Assessing the daily stability of the cortisol awakening response in a controlled environment.

Background: Levels of cortisol, the end product of the hypothalamic-pituitary-adrenal (HPA) axis, display a sharp increase immediately upon awakening, known as the cortisol awakening response (CAR). The daily stability of the CAR is potentially influenced by a range of methodological factors, including light exposure, participant adherence, sleep duration and nocturnal awakenings, making inferences about variations in the CAR difficult. The aim of the present study was to determine the daily stability of multiple measurement indices of the CAR in a highly-controlled sleep laboratory environment.

Morningness/eveningness and the synchrony effect for spatial attention.

There is evidence that a decrease in alertness is associated with a rightward shift of attention. Alertness fluctuates throughout the day and peak times differ between individuals. Some individuals feel most alert in the morning; others in the evening.

A 30-Minute, but Not a 10-Minute Nighttime Nap is Associated with Sleep Inertia.

Study Objectives: To assess sleep inertia following 10-min and 30-min naps during a simulated night shift.

Methods: Thirty-one healthy adults (aged 21-35 y; 18 females) participated in a 3-day laboratory study that included one baseline (BL) sleep (22:00-07:00) and one experimental night involving randomization to either: total sleep deprivation (NO-NAP), a 10-min nap (10-NAP) or a 30-min nap (30-NAP). Nap opportunities ended at 04:00.

Alcohol use in shiftworkers.

It has been suggested that shiftworkers may consume alcohol to help them sleep, resulting in greater consumption. A large study in Australian workers suggested that those on non-standard schedules (outside 8am-6pm, Monday-Friday) do not drink more, but are at increased odds of binge drinking (heavy periods of drinking followed by abstinence) than workers on standard schedules. However, differences in types of non-standard schedules were not examined in the study.

Do night naps impact driving performance and daytime recovery sleep?

Short, nighttime naps are used as a fatigue countermeasure in night shift work, and may offer protective benefits on the morning commute. However, there is a concern that nighttime napping may impact upon the quality of daytime sleep. The aim of the current project was to investigate the influence of short nighttime naps (<30min) on simulated driving performance and subsequent daytime recovery sleep.

The sleep architecture of Australian volunteer firefighters during a multi-day simulated wildfire suppression: Impact of sleep restriction and temperature.

Wildland firefighting exposes personnel to combinations of occupational and environmental stressors that include physical activity, heat and sleep restriction. However, the effects of these stressors on sleep have rarely been studied in the laboratory, and direct comparisons to field scenarios remain problematic. The aim of this study was to examine firefighters' sleep during a three-day, four-night simulated wildfire suppression that included sleep restriction and physical activity circuits representative of firefighting wildfire suppression tasks in varied temperatures.

Sleep inertia associated with a 10-min nap before the commute home following a night shift: A laboratory simulation study.

Night shift workers are at risk of road accidents due to sleepiness on the commute home. A brief nap at the end of the night shift, before the commute, may serve as a sleepiness countermeasure. However, there is potential for sleep inertia, i.

Using interstimulus interval to maximise sensitivity of the Psychomotor Vigilance Test to fatigue.

There is some evidence that short interstimulus intervals (ISIs) on the Psychomotor Vigilance Test (PVT) are associated with longer and more varied reaction times (RTs). Preparation processes may impede RT following short ISIs, resulting in additional unexplained variance. The aims of this study were to investigate whether there is an effect of ISI on RT and errors within the PVT, and whether such an effect changes with three elements of fatigue: time of day, prior wake and time on task.

REM dream activity of insomnia sufferers: a systematic comparison with good sleepers.

Background And Objective: The dream activity of patients with primary insomnia (PI) has rarely been studied, especially using in-laboratory dream collection, although dreams could be linked to their state of hyperarousal and their negative waking experiences. The objective of the study was to compare patients with PI and good sleeper controls (GSCs) in terms of dream recall frequency and dream content.

Patients/methods: Polysomnography was recorded in 12 patients with PI and 12 GSCs (aged between 30 and 45 years) for five consecutive nights.

Increased Sensitivity of the Circadian System to Light in Early/Mid-Puberty.

Context: Late adolescence is marked by a delay in sleep timing, which is partly driven by a delay shift of the circadian timing system. This study examined whether the sensitivity of the circadian system to light-the primary entraining stimulus to the circadian system-differs between pre- to mid-pubertal and late to postpubertal adolescents.

Objective: The study was designed to determine the influence of puberty on the sensitivity of the circadian system to light in humans.

People with insomnia: experiences with sedative hypnotics and risk perception.

Background: Sedative hypnotics form an important part of managing insomnia and are recommended for short-term use. It is standard practice for clinicians to inform the patient to use medications only 'when required', but the use of these medications is often chronic. Little is known about the impact of standard labelling/instructions on promoting appropriate medication use for managing insomnia.

Sleepiness and Cognitive Performance among Younger and Older Adolescents across a 28-Hour Forced Desynchrony Protocol.

Study Objectives: Quantify the homeostatic and circadian effects on sleepiness and performance of adolescents. Examine age-related changes in homeostatic and circadian regulation of sleepiness and performance by comparing younger and older adolescent groups.

Design: Three-week laboratory study including 12 cycles of a 28-h forced desynchrony protocol.

