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Katya Kovac,1 Grace E Vincent,1 Jessica L Paterson,2 Sally A Ferguson1 1School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Wayville, SA, Australia; 2Flinders Institute of Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA, AustraliaCorrespondence: Katya Kovac, School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, 44 Greenhill Road, Wayville, SA, 5034, Australia, Tel +61 420 718 242, Email katya.kovac@cqumail.comPurpose: The aim of this exploratory cross-sectional mixed methods study was to determine 1) whether sleep inertia, the temporary state of impaired vigilance performance upon waking, is perceived to be a concern by emergency service personnel, 2) what strategies are currently used by emergency service workplaces to manage sleep inertia, 3) the barriers to implementing reactive sleep inertia countermeasures, and 4) what strategies personnel suggest to manage sleep inertia.Participants and Methods: A sample (n = 92) of employed and volunteer Australian emergency service personnel (fire and rescue, ambulance, police, state-based rescue and recovery personnel) completed an online survey. Data collected included demographic variables and work context, experiences of sleep inertia in the emergency role, barriers to sleep inertia countermeasures, and existing workplace sleep inertia countermeasures and recommendations. Quantitative data were analysed using descriptive statistics, and qualitative data were thematically analysed.Results: Approximately 67% of participants expressed concern about sleep inertia when responding in their emergency role. Despite this, there were few strategies to manage sleep inertia in the workplace. One major barrier identified was a lack of time in being able to implement sleep inertia countermeasures. Fatigue management strategies, such as reducing on-call periods, and operational changes, such as screening calls to reduce false alarms, were suggested by participants as potential strategies to manage sleep inertia.Conclusion: Sleep inertia is a concern for emergency service personnel and thus more research is required to determine effective sleep inertia management strategies to reduce the risks associated with sleep inertia and improve personnel safety and those in their care. In addition, future studies could investigate strategies to integrate reactive sleep inertia countermeasures into the emergency response procedure.Keywords: fatigue management, on-call, shiftwork, intervention effectiveness, barriers

There is increased recognition that young people (25 years) may occupy a carer role for family or others with health conditions or disability. This is often in addition to study and social activities. This means competing demands on time, and insufficient sleep. Our aim was to determine the contribution of caring duties to problematic sleep in young carers.A survey of Australian carers was conducted, including questions on demographics, characteristics of the carer and care recipient, and sleep quality and quantity. Participants were eligible if they reported sleep time7 hr or dissatisfaction with their sleep, and were aged 15-24 years.A total of 110 participants (71.8%_female = 79, 15-17 years = 62, 18-24 years = 48) were included in analysis; 55.5% (Young carers experience reduced sleep duration and poor sleep quality. Strategies to alleviate the burden of care work on young carer's sleep would benefit the health and safety of this group.

Sedentary behavior at work contributes to detrimental cognitive outcomes (e.g., decreases in attention). The length of time that cognitive performance benefits are sustained following bouts of breaking up sitting (e.g., using sit-stand desks or walking) is not known. A narrative review of the literature was conducted using a systematic search strategy, with keywords related to breaking up sitting interventions in office-based environments and cognitive performance outcomes in the period immediately post the cessation of the breaking up sitting intervention. Three types of office-based breaking up sitting interventions were identified; 1) sit-stand desks, 2) walking desks and 3) cycling desks. From the eight studies which met the criteria, the impacts of these interventions on cognitive performance outcomes were mixed, with significant benefits in some studies and others reporting no benefit. Of the cognitive domains assessed, working memory, attention, and psychomotor function showed significant sustained improvement for up to 30 minutes post intervention. While there are benefits to a key set of cognitive performance domains following breaking up sitting interventions in office-based settings, no studies have evaluated whether benefits to cognitive performance persist for longer than 30 minutes after the breaking up sitting intervention. Furthermore, specific applications of these cognitive benefits to tasks outside of work (e.g., driving home from work) are unknown.

