Showing papers by "Mathias Basner published in 2017"

Meta-Analysis of the Antidepressant Effects of Acute Sleep Deprivation.

Abstract: Objective To provide a quantitative meta-analysis of the antidepressant effects of sleep deprivation to complement qualitative reviews addressing response rates. Data sources English-language studies from 1974 to 2016 using the keywords sleep deprivation and depression searched through PubMed and PsycINFO databases. Study selection A total of 66 independent studies met criteria for inclusion: conducted experimental sleep deprivation, reported the percentage of the sample that responded to sleep deprivation, provided a priori definition of antidepressant response, and did not seamlessly combine sleep deprivation with other therapies (eg, chronotherapeutics, repetitive transcranial magnetic stimulation). Data extraction Data extracted included percentage of responders, type of sample (eg, bipolar, unipolar), type of sleep deprivation (eg, total, partial), demographics, medication use, type of outcome measure used, and definition of response (eg, 30% reduction in depression ratings). Data were analyzed with meta-analysis of proportions and a Poisson mixed-effects regression model. Results The overall response rate to sleep deprivation was 45% among studies that utilized a randomized control group and 50% among studies that did not. The response to sleep deprivation was not affected significantly by the type of sleep deprivation performed, the nature of the clinical sample, medication status, the definition of response used, or age and gender of the sample. Conclusions These findings support a significant effect of sleep deprivation and suggest the need for future studies on the phenotypic nature of the antidepressant response to sleep deprivation, on the neurobiological mechanisms of action, and on moderators of the sleep deprivation treatment response in depression.

Aviation Noise Impacts: State of the Science

Abstract: Noise is defined as 'unwanted sound.' Aircraft noise is one, if not the most detrimental environmental effect of aviation. It can cause community annoyance, disrupt sleep, adversely affect academic performance of children, and could increase the risk for cardiovascular disease of people living in the vicinity of airports. In some airports, noise constrains air traffic growth. This consensus paper was prepared by the Impacts of Science Group of the Committee for Aviation Environmental Protection of the International Civil Aviation Organization and summarizes the state of the science of noise effects research in the areas of noise measurement and prediction, community annoyance, children's learning, sleep disturbance, and health. It also briefly discusses civilian supersonic aircraft as a future source of aviation noise. © 2017 Noise & Health | Published by Wolters Kluwer - Medknow.

Sleep and Alertness in Medical Interns and Residents: An Observational Study on the Role of Extended Shifts.

Abstract: Study Objectives Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Methods Sleep-wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy. Alertness was assessed daily with a brief Psychomotor Vigilance Test (PVT) and the Karolinska Sleepiness Scale. Results Interns averaged 6.93 hours (95% confidence interval [CI] 6.84-7.03 hours) sleep per 24 hours across shifts, significantly less than residents not working overnight shifts (7.18 hours, 95% CI 7.06-7.30 hours, p = .007). Interns obtained on average 2.19 hours (95% CI 2.02-2.36 hours) sleep during on-call nights (17.5% obtained no sleep). Alertness was significantly lower on mornings after on-call nights compared to regular shifts (p < .001). Naps between 9 am and 6 pm on the first day post-call were frequent (90.8%) and averaged 2.84 hours (95% CI 2.69-3.00 hours), but interns still slept 1.66 hours less per 24 hours (95% CI 1.56-1.76 hours) compared to regular shift days (p < .001). Sleep inertia significantly affected alertness in the 60 minutes after waking on-call. Conclusions Extended overnight shifts increase the likelihood of chronic sleep restriction in interns. Reduced levels of alertness after on-call nights need to be mitigated. A systematic comparison of sleep, alertness, and safety outcomes under current and past duty hour rules is encouraged.

Validation of the Cognition Test Battery for Spaceflight in a Sample of Highly Educated Adults.

