Carskadon MA, Dement WC. The multiple sleep latency test: what does it measure? Sleep 1982;5:S67-S72.
Carskadon MA, Dement WC, Mitler MM, Roth T, Westbrook PR, Keenan S. Guidelines for the Multiple Sleep Latency Test (MSLT), a standard measure of sleepiness. Sleep 1986;9:519-24. [PubMed]
Sangal R B, Thomas L, Mitler MM. Maintenance of wakefulness test and multiple sleep latency test. Measurement of different abilities in patients with sleep disorders. Chest 1992;101:898-902. [CrossRef] [PubMed]
Dinges DF, Powell JW. Microcomputer analyses of performance on a portable, simple visual RT task during sustained operations. Behav Res Meth Ins C 1985;17:652-5. [CrossRef]
Johns MW. A new method for measuring sleepiness, the Epworth Sleepiness Scale. Sleep 1991;14:540-5. [PubMed]
Littner MR, Kushida C, Wise M, Davila DG, Morgenthaler T, Lee-Chiong T, Hirshkowitz M, Loube DL, Bailey D, Berry RB, Kapen S, Kramer M. Practice parameters for clinical use of the Multiple Sleep Latency Test and the Maintenance of Wakefulness Test. Standards of practice committee of the American Academy of Sleep Medicine. Sleep 2005;28:113-21. [PubMed]
Dinges DF. An overview of sleepiness and accidents. J Sleep Res 1997;4(Suppl 2):4-14.
Garbarino S, Nobili L, Beelke M, De Carli F, Ferrillo F. The contributing role of sleepiness in highway vehicle accidents. Sleep 2001;24:203-6. [PubMed]
Philip P, Sagaspe P, Lagarde E, Leger D, Ohayon M, Bioulac B, Boussuge J, Taillard J. Sleep disorders and accidental risk in a large group of regular registered highway drivers. Sleep Med 2010;11:973-9. [CrossRef]
Åkerstedt T, Fredlund P, Gillberg M, Jansson B. A prospective study of fatal occupational accidents - relationship to sleeping difficulties and occupational factors. J Sleep Res 2002;11:69-71. [CrossRef] [PubMed]
Lauber JK, Kayten PJ. Sleepiness, circadian dysrhythmia, and fatigue in transportation system accidents. Sleep 1998;11:503-12.
Mitler MM, Carskadon MA, Czeisier CA, Dement WC, Dinges DF, Graeber RS. Catastrophes, sleep, and public policy: consensus report. Sleep 1988;11:100-9. [PubMed]
El-Ad B, Korczyn AD. Disorders of excessive daytime sleepiness - an update. J Neurol Sci 1998;153:192-202.
Blagrove M, Alexander C, Horne JA. The effects of chronic sleep reduction on the performance of cognitive tasks sensitive to sleep deprivation. Appl Cogn Psychol 1995;9:21-40. [CrossRef]
Dinges DF, Pack F, Williams K, Gillen KA., Powell JW, Ott GE, Aptowicz C, Pack AI. Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4-5 hours per night. Sleep 1997;20:267-77.
Horne JA, Wilkinson S. Chronic sleep reduction: daytime vigilance performance and EEG measures of sleepiness, with particular reference to "practice" effects. Psychophysiology 1985;22:69-78. [CrossRef] [PubMed]
Van Dongen HPA, Maislin G, Mullington JM, Dinges DF. The cumulative cost of additional wakefulness, dose-response effects on neurobehavioral functions and sleep physiology from chronic sleep restriction and total sleep deprivation. Sleep 2003;26:117-26. [PubMed]
Borbély AA. A two process model of sleep regulation. Hum Neurobiol 1982;1:195-204. [PubMed]
Borbély AA, Achermann P, Trachsel L, Tobler I. Sleep initiation and initial sleep intensity: interactions of homeostatic and circadian mechanisms. J Biol Rhythms 1989;4:37-48. [CrossRef]
Babkoff H, Caspy T, Mikulincer M. Subjective sleepiness ratings, the effects of sleep deprivation, circadian rhythmicity and cognitive performance. Sleep 1991;14:534-9. [PubMed]
Dingens DF. The nature of sleepiness: Nature, causes, and consequences. In: Stunkard AJ, Baum A, editors. Perspectives in behavioral medicine. Eating, sleeping, and sex. New Jersey: Lawrence Erlbaum Associates, Inc.; 1989. p. 147-79.
