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Clocks & Sleep, Volume 6, Issue 2 (June 2024) – 6 articles

Cover Story (view full-size image): Traumatic brain injury (TBI) affects sleep, mood, and fatigue, impeding daily functioning and recovery. TBI stems from various causes, leading to long-term health management needs. Light plays a crucial role in human health, regulating circadian rhythms. Morning light exposure advances circadian rhythms, leading to earlier bedtimes, enhanced alertness, and improved mood. This systematic review explores the efficacy of morning blue light and bright white light exposure in addressing sleep, mood, and fatigue challenges in TBI patients, building upon existing literature to provide valuable insights into potential interventions for this complex condition. View this paper
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10 pages, 548 KiB  
Brief Report
Time of Day and Sleep Deprivation Effects on Risky Decision Making
by Noelia Ruiz-Herrera, Mia Friedman, Melissa A. St. Hilaire, Arturo Arrona-Palacios, Charles A. Czeisler and Jeanne F. Duffy
Clocks & Sleep 2024, 6(2), 281-290; https://doi.org/10.3390/clockssleep6020020 - 20 Jun 2024
Viewed by 1501
Abstract
Previous research has revealed that daily variations in human neurobehavioral functions are driven in part by the endogenous circadian system. The objective of this study was to explore whether there exists a circadian influence on performance regarding a risky decision-making task and to [...] Read more.
Previous research has revealed that daily variations in human neurobehavioral functions are driven in part by the endogenous circadian system. The objective of this study was to explore whether there exists a circadian influence on performance regarding a risky decision-making task and to determine whether the performance changes with sleep deprivation (SD). Thirteen participants underwent a 39 h constant routine (CR) protocol, during which they remained awake in constant conditions and performed the BART (balloon analogue risk task) every two hours. The mean pumps (gains) (p < 0.001) and balloons popped (losses) (p = 0.003) exhibited variation during the CR. The reaction time (RT) also showed significant variation across the CR (p < 0.001), with slower mean RTs in the morning hours following SD. A greater risk propensity was observed around midday before SD and a lower risk propensity after 29.5 h of being awake. The sensitivity to punishment varied during the CR, but did not follow a predictable trend. Further research using real monetary incentives and neurophysiological measures is warranted to elucidate these findings. Full article
(This article belongs to the Section Human Basic Research & Neuroimaging)
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14 pages, 609 KiB  
Article
SleepSync: Early Testing of a Personalised Sleep–Wake Management Smartphone Application for Improving Sleep and Cognitive Fitness in Defence Shift Workers
by Prerna Varma, Svetlana Postnova, Stuart Knock, Mark E. Howard, Eugene Aidman, Shantha W. M. Rajaratnam and Tracey L. Sletten
Clocks & Sleep 2024, 6(2), 267-280; https://doi.org/10.3390/clockssleep6020019 - 29 May 2024
Viewed by 1416
Abstract
Shift work, long work hours, and operational tasks contribute to sleep and circadian disruption in defence personnel, with profound impacts on cognition. To address this, a digital technology, the SleepSync app, was designed for use in defence. A pre-post design study was undertaken [...] Read more.
Shift work, long work hours, and operational tasks contribute to sleep and circadian disruption in defence personnel, with profound impacts on cognition. To address this, a digital technology, the SleepSync app, was designed for use in defence. A pre-post design study was undertaken to examine whether four weeks app use improved sleep and cognitive fitness (high performance neurocognition) in a cohort of shift workers from the Royal Australian Air Force. In total, 13 of approximately 20 shift-working personnel from one base volunteered for the study. Sleep outcomes were assessed using the Insomnia Severity Index (ISI), the Patient-Reported Outcomes Measurement Information System (PROMIS), Sleep Disturbance and Sleep-Related Impairment Scales, the Glasgow Sleep Effort Scale, the Sleep Hygiene Index, and mental health was assessed using the Depression, Anxiety, and Stress Scale-21. Sustained attention was measured using the 3-min Psychomotor Vigilance Task (PVT) and controlled response using the NBack. Results showed significant improvements in insomnia (ISI scores 10.31 at baseline and 7.50 after app use), sleep-related impairments (SRI T-scores 53.03 at baseline to 46.75 post-app use), and healthy sleep practices (SHI scores 21.61 at baseline to 18.83 post-app use; all p < 0.001). Trends for improvement were recorded for depression. NBack incorrect responses reduced significantly (9.36 at baseline; reduced by −3.87 at last week of app use, p < 0.001), but no other objective measures improved. These findings suggest that SleepSync may improve sleep and positively enhance cognitive fitness but warrants further investigation in large samples. Randomised control trials with other cohorts of defence personnel are needed to confirm the utility of this intervention in defence settings. Full article
(This article belongs to the Section Human Basic Research & Neuroimaging)
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12 pages, 548 KiB  
Review
Efficacy of Morning Shorter Wavelength Lighting in the Visible (Blue) Range and Broad-Spectrum or Blue-Enriched Bright White Light in Regulating Sleep, Mood, and Fatigue in Traumatic Brain Injury: A Systematic Review
by Chin Moi Chow, Kanchana Ekanayake and Daniel Hackett
Clocks & Sleep 2024, 6(2), 255-266; https://doi.org/10.3390/clockssleep6020018 - 28 May 2024
Viewed by 1538
Abstract
Traumatic brain injury (TBI) profoundly affects sleep, mood, and fatigue, impeding daily functioning and recovery. This systematic review evaluates the efficacy of morning shorter wavelength lighting in the visible (blue) range and broad-spectrum or blue-enriched bright white light exposure in mitigating these challenges [...] Read more.
