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Inadequate Sleeping Impairs Brain Function and Aggravates Everyday’s Life

2017; Hogrefe Verlag; Volume: 31; Issue: 3 Linguagem: Inglês

10.1027/0269-8803/a000207

2151-2124

Sergio Garbarino, Walter G. Sannita, Michael Falkenstein,

Circadian rhythm and melatonin

Free AccessInadequate Sleeping Impairs Brain Function and Aggravates Everyday's LifeA Challenge for Human Psychophysiology?Sergio Garbarino, Walter G. Sannita, and Michael FalkensteinSergio Garbarino Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Italy Department of Health Sciences, University of Genova, Italy , Walter G. Sannita Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Italy , and Michael Falkenstein Leibniz Research Centre for Working Environment and Human Factors at TU Dortmund (IfADo), Dortmund, Germany Institute for Working, Learning, and Aging, Bochum, Germany Published Online:August 11, 2017https://doi.org/10.1027/0269-8803/a000207PDF ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinkedInReddit SectionsMorePhysiological sleep-wake cycling is necessary to the subject's health, homeostasis, efficiency, and well-being. Sleep disorders of medical relevance, sleeping habits aimed at complying with work assignments at night or in shifts, and voluntary sleep deprivation compare in their disrupting the physiological circadian rhythms and as major risk factors for comorbidity and psychiatric, cerebro-cardiovascular, metabolic, or hormonal diseases (Garbarino, Lanteri, Durando, Magnavita, & Sannita, 2016). Their nonmedical detrimental effects on everyday's life are substantial and impoverish life quality to relevant extents. Excessive daytime drowsiness, impaired cognition, reduced attention and tolerance to pain, mood changes and behavioral inadequacies, anxiety, and subjective fatigue are reported more often than by good sleepers (Barclay & Gregory, 2013); medical assistance and prescribed medication are requested, and anticipated retirement is applied for, more frequently; self-medication is widespread, but remains undetected and uncontrolled. Major sleep disorders and inadequate sleeping qualify today as a major healthcare, welfare, and social problem. The estimated direct and indirect costs of medical assistance, lost productivity, worsened quality of life, etc., are alarming (Garbarino et al., 2016; Garbarino & Sannita, 2017). The incidence of major sleep disorders is high (approx. 18–23%) in Western societies (Uehli et al., 2014), that of inadequate sleeping because of occupational requirements or due to personal choice is conceivably higher, most likely underestimated. However, professional or voluntary sleep deprivation appears today unavoidable.The nonmedical effects of disrupted circadian rhythms on everyday's life are not just subjective complaints without consequences. Sleep is important to organizations because of its relationship with the workers' attitude, performance, safety, and health (Litwiller, Snyder, Taylor, & Steele, 2016). Absenteeism proved higher and productivity, progression in career, and professional reward worse in poor sleepers. The prevalence of complaints about insomnia, poor sleep quality, and daytime sleepiness is higher in shift-workers than among workers on regular schedule (Yazdi, Sadeghniiat-Haghighi, Loukzadeh, Elmizadeh, & Abbasi, 2014). There is also an association between the perceived level of stress and complaints of poor sleep (Rowshan Ravan, Bengtsson, Lissner, Lapidus, & Björkelund, 2010). On the other hand, sleep disorders reduce the workers' adaptation to shift schedules and increase accidents at work (Akerstedt, 2003). Efficiency at work and sleep quality are inversely related. Chronically inadequate sleeping due to shift-work impairs cognition, with potentially critical consequences on safety not only for individuals, but also for society (Marquié, Tucker, Folkard, Gentil, & Ansiau 2015), with an estimated loss in overall professional efficiency of around 10.3% (Yazdi et al., 2014). Workers with sleep problems have a 1.62 times higher risk of being injured compared to those without sleep problems and the odds for work accident was found to be nearly double in workers with obstructive sleep apneas (Uehli et al., 2014; Garbarino et al., 2016). Thirty-two percent of healthcare workers report they do not get enough sleep, and errors due to poor sleep and fatigue are potentially harmful to patients (Caruso, 2014). As a result, occupational injuries are a major problem