Roehrs T, Shore E, Papineau K, Rosenthal L, Roth T. A two-week sleep extension in sleepy normals. Sleep 1996;19:576-82. [PubMed]
Roehrs T, Timms V, Zwyghuizen-Doorenbos A, Roth T. Sleep extension in sleepy and alert normals. Sleep 1989;12:449-57. [PubMed]
Gillberg M, Kecklund G, Axelsson J, Åkerstedt T. The effects of a short daytime nap after restricted night sleep. Sleep 1996;19:570-5.
Hayashi M, Masuda A, Hori T. The alerting effects of caffeine, bright light and face washing after a short daytime nap. Clin Neurophysiol 2003;114:2268-78. [CrossRef]
Åkerstedt T, Fröberg JE. Psychophysiological circadian rhythms in women during 72 h of sleep deprivation. Waking Sleeping 1977;1:387-94.
Zulley J, Wever R, Aschoff J. The dependence of onset and duration of sleep on the circadian rhythm of rectal temperature. Eur J Physiol 1981;4:314-8.
Carskadon MA, Dement WC. Multiple sleep latency tests during the constant routine. Sleep 1992;15:396-9. [PubMed]
Edgar DM, Dement WC, Fuller CA. Effect of SCN lesions on sleep in squirrel monkeys: Evidence for opponent processes in sleep-wake regulation. J Neurosci 1993;13:1065-79. [PubMed]
Dijk D-J, Czeisler CA. Contribution of the circadian pacemaker and the sleep homeostat to sleep propensity, sleep structure, electroencephalographic slow waves, and sleep spindle activity in humans. J Neurosci 1995;15:3526-38. [PubMed]
Folkard S, Åkerstedt T. Towards a model for the prediction of alertness and/or fatigue on different sleep/wake schedules. In: Oginski A, Pokorski J, Rutenfranz J, editors. Contemporary advances in shiftwork research. Krakóv: Medical Academy; 1987. p. 231-40.
Stepanski E, Lamphere J, Badia P, Zorick F, Roth T. Sleep fragmentation and daytime sleepiness. Sleep 1984;7:18-26. [PubMed]
Bonnet MH, Arand DL. Sleepiness as measured by modified Multiple Sleep Latency Testing varies as a function of preceding activity. Sleep 1998;21:477-83. [PubMed]
Bonnet MH, Arand DL. Level of arousal and the ability to maintain wakefulness. J Sleep Res 1999;8:247-54. [PubMed]
Bonnet MH, Arand DL. Arousal components which differentiate the MWT from the MSLT. Sleep 2001;24:441-7. [PubMed]
Gross RT, Borkovec TD. Effects of a cognitive intrusion manipulation on the sleep onset latency of good sleepers. Behav Ther 1982;13:112-6. [CrossRef]
De Valck, E, Cluydts R, Pirrera S. Effect of cognitive arousal on sleep latency, somatic and cortical arousal following partial sleep deprivation. J Sleep Res 2004;13:295-304.
Johns MW, Thornton C, Dore C. Heart rate and sleep latency in young men. J Psychosom Med 1976;20:549-53. [CrossRef]
Kronholm E, Hyyppä MT, Alanen E, Halonen JP, Partinen M. What does the Multiple Sleep Latency Test measure in a community sample? Sleep 1995;18:827-35.
Pressman MR, Fry JM. Relationship of autonomic nervous system activity to daytime sleepiness and prior sleep. Sleep 1989;12:239-45. [PubMed]
Webb WB. An objective behavioral model of sleep. Sleep 1988;11:488-96. [PubMed]
Perlis ML, Smith MT, Pigeon WR. Etiology and pathophysiology of insomnia. In: Kryger NH, Roth T, Dement WC, editors. Principles and practice of sleep medicine. Philadelphia: Sanders Co; 2000. p. 714-25.
