Showing papers by "Mathias Basner published in 2014"

Cardiovascular effects of environmental noise exposure

Abstract: The role of noise as an environmental pollutant and its impact on health are being increasingly recognized. Beyond its effects on the auditory system, noise causes annoyance and disturbs sleep, and it impairs cognitive performance. Furthermore, evidence from epidemiologic studies demonstrates that environmental noise is associated with an increased incidence of arterial hypertension, myocardial infarction, and stroke. Both observational and experimental studies indicate that in particular night-time noise can cause disruptions of sleep structure, vegetative arousals (e.g. increases of blood pressure and heart rate) and increases in stress hormone levels and oxidative stress, which in turn may result in endothelial dysfunction and arterial hypertension. This review focuses on the cardiovascular consequences of environmental noise exposure and stresses the importance of noise mitigation strategies for public health.

Sleep deprivation potentiates HPA axis stress reactivity in healthy adults.

Abstract: OBJECTIVE This article describes an experiment that was designed to investigate the effects of sleep deprivation on physiological stress responses in healthy adults. METHOD Twenty-six participants, ages 22-49, completed a 3-night laboratory experiment with randomization to one night of sleep-deprivation or a normal-sleep control condition. After a night of baseline sleep, 12 participants were sleep deprived and 14 were not. After the sleep manipulation, each participant completed the Trier Social Stress Test, a task that requires delivering a speech and performing difficult arithmetic in front of a stern, three-person panel. The stressor was administered from 5:00 p.m.-5:30 p.m. and saliva samples were collected 20 and 5 min before (baseline) and 5, 20, and 40 min after the stressor. Samples were assayed for cortisol (a biomarker for the HPA axis) and alpha-amylase (a putative biomarker for the sympatho-adrenal medullar system). RESULTS Sleep deprivation was associated with higher cortisol levels at baseline (p < .0001) and an amplified cortisol response to the stressor relative to control participants (pinteraction = 0.0039). Alpha-amylase showed a significant main effect of the stressor (p = .0026), but there was no effect of sleep loss at baseline or in response to the stressor. CONCLUSIONS Sleep deprivation is associated with both elevated resting cortisol release and with an exaggerated cortisol response to a stressor indicative of elevated HPA axis responses in healthy adults. Individual differences in the magnitude of this response may represent a risk factor for psychological and physical health consequences associated with heightened cortisol exposure.

Psychological and Behavioral Changes during Confinement in a 520-Day Simulated Interplanetary Mission to Mars

Abstract: Behavioral health risks are among the most serious and difficult to mitigate risks of confinement in space craft during long-duration space exploration missions. We report on behavioral and psychological reactions of a multinational crew of 6 healthy males confined in a 550 m3 chamber for 520 days during the first Earth-based, high-fidelity simulated mission to Mars. Rest-activity of crewmembers was objectively measured throughout the mission with wrist-worn actigraphs. Once weekly throughout the mission crewmembers completed the Beck Depression Inventory-II (BDI-II), Profile of Moods State short form (POMS), conflict questionnaire, the Psychomotor Vigilance Test (PVT-B), and series of visual analogue scales on stress and fatigue. We observed substantial inter-individual differences in the behavioral responses of crewmembers to the prolonged mission confinement and isolation. The crewmember with the highest average POMS total mood disturbance score throughout the mission also reported symptoms of depression in 93% of mission weeks, which reached mild-to-moderate levels in >10% of mission weeks. Conflicts with mission control were reported five times more often than conflicts among crewmembers. Two crewmembers who had the highest ratings of stress and physical exhaustion accounted for 85% of the perceived conflicts. One of them developed a persistent sleep onset insomnia with ratings of poor sleep quality, which resulted in chronic partial sleep deprivation, elevated ratings of daytime tiredness, and frequent deficits in behavioral alertness. Sleep-wake timing was altered in two other crewmembers, beginning in the first few months of the mission and persisting throughout. Two crewmembers showed neither behavioral disturbances nor reports of psychological distress during the 17-month period of mission confinement. These results highlight the importance of identifying behavioral, psychological, and biological markers of characteristics that predispose prospective crewmembers to both effective and ineffective behavioral reactions during the confinement of prolonged spaceflight, to inform crew selection, training, and individualized countermeasures.

Sociodemographic characteristics and waking activities and their role in the timing and duration of sleep.