Abstract: Background Neuropsychological changes that may occur due to the environmental and psychological stressors of prolonged spaceflight motivated the development of the Cognition Test Battery. The battery was designed to assess multiple domains of neurocognitive functions linked to specific brain systems. Tests included in Cognition have been validated, but not in high-performing samples comparable to astronauts, which is an essential step toward ensuring their usefulness in long-duration space missions. Methods We administered Cognition (on laptop and iPad) and the WinSCAT, counterbalanced for order and version, in a sample of 96 subjects (50% women; ages 25-56 yr) with at least a Master's degree in science, technology, engineering, or mathematics (STEM). We assessed the associations of age, sex, and administration device with neurocognitive performance, and compared the scores on the Cognition battery with those of WinSCAT. Confirmatory factor analysis compared the structure of the iPad and laptop administration methods using Wald tests. Results Age was associated with longer response times (mean β = 0.12) and less accurate (mean β = -0.12) performance, women had longer response times on psychomotor (β = 0.62), emotion recognition (β = 0.30), and visuo-spatial (β = 0.48) tasks, men outperformed women on matrix reasoning (β = -0.34), and performance on an iPad was generally faster (mean β = -0.55). The WinSCAT appeared heavily loaded with tasks requiring executive control, whereas Cognition assessed a larger variety of neurocognitive domains. Discussion Overall results supported the interpretation of Cognition scores as measuring their intended constructs in high performing astronaut analog samples.Moore TM, Basner M, Nasrini J, Hermosillo E, Kabadi S, Roalf DR, McGuire S, Ecker AJ, Ruparel K, Port AM, Jackson CT, Dinges DF, Gur RC. Validation of the Cognition Test Battery for spaceflight in a sample of highly educated adults. Aerosp Med Hum Perform. 2017; 88(10):937-946.

Protocol for the Reconstructing Consciousness and Cognition (ReCCognition) Study.

Abstract: Important scientific and clinical questions persist about general anesthesia despite the ubiquitous clinical use of anesthetic drugs in humans since their discovery. For example, it is not known how the brain reconstitutes consciousness and cognition after the profound functional perturbation of the anesthetized state, nor has a specific pattern of functional recovery been characterized. To date, there has been a lack of detailed investigation into rates of recovery and the potential orderly return of attention, sensorimotor function, memory, reasoning and logic, abstract thinking, and processing speed. Moreover, whether such neurobehavioral functions display an invariant sequence of return across individuals is similarly unknown. To address these questions, we designed a study of healthy volunteers undergoing general anesthesia with electroencephalography and serial testing of cognitive functions (NCT01911195). The aims of this study are to characterize the temporal patterns of neurobehavioral recovery over the first several hours following termination of a deep inhaled isoflurane general anesthetic and to identify common patterns of cognitive function recovery. Additionally, we will conduct spectral analysis and reconstruct functional networks from electroencephalographic data to identify any neural correlates (e.g., connectivity patterns, graph-theoretical variables) of cognitive recovery after the perturbation of general anesthesia. To accomplish these objectives, we will enroll a total of sixty consenting adults aged 20-40 across the three participating sites. Half of the study subjects will receive general anesthesia slowly titrated to loss of consciousness with an intravenous infusion of propofol and thereafter be maintained for three hours with 1.3 age adjusted minimum alveolar concentration of isoflurane, while the other half of subjects serves as awake controls to gauge effects of repeated neurobehavioral testing, spontaneous fatigue, and endogenous rest-activity patterns. □

Noise exposure-response relationships established from repeated binary observations: Modeling approaches and applications

Abstract: Noise exposure-response relationships are used to estimate the effects of noise on individuals or a population. Such relationships may be derived from independent or repeated binary observations, and modeled by different statistical methods. Depending on the method by which they were established, their application in population risk assessment or estimation of individual responses may yield different results, i.e., predict "weaker" or "stronger" effects. As far as the present body of literature on noise effect studies is concerned, however, the underlying statistical methodology to establish exposure-response relationships has not always been paid sufficient attention. This paper gives an overview on two statistical approaches (subject-specific and population-averaged logistic regression analysis) to establish noise exposure-response relationships from repeated binary observations, and their appropriate applications. The considerations are illustrated with data from three noise effect studies, estimating also the magnitude of differences in results when applying exposure-response relationships derived from the two statistical approaches. Depending on the underlying data set and the probability range of the binary variable it covers, the two approaches yield similar to very different results. The adequate choice of a specific statistical approach and its application in subsequent studies, both depending on the research question, are therefore crucial.

