Pre-Race Sleep Management Strategy and Chronotype of Offshore Solo Sailors

Purpose: To evaluate chronotype and the sleep management strategy adopted by sailors before the offshore solo sailing race “Mini Transat La Boulangère”. As secondary aim, we assessed whether adopting pre-race sleep management strategy influences performance at race. Materials and Methods: Forty-two solo sailors completed questionnaires on sleep quality, sleepiness, chronotype and an ad hoc questionnaire on the pre-race sleep management strategy adopted. Arrival times, separately for each race’s leg, were provided by the race organization team. Results: Solo sailors present mainly with a morning-type (40%) and intermediate-type (60%) chronotype, while none have an evening-type chronotype. Fifty-five percent of sailors adopted pre-race sleep management strategy. Sailors that adopted strategy have travelled more miles in offshore compared to sailors that did not adopt strategy (p<0.05). Significant differences emerged in rMEQ scores, with sailors that adopted strategy presenting lower score compared to sailors that did not adopt sleep strategy (p<0.05), as well as in chronotype distribution with morning-type sailors that are less likely to adopt pre-race sleep management strategy compared to intermediate type sailors (p<0.05). No differences emerged in final arrival times and in arrival time at leg1 and leg2. The most commonly adopted strategy (52% of sailors) consists of sleep extension, followed by the polyphasic sleep (26%), and sleep deprivation (22%) strategy. Sailors trained in polyphasic sleep have higher ESS than sailors trained in sleep deprivation (p<0.05). Conclusion: Morning-type chronotype is overrepresented in this large cohort of solo sailors compared to the general population; moreover, chronotype seems to influence the adoption of sleep management strategy. A little over half of solo sailors participating in the Mini Transat trained in sleep management strategy before the race; however, neither the general adoption of pre-race sleep management strategy nor the adoption of a specific sleep strategy seems to significantly influence final arrival times

L'attraversamento del Serchio in localita' S.Anna sulla rete ciclo-pedonale nell'ambito del Parco Fluviale Lucchese

Introduzione e progettazione preliminare di una passerella pedonale strallata e sua contestualizzazione nella rete di percorsi ciclo-pedonali interni al Parco Fluviale Lucches

Circadian Rhythms and Attentional Dysfunction in type1 Narcolepsy

The aim of this investigation was to explore the nature and the severity of circadian abnormalities and attentional deficit in type 1 narcolepsy. In three studies, narcolepsy patients were compared with patients suffering from other central disorders of hypersomnolence and healthy controls on attentional functions and circadian rhythms. Study 1 evaluated the sensibility of actigraphic monitoring in distinguishing the features of daytime and nighttime sleep between adult patients with type 1 Narcolepsy, Idiopathic Hypersomnia and healthy controls. Actigraphy provides a reliable assessment of sleep quality and daytime napping behavior able to distinguish central disorders of hypersomnolence and identify Narcolepsy Type 1 patients. Study 2 describes the features of circadian activity rhythm of narcolepsy type 1 children with recent disease onset. Type 1 narcolepsy children and healthy children were monitored for seven days during the school week, circadian activity rhythms were analyzed through functional linear modeling. Children with type 1 narcolepsy present an altered rest-activity rhythm characterized by enhanced motor activity throughout the night and blunted activity in the first afternoon. The observation of a discrete circadian profile provides new insight on the nature of diurnal variations and suggested that the quantitative assessment of motor activity is a promising behavioral biomarker of Type 1 narcolepsy. The aim of Study 3 was to explore the nature and the severity of attentional Deficits of Narcoleptic patients. This study examined whether narcoleptic patients would exhibit impairments in alerting, orienting, and executive control of attention relative to healthy controls. Narcoleptic patients present a deficit in alerting network, while orienting and executive control networks resulted preserved. Moreover the alerting network efficiency significantly correlate with levels of subjective sleepiness. Results indicates that in narcolepsy the unstable tonic component of alerting process make necessary monitoring and compensation strategies

Validity of the Perceived Physical Ability Scale for Children: An Actigraphic Study