Abstract: Study objectives Chronic sleep restriction is prevalent in the U.S. population and associated with increased morbidity and mortality. The primary reasons for reduced sleep are unknown. Using population data on time use, we sought to identify individual characteristics and behaviors associated with short sleep that could be targeted for intervention programs. Design Analysis of the American Time Use Survey (ATUS). Setting Cross-sectional annual survey conducted by the U.S. Bureau of Labor Statistics. Participants Representative cohort (N = 124,517) of Americans 15 years and older surveyed between 2003 and 2011. Interventions None. Measurements and results Telephone survey of activities over 24 hours. Relative to all other waking activities, paid work time was the primary waking activity exchanged for sleep. Time spent traveling, which included commuting to/ from work, and immediate pre- and post-sleep activities (socializing, grooming, watching TV) were also reciprocally related to sleep duration. With every hour that work or educational training started later in the morning, sleep time increased by approximately 20 minutes. Working multiple jobs was associated with the highest odds for sleeping ≤6 hours on weekdays (adjusted OR 1.61, 95% CI 1.44; 1.81). Self-employed respondents were less likely to be short sleepers compared to private sector employees (OR 0.83, 95% CI 0.72; 0.95). Sociodemographic characteristics associated with paid work (age 25-64, male sex, high income, and employment per se) were consistently associated with short sleep. Conclusions U.S. population time use survey findings suggest that interventions to increase sleep time should concentrate on delaying the morning start time of work and educational activities (or making them more flexible), increasing sleep opportunities, and shortening morning and evening commute times. Reducing the need for multiple jobs may increase sleep time, but economic disincentives from working fewer hours will need to be offset. Raising awareness of the importance of sufficient sleep for health and safety may be necessary to positively influence discretionary behaviors that reduce sleep time, including television viewing and morning grooming.

520-d Isolation and confinement simulating a flight to Mars reveals heightened immune responses and alterations of leukocyte phenotype.

Abstract: During interplanetary exploration, chronic stress caused by long term isolation and confinement in the spacecraft is one of the major concerns of physical and psychological health of space travelers. And for human on Earth, more and more people live in an isolated condition, which has become a common social problem in modern western society. Collective evidences have indicated prolonged chronic stress could bring big influence to human immune function, which may lead to a variety of health problems. However, to what extent long-term isolation can affect the immune system still remains largely unknow. A simulated 520-d Mars mission provided an extraordinary chance to study the effect of prolonged isolation. Six healthy males participated in this mission and their active neuroendocrine and immune conditions were studied with saliva and blood samples from all participants on chosen time points during the isolation period. As a typical neuroendocrine parameter, stress hormone cortisol was measured in the morning saliva samples. Immune phenotype changes were monitored through peripheral leukocyte phenotype analysis. Using an ex vivo viral infection simulation assay we assessed the immune response changes characterized by the ability to produce representative endogenous pro-inflammatory cytokines. The results of this study revealed elevated cortisol levels, increased lymphocyte amount and heightened immune responses, suggesting that prolonged isolation acting as chronic stressors are able to trigger leukocyte phenotype changes and poorly controlled immune responses.

Significance of time awake for predicting pilots' fatigue on short-haul flights: implications for flight duty time regulations.

Abstract: European regulations restrict the duration of the maximum daily flight duty period for pilots as a function of the duty start time and the number of scheduled flights. However, late duty end times that may include long times awake are not specifically regulated. In this study, fatigue levels in pilots finishing their duty late at night (00:00-01:59 hour) were analysed and compared with pilots starting their duty early (05:00-06:59 hour). Fatigue levels of 40 commercial short-haul pilots were studied during a total of 188 flight duty periods, of which 87 started early and 22 finished late. Pilots used a small handheld computer to maintain a duty and sleep log, and to indicate fatigue levels immediately after each flight. Sleep logs were checked with actigraphy. Pilots on late-finishing flight duty periods were more fatigued at the end of their duty than pilots on early-starting flight duty periods, despite the fact that preceding sleep duration was longer by 1.1 h. Linear mixed-model regression identified time awake as a preeminent factor predicting fatigue. Workload had a minor effect. Pilots on late-finishing flight duty periods were awake longer by an average of 5.5 h (6.6 versus 1.1 h) before commencing their duty than pilots who started early in the morning. Late-finishing flights were associated with long times awake at a time when the circadian system stops promoting alertness, and an increased, previously underestimated fatigue risk. Based on these findings, flight duty limitations should consider not only duty start time, but also the time of the final landing.