Due to the unpredictable nature of working time arrangements, on-call workers experience regular disruption to sleep, particularly if woken by calls. Sleep disruption can impact long term physical and mental health, next day performance, and importantly, performance immediately after waking. To reduce the impact of performance impairments upon waking (i.e., reducing sleep inertia), research has investigated strategies to promote alertness (e.g., bright light, caffeine, and exercise). This review puts forth on-call workers who are likely to return to sleep after a call, it is also important to consider the impact of these sleep inertia countermeasures on subsequent sleep. Future research should build on the preliminary evidence base for sleep inertia countermeasures by examining the impact on subsequent sleep. This research is key for both supporting alertness and performance during a call ("switching on") and for allowing the on-call worker to return to sleep after a call ("switching off").

INTRODUCTION: Research has highlighted the significant impact that jet lag can have upon performance, health, and safety. International business travelers have an important role in economic growth; however, there is a lack of research investigating jet lag and jet-lag management in international business travelers. This study aimed to investigate international business travelers use of jet-lag countermeasures. METHODS: International business travelers from Australia (N = 107) participated in a survey examining use of jet-lag countermeasures (pharmacological and nonpharmacological). Chi-squared tests were conducted examining the association between duration of stay and traveling experience on jet-lag countermeasure use. RESULTS: Most subjects had traveled for business for less than 15 yr and 57% reported taking between 14 trips annually. Durations of stay averaged 10 d (SD 13 d). Nonpharmacological countermeasure use was high. Pharmacological countermeasure use was less common. There were no significant associations between duration of stay and countermeasure implementation. Travel experience was only associated with nonpharmacological countermeasures after arrival home. CONCLUSION: Education programs delivered through businesses would be beneficial for providing information on jet lag, its implications, and recommended countermeasures to travelers. Rigney G, Walters A, Bin YS, Crome E, Vincent GE. Jet-lag countermeasures used by international business travelers. Aerosp Med Hum Perform. 2021; 92(10):825830.

Older adults more frequently experience reduced sleep quality and quantity compared to younger adults. Diet is one modifiable lifestyle factor that may influence sleep outcomes in older adults. The purpose of this review is to synthesise the current literature investigating the impact of diet, including foods and nutrients, on the sleep quality and quantity of older adults. Overall, the observational and intervention studies suggest that following a Mediterranean diet, and the consumption of certain food items (e.g. milk), and nutrients (e.g. vitamin D and vitamin E) may influence (improve or reduce) sleep quality and quantity. This review describes the potential efficacy for dietary factors to improve sleep outcomes in older adults. However, given the heterogeneity of included studies in this review (i.e. aims, methodologies, and outcomes assessed), it is difficult to consolidate the available evidence to make specific recommendations. More targeted research exploring the relationship between diet and sleep in older adults is needed to strengthen the current evidence base.

Purpose: The objective of this systematic review was to 1) determine how studies evaluated napping behavior in athletes (frequency, duration, timing and measurement); 2) explore how napping impacted physical performance, cognitive performance, perceptual measures (eg, fatigue, muscle soreness, sleepiness and alertness), psychological state and night-time sleep in athletes. Methods: Five bibliographic databases were searched from database inception to 11 August 2020. Observational and experimental studies comprising able-bodied athletes (mean age ≥ 12 years), published in English, in peer-reviewed journal papers were included. The Downs and Black Quality Assessment Checklist was used for quality appraisal. Results: Thirty-seven studies were identified of moderate quality. Most studies did not include consistent information regarding nap frequency, duration, and timing. Napping may be beneficial for a range of outcomes that benefit athletes (eg, physical and cognitive performance, perceptual measures, psychological state and night-time sleep). In addition, napping presents athletes with the opportunity to supplement their night-time sleep without compromising sleep quality. Conclusion: Athletes may consider napping between 20 to 90 min in duration and between 13:00 and 16:00 hours. Finally, athletes should allow 30 min to reduce sleep inertia prior to training or competition to obtain better performance outcomes. Future studies should include comprehensive recordings of nap duration and quality, and consider using sleep over a 24 hour period (daytime naps and night-time sleep period), specifically using objective methods of sleep assessment (eg, polysomnography/actigraphy).