This study aimed to provide evidence of the validity of the Perceived Physical Ability Scale for Children against an external-objective criterion of the 24 h motor activity pattern assessed through actigraphy. A total of 107 children (60 females; mean age 10.25 ± 0.48) were originally enrolled. Children wore the actigraph model Actiwatch AW64 (Cambridge Neurotechnology Ltd., Fenstanton, UK) for seven days, 24 h per day, around the non-dominant wrist. At the beginning of the actigraphic recording, participants filled in the Perceived Physical Ability Scale for Children. Functional Linear Modeling was used to examine variation in the 24 h motor activity pattern according to the total score in the Perceived Physical Ability Scale for Children. Higher physical self-efficacy was significantly related to greater levels of motor activity in the afternoon. Overall, this pattern of results supports the validity of the Perceived Physical Ability Scale for Children against the external-objective criterion of the 24 h motor pattern. The Perceived Physical Ability Scale for Children could represent a promising endpoint for studies assessing the effectiveness of physical activity promotion interventions

Metabolic and cardiovascular response to exercise in patients with type 1 diabetes

Physical activity is an effective therapeutic tool for cardiovascular risk prevention. However, exercise aerobic capacity of patients with type 1 diabetes (T1DM) has not been thoroughly investigated. Aim of the present study is to evaluate exercise aerobic capacity in patients with T1DM compared to a normal control population

In-field assessment of sodium oxybate effect in pediatric type 1 narcolepsy: An actigraphic study

Study Objectives: Sodium oxybate (SXB) is a GABAergic agent widely used as off-label treatment in pediatric type 1 narcolepsy (NT1). Here, we aimed at analyzing by wrist actigraphy the sleep/wake profile of NT1 children and adolescents in drug-na\uefve condition and after 1 year of SXB treatment. As secondary aim, we investigated changes on sleepiness, cataplexy, and children's anthropometric profile after 1 year of SXB treatment. Methods: Twenty-four drug-na\uefve NT1 children underwent 7 days of actigraphy during the school week. Information on sleepiness, narcolepsy symptoms, and anthropometric features were collected during the same week with questionnaires and semistructured clinical interview. Children started SXB treatment and underwent a second evaluation encompassing actigraphy, clinical interview, questionnaires, and anthropometric assessment after 1 year of stable treatment. Results: Actigraphy effectively documented an improvement of nocturnal sleep quality and duration coupled with a reduction of diurnal total sleep time, nap frequency, and duration at 1 year follow-up. Reduction of sleepiness, cataplexy frequency and severity, and weight loss, mainly in obese and overweight NT1 children, were also observed at the 1 year follow-up. Conclusions: Actigraphy objectively documented changes in nocturnal sleep quality and diurnal napping behavior after 1 year of SXB treatment, thus representing a valid approach to ecologically assess SXB treatment effect on NT1 children's sleep/wake profile. NT1 symptoms severity and children's anthropometric features also changed as expected. Actigraphy offers the possibility to longitudinally follow up children and has potential to become a key tool to tailor treatment in pediatric patients

Meditation-Relaxation (MR Therapy) for Sleep Paralysis: A Pilot Study in Patients With Narcolepsy

Sleep paralysis (SP) is a condition where a person is paralyzed upon waking or falling asleep. SP afflicts ~20% of people, and is also one of the typical symptoms in narcolepsy. During SP the sleeper may experience hallucinations. Unsurprisingly, SP is associated with great fear globally. To date, there are no published clinical trials or outcome data for treating this condition. However, few non-pharmacological interventions have been proposed, including cognitive behavioral approaches, and case studies showing clinical amelioration with auto-hypnosis and Meditation-Relaxation (MR) therapy. The latter for instance showed positive preliminary results; when applied for 8 weeks it reduced SP frequency and anxiety/worry symptoms. With this paper we aimed to evaluate, with a small-scale pilot study, the efficacy of MR therapy for SP in patients with narcolepsy. Ten patients with narcolepsy and SP were enrolled in the study. Notably, MR therapy (n = 6), applied for 8 weeks, resulted in a dramatic decrease in the number of days SP occurred (50% reduction); and the total number of SP episodes (54% reduction) in the last month of the study (demonstrated by large within-group effect sizes); unlike the control intervention (deep breathing) (n = 4). These findings are preliminary and exploratory given the small sample. Nonetheless, they represent the first proof of concept at providing empirically-guided insights into the possible efficacy of a novel treatment for frequently occurring SP. Although the study was conducted in patients with narcolepsy we cautiously suggest that the findings may generalize to individuals with isolated SP