0162 pilot study examining the effects of aircraft noise on sleep in communities near philadelphia international airport

Abstract: Aircraft noise can disturb sleep and impair recuperation. Representative field studies are needed for health impact assessments and to inform noise policy. To evaluate feasibility of a new unobtrusive methodology that objectively monitors sleep and identifies awakenings based on heart rate and actigraphy, an unattended pilot field study was conducted in the vicinity of Philadelphia International Airport. Seventy-nine participants (39 exposed to aircraft noise, 40 controls) were monitored for 3 consecutive nights with concurrent sound recordings in the bedroom. Blood pressure measurements and brief questionnaires were completed each morning. Based on linear mixed models controlling for age, gender, and BMI, individuals living near the airport reported poorer sleep quality on the PSQI (p=0.0180) and worse health on the SF-36 (p=0.0074) surveys. No statistically significant differences were found for morning sleep assessments, diastolic (p=0.7108) and systolic (p=0.3255) blood pressure, or the sleep fragmentation index (p=0.6986) (calculated based on the ECG and actigraphy data). This study demonstrates feasibility of unattended physiological and noise measurements.

Association between residents’ attitude towards air traffic and their objective sleep quality at Frankfurt Airport.

Abstract: Sleep disturbances and impaired quality of life are among frequent complaints from residents around airports. This paper aims at investigating whether psychological factors such as subjective attitude towards air traffic are related to the objective sleep quality of an individual. In 2012 as part of the NORAH sleep study, 74 residents around Frankfurt Airport rated their attitude towards air traffic and assessed its necessity. Polysomnography was recorded in residents’ home environment. In the NORAH study, a negative attitude towards air traffic was associated with a significantly impaired sleep quality (i.e. prolonged sleep onset latency: Δ 5.6 min, increased wake after sleep onset: Δ 12.3 min, reduced sleep efficiency: Δ 3 %, and less deep sleep: Δ 12.3 min). The assessment of air traffic as less necessary was related to a significant reduction in deep sleep duration (Δ 15.1 min). These results suggest that residents’ objective sleep quality and their subjective assessment of air traffic are related. Cause and effect of the relationship remain to be identified.

A comparison of the effects of night time air traffic noise on sleep at Cologne/Bonn and Frankfurt Airport after the night flight ban

Abstract: In the STRAIN study (2001/2002) the German Aerospace Center (DLR) measured the sleep of 64 residents (19-61 years old, average: 38 years) around Cologne/Bonn airport for 9 consecutive nights each with polysomnography. Cologne/Bonn airport has no night time restrictions for chapter 3 airplanes and is one of the busiest airports in Germany during the night. Frankfurt is the airport with the highest traffic volume in Germany. A night flight ban (11 p.m. - 5 a.m.) was implemented in October 2011. Traffic density during shoulder hours is high. DLR examined 83 Frankfurt airport residents (18-77 years old, average: 43 years) with polysomnography as part of the NORAH study in 2012. In both studies sound pressure level and noise events were recorded with microphones near the sleeper's ear. Participants filled out questionnaires each morning. The analysis shows that aircraft noise induced awakening probabilities are 3.8-7.5% higher for maximum indoor levels from 30-70 dB(A) at Cologne/Bonn Airport whereas night time aircraft noise annoyance is considerably increased in Frankfurt. The results of both studies are compared, and limitations of the comparisons are discussed.