instructeur TOP par rapport a une sieste sans TOP. Ces resultats sont confirmes par l’analyse par sieste. L’evaluation individuelle montre que le benefice de ce programme TOP s’applique a 7 sujets sur 11 quant a l’augmentation du % de temps de sommeil, a 8 sujets quant au %N2 et a 6 sujets quant au %N3.
Conclusion
L’utilisation des TOP et plus particulierement de la suggestion hypnotique, apparait comme une maniere efficace d’optimiser un temps court de sieste (30 min) en augmentant a la fois la duree totale de sommeil et sa profondeur, chez plus de la moitie des sujets.
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Objectives
Professional burnout is closely related to work stress but less frequently associated with disturbed sleep. This study determines whether job strain and sleep disturbances are associated risk factors of burnout among financial workers.
Design
Observational study.
Participants
1300 employees (725 female) of a financial company.
Primary measures
Self-reported questionnaires (Maslach Burnout Inventory, Job Content Questionnaire, Sleep questionnaire based on ICSD-3 classification), the Epworth sleepiness scale and the Hospital Anxiety and Depression Scale (HADS).
Result
The prevalence of burnout was 10.2% (9.0% moderate and 1.2% severe). 23.3% of workers were considered with high job strain, and 93.1% had a high level of job satisfaction. 16.8% of individuals had insomnia and 97% reported non-restorative sleep. The bivariate analyses demonstrate a higher risk of burnout in participants with insomnia (OR=14.7, 95% CI 9.8 to 21.9), non-restorative sleep (OR=9.9, 95% CI 5.1 to 19.5) and anxiety (OR=10.2, 95% CI 6.8 to 15.3). High job strain was associated with burnout (OR=1.9, 95% CI 1.1 to 3.6). This association was not maintained after adjustment for sleep parameters. Job satisfaction was another independent risk factor for burnout (OR=124, 95% CI 65 to 237).
Conclusions
In our sample of financial workers, job strain represents a burnout risk factor only if associated with insomnia. Insomnia can be considered as a relevant clinical marker that should be targeted in mental health prevention programmes at the workplace.
Chronic sleep restriction (CSR) induces neurobehavioral deficits in young and healthy people with a morning failure of sustained attention process. Testing both the kinetic of failure and recovery of different cognitive processes (i.e. attention, executive) under CSR and their potential links with subject’s capacities (stay awake, baseline performance, age) and with some biological markers of stress and anabolism would be useful in order to understand the role of sleep debt on human behavior. Twelve healthy subjects spent 14 days in laboratory with 2 baseline days (B1 and B2, 8h TIB) followed by 7 days of sleep restriction (SR1-SR7, 4h TIB), 3 sleep recovery days (R1-R3, 8h TIB) and 2 more ones 8 days later (R12-R13). Subjective sleepiness (KSS), maintenance of wakefulness latencies (MWT) were evaluated 4 times a day (10:00, 12:00 a.m. and 2:00, 4:00 p.m.) and cognitive tests were realized at morning (8:30 a.m.) and evening (6:30 p.m.) sessions during B2, SR1, SR4, SR7, R2, R3 and R13. Saliva (B2, SR7, R2, R13) and blood (B1, SR6, R1, R12) samples were collected in the morning. Cognitive processes were differently impaired and recovered with a more rapid kinetic for sustained attention process. Besides, a significant time of day effect was only evidenced for sustained attention failures that seemed to be related to subject’s age and their morning capacity to stay awake. Executive processes were equally disturbed/recovered during the day and this failure/recovery process seemed to be mainly related to baseline subject’s performance and to their capacity to stay awake. Morning concentrations of testosterone, cortisol and α-amylase were significantly decreased at SR6-SR7, but were either and respectively early (R1), tardily (after R2) and no recovered (R13). All these results suggest a differential deleterious and restorative effect of CSR on cognition through biological changes of the stress pathway and subject’s capacity (ClinicalTrials-NCT01989741).
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.
Sleep loss may induce endothelial dysfunction, a key factor in cardiovascular risk. We examined the endothelial function during one week of sleep restriction and a recovery period (from 3-to-13days) in healthy subjects, and its link to autonomic, inflammatory and/or endocrine responses.
12 men were followed at baseline (B1, 8-h sleep), after 2 (SR2) and 6 (SR6) days of SR (4-h sleep: 02:00-06:00) and after 1 (R1) and 12 (R12) recovery nights (8h sleep). At 10:00, we assessed changes in: arm cutaneous vascular conductance (CVC) induced by local application of methacholine (MCh), cathodal current (CIV) and heat (44°C), finger CVC and skin temperature (Tfi) during local cold exposure (5°C, 20-min) and passive recovery (22°C, 20-min). Blood samples were collected at 08:00.