Seidel WF, Ball S, Cohen S, Patterson N, Yost D, Dement WC. Daytime alertness in relation to mood, performance, and nocturnal sleep in chronic insomniacs and noncomplaining sleepers. Sleep 1984;7:230-8. [PubMed]
Sugarman IL, Stern JA, Walsh JK. Daytime alertness in subjective and objective insomnia: some preliminary findings. Biol Psychiatry 1985;20:741-50. [CrossRef]
Stepanski E, Zorick F, Roehrs T, Young D, Roth T. Daytime alertness in patients with chronic insomnia compared with asymptomatic control subjects. Sleep 1988;11:54-60. [PubMed]
Bonnet MH, Arand DL. Caffeine use as a model of acute and chronic insomnia. Sleep 1992;15:526-36. [PubMed]
Adams K, Tomeny M, Oswald I. Physiological and psychological differences between good and poor sleepers. J Psychiatr Res 1986;20:301-16. [CrossRef]
Campbell SS, Murphy PJ. Relationship between sleep and body temperature in middle-aged and older subjects. J Am Geriatr Soc 1998;46:458-62. [PubMed]
Rosa R, Bonnet M. Reported chronic insomnia is independent of poor sleep as measured by electroencephalography. Psychosom Med 2000;62:474-82. [PubMed]
Bonnet MH, Arand DL. 24-hour metabolic rate in insomniacs and matched normal sleepers. Sleep 1995;18:581-8.
Bonnet MH, Arand DL. Heart rate variability in insomniacs and matched normal sleepers. Psychosom Med 1998;60:610-5. [PubMed]
Stepanski E, Glinn M, Zorick FJ, Roehrs T, Roth T. Heart rate changes in chronic insomnia. Stress Med 1994;10:261-6. [CrossRef]
Varkevisser M, Kerkhof GA. Chronic insomnia and performance in a 24-h constant routine study. J Sleep Res 2005;14:49-59. [CrossRef]
Rodenbeck A, Huether G, Rüther E, Hajak G. Interactions between evening andnocturnal cortisol secretion and sleep parameters in patients with severe chronic primary insomnia. Neurosci Lett 2002;324:159-63. [PubMed] [CrossRef]
Vgontzas AN, Bixler EO, Lin HM, Prolo P, Mastorakos G, Vela-Bueno A, Kales A, Chrousos GP. Chronic insomnia is associated with nyctohemeral activation of the hypothalamic-pituitary-adrenal axis, clinical implications. J Clin Endocrinol Metab 2001;86:3787-94. [CrossRef] [PubMed]
Riemann D, Klein T, Rodenbeck A, Feigea B, Hornya A, Hummela R, Weskea G, Al-Shajlawia A, Voderholzera U. Nocturnal cortisol and melatonin secretion in primary insomnia. Psychiatry Res 2002;113:17-27. [PubMed] [CrossRef]
Irwin M, Clark C, Kennedy B, Gillin JC, Ziegler M. Nocturnal catecholamines and immune function in insomniacs, depressed patients, and control subjects. Brain Behav Immun 2003;17:365-72. [CrossRef] [PubMed]
Lamarche CH, Ogilvie RD. Electrophysiological changes during the sleep onset period of psychophysiological insomniacs, psychiatric insomniacs, and normal sleepers. Sleep 1997;20:724-33. [PubMed]
Mercia H, Blois R, Gaillard JM. Spectral characteristics of sleep EEG in chronic insomnia. Eur J Neurosci 1998;10:1826-34.