Adults with chronic low back pain (CLBP) suffer impaired sleep. Medications for CLBP can impact sleep which in turn may influence treatment outcomes. This systematic review and meta-analysis examined the effects of pharmacotherapy (any type) on sleep in adults with CLBP.In this systematic review and meta-analysis, we searched PubMed, CINAHL, SPORTDiscus, PsycINFO, EMBASE, and CENTRAL from inception to 10 July 2022. Randomised controlled trials that investigated the effects of pharmacotherapy on sleep in adults with CLBP were included. Manual citation search of relevant systematic reviews and included studies were also conducted. Mean change from baseline for sleep outcomes (e.g., sleep quality, total sleep time, wake after sleep onset) was the effect of interest. Pairwise inverse-variance random effect meta-analysis was performed to impute pooled estimates (Hedges' g or risk ratios). The Hartung-Knapp-Sidik-Jonkman method was used where there were ≤5 studies. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system was used for evaluating the certainty of evidence. This study was registered with PROSPERO (CRD42022309419).Assessment of 3959 records resulted in nine studies (n = 2927) being included. Pharmacotherapy for CLBP management had a small, yet unlikely clinically significant, effect on improving sleep in adults with CLBP, when compared to placebo (g [95% CI]: -0.23 [-0.37, -0.09],Pharmacotherapy used to manage CLBP provided improvements in sleep in adults with CLBP. Given that these effects were small and unlikely clinically significant, clinicians could consider alternative treatments (e.g., non-pharmacological interventions) for managing sleep in adults with CLBP. However, low to very low certainty of evidence precluded strong conclusions. To improve certainty of evidence and confidence in the effect estimates, future research needs to use robust method to minimise bias. Additional research evaluating multiple sleep characteristics, using both validated objective and subjective measures, is also warranted to further investigate the influence of distinct sleep parameters.The Summer Research Scholarship from the Appleton Institute, Central Queensland University, Australia.

ObjectivesShiftworkers routinely obtain inadequate sleep, which has major health consequences. Sleep hygiene describes a range of behaviours, lifestyle and environmental factors that can improve sleep. To date, limited research has examined sleep hygiene in shiftworkers. This study aimed to assess the sociodemographic and behavioural correlates of sleep hygiene knowledge and engagement with sleep hygiene practices in Australian shiftworkers.Study designAn online, cross-sectional survey.Setting and participantsAustralian adults from across multiple industries (n=588) who work shift work.MeasuresThe online survey included questions regarding sleep hygiene knowledge and questions from modified versions of the Pittsburgh Sleep Quality Index and Sleep Hygiene Index.ResultsOf the 588 participants, 52.9% reported having heard of ‘sleep hygiene’. Of these participants, 77.5% reported understanding the term moderately, extremely or very well. Engagement with each sleep hygiene practice was varied. Common sleep hygiene practices were controlling the bedroom environment (eg, a cool, dark and quiet bedroom). Less common practices were avoiding light as bedtime approaches. Logistic regressions revealed that shiftworkers who had heard of sleep hygiene were more likely to engage in sleep hygiene practices and had better sleep quality compared with those who had not heard of sleep hygiene. Increased engagement in sleep hygiene practices did not predict the likelihood of individuals reporting better sleep quality.ConclusionsShiftworkers demonstrated varied knowledge, understanding and engagement with individual sleep hygiene practices. Future research should focus on the development of sleep hygiene interventions that accommodate the unique challenges of shift work to optimise sleep.