worldwide and impaired efficiency at work is a costly burden on workers, healthcare systems, and employers. It can also induce subtle changes in cognitive styles in complex working tasks, such as greater rigidity and a loss of systematic strategies due to a depletion of frontal resources (van der Linden, Frese, & Sonnentag, 2003). Evidence on the relationship between sleep disorders and road accident is also impressive, with the drivers' fatigue being a major cause of road accidents (Lal & Craig, 2001). Approximately 50% of injured motor drivers surviving vehicle collision had at least one sleep-related risk factor in an Australian study (Crummy, Cameron, Swann, Kossmann, & Naughton, 2008); 8.9% of drivers reported experiencing at least once a month an episode of sleepiness at the wheel forcing them to stop driving. One-third of drivers (31.1%) reported near-miss accidents (50% being sleep-related), 7.2% reported a driving accident in the past year, and 5.8% of these driving accidents were sleep-related (Philip, 2010). A variety of psychophysiological parameters have been tested as possible indicators of fatigue, with electroencephalography perhaps being the most promising although of difficult application outside the laboratory setting (Lal & Craig, 2001; Anund et al., 2008).Prevention could help reduce incidence, comorbidity, side effects, and the personal and social costs. Protocols and procedures to identify individual poor sleepers or categories would be easily applicable to shift-workers, whose activities are regulated and can be monitored (Garbarino et al., 2016). Working schedules with proper timing of the sleep/work/rest cycle and enforced ergonomic criteria helping reduce the circadian disruption and accumulation of sleep loss and fatigue may be devised (Uehli et al., 2014).Prevention and monitoring have been made mandatory in the European Union (EU), but regulation allocates to the medical domain all effects of sleep deprivation, irrespective of pathophysiology and without taking the limits of medical action into adequate consideration. However, most effects on everyday's life of occupational or voluntary insufficient sleep do not pertain to the medical domain (Garbarino & Sannita, 2017). Inadequate sleeping with no medical relevance may therefore remain overlooked in the absence of reliable tools and operational criteria to help identify its effects on the psychophysiological status and central nervous system (CNS) function during the day, at work, or in other usual activities. A close scrutiny of the psychophysiological methodologies available today would define their potentialities and estimate their reliability in monitoring the poor sleepers' attention, drowsiness, accuracy, and the like in their everyday life, give physicians new tools and psychophysiologists a novel applicative domain. And help setting guidelines in the approach (Philip, Chaufton, Nobili, & Garbarino, 2014).The authors equally contributed to the manuscript preparation. The paper has not been published previously, is not under consideration for publication elsewhere, and if accepted will not be published elsewhere including electronically in the same form, in English or in any other language, without written consent. No funding has been requested or obtained. There is no conflict of interest to be disclosed.References Akerstedt, T. (2003). Shift work and disturbed sleep/wakefulness. Occupational Medicine, 53, 89–94. 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Prevalence of sleep disorders and their impacts on occupational performance: A comparison between shift workers and nonshift workers. Sleep Disorders, 870320. doi: 10.1155/2014/870320 First citation in articleCrossref, Google ScholarWalter G. Sannita, Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, 3, Largo P. Daneo, 16132 Genova, Italy, wgs@dism.unige.itFiguresReferencesRelatedDetails Volume 31Issue 3July 2017ISSN: 0269-8803eISSN: 2151-2124 InformationJournal of Psychophysiology (2017), 31, pp. 91-93 https://doi.org/10.1027/0269-8803/a000207.© 2017Hogrefe PublishingAcknowledgments:The authors equally contributed to the manuscript preparation. The paper has not been published previously, is not under consideration for publication elsewhere, and if accepted will not be published elsewhere including electronically in the same form, in English or in any other language, without written consent. No funding has been requested or obtained. There is no conflict of interest to be disclosed.PDF download