Traumatic brain injury (TBI) profoundly affects sleep, mood, and fatigue, impeding daily functioning and recovery. This systematic review evaluates the efficacy of morning shorter wavelength lighting in the visible (blue) range and broad-spectrum or blue-enriched bright white light exposure in mitigating these challenges among TBI patients. Through electronic database searches up to May 2023, studies assessing sleep, circadian rhythm, sleepiness, mood, and fatigue outcomes in TBI patients exposed to morning shorter wavelength lighting in the visible (blue) range and broad-spectrum or blue-enriched bright white light were identified. Seven studies involving 309 participants met the inclusion criteria. Results indicated consistent advancement in sleep timing among individuals with mild TBI, alongside improvements in total sleep time, mood, and reduced sleepiness with both types of light exposure, particularly in mild TBI cases. Notably, two studies demonstrated alleviation of fatigue exclusively in severe TBI cases following light exposure. Despite promising findings, evidence remains limited, emphasizing the need for future research with standardized protocols to confirm the potential and optimize the benefits of light therapy for TBI recovery. Full article
(This article belongs to the Section Impact of Light & other Zeitgebers)
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9 pages, 633 KiB  
Communication
Associations between Sleep Hygiene and Mental Complaints in a French Healthcare Worker Population during the COVID-19 Crisis: A Cross-Sectional Analysis to Personalize Sleep Health Interventions
by Julien Coelho, Jean-Arthur Micoulaud-Franchi and Pierre Philip
Clocks & Sleep 2024, 6(2), 246-254; https://doi.org/10.3390/clockssleep6020017 - 22 Apr 2024
Viewed by 1628
Abstract
Healthcare workers often have irregular work schedules and experience significant stress, which can lead to poor sleep quality and frequent mental health issues, especially in the context of the COVID-19 pandemic. In this cross-sectional study, we aimed to assess the prevalence of poor [...] Read more.
Healthcare workers often have irregular work schedules and experience significant stress, which can lead to poor sleep quality and frequent mental health issues, especially in the context of the COVID-19 pandemic. In this cross-sectional study, we aimed to assess the prevalence of poor sleep hygiene and mental health complaints among healthcare workers and examine their associations. We investigated participants’ typical sleep–wake patterns on workdays and free days as indicators of sleep hygiene. Sleep efficiency and social jetlag were calculated as the ratio of mean sleep duration to time spent in bed, while sleep rebound was defined as the difference in mean sleep duration between workdays and free days. Social jetlag was determined as the difference in mid-sleep timing between workdays and free days, with mid-sleep defined as the midpoint between bedtime and wake-up time. Insomnia severity was assessed using the Insomnia Severity Index (ISI), daytime sleepiness using the Epworth Sleepiness Scale (ESS), and symptoms of anxiety and depression using the Patient Health Questionnaire 4 (PHQ-4). Fatigue was measured using a single item inspired by the Maslach Burnout Inventory (MBI). A total of 1562 participants (80.5% women, mean age 40.0 years) were included in the study. The results revealed that 25.9% of participants slept less than 6 h, 24.3% had a sleep efficiency of less than 85%, 27.3% experienced a sleep rebound of more than 2 h, and 11.5% reported a social jetlag exceeding 2 h. Additionally, 33.9% of participants reported insomnia, 45.1% reported excessive daytime sleepiness, 13.1% reported fatigue, 16.5% reported symptoms of depression, and 35.7% reported symptoms of anxiety. After adjustment, mean sleep duration and sleep efficiency were associated with most mental health complaints. Sleep rebound and social jetlag were associated with significant insomnia but not with anxiety or depression symptoms. Our findings underscore the high prevalence of poor sleep hygiene and mental health complaints among healthcare workers, exacerbated by the COVID-19 crisis. We advocate for the promotion of sleep health through behavioral sleep strategies to safeguard the well-being of healthcare professionals. Full article
(This article belongs to the Special Issue Role of Sleep and Circadian Rhythms in Health III)
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12 pages, 233 KiB  
Article
Neighborhood Light at Night and Noise Levels, and Long-Term Sleep Trajectories in the Southern Community Cohort Study
by Samuel H. Nyarko and Qian Xiao
Clocks & Sleep 2024, 6(2), 234-245; https://doi.org/10.3390/clockssleep6020016 - 5 Apr 2024
Viewed by 2329
Abstract
While light at night (LAN) and noise levels have been linked to suboptimal sleep outcomes, little is known about the link between these factors and long-term suboptimal sleep trajectories. The current study examined the association of neighborhood LAN and nighttime noise with long-term [...] Read more.