Characterization of the Santa Maria del Fiore Cupola construction tools using X-ray fluorescence

This paper presents the characterization of different tools employed in the construction of the Santa Maria del Fiore cathedral in Florence; they are part of the Opera di Santa Maria del Fiore collection and are currently exhibited in the Museo dell’Opera del Duomo. The analyzed objects are turnbuckles, pulleys, three-legged lewises, and pincers; indeed, despite their uniqueness and their importance from the historical point of view, this study is the first one that investigates their alloys composition. Actually, this information can be of great interest for curators to find the best conservation strategies and to have new insights on the production techniques typical of the Renaissance. The study was performed using X-Ray Fluorescence (XRF) in order to identify the materials constituting the objects. Then, XRF spectra were analyzed using chemometric techniques, namely Principal Components Analysis (PCA), in order to investigate possible similarities among different alloys and thus provide new indications to help collocating these tools in a specific historical period

Non-24-hour sleep-wake rhythm disorder and melatonin secretion impairment in a patient with pineal cyst

We report the case of a 14-year-old girl with a wide non-compressive pineal cyst, associated with the inability to control her sleep-wake schedule. Actigraphic monitoring showed a 24-hour free-running disorder (tau 26.96 hours). A 24-hour serum melatonin curve assay, with concomitant video-polysomnographic and body-core temperature monitoring, was performed. Melatonin curve showed a blunted nocturnal peak, lower total quantity of melatonin, and prolonged melatonin secretion in the morning, with normal temperature profile and sleep parameters. Treatment with melatonin up to 14 mg at bedtime was initiated with complete realignment of the sleep-wake rhythm (tau 23.93 hours). The role of the pineal cyst in the aforementioned alteration of melatonin secretion and free-running disorder remains controversial, but our case supports the utility of monitoring sleep/wake, temperature, and melatonin rhythms in the diagnostic work-up of pineal cysts associated with free-running disorder

The spectrum of REM sleep-related episodes in children with type 1 narcolepsy

Type 1 narcolepsy is a central hypersomnia due to the loss of hypocretin-producing neurons and characterized by cataplexy, excessive daytime sleepiness, sleep paralysis, hypnagogic hallucinations and disturbed nocturnal sleep. In children, close to the disease onset, type 1 narcolepsy has peculiar clinical features with severe cataplexy and a complex admixture of movement disorders occurring while awake. Motor dyscontrol during sleep has never been systematically investigated. Suspecting that abnormal motor control might affect also sleep, we systematically analysed motor events recorded by means of video polysomnography in 40 children with type 1 narcolepsy (20 females; mean age 11.8 \ub1 2.6 years) and compared these data with those recorded in 22 age- and sex-matched healthy controls. Motor events were classified as elementary movements, if brief and non-purposeful and complex behaviours, if simulating purposeful behaviours. Complex behaviours occurring during REM sleep were further classified as 'classically-defined' and 'pantomime-like' REM sleep behaviour disorder episodes, based on their duration and on their pattern (i.e. brief and vivid-energetic in the first case, longer and with subcontinuous gesturing mimicking daily life activity in the second case). Elementary movements emerging either from non-REM or REM sleep were present in both groups, even if those emerging from REM sleep were more numerous in the group of patients. Conversely, complex behaviours could be detected only in children with type 1 narcolepsy and were observed in 13 patients, with six having 'classically-defined' REM sleep behaviour disorder episodes and seven having 'pantomime-like' REM sleep behaviour disorder episodes. Complex behaviours during REM sleep tended to recur in a stereotyped fashion for several times during the night, up to be almost continuous. Patients displaying a more severe motor dyscontrol during REM sleep had also more severe motor disorder during daytime (i.e. status cataplecticus) and more complaints of disrupted nocturnal sleep and of excessive daytime sleepiness. The neurophysiological hallmark of this severe motor dyscontrol during REM sleep was a decreased atonia index. The present study reports for the first time the occurrence of a severe and peculiar motor disorder during REM sleep in paediatric type 1 narcolepsy and confirms the presence of a severe motor dyscontrol in these patients, emerging not only from wakefulness (i.e. status cataplecticus), but also from sleep (i.e. complex behaviours during REM sleep). This is probably related to the acute imbalance of the hypocretinergic system, which physiologically acts by promoting movements during wakefulness and suppressing them during sleep