Background Nursing students are at risk of inadequate sleep and poor lifestyle behaviours due to academic, clinical and personal stressors faced throughout their training. However, the relationship between lifestyle and sleep in this population is not well understood. Aim The aim of this study was to determine whether inadequate sleep was associated with poor diet, physical inactivity, alcohol consumption and smoking in Australian nursing students. Methods Using a cross-sectional design, nursing students (n = 470) completed an online questionnaire that assessed sleep and lifestyle behaviours. One-way ANOVA, t-tests, Pearson’s bivariate correlation and multiple regression testing were used to determine relationships between variables. Findings Most nursing students experienced inadequate sleep (78%). Patterns of irregular eating, increased intake of discretionary foods, high-risk alcohol consumption and smoking were associated with indicators of inadequate sleep (p Conclusion This study highlights that nursing students experience inadequate sleep, and that poor lifestyle behaviours were associated with inadequate sleep in this sample. Strategies are needed to address inadequate sleep and poor lifestyle behaviours in nursing students, to support health, academic and clinic performance, as well as the transition to professional nursing practice.

Introduction: Inadequate sleep is a major public health concern, with large economic, health, and operational costs to Australia. Despite the implementation of public sleep health campaigns, approx...

Shift work is associated with adverse chronic health outcomes. Addressing chronic disease risk factors including biomedical risk factors, behavioural risk factors, as well as sleep and perceived health status, affords an opportunity to improve health outcomes in shift workers. The present study aimed to conduct a systematic review, qualitative synthesis, and meta-analysis of non-pharmacological interventions targeting chronic disease risk factors, including sleep, in shift workers. A total of 8465 records were retrieved; 65 publications were eligible for inclusion in qualitative analysis. Random-effects meta-analysis were conducted for eight eligible health outcomes, including a total of thirty-nine studies. Interventions resulted in increased objective sleep duration (Hedges’ g = 0.73; CI: 0.36, 1.10, k = 16), improved objective sleep efficiency (Hedges’ g = 0.48; CI: 0.20, 0.76, k = 10) and a small increase in both subjective sleep duration (Hedges’ g = 0.11; CI: −0.04, 0.27, k = 19) and sleep quality (Hedges’ g = 0.11; CI: −0.11, 0.33, k = 21). Interventions also improved perceived health status (Hedges’ g = 0.20; CI: −0.05, 0.46, k = 8), decreased systolic (Hedges’ g = 0.26; CI: −0.54, 0.02, k = 7) and diastolic (Hedges’ g = 0.06; CI: −0.23, 0.36, k = 7) blood pressure, and reduced body mass index (Hedges’ g = −0.04; CI: −0.37, 0.29, k = 9). The current study suggests interventions may improve chronic disease risk factors and sleep in shift workers; however, this could only be objectively assessed for a limited number of risk factor endpoints. Future interventions could explore the impact of non-pharmacological interventions on a broader range of chronic disease risk factors to better characterise targets for improved health outcomes in shift workers.

Objectives: The aims of the present study were to (1) quantify sleep behaviours of soccer referees and (2) compare sleep behaviours between nights before training, before matches, and after matches. Methods: Fourteen professional soccer referees from the A-League (mean±SD; age 34 ± 4 years; sex: 11 males, 3 females) participated in this observational study. Referees’ sleep behaviours were examined using sleep diaries and wrist activity monitors for 31 consecutive nights during the 2018–2019 A-League season. Separate linear mixed models were conducted to assess differences in sleep behaviours between nights before training, before matches, and after matches. Results: On average, referees did not obtain recommended sleep durations across the in-season (mean±SD sleep duration: 6.4 h ± 0.7 h). Referees went to bed later, spent less time in bed, and slept significantly less post-matches compared to pre-training and pre-match nights (p

