Objectives
To explore changes in quality of life and perceived productivity, focusing on the effects of working from home during the first COVID-19 50-day mitigation period in Austria.
Methods
We ...conducted an Austrian-representative online survey (
N
= 1010) of self-reported life- and work-related changes during the first COVID-19 50-day mitigation period (March 16 through May 1 2020) compared to the situation before. We used multinominal logistic regression models to identify correlates of improved/decreased quality of life in the entire sample, and of improved/decreased productivity in a subsample of the working population (
N
= 686). We also calculated age- and multivariable-adjusted ORs and 95% CIs of an improved/decreased quality of life and an improved/decreased productivity by work from home status.
Results
During the COVID-19 mitigation period, quality of life improved in 17.5%, but decreased in 20.7% of the general Austrian population; perceived productivity at work increased in 12.7%, but decreased in 30.2% of the working population. Working from home during the mitigation period was associated with an increased quality of life (vs. none, partially: OR 2.07, 95% CI 1.09–3.91; all the time: 3.69, 1.86–7.29). In contrast, perceived productivity seemed to decrease when people worked from home (vs. none, partially: 1.42, 0.86–2.35; all the time: 1.48, 0.85–2.58). Working from home and related benefits were not equally distributed among gender, age, and educational attainment.
Conclusions
A transition to more flexibility of workplace and working hours for employees could have important positive consequences for family and professional life, for stakeholders, for public health, and ultimately for the environment.
Revisiting the Concept of Vigilance Klösch, Gerhard; Zeitlhofer, Josef; Ipsiroglu, Osman
Frontiers in psychiatry,
06/2022, Letnik:
13
Journal Article
Recenzirano
Odprti dostop
Vigilance deficits can be observed after a period of prolonged, continuous wakefulness. In this context there has been extensive research targeting the impact of sleep deficits on different aspects ...of vigilance, but the underlying concept of vigilance was hardly ever addressed and discussed. One reason for this shortcoming is the unclear and ambiguous definition of the term vigilance, which is commonly used interchangeably with sustained attention and even wakefulness. This confusion is the result of a wide range of misleading definitions, starting in the 1940s, as psychologists redefined the concept of vigilance suggested by British Neurologist, Henry Head, in 1923. Nevertheless, the concept of vigilance is still useful and innovative, especially in treating sleep problems in children and young adults. This paper reviews the current usage of the term vigilance in sleep-wake-research and describes not only the benefits, but even more clearly, its limitations. By re-focusing on the definitions given by Henry Head, the concept of vigilance is an innovative way to gather new insights into the interplay between sleep– and daytime behaviors. In addition, future research on vigilance should consider three perspectives: 1st vigilance perceived as a process to allocate resources, 2nd vigilance associated with compensatory behaviors and 3rd the role of vigilance in human environmental interactions. This approach, understood as a conceptual framework, provides new perspectives by targeting sleep-wake behaviors as a ‘real life’ outcome measure, reflecting both physical and cognitive performance as well as sleep quality and quantity.
Self-reported perception of sleep often differs from objective sleep study measures, but factors predicting the discrepancy between self-reported and objective sleep parameters are controversial, and ...a comparison of laboratory vs ambulatory polysomnography (PSG) is lacking.
We retrospectively analyzed PSGs conducted between 2012 and 2016. Linear regression was applied to predict the discrepancy between self-reported and objective sleep parameters (total sleep time, sleep efficiency, sleep latency, using age, sex, arousal index, type of sleep disorder, and PSG type laboratory vs ambulatory as regressors).
A total of 303 PSGs were analyzed (49% women, median age 48 years), comprising patients with insomnia (32%), sleep-related breathing disorders (27%), sleep-related movement disorders (15%), hypersomnia/narcolepsy (14%), and parasomnias (12%). Sleep disorder was the best predictor of discrepancy between self-reported and objective total sleep time, and patients with insomnia showed higher discrepancy values compared to all other patient groups (P < .001), independent of age and PSG type (P > .05). Contributory effects for higher discrepancy values were found for lower arousal index. Patients with insomnia underestimated both total sleep time (median discrepancy: 46 minutes, P < .001) and sleep efficiency (median discrepancy: 11%, P < .001). No significant predictor for discrepancy of sleep latency was found.