While light at night (LAN) and noise levels have been linked to suboptimal sleep outcomes, little is known about the link between these factors and long-term suboptimal sleep trajectories. The current study examined the association of neighborhood LAN and nighttime noise with long-term sleep trajectories in a cohort of Black individuals and White individuals predominantly from low-income communities. We used data from the Southern Community Cohort Study (N = 28,759 Black individuals and 16,276 White individuals). Sleep duration was self-reported at baseline and after an average of five years of follow-up, based on which we constructed nine sleep trajectories: normal–normal (optimal, reference), short–short, long–long, short–long, long–short, normal–short, normal–long, short–normal, and long–normal. LAN and nighttime noise were derived from satellite imagery and model-based estimates, respectively. Multinomial logistic regression was used to determine the relationship between LAN and noise exposures and sleep trajectories. Higher exposures to LAN and nighttime noise were associated with multiple suboptimal long-term sleep trajectories. In the total sample, higher LAN was associated with higher odds of long–long (OR Q5 vs. Q1 = 1.23 (CI = 1.02, 1.48)) and long–short (OR = 1.35 (CI = 1.06, 1.72)) trajectories, while higher nighttime noise was associated with short–short (1.19 (1.07, 1.31)), long–short (1.31 (1.05, 1.64)), and normal–song (1.16 (1.01, 1.34)) trajectories. Black and White individual-specific results showed qualitatively similar patterns between Black individuals and White individuals, although we also observed suggestive evidence for Black–White individual differences. In conclusion, elevated LAN and nighttime noise levels were associated with various suboptimal long-term sleep trajectories. However, it is noteworthy that the light and noise measures in our study may not accurately reflect individual-level exposures, and residual confounding from other factors is a concern. Future studies should use more accurate exposure measurements, collect information on and control for a wider range of factors, and examine whether reductions in neighborhood light and noise levels may contribute to improved long-term sleep health. Full article
(This article belongs to the Section Impact of Light & other Zeitgebers)
23 pages, 2432 KiB  
Article
No Benefit in Memory Performance after Nocturnal Memory Reactivation Coupled with Theta-tACS
by Sandrine Baselgia, Florian H. Kasten, Christoph S. Herrmann, Björn Rasch and Sven Paβmann
Clocks & Sleep 2024, 6(2), 211-233; https://doi.org/10.3390/clockssleep6020015 - 25 Mar 2024
Viewed by 1941
Abstract
Targeted memory reactivation (TMR) is an effective technique to enhance sleep-associated memory consolidation. The successful reactivation of memories by external reminder cues is typically accompanied by an event-related increase in theta oscillations, preceding better memory recall after sleep. However, it remains unclear whether [...] Read more.
Targeted memory reactivation (TMR) is an effective technique to enhance sleep-associated memory consolidation. The successful reactivation of memories by external reminder cues is typically accompanied by an event-related increase in theta oscillations, preceding better memory recall after sleep. However, it remains unclear whether the increase in theta oscillations is a causal factor or an epiphenomenon of successful TMR. Here, we used transcranial alternating current stimulation (tACS) to examine the causal role of theta oscillations for TMR during non-rapid eye movement (non-REM) sleep. Thirty-seven healthy participants learned Dutch–German word pairs before sleep. During non-REM sleep, we applied either theta-tACS or control-tACS (23 Hz) in blocks (9 min) in a randomised order, according to a within-subject design. One group of participants received tACS coupled with TMR time-locked two seconds after the reminder cue (time-locked group). Another group received tACS in a continuous manner while TMR cues were presented (continuous group). Contrary to our predictions, we observed no frequency-specific benefit of theta-tACS coupled with TMR during sleep on memory performance, neither for continuous nor time-locked stimulation. In fact, both stimulation protocols blocked the TMR-induced memory benefits during sleep, resulting in no memory enhancement by TMR in both the theta and control conditions. No frequency-specific effect was found on the power analyses of the electroencephalogram. We conclude that tACS might have an unspecific blocking effect on memory benefits typically observed after TMR during non-REM sleep. Full article
(This article belongs to the Section Human Basic Research & Neuroimaging)
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