Research has indicated that individuals with certain traits may be better suited to shiftwork and non-standard working arrangements. However, no research has investigated how individual differences impact on-call outcomes. As such, this study investigated the impact of trait anxiety on sleep and performance outcomes on-call. Seventy male participants (20–35 years) completed an adaptation night, a control night, and two on-call nights in a laboratory. Trait anxiety was determined using the State Trait Anxiety Inventory (STAI) X-2, and participants completed the STAI X-1 prior to bed each night to assess state anxiety. Sleep was measured using polysomnography and quantitative electroencephalographic analysis. Performance was assessed using a 10-min psychomotor vigilance task (PVT) performed each day at 0930, 1200, 1430 and 1700 h. Data pooled from three separate but inter-related studies was used for these analyses. Results indicated that the effects of trait anxiety on state anxiety, sleep and performance outcomes on-call were generally limited. These findings suggest that on-call outcomes are not negatively affected by higher levels of trait anxiety. Refereed/Peer-reviewed

Emergency responders often credit 'adrenaline' (i.e. sympathetic activity) as the reason they respond quickly upon waking, unimpaired by sleep inertia. Movement upon waking may promote sympathetic activity in this population. This pilot study (n = 4 healthy males) tested the effects of a 30 s exercise bout (maximal sprint) upon waking during the night (02:00 h) on sympathetic activity and sleep inertia. When compared to sedentary conditions, exercise reduced subjective sleepiness levels and elicited a temporary increase in sympathetic activity, measured by plasma noradrenaline levels. These findings provide preliminary support for exercise as a potential sleep inertia countermeasure.

On-call working arrangements have been shown to negatively impact sleep. However, workers may perceive their sleep to be worse than it actually is. The aim of this study was to compare participants' pre- and post-sleep estimates of sleep duration and sleep quality with objectively measured sleep when on-call under laboratory conditions.72 healthy, adult males.Analyses were performed on three interrelated studies, all of which consisted of four nights in a sleep laboratory. Following adaptation and baseline nights were two on-call nights (sleep opportunity 23:00 h - 07:00 h). Before and after each sleep opportunity, participants provided subjective estimates of sleep. Sleep was objectively measured using polysomnography.Estimated sleep duration (6.74 ± 1.13 h) and sleep onset latency (20.55 ± 14.85 min) were significantly poorer than objectively measured sleep outcomes (sleep duration 7.21 ± 1.25 h; sleep latency 13.20 ± 10.06 min). Of the variance in post-sleep estimated sleep duration, 14% was associated with objectively measured minutes of N3 (RSome objective measures of sleep were associated with subjective estimates of sleep duration and sleep quality. However, individuals may overestimate sleep onset latency and underestimate sleep duration during on-call periods. It may be beneficial for on-call workers to actively reflect on feelings of fatigue/alertness for workplace fatigue management, rather than relying solely on estimates of sleep.

Although sports officials are essential in the adjudication of rules during competitions, research into officiating populations is preliminary. This review explores existing research on the effects of sleep loss on decision-making in athlete populations, to gain relevant insight into sports officials and the growing decision-making demands of their role. Specifically, cognitive factors that influence decision-making are identified, and the potential relationship between sleep/wake behaviours and decision-making in sports officials were examined. Particular focus was granted to sleep, specifically sleep restriction in athlete populations, and the hypothesized relationship between sleep/wake behaviours and decision-making in sports officials. Impaired sleep duration and quality has been shown to impair cognitive performance. In the context of sport, impairments to sleep can negatively impact motivation, physical strength, reaction time, and decision-making, all of which are imperative to the role of the sports official. Despite numerous studies demonstrating that sleep loss reduces cognitive performance in athletes, this review revealed that similar research in sports officials has surprisingly yet to be conducted. Since sports officials require a high level of cognitive and physical skills to make correct decisions, an inquiry into the influence of sleep on cognitive performance may encourage research that facilitates improved performance training methods for decision-making in officials. Such findings are important to maintain the standard of officiating and allow for the development of guidelines and strategies to manage sleep and optimize decision-making across various sporting codes.

Objective: On-call work is becoming increasingly common in response to service demands. This study had two aims; 1) describe the demographic profile of on-call workers in Australia, and 2) establis...