Misperception of sleep duration and efficiency is common in sleep lab patients, but most prominent in insomnia, independent of age, sex, or laboratory vs ambulatory recording setting. This underlines the role of PSG in patients with a clinical diagnosis of insomnia and its use in cognitive behavioral therapy.
The discrepancy between natural sleep-wake rhythm and actual sleep times in shift workers can cause sleep loss and negative daytime consequences. Irregular shift schedules do not follow a fixed ...structure and change frequently, which makes them particularly harmful and makes affected individuals more susceptible to insomnia. The present study compares insomnia symptoms of non-shift workers, regular shift workers, and irregular shift workers and takes into account the moderating role of the Big Five personality traits and levels of perfectionism. Employees of an Austrian railway company completed an online survey assessing shift schedules, sleep quality and duration, daytime sleepiness, and personality traits. A total of 305 participants, of whom 111 were non-shift workers, 60 regular shift workers, and 134 irregular shift workers, made up the final sample. Irregular shift workers achieved significantly worse scores than one or both of the other groups in time in bed, total sleep time, sleep efficiency, sleep duration, sleep quality, sleep latency, and the number of awakenings. However, the values of the irregular shifts workers are still in the average range and do not indicate clinical insomnia. Participants working regular shifts reported the best sleep quality and longest sleep duration and showed the least nocturnal awakenings, possibly due to higher conscientiousness- and lower neuroticism scores in this group. Agreeableness increased the effect of work schedule on total sleep time while decreasing its effect on the amount of sleep medication taken. Perfectionism increased the effect of work schedule on time in bed and total sleep time. Generalization of results is limited due to the high percentage of males in the sample and using self-report measures only.
In this case report, we explain the story of a woman diagnosed with severe PTSD, suffering from recurrent nightmares involving a traumatizing event. She participated in 6 week lucid dreaming training ...to help her reduce her nightmare frequency. Our descriptions include her dream reports as well as the results of the psychological assessment conducted. In only 6 weeks, she was able to begin to change her dream plots and to improve several of the psychological measures. In this case, we stated that paying more attention to sleep and, especially nightmares, not only in patients with PTSD, should be standard in treatment processes for psychiatric disorders. We, therefore, underpin our case with literature that explains the benefits of treatments, specifically for sleep problems that do not involve medication.
In order to control the rapid spread of the COVID-19 pandemic, Austria was put under national lockdown beginning on March 13, 2020, forcing its inhabitants to live in home confinement. The aim of ...this study was to measure the impact of the lockdown on sleep and dream behavior in Austrian citizens. 77 participants (50 women, Mage= 40.88 years, SDage = 13.72) filled in an online questionnaire during the lockdown between April and May 2020. Sleep quality, sleep quantity, daytime sleepiness, and nightmare frequency were assessed and analyzed in relation to gender, burnout risk, perfectionism and chronotype. Results demonstrated higher subjective sleep quality during lockdown, especially in women. Daytime sleepiness was significantly lower during the lockdown period while sleep duration did not change. Results suggest that sleep issues are less prominent during the COVID-19 lockdown but point to the importance of prevention and treatment of sleep disorders aside from the pandemic. Findings indicate the need for more flexibility in social time structures to relieve those managing tasks from multiple areas of interests such as working mothers. Generalization of results is limited due to small sample size, self-selection bias, and purely subjective measures.
•Sleep quality was significantly higher during national COVID-19 lockdown in Austria.•Daytime Sleepiness was significantly lower during the COVID-19 lockdown in Austria.•Women reported a bigger improvement in sleep quality during the lockdown.•The pandemic lockdown allows for more flexible time structures and better sleep.•Living situation plays a big role when investigating the impact of a worldwide health crisis.
