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Polyphasic Sleep / Wake Patterns and Their Significance To Vigilance (
Polyphasic Sleep / Wake Patterns and Their Significance To Vigilance (
SUMMARY
Under conditions i n which no r e s t r a i n t s on s l e e p and minimized
a l t e r n a t i v e s t o s l e e p are given, the sleep/wake p a t t e r n e x h i b i t s a
polyphasic d i s t r i b u t i o n • This r e s u l t was found i n a study i n which
12 subjects were p o l y g r a p h i c a l l y recorded i n two sessions, each
lasting 32 hours. During one session, t h e subjects had constant
bedrest f o r t h e e n t i r e p e r i o d , while the other session s t a r t e d w i t h
8 hours o f s l e e p d e p r i v a t i o n , followed by constant bedrest. During
the day, subjects s l e p t a t average i n t e r v a l s o f 4 hours. After
s l e e p d e p r i v a t i o n , t h e recovery sleep covered t h e time i n t e r v a l o f
the f i r s t two nap episodes o f t h e c o n d i t i o n without sleep depriva-
tion. Compared t o b a s e l i n e a l e r t n e s s , mood and performance a r e
decreased during these two c o n d i t i o n s . This r e s u l t suggests t h e
presence o f an underlying polyphasic placement o f sleep and wake-
fulness. Under t h e given c o n d i t i o n , the r e a l i z a t i o n o f such a
sleep/wake p a t t e r n leads t o oversleeping, which r e s u l t s i n a de-
t e r i o r a t i o n i n the psychological variables.
Introduction
In numerous s t u d i e s (e.g. Wever, 1979) i t has been concluded t h a t t h e
human sleep/wake system i s governed by a c i r c a d i a n c l o c k mechanism. Such an
underlying r e g u l a t i o n has a l s o been assumed i n s t u d i e s which focused on t h e
influence o f t h e sleep/wake p a t t e r n on performance (Taub & Berger, 1973).
Other s t u d i e s i n t h i s context have analyzed the p s y c h o l o g i c a l consequences
o f r e s t r i c t e d s l e e p (Mullaney e t a l . , 1983), t h e recuperative f u n c t i o n o f a
nap a f t e r s l e e p d e p r i v a t i o n (Naitoh, 1981) and the i n f l u e n c e o f a d d i t i o n a l
s l e e p given as scheduled naps (Dinges e t a l . , 1981; Godbout & M o n t p l a i s i r ,
1986).
Methods
Twelve healthy volunteers (7 females, 5 males; ages 17-46) p a r t i c i p a t e d
i n t h i s study* Each subject underwent two sessions i n the s l e e p l a b o r a t o r y ,
each l a s t i n g 32 hours, s t a r t i n g a t 23:00* One s e s s i o n began w i t h constant
bedrest (condition S). The other session comprised o f an 8-hour p e r i o d o f
total sleep d e p r i v a t i o n followed by constant bedrest f o r t h e remaining 24
hours ( c o n d i t i o n TSD). I n constant bedrest t h e subjects had t o c o n s t a n t l y
l i e i n bed, where they c o u l d take t h e i r snacks as they wished.
The c o n t r o l o f t h e dim i l l u m i n a t i o n i n the room was a t the d i s c r e t i o n o f
the s u b j e c t , who had no knowlege o f the time o f day. Subjects had no p o s s i -
bility t o read, write, l i s t e n t o music, or exercise. I t was p o s s i b l e t o
cxxtitunicate w i t h subjects (e.g. regarding experimental i n s t r u c t i o n s ) by an
intercom system.
The f o l l o w i n g measurements were recorded continuously: EBG, BOG, EMG,
r e c t a l temperature and w r i s t a c t i v i t y .
Subjects were asked t o estimate t h e i r mood and a l e r t n e s s hourly on sepa-
r a t e 100 itm v i s u a l analogue s c a l e s ( a l e r t n e s s : 0=drowsy, 100=alert; mood:
0=negative, 100=positive). A t t h e same time a performance t e s t (Test d2:
c o n c e n t r a t i o n speed t e s t , Brickenkanp 1975) was c a r r i e d out.
The sequence o f the two c o n d i t i o n s (S; TSD) was randomized. Before
each session, each subject underwent b a s e l i n e measurements i n which he
estimated h i s mood and a l e r t n e s s and c a r r i e d out t h e performance tests
hourly during h i s normal d a i l y l i f e .
The criterion used here t o d e f i n e a s l e e p episode was: a sequence o f
successive uninterrupted 6-minute i n t e r v a l s of polygraphically recorded
sleep i f these were not i n t e r r u p t e d by sequences o f wakefulness lasting
longer than 30 min.
A major s l e e p episode (MSE) was defined as any sleep episode i n i t i a t e d i n
the night phase (20:00 - 7:00). A nap was defined as any s l e e p episode
i n i t i a t e d between 7:00 and 20:00.
Results
O v e r a l l sleep/wake p a t t e r n
Oondition S
I n t h i s s e s s i o n , the s u b j e c t s s l e p t an average o f 18.8 4 1.8 hours (59%).