On-call work arrangements are commonly utilised in the emergency services sector and are consistency associated with inadequate sleep. Despite sleep being a common shared behaviour, studies are yet to assess the impact of on-call work on the sleep of co-sleeping partners. This study aimed to investigate whether frequent 24/7 on-call work impacted the sleep and relationship happiness of firefighters&rsquo, partners. Two key research questions were investigated: (1) Does the frequency of calls impact sleep and relationship happiness? and, (2) Does the (a) sleep quantity and (b) sleep quality of partners impact perceived relationship happiness? A cross-sectional study was conducted using an online questionnaire completed by partners of on-call workers (n = 66, 93% female). The questionnaire included items on (i) sleep quantity and quality, (ii) on-call sleep disturbances and, (iii) relationship happiness. Responses were analysed using logistic regression models. Higher overnight call frequency was associated with greater self-reported levels of inadequate sleep (&lt, 7 h per night, p = 0.024). Support for continuance of a firefighter&rsquo, s role was less likely if the partner reported they regularly had trouble falling asleep within 30 min (p &lt, 0.001). There were no other significant relationships between the frequency of calls or other sleep quantity or quality variables and relationship happiness. This study provides important first insights into how firefighters&rsquo, on-call work arrangements impact partners&rsquo, sleep. Future research is needed across periods of high and low call demand, using objective measures of sleep to further define the impacts of on-call work on partners&rsquo, sleep.

Poor intervertebral disc (IVD) health is associated with low back pain (LBP). This 12-week parallel randomised controlled trial will evaluate the efficacy of a progressive interval running programme on IVD health and other clinical outcomes in adults with chronic LBP. Participants will be randomised to either a digitally delivered progressive interval running programme or waitlist control. Participants randomised to the running programme will receive three individually tailored 30 min community-based sessions per week over 12 weeks. The waitlist control will undergo no formal intervention. All participants will be assessed at baseline, 6 and 12 weeks. Primary outcomes are IVD health (lumbar IVD T2 via MRI), average LBP intensity over the prior week (100-point visual analogue scale) and disability (Oswestry Disability Index). Secondary outcomes include a range of clinical measures. All outcomes will be analysed using linear mixed models. This study has received ethical approval from the Deakin University Human Research Ethics Committee (ID: 2022-162). All participants will provide informed written consent before participation. Regardless of the results, the findings of this study will be disseminated, and anonymised data will be shared via an online repository. This will be the first study to evaluate whether a progressive interval running programme can improve IVD health in adults with chronic LBP. Identifying conservative options to improve IVD health in this susceptible population group has the potential to markedly reduce the burden of disease. This study was registered via the Australian New Zealand Clinical Trials Registry on 29 September 2022 (ACTRN12622001276741).

Bedtime procrastination is defined as the volitional delay of going to bed, without any external circumstances causing the delay, and is associated with inadequate sleep. Alleviating bedtime procrastination is an important target for interventions promoting adequate sleep, yet the correlates of bedtime procrastination are poorly understood. This study examined (1) correlates of bedtime procrastination, and (2) strength and direction of the association between bedtime procrastination and sleep outcomes. Six databases (CINAHL, EMBASE, PsychINFO, PubMed, Scopus, Web of Science) were searched from inception to September 2021 against pre-determined eligibility criteria. Forty-three studies were included (GRADE = low). Meta-analysis revealed that bedtime procrastination had a moderate negative association with self-control (z = -0.39; CI: -0.45, -0.29) and a moderate positive association with evening chronotype (z = 0.43; CI: 0.32, 0.48). Furthermore, bedtime procrastination was moderately negatively associated with sleep duration (z = -0.31; CI: -0.37, -0.24), sleep quality (z = -0.35; CI: -0.42, -0.27) and moderately positively associated with daytime fatigue (z = 0.32; CI: 0.25, 0.38). Further high-quality studies are needed to identify causal relationships between bedtime procrastination and correlates, as well as bedtime procrastination and sleep. Future work will guide the development of interventions targeting bedtime procrastination for improved sleep outcomes. STUDY REGISTRATION: PROSPERO registration number CRD42021248891.