Compared with baseline (B1), MCh and heat-induced maximal CVC values (CVCpeak) were decreased at SR6 and R1. No effect of SR was observed for Tfi and CVC during immersion whereas these values were lower during passive recovery on SR6 and R1. From SR2 to R12, plasma concentrations of insulin, IGF-1 (total and free) and MCP-1 were significantly increased while those of testosterone and prolactin were decreased. Whole-blood blood mRNA concentrations of TNF-α and IL-1β were higher than B1. No changes in noradrenaline concentrations, heart rate and blood pressure were observed.
These results demonstrate that SR reduces endothelial-dependent vasodilatation and local tolerance to cold. This endothelial dysfunction is independent of blood pressure and sympathetic activity but associated with inflammatory and metabolic pathway responses (ClinicalTrials-NCT01989741).
Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Context:
Neuroendocrine and immune stresses imposed by chronic sleep restriction are known to be involved in the harmful cardiovascular effects associated with poor sleep.
Objectives:
Despite a well-known beneficial effect of napping on alertness, its effects on neuroendocrine stress and immune responses after sleep restriction are largely unknown.
Design:
This study was a strictly controlled (sleep-wake status, light environment, caloric intake), crossover, randomized design in continuously polysomnography-monitored subjects.
Setting:
The study was conducted in a laboratory-based study.
Participants:
The subjects were 11 healthy young men.
Intervention:
We investigated the effects on neuroendocrine and immune biomarkers of a night of sleep restricted to 2 h followed by a day without naps or with 30 minute morning and afternoon naps, both conditions followed by an ad libitum recovery night starting at 20:00.
Main outcome measures:
Salivary interleukin-6 and urinary catecholamines were assessed throughout the daytime study periods.
Results:
The increase in norepinephrine values seen at the end of the afternoon after the sleep-restricted night was not present when the subjects had the opportunity to take naps. Interleukin-6 changes observed after sleep deprivation were also normalized after napping. During the recovery day in the no-nap condition, there were increased levels of afternoon epinephrine and dopamine, which was not the case in the nap condition. A recovery night after napping was associated with a reduced amount of slow-wave sleep compared to after the no-nap condition.
Conclusions:
Our data suggest that napping has stress-releasing and immune effects. Napping could be easily applied in real settings as a countermeasure to the detrimental health consequences of sleep debt.
Sleep is critical for military operational readiness but is commonly disregarded during operational planning. The start of combat operations with Operation Iraqi Freedom saw a dramatic rise in diagnosis rates of clinically significant sleep disorders among officers and enlisted. This coincided with a parallel rise in behavioral health disorders. In this article, the etiology of sleep problems and sleep disorders in our military population is reviewed, and guidance is provided for improving sleep health in our military population. It is our view that appropriate sleep planning and management affords military units and commanders a near-term tactical advantage in terms of maintaining alertness, a midterm tactical advantage of decreasing susceptibility to sleep and behavioral health disorders, and a long-term strategic advantage with increased readiness and resiliency of their Soldiers.
Sleep specialists have proposed measures to counteract the negative short- and long-term consequences of sleep debt, and some have suggested the nap as a potential and powerful “public health tool”. Here, we address this countermeasure aspect of napping viewed as an action against sleep deprivation rather than an action associated with poor health. We review the physiological functions that have been associated positively with napping in both public health and clinical settings (sleep-related accidents, work and school, and cardiovascular risk) and in laboratory-based studies with potential public health issues (cognitive performance, stress, immune function and pain sensitivity). We also discuss the circumstances in which napping—depending on several factors, including nap duration, frequency, and age—could be a potential public health tool and a countermeasure for sleep loss in terms of reducing accidents and cardiovascular events and improving sleep-restriction-sensitive working performance. However, the impact of napping and the nature of the sleep stage(s) involved still need to be evaluated, especially from the perspective of coping strategies in populations with chronic sleep debt, such as night and shift workers.
Objectives:
Progressive muscle relaxation (PMR) is one of the self-management relaxation techniques that can be used in the general population and patients with specific issues. However, no study to date has revealed the brain activity associated with PMR. Therefore, we assessed the changes in brain activity induced by PMR using functional magnetic resonance imaging (fMRI).
Design and setting:
We conducted an intervention study with PMR and control sessions. The subjects were twelve healthy adult men who had no prior experience of PMR.
Interventions:
Subjects performed a control session in which muscles were repeatedly simply tensed and relaxed. Subsequently, a PMR session took place, during which muscle tension was reduced through a systematic procedure of tensing and relaxing of muscle groups combined with structured breathing.
Main outcome measures:
We identified and visualised brain activity based on individual and group-level analysis of fMRI data.
Results:
Eleven subjects' data were analysed. In the control session, brain activity broadly changed, while the change was limited to specific parts of the cerebral cortex and limbic system in the PMR session. PMR gradually decreased activity in the superior frontal gyrus (SFG), inferior frontal gyrus (IFG), and posterior cingulate cortex (PCC). In a region of interest (ROI) analysis, interactions between sessions were observed in the putamen, anterior cingulate cortex (ACC), postcentral gyrus (PCG), and insula.
Conclusions:
That PMR led to few areas showing changed activity suggests that the technique may suppress brain activity. Even novices may be able to induce such a focused mental state.