Perlis ML, Giles DE, Mendelson WB, Bootzin RR, Wyatt JK. Psychophysiological insomnia: the behavioral model and a neurocognitive perspective. J Sleep Res 1997;6:179-88. [CrossRef]
Perlis ML, Smith MT, Andrews PJ, Orff H, Giles DE. Beta/Gamma EEG activity in patients with primary and secondary insomnia and good sleeper controls. Sleep 2001;24:110-7. [PubMed]
Espie CA, Brooks DN, Lindsay WR. An evaluation of tailored psycological treatment of insomnia. J Behav Ther Exp Psychiatry 1989;20:143-53. [CrossRef]
Carter NL, Hunyor SN, Crawford G, Kelly D, Smith AJ. Environmental noise and sleep: a study of arousals, cardiac arrhythmia and urinary catecholamines. Sleep 1994;17:298-307. [PubMed]
Carter N, Henderson R, Lal S, Hart M, Booth S, Hunyor S. Cardiovascular and autonomic response to environmental noise during sleep in night shift workers. Sleep 2002;25:457-64. [PubMed]
Griefahn B, Bröde P, Marks A, Basner M. Autonomic arousals related to traffic noise during sleep. Sleep 2008;31:569-77. [PubMed]
Saremi M, Grenèchea J, Bonnefonda A, Rohmera O, Eschenlauera A, Tassia, P. Effects of nocturnal railway noise on sleep fragmentation in young and middle-aged subjects as a function of type of train and sound level. Int J Psychophysiol 2008;70;184-91. [CrossRef]
Reyner LA, Horne JA. Evaluation of "in-car" countermeasures to sleepiness: Cold air and radio. Sleep 1998;21:46-50. [PubMed]
Cajochen C, Zeitzer JM, Czeislerm CA, Dijk DJ. Doseresponse relationship for light intensity and ocular and electroencephalographic correlates of human alertness. Behav Brain Res 2000;115:75-83. [CrossRef]
Bjorvatn B, Kecklund G, Åkerstedt T. Bright light treatment used for adaptation to night work and re-adaptation back to day life. A field study at an oil platform in the North Sea. J Sleep Res 1999;8:105-12. [CrossRef] [PubMed]
Sadeghniiat-Haghighi K, Yazdi Z, Jahanihashemi H, Aminian O. The effect of bright light on sleepiness among rapidrotating 12-hour shift workers. Scand J Work Environ Health 2011;37:77-9.
Phipps-Nelson J, Redman JR, Dijk D-J, Rajaratnam SMW. Daytime exposure to bright light, as compared to dim light, decreases sleepiness and improves psychomotor vigilance performance. Sleeep 2003;26:695-700.
Ruger M, Gordijn MCM, Beersma DGM, de Vries B, Daan S. Time-of-day-dependent effects of bright light exposure on human psychophysiology: comparison of daytime and nighttime exposure. Am J Physiol Regul Integr Comp Physiol 2006;290:R1413-20.
Vandewalle G, Balteau E, Phillips C, Degueldre C, Moreau V, Sterpenich V, Albouy G, Darsaud A, Desseilles M, Dang-Vu TT, Peigneux P, Luxen A, Dijk D-J, Maquet P. Daytime light exposure dynamically enhances brain responses. Curr Biol 2006;16:1616-21. [CrossRef] [PubMed]
Cajochen C, Münch M, Kobialka S, Kräuchi K, Steiner R, Oelhafen P, Orgül S, Wirz-Justice A. High sensitivity of human melatonin, alertness, thermoregulation, and heart rate to short wavelength light. J Clin Endocrinol 2005;90:1311-6.
Lockley SW, Evans EE, Scheer FAJL, Brainard GC, Czeisler CA, Aeschbach D. Short-wavelength sensitivity for the direct effects of light on alertness, vigilance, and the waking electroencephalogram in humans. Sleep 2006;29:161-8. [PubMed]
Revell VL, Arendt J, Fogg LF, Skene DJ. Alerting effects of light are sensitive to very short wavelengths. Neusrosci Lett 2006;399:96-100. [CrossRef]
Lindqvist A, Jalonen J, Parviainen P, Antila K, Laitinen LA. Effect of posture on spontaneous and thermally stimulated cardiovascular oscillations. Cardiovasc Res 1989;24:373-80.
Hartse KM, Roth T, Zorick FJ. Daytime sleepiness and daytime wakefulness: the effect of instruction. Sleep 1982;5(Suppl 2):S107-18.
Roehrs T. Stress and insomnia. In: Bolis L, Licinio J, edtors. Stress and the nervous system. Geneva: World Health Organisation Advisory Committee on Health Research; 1998. p. 63-76.
Tang NKY, Harvey AG. Effects of cognitive arousal and physiological arousal on sleep perception. Sleep 2004;27:69-78. [PubMed]
Bakotić M. Razlike u razini aktivacije i dnevna pospanost nakon djelomične deprivacije spavanja [Differences in the level of activation and daytime sleepiness after partial sleep deprivation; in Croatian] [PhD thesis]. Zagreb: Faculty of Philosophy, University of Zagreb; 2011.