Sleepiness and Safety: Where Biology Needs Technology.

Abstract: Maintaining human alertness and behavioral capability under conditions of sleep loss and circadian misalignment requires fatigue management technologies due to: (i) dynamic nonlinear modulation of performance capability by the interaction of sleep homeostatic drive and circadian regulation; (ii) large differences among people in neurobehavioral vulnerability to sleep loss; (iii) error in subjective estimates of fatigue on performance; and (iv) to inform people of the need for recovery sleep. Two promising areas of technology have emerged for managing fatigue risk in safety-sensitive occupations. The first involves preventing fatigue by optimizing work schedules using biomathematical models of performance changes associated with sleep homeostatic and circadian dynamics. Increasingly these mathematical models account for individual differences to achieve a more accurate estimate of the timing and magnitude of fatigue effects on individuals. The second area involves technologies for detecting transient fatigue from drowsiness. The Psychomotor Vigilance Test (PVT), which has been extensively validated to be sensitive to deficits in attention from sleep loss and circadian misalignment, is an example in this category. Two shorter-duration versions of the PVT recently have been developed for evaluating whether operators have sufficient behavioral alertness prior to or during work. Another example is online tracking the percent of slow eyelid closures (PERCLOS), which has been shown to reflect momentary fluctuations of vigilance. Technologies for predicting and detecting sleepiness/fatigue have the potential to predict and prevent operator errors and accidents in safety-sensitive occupations, as well as physiological and mental diseases due to inadequate sleep and circadian misalignment.

Impact of protected sleep period for internal medicine interns on overnight call on depression, burnout, and empathy

Abstract: Background Patient safety and sleep experts advocate a protected sleep period for residents. Objective We examined whether interns scheduled for a protected sleep period during overnight call would have better end-of-rotation assessments of burnout, depression, and empathy scores compared with interns without protected sleep periods and whether the amount of sleep obtained during on call predicted end-of-rotation assessments. Methods We conducted a randomized, controlled trial with internal medicine interns at the Philadelphia Veterans Affairs Medical Center (PVAMC) and the Hospital of the University of Pennsylvania (HUP) in academic year 2009–2010. Four-week blocks were randomly assigned to either overnight call permitted under the 2003 duty hour standards or a protected sleep period from 12:30 am to 5:30 am. Participants wore wrist actigraphs. At the beginning and end of the rotations, they completed the Beck Depression Inventory (BDI-II), Maslach Burnout Inventory (MBI-HSS), and Interpersonal ...

A randomized trial of a three-hour protected nap period in a medicine training program: sleep, alertness, and patient outcomes.

Abstract: PurposeProtected sleep periods for internal medicine interns have previously resulted in increased amount slept and improved cognitive alertness but required supplemental personnel. The authors evaluated intern and patient outcomes associated with protected nocturnal nap periods of three hours that

Nocturnal air, road, and rail traffic noise and daytime cognitive performance and annoyance.

Abstract: Various studies indicate that at the same noise level and during the daytime, annoyance increases in the order of rail, road, and aircraft noise. The present study investigates if the same ranking can be found for annoyance to nocturnal exposure and next day cognitive performance. Annoyance ratings and performance change during combined noise exposure were also tested. In the laboratory 72 participants were exposed to air, road, or rail traffic noise and all combinations. The number of noise events and LAS,eq were kept constant. Each morning noise annoyance questionnaires and performance tasks were administered. Aircraft noise annoyance ranked first followed by railway and road noise. A possible explanation is the longer duration of aircraft noise events used in this study compared to road and railway noise events. In contrast to road and rail traffic, aircraft noise annoyance was higher after nights with combined exposure. Pooled noise exposure data showed small but significant impairments in reaction times (6 ms) compared to nights without noise. The noise sources did not have a differential impact on performance. Combined exposure to multiple traffic noise sources did not induce stronger impairments than a single noise source. This was reflected also in low workload ratings.

Lost in space: sleep.