Hie d i s t r i b u t i o n o f s l e e p over the day and the n i g h t s can be seen i n Table
1. It i s shown t h a t the r e l a t i v e amount o f s l e e p taken during the day was
about h a l f o f the amount taken d u r i n g the n i g h t s . Furthermore, compared t o
the first night, the amount o f s l e e p was s l i g h t l y reduced i n the second
night.
On average, the f i r s t major s l e e p episode (MSE) s t a r t e d a t 23:54 ± 24 min
w h i l e the second MSE was i n i t i a t e d a t 23:16 ± 88 min. Sleep onset l a t e n c y i n
the f i r s t MSE had a mean o f 28.0 £ 16 min. The d u r a t i o n o f the s l e e p epi-
sodes throughout the e n t i r e experiment showed a c l e a r c i r c a d i a n variation
with long s l e e p episodes i n i t i a t e d d u r i n g the first night, short sleep
episodes i n i t i a t e d during t h e day and again long s l e e p episodes i n i t i a t e d i n
the second n i g h t (Table 2 ) . The waking episodes (only those longer then 30
min) were longer when i n i t i a t e d d u r i n g the day than during the n i g h t (Table
2).
The frequency of napping ( s l e e p episodes i n i t i a t e d between 7:00 and
20:00) per s u b j e c t showed a c l e a r peak w i t h 3 naps (6 s u b j e c t s ) , while 3
s u b j e c t s took 2 naps, 2 s u b j e c t s took 5 naps, and one s u b j e c t took 6 naps.
With respect t o the placement o f the roost frequent 3-nap s t r u c t u r e , it was
possible t o c l e a r l y d i f f e r e n t i a t e t h e i r time of occurrence. A l l f i r s t naps
(nap 1) were taken between 7:00 and 12:00 w i t h a mean a t 9:30. A l l second
naps (nap 2) were taken between 11:30 and 16:30 w i t h a mean a t 13:45. A l l
t h i r d naps (nap 3) were taken between 16:00 and 20:00 w i t h a mean a t 18:15.
The placement of these naps i s used i n t h e f o l l o w i n g f o r the d i f f e r e n t i a t i o n
of a l l naps. The upper p a r t o f Figure 1 shows a summation histogram o f the
number of subjects asleep with a d i f f e r e n t i a t i o n i n t o d i f f e r e n t groups of
naps. The t h r e e groups of naps can be seen t o be between two MSEs. The phase
positions o f the nap groups and t h e amount of s l e e p w i t h i n these groups can
be seen i n Table 3. The placement o f the o v e r a l l groups o f naps i s nearly
identical to the placement o f naps by those s u b j e c t s showing the 3-nap
structure.
Oondition TSD
One subject was excluded from the f o l l o w i n g data analysis because he
slept continuously for 24 hours w i t h the exception of one interruption
( i n t e r v e n i n g wakefulness longer than 30 minutes). I n t h i s s e s s i o n , t h e other
subjects s l e p t an average o f 17.5 t 2.3 hours (73%). The s l e e p was d i s t r i -
buted over t h e day and t h e n i g h t w i t h more absolute amount o f s l e e p during
the day than during the n i g h t (Table 4 ) .
The onset o f t h e f i r s t sleep episode a f t e r TSD (recovery sleep) was a t
7:17 t 14 min, w h i l e t h e MSE began a t 23:27 ± 75 min i n t h e f o l l o w i n g n i g h t .
Sleep onset latency i n t h e recovery sleep was 6.0 min ± 5.4 min. The dura-
tion o f t h e s l e e p episodes showed long sleep episodes a f t e r TSD (recovery
sleep), s h o r t e r episodes during t h e r e s t o f the day and long s l e e p episodes
again i n t h e n i g h t phase (Table 5 ) .
time of day
Figure 1
Sutmation histogram o f t h e number o f subjects asleep over t h e e n t i r e e x p e r i -
mental episode i n l o c a l time. Upper p a r t : c o n d i t i o n S; lower p a r t : c o n d i t i o n
TSD. Sleep episodes a r e d i f f e r e n t i a t e d w i t h respect t o a 3-nap structure
(see text>.
Table 1* Amount o f s l e e p (mean t SD) i n each phase i n a b s o l u t e (hours) and
r e l a t i v e values (percentage o f each phase) under c o n d i t i o n S.
Discussion
Under conditions allowing spontaneous expression o f t h e sequence o f
sleeping and waking, a polyphasic d i s t r i b u t i o n of the occurrence of sleep
becomes obvious. Under these c o n d i t i o n s , the placement of sleep shows pre-
ferred phase p o s i t i o n s throughout the day besides major sleep episodes i n
the n i g h t phase. The p e r i o d i c occurrence of day sleep a t i n t e r v a l s of about
4 hours has a l s o been found i n e a r l i e r s t u d i e s . Nakagawa (1980) reported a
sleep/waking c y c l e length of approximately 4 hours f o r subjects confined t o
Change in performance
high Median of performance in 4 and 6 hour blocks
520-
500-
CD
c
tX)
E
o 480-
<_
o>
CL
460-
440<
Figure 2
Performance measurements i n the three c o n d i t i o n s and during s l e e p depriva-
t i o n . Values (median) are averaged over 4 and 6-hour b l o c k s .
bed f o r 10-12 hours during the day. I n experiments without time cues, when
s u b j e c t s showed i n t e r n a l desynchronization o f rhythms, s e v e r a l peaks i n the
distribution o f s u b j e c t i v e n i g h t s l e e p c o u l d be observed d u r i n g the circa-
d i a n day ( Z u l l e y and Wever, 1982). These peaks had a mean i n t e r v a l o f 5.74
hours. I n a study where s u b j e c t s were recorded d u r i n g 60 hours o f enforced
bedrest, the median day phase sleep/waking c y c l e length was 4.65 hours
(Canpbell, 1984).