Morin CM. Cognitive-behavioral approaches to the treatment of insomnia. J Clin Psychiatry 2004;65(Suppl 16):33-40. [PubMed]
Yang C-M, Spielman AJ. The role of behavioural treatment in the management of insomnia. Dis Manage Health Outcomes 1999;5:209-24. [CrossRef]
Fisher F, Radošević-Vidaček B, Košćec A, Teixeira L, Moreno C, Lowden A. Internal and external time conflicts in adolescents: sleep characterstics and interventions. Mind Brain Educ 2008;2:17-23. [CrossRef]
NTSB. Grounding of the US tankship Exxon Valdez on Bligh Reef, Prince William Sound near Valdez, Alaska, March 24, 1989. National Transportation Safety Board. Maritime Accident Report, NTSB/MAR-90/04, 1990.
Mitler MM, Carskadon MA, Czeisler CA, Dement WC, Dinges DF, Graeber RC. Catastrophes, sleep, and public policy: consensus report. Sleep 1988;11:100-9. [PubMed]
Morishima H, Sugiyama E, Matsushita M, Uruha S, Ito S, Abe Y, Nishitani M, Watanabe T, Suganuma N, Yamamura S, Yanagi K, Shigedo Y, Kumano-Go T, Adachi H, Mikami A, Sugita Y, Takeda M. How is autonomic nervous system activity in subjects who are sleepy but are unable to sleep in the daytime? Sleep Biol Rhythms 2009;7:23-30. [CrossRef]
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Regulation of Sleepiness: The Role of the Arousal System
Institute for Medical Research and Occupational Health, Zagreb, Croatia1
This content is open access.
Citation Information: Archives of Industrial Hygiene and Toxicology. Volume 63, Issue Supplement 1, Pages 23–34, ISSN (Print) 0004-1254, DOI: 10.2478/10004-1254-63-2012-2137, May 2012
- Published Online:
Regulation of Sleepiness: The Role of the Arousal System
Sleepiness is a widespread phenomenon in the busy industrial countries, and many studies have identified its significant negative impacts on individuals and society. Particularly important are the data that associate sleepiness with the risk of accidents at workplace and in transport, pointing to shift workers as the most vulnerable population. It is generally accepted that two basic physiological processes regulate sleepiness: homeostatic and circadian rhythmic processes. Recent research has proposed the third component regulating sleepiness, that is, the wake drive or the arousal system. The role of the arousal system in regulating sleepiness has partly been addressed by the studies of the pathophysiology of insomnia, which is often described as a disorder of hyperarousal. Experimental and correlational studies on the relation between sleepiness and arousal in good sleepers have generally indicated that both physiological and cognitive arousal are related to the standard measures of sleepiness. Taking into account the role of the arousal system in regulating sleepiness widens the possibilities for the management of sleep disorders and could also help in solving the problem of excessive sleepiness at work and the wheel.
Uloga aktivacijskoga sustava u regulaciji pospanosti
Pospanost je raširena pojava u industrijskim zemljama i njeni negativni učinci na pojedince i društvo ustanovljeni su u brojnim istraživanjima. Od posebne su važnosti podaci koji upućuju na to da pospanost povećava vjerojatnost nesreća na radu i u prometu, što je naročito izraženo u populaciji smjenskih radnika. Općenito je prihvaćeno da pospanost reguliraju dva temeljna fiziološka procesa, od koji se jedan odnosi na homeostazu spavanja, a drugi na cirkadijurno funkcioniranje organizma. Nedavno objavljeni modeli pospanosti predložili su uključivanje nagona za budnošću, odnosno razine aktivacije, kao trećeg čimbenika koji sudjeluje u regulaciji pospanosti. Ideje o važnosti aktivacijskog sustava u regulaciji pospanosti dijelom su proizašle iz ispitivanja patofiziologije nesanice koja se često opisuje kao poremećaj pretjerane pobuđenosti. Eksperimentalna i korelacijska istraživanja odnosa između pospanosti i aktivacije kod dobrih spavača općenito su pokazala kako su fiziološka i kognitivna aktivacija povezane sa standardnim mjerama pospanosti. Uvažavanje aktivacijskog sustava u regulaciji pospanosti otvara šire mogućnosti za rješavanje problema sa spavanjem te bi također moglo pomoći u rješavanju problema pretjerane pospanosti u različitim radnim okruženjima i prometu.