Social restriction measures (SRM) implemented during the COVID-19 pandemic led to a reduction in time spent outdoors (TSO). The aim of this study was to describe TSO and evaluate its association with ...sleep outcomes, optimism, happiness and health-status before and during SRM. Two online surveys were conducted in 2017 (N = 1004) and 2020, during SRM (N = 1010), in samples representative of the age, sex and region of the Austrian population. Information on the duration of TSO, sleep, optimism, happiness and health-status was collected. Multivariable-adjusted logistic regression models were used to study the association of TSO with chronic insomnia, short sleep, late chronotype, optimism, happiness and self-rated health-status. The mean TSO was 3.6 h (SD: 2.18) in 2017 and 2.6 h (SD: 1.87) during times of SRM. Men and participants who were older, married or in a partnership and lived in a rural area reported longer TSO. Participants who spent less time outdoors were more likely to report short sleep or a late chronotype in both surveys and, in 2020, also chronic insomnia. Less TSO was associated with lower happiness and optimism levels and poor health-status. Our findings suggest that TSO may be a protective factor for sleep, mood and health, particularly during stressful and uncertain times.
Summary
Background
Excessive daytime sleepiness (EDS) is the main complaint in many neurological sleep disorders, such as idiopathic hypersomnia, narcolepsy, or obstructive sleep apnea/hypopnea ...syndrome (OSAS). The validity of the Epworth Sleepiness Scale (ESS) as a screening tool for EDS remains controversial. We therefore investigated (1) the interrelation of the ESS total score and the mean sleep latency (MSL) during the multiple sleep latency test (MSLT) and (2) the diagnostic accuracy of the ESS total score to detect EDS in patients with the chief complaint of subjective EDS.
Methods
A total of 94 patients (48 males) with subjective EDS were included in this study. Regression analyses and ROC curve analyses were carried out to assess the predictive value of the ESS score for MSL.
Results
The ESS score significantly predicted a shortened MSL (
p
= 0.01, β = −0.29). After dichotomizing into two groups, the ESS score predicted MSL only in patients with hypersomnia or narcolepsy (
p
= 0.01, β = −0.33), but not in patients with other clinical diagnoses (e. g. OSAS;
p
= 0.36, β = −0.15). The ROC curve analyses indicated an optimal ESS cut-off value of 16 with a sensitivity of 70%; however, specificity remained unsatisfactory (55.6%).
Conclusions
Our results suggest that the predictive value of the ESS score in patients with subjective EDS is low and patient subgroup-specific (superior in hypersomnia/narcolepsy vs. other diagnoses) and that the commonly used cut-off of 11 points may be insufficient for clinical practice.
Purpose
To measure the effect of a 2-day sleepcoaching seminar on daytime sleepiness and sleep-related variables of shift workers employed in an Austrian railway company (ÖBB: Österreichische ...Bundesbahnen).
Method
Participants filled in pre- and post-intervention questionnaires, containing items of the PSQI and the ESS, questions about chronotype, personality factors and possible burnout risk factors. About 30 shift workers, working in shifts for more than 300 months on average (28 male; mean age = 24 ± 45.90, age range 24–56 years) voluntarily took part in the investigation twice. Sleep coaching by Holzinger and Kloesch™ (SC) is a new holistic approach for non-pharmacological treatment of non-restorative sleep and is based on Gestalt therapy. It includes psychotherapeutic aspects, which enable clients to improve their sleep quality by developing one’s own coping strategies which can be implemented in daily routine. Dream work and relaxation techniques are also part of the programme.
Results
The 2-day SC seminar was beneficial by focusing on the sleep problems related to shift work. A significant improvement of the global PSQI score and the PSQI variables subjective sleep quality, diurnal fatigue, and sleep latency was achieved, with a medium effect size. However, the programme did not result in the reduction of daytime sleepiness (ESS). Six more variables did not change significantly.
Conclusion
While some sleep problems related to shift work were successfully addressed by SC, daytime sleepiness (ESS) could not be reduced contrary to our expectations. More research with a greater sample and a longitudinal design is needed to examine the long-term effects of SC.
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