Background On-call research and guidance materials typically focus on ‘traditional’ on-call work (e.g., emergency services, healthcare). However, given the increasing prevalence of non-standard employment arrangements (e.g., gig work and casualisation), it is likely that a proportion of individuals who describe themselves as being on-call are not included in current on-call literature. This study therefore aimed to describe the current sociodemographic and work characteristics of Australian on-call workers. Methods A survey of 2044 adults assessed sociodemographic and work arrangements. Of this population, 1057 individuals were workforce participants, who were asked to provide information regarding any on-call work they performed over the last three months, occupation type, weekly work hours, and the presence or absence of non-standard work conditions. Results Of respondents who were working, 45.5% reported working at least one day on-call in the previous month. There was a high prevalence of on-call work in younger respondents (63.1% of participants aged 18–24 years), and those who worked multiple jobs and more weekly work hours. Additionally, high prevalence rates of on-call work were reported by machinery operators, drivers, community and personal service workers, sales workers, and high-level managers. Conclusions These data suggest that on-call work is more prevalent than previously recorded and is likely to refer to a broad set of employment arrangements. Current classification systems may therefore be inadequate for population-level research. A taxonomy for the classification of on-call work is proposed, incorporating traditional on-call work, gig economy work, relief, or unscheduled work, and out of hours work.

ObjectivesThe global prevalence of Parkinsonism continues to rise given ageing populations. Individuals with Parkinsonism who have moderate or severe symptoms typically require a high level of care, including assistance with activities of daily living. This care is often provided across the 24-hour period by a family member or friend. It is likely that providing care significantly impacts the sleep duration and quality of the caregiver given overnight caring responsibilities, in addition to worry and stress associated with the caregiving role. The aim of this systematic review and meta-analysis was to investigate whether providing care to an individual with Parkinsonism was associated with disturbed caregiver sleep, and to identify associated factors that may contribute to disturbed sleep in this population.SettingFive databases were electronically searched on 30 June 2021 including CINAHL, PubMed, PsycINFO, CENTRAL and EMBASE.ParticipantsEligibility criteria included a population of caregivers whose care recipient has a form of Parkinsonism.Primary and secondary outcome measuresTo be included in this systematic review, outcome measures of caregiver sleep (eg, sleep duration, sleep quality) were required.ResultsEighteen studies (n=1998) were included. Findings indicated that caregivers of individuals with Parkinsonism typically experience poor sleep quality (mean (95% CI): 5.6 (4.8 to 6.4) points on the Pittsburgh Sleep Quality Index), increased sleep latency and poor sleep efficiency.ConclusionsThe degree of poor sleep quality was clinically significant. However, further investigation of sleep outcomes is required using sleep measurement tools tailored for this population (eg, measures that capture overnight sleep disruption by care recipient/s). Additionally, there is a need for appropriate individual and societal-level interventions to improve caregiver sleep.PROSPERO registration numberCRD42021274529.

Determine whether 30 s (s) of exercise performed upon waking can reduce sleep inertia and accelerate an increase in the cortisol awakening response (CAR) and core body temperature (CBT), compared to when sedentary.Fifteen participants (mean age ± SD, 25.9 ± 5.9 years; six females) completed a counterbalanced, repeated measures, in-laboratory study involving three single experimental nights, each separated by a four-night recovery period. Participants were woken following a 2-h nap (2400-0200) and completed a cycling bout of high-intensity (30-s sprint), low-intensity (30 s at 60% maximum heart rate), or no exercise (sedentary). Sleep inertia testing (eight batteries, 15-min intervals) began immediately following and included measures of subjective sleepiness (Karolinska Sleepiness Scale) and cognitive performance tasks (psychomotor vigilance, serial addition and subtraction, and spatial configuration). CBT was measured continuously via an ingestible telemetric capsule. The CAR was determined using salivary cortisol samples collected at 0, 30 and 45 min post-waking. Data were analysed using mixed effects analysis of variance.There was no difference in cognitive performance or CBT between conditions. Participants felt less sleepy in the high-intensity condition, followed by the low-intensity and sedentary conditions (p = .003). The CAR was greatest in the high-intensity condition, followed by the sedentary condition, and low-intensity condition (p 0.001), with no differences between the low-intensity and sedentary conditions.Those who exercise upon waking should be aware that while they may feel more alert, they may not be performing better than if they had not exercised. Future research should investigate whether exercise of different duration or timing may impact sleep inertia.