Sleep deprivation leads to mood deficits in healthy adolescents.

Study Objectives: The objectives of the study were to investigate the effects of 36 h of sleep deprivation on the discrete mood states of anger, depression, anxiety, confusion, fatigue, and vigour in healthy adolescents.

Method: Twelve healthy adolescent good sleepers (six male), aged 14-18 years (M = 16.17, standard deviation (SD) = 0.

Estimating sleep from multisensory armband measurements: validity and reliability in teens.

Given the recognition that sleep may influence obesity risk, there is increasing interest in measuring sleep parameters within obesity studies. The goal of the current analyses was to determine whether the SenseWear(®) Pro3 Armband (armband), typically used to assess physical activity, is reliable at assessing sleep parameters. The armband was compared with the AMI Motionlogger(®) (actigraph), a validated activity monitor for sleep assessment, and with polysomnography, the gold standard for assessing sleep.

A systematic review of the sleep, sleepiness, and performance implications of limited wake shift work schedules.

Objectives: The aim of this review was to identify which limited wake shift work schedules (LWSW) best promote sleep, alertness, and performance. LWSW are fixed work/rest cycles where the time-at-work does is ≤8 hours and there is >1 rest period per day, on average, for ≥2 consecutive days. These schedules are commonly used in safety-critical industries such as transport and maritime industries.

Surgical site infection-a population-based study in Australian adults measuring the compliance with and correct timing of appropriate antibiotic prophylaxis.

Prophylaxis for surgical site infection (SSI) is often at variance with guidelines, despite the prevalence of SSI and its associated cost, morbidity, and mortality. The CareTrack Australia study, undertaken by a number of the authors, demonstrated that appropriate care (in line with evidence- or consensus-based guidelines) was provided at 38% of eligible SSI healthcare encounters. Here, we report the indicator-level CareTrack Australia findings for SSI prophylaxis.

The Timing of the Circadian Clock and Sleep Differ between Napping and Non-Napping Toddlers.

The timing of the internal circadian clock shows large inter-individual variability across the lifespan. Although the sleep-wakefulness pattern of most toddlers includes an afternoon nap, the association between napping and circadian phase in early childhood remains unexplored. This study examined differences in circadian phase and sleep between napping and non-napping toddlers.

CareTrack Kids-part 3. Adverse events in children's healthcare in Australia: study protocol for a retrospective medical record review.

Introduction: A high-quality health system should deliver care that is free from harm. Few large-scale studies of adverse events have been undertaken in children's healthcare internationally, and none in Australia. The aim of this study is to measure the frequency and types of adverse events encountered in Australian paediatric care in a range of healthcare settings.

CareTrack Kids-part 2. Assessing the appropriateness of the healthcare delivered to Australian children: study protocol for a retrospective medical record review.

Introduction: Australian and international clinical practice guidelines are available for common paediatric conditions. Yet there is evidence that there are substantial variations between the guidelines, recommendations (appropriate care) and the care delivered. This paper describes a study protocol to determine the appropriateness of the healthcare delivered to Australian children for 16 common paediatric conditions in acute and primary healthcare settings.

CareTrack Kids-part 1. Assessing the appropriateness of healthcare delivered to Australian children: study protocol for clinical indicator development.

Introduction: Despite the widespread availability of clinical guidelines, considerable gaps remain between the care that is recommended (appropriate care) and the care provided. This protocol describes a research methodology to develop clinical indicators for appropriate care for common paediatric conditions.

Methods And Analysis: We will identify conditions amenable to population-level appropriateness of care research and develop clinical indicators for each condition.

Evaluation of novel school-based interventions for adolescent sleep problems: does parental involvement and bright light improve outcomes?

Objectives: The current study aimed to evaluate school-based motivational sleep education programs (SEPs) with adjunct bright light therapy (BLT) and/or parental involvement (PI).

Design: Randomized controlled trial.

Setting: Six high schools, matched on socio-economic status (SES).

Accuracy of self-reported sleep position in late pregnancy.

Background: There is emerging research to suggest that supine maternal sleep position in late pregnancy may adversely affect fetal wellbeing. However, these studies have all been based on maternal report of sleeping position. Before recommendations to change sleep position can be made it is important to determine the validity of these studies by investigating how accurate pregnant women are in reporting their sleep position.

Treating Acute Insomnia: A Randomized Controlled Trial of a "Single-Shot" of Cognitive Behavioral Therapy for Insomnia.

Study Objectives: Despite considerable evidence supporting cognitive behavioral therapy for insomnia (CBT-I) for chronic insomnia, it remains untested within the context of acute insomnia. This study examined the efficacy of a single session of CBT-I, with an accompanying self-help pamphlet, for individuals with acute insomnia.

Design: A pragmatic parallel group randomized controlled trial.

A longitudinal assessment of sleep timing, circadian phase, and phase angle of entrainment across human adolescence.

The aim of this descriptive analysis was to examine sleep timing, circadian phase, and phase angle of entrainment across adolescence in a longitudinal study design. Ninety-four adolescents participated; 38 (21 boys) were 9-10 years ("younger cohort") and 56 (30 boys) were 15-16 years ("older cohort") at the baseline assessment. Participants completed a baseline and then follow-up assessments approximately every six months for 2.