Abstract: 860 www.thelancet.com/neurology Vol 13 September 2014 investigation. In any event, there is contribution at the identifi ed loci across more than one cohort, but the extent and nature of the overall association remains unclear. Heterogeneity is often the price paid for assembly of huge sample sizes for GWAS or meta-analyses. However, the power of GWAS can be boosted not only by increasing sample size, but also in creative ways that exploit previous biological knowledge. For example, fi ndings from many studies have suggested an important role for GABAA receptor function in genetic generalised epilepsies, and techniques such as genomewide pathway and hypothesis-driven analyses can be exploited to test such specifi c hypotheses and generate potential therapeutic targets. Another approach that sidesteps the complications of phenotype integrity is the use of imaging endophenotypes; changes in structural connectivity and grey matter volume have already been identifi ed in juvenile myoclonic epilepsy. Quantitative measures closer to the underlying biology than the clinical phenotype might also reduce required sample sizes to the hundreds with newly developed mathematical methods, while improving specifi city of fi ndings. Knowledge of the genetics of common epilepsies is in need of integration. Strong but rare risk factors in the form of recurrent copy-number variation are known, and researchers have understood for some time that there are distinct genetic infl uences on absence and myoclonic seizure types within the genetic generalised epilepsies. We openly speak of complex models for common epilepsies, but recent eff orts have been largely in search of rare monogenic causes, or single common variants for heterogeneous phenotypic groupings. A change in research strategy towards use of more specifi c phenotypes (that are guided by family studies of phenotype coaggregation in epilepsy syndromes, or by endophenotypes), and modelling of complexity in studies of the genetic architecture of these phenotypes, would serve to reduce heterogeneity and identify genes for specifi c syndromes, seizures, and comorbid traits. Such studies, hand-in-hand with epigenetics and other omics methods, could off er a way to account for individual patient diff erences in presentation, comorbidity, and prognosis.

Research Methods for Understanding Aircraft Noise Annoyances and Sleep Disturbance

Abstract: This document explores the development and validation of a research protocol for a large-scale study of aircraft noise exposure-annoyance response relationships. Alternative research methods for field studies to assess the relationship between aircraft noise and sleep disturbance for U.S. airports are also investigated. This report presents the final documentation for the two parts of this project. Phase I included data collection for the purpose of testing an aircraft noise annoyance survey that can be used in a national study to update the dose-response relationship between noise exposure and the percentage of people who are highly annoyed. Two modes for collecting the survey responses were tested: telephone interview and mail questionnaire. The main goals were to compare response rates and yield for the two surveys, and evaluate whether the relationship between percent highly annoyed and aircraft noise exposure differs for the two survey modes. Findings show that response rates for the mail survey were much higher than those for the telephone survey. There is no evidence that the response of percentage highly annoyed differs between the telephone and mail surveys. Statistical tests show no significant difference overall between the mail and telephone surveys in percent highly annoyed. Respondents to the survey are disproportionately likely to be white non-Hispanic and age 50 or more, when compared with census figures, although the differences from the census are greater for the telephone survey than for the mail survey. Among the respondents, however, there is no statistically significant relationship, after accounting for the level of noise exposure and airport-to-airport differences, between these demographic characteristics and annoyance. The main objectives of Phase II were to develop at least two general research protocols to improve the understanding of the relationship between aircraft noise and sleep disturbance in a field setting; and to identify criteria to be used to test and evaluate the protocols. The two general research protocols outlined in this report (polysomnography or actigraphy plus ECG) are identical in aspects related to the selection of measurement sites, study population, acoustical measurements, and supplementary data gathered. The two research protocols differ in the methodology used to measure sleep. This primarily affects the staffing level needed to collect the physiological data in the field and to analyze the data afterwards. The per subject costs are higher for polysomnography, which limits the maximum number of investigated subjects at the same level of funding.

Effects of time in mission: iss astronauts ratings of stress

Abstract: INTRODUCTION Astronauts on the International Space Station (ISS) must manage the stressors of space flight, which can include working at a high level for long periods, experiencing altered sleep, and coping with a range of physical and psychological reactions to living in microgravity. Because exploration spaceflight will require missions even longer than the current 6-month stays on ISS, there is a need to identify whether the chronic effects of stressors across time in mission produce cumulative or escalating behavioral and biomedical risks for astronauts. Recent findings from the Mars 500 analog study of isolation and confinement for 17 months indicated that time in mission was associated with cumulative increases in adverse neurobehavioral responses [1] and stress in some individuals [2]. To inform the question of the whether time in mission in microgravity is associated with increasing stress, we analyzed astronauts' ratings of their stress levels, and other indications of negative neurobehavioral reactions, as a function of time in mission during 6-month stays on ISS.