Athletes are increasingly required to travel domestically and internationally, often resulting in travel fatigue and jet lag. Despite considerable agreement that travel fatigue and jet lag can be a real and impactful issue for athletes regarding performance and risk of illness and injury, evidence on optimal assessment and management is lacking. Therefore 26 researchers and/or clinicians with knowledge in travel fatigue, jet lag and sleep in the sports setting, formed an expert panel to formalise a review and consensus document. This manuscript includes definitions of terminology commonly used in the field of circadian physiology, outlines basic information on the human circadian system and how it is affected by time-givers, discusses the causes and consequences of travel fatigue and jet lag, and provides consensus on recommendations for managing travel fatigue and jet lag in athletes. The lack of evidence restricts the strength of recommendations that are possible but the consensus group identified the fundamental principles and interventions to consider for both the assessment and management of travel fatigue and jet lag. These are summarised in travel toolboxes including strategies for pre-flight, during flight and post-flight. The consensus group also outlined specific steps to advance theory and practice in these areas. Supplementary Information The online version contains supplementary material available at 10.1007/s40279-021-01502-0.

Gambling has significant costs to the community, with a health burden similar in scale to major depression. To reduce its impact, it is necessary to understand factors that may exacerbate harm from gambling. The gambling environment of late-night licensed venues and 24/7 online gambling has the potential to negatively impact sleep and increase alcohol consumption. This study explored gambling, alcohol, and sleep problems to understand whether there is a relationship between these three factors. Telephone interviews were conducted with a representative sample of Australian adults (n = 3760) combined across three waves of the National Social Survey. Participants completed screening measures for at-risk gambling, at-risk alcohol consumption, insomnia (2015 wave only), and sleep quality. There were small but significant positive correlations between problem gambling and alcohol misuse, problem gambling and insomnia, and problem gambling and poor sleep quality. A regression model showed that gambling problems and alcohol misuse were significant independent predictors of insomnia. A separate regression showed gambling problems (and not alcohol misuse) were a significant predictor of poor sleep quality, but only in one survey wave. Findings suggest that gambling, alcohol, and sleep problems are related within persons. Further research should examine the mechanisms through which this relationship exists.

This study used a bibliometric analysis through the Scopus database to examine papers that combined physical activity and sleep, published between 1979 and 2018. Bibliometric indicators of productivity included publication volume and citation distribution, top 10 authors, average authors per paper, single- and multicountry collaboration, collaborative index, top 10 countries, leading journals, highly cited papers and network visualization for coauthorship, international collaboration, and co-occurrence of author keywords. The initial search identified 1,509 papers, of which 607 passed through comprehensive screening and were included in the final analysis. Most of the papers were research articles (90.8%) and published in English (90.8%). Most papers (81.4%) were published within the past decade, 2009-2018. The mean number of papers published per year was 15.2, the mean number of citations per paper was 257.3, and the mean number of authors per paper was 5.5. International collaboration was evident for 21.6% of the papers, and 95.6% of papers were multiauthored. The most prolific publishing institutions and authors were from the United States, Canada, Australia, Switzerland, and Brazil. Keyword analysis suggested that almost all age groups and study designs were covered, but most papers focus on noncommunicable diseases. Although there has been a rise in scientific production on combined physical activity and sleep research in recent years, future work in this area should include researchers from developing countries. Refereed/Peer-reviewed