These r e s u l t s support t h e assumption t h a t t h e huran sleep/wake system is
more a c c u r a t e l y described by a polyphasic d i s t r i b u t i o n w i t h a 4-hour p e r i o d .
The a c t u a l frequency of napping seems t o depend on the degree t o which the
conditions a l l o w such napping and on the presence o f b e h a v i o r a l o p t i o n s to
sleep. This aspect can be d e s c r i b e d by a p u t a t i v e s l e e p t h r e s h o l d which i s
decreased under the above mentioned experiments. This sleep threshold has
been r a i s e d experimentally by a l l o w i n g more b e h a v i o r a l options to sleep
(Caiqpbell & Z u l l e y , 1985). I n t h i s study, s u b j e c t s showed a c l e a r l y bimodal
distribution o f s l e e p and wakefulness. The nap peak occurred a t about the
same time as nap 2 i n the present experiment. In other words, nap 1 and nap
3, the two adjacent phase p o s i t i o n s f o r s l e e p , were masked by the decrease
o f s l e e p p r o p e n s i t y w h i l e nap 2 s t i l l remained. A p o s s i b l e i n t e r p r e t a t i o n of
this is that, by r a i s i n g the s l e e p t h r e s h o l d , the two l e s s robust phase
positions f o r sleep were diminished, w h i l e the more robust phase p o s i t i o n
(nap 2) can s t i l l be seen, p l a c e d halfway between the two major sleep
episodes. Such a bimodal d i s t r i b u t i o n can a l s o be seen i n experiments in
which no i n s t r u c t i o n s regarding s l e e p were given o r when s u b j e c t s napped i n
s p i t e o f the i n s t r u c t i o n s ( Z u l l e y & Campbell, 1985). I f , i n a d d i t i o n , the
propensity f o r s l e e p i s s t i l l decreased by experimental instructions, the
sleep/wake p a t t e r n becomes monophasic. T h i s r e s u l t can be seen i n experi-
ments where napping i s e f f e c t i v e l y suppressed by i n s t r u c t i o n s (Wever, 1979).
The r e s u l t t h a t some s u b j e c t s show a monophasic s l e e p placement, even when
napping i s allowed, c o u l d be e x p l a i n e d by the assumption t h a t the sleep
t h r e s h o l d shows strong i n d i v i d u a l d i f f e r e n c e s . T h i s r e s u l t s i n the phenome-
non that, at a given s l e e p t h r e s h o l d (when napping is allowed), some
s u b j e c t s f e e l unable t o take a nap ( Z u l l e y & Canpbell; i n p r e p a r a t i o n ) .
This variation in the degree o f s l e e p propensity can a l s o be seen in
d a i l y l i f e . I n newborns, M e i e r - K o l l (1979) showed "that the u l t r a d i a n 4-hour
rhythm e s t a b l i s h e d a l r e a d y a t b i r t h does not disappear during the first
month o f l i f e " .
I t can be assumed t h a t , i n newborns, the sleep t h r e s h o l d i s decreased and
that, w i t h aging, the t h r e s h o l d increases. This assumption i s supported by
the finding that, i n children, the polyphasic p a t t e r n becomes b i p h a s i c ,
which i n our western c u l t u r e i s replaced by a ironophasic p a t t e r n i n a d u l t s .
This hypothesis i s a l s o supported by s t u d i e s which show t h a t , in other
cultures with less structured sociocultural conditions, a biphasic pattern
still remains (Soldatos e t a l . , 1983). I n the g e r i a t r i c population the
b i p h a s i c p a t t e r n reappears, assuming a decrease of the sleep t h r e s h o l d w i t h
age. This p a t t e r n can become polyphasic as has been shown i n demented pa-
t i e n t s (Spiegel e t a l . , 1985). I n a l l these cases, the d i f f e r e n t p r e f e r r e d
phase p o s i t i o n s f o r s l e e p correspond t o those p o s i t i o n s found i n the present
experiment.
Thus, i t can be concluded t h a t the human sleep/wake system i s b a s i c a l l y
expressed by polyphasic d i s t r i b u t i o n o f sleep and wakefulness w i t h a period
of about 4 hours. Yet, i t depends on the environmental c o n d i t i o n s and on
self-imposed behavioral c o n t r o l s t o which extent the separate peaks o f sleep
propensity become obvious. By decreasing the sleep t h r e s h o l d , a ironophasic
circadian p a t t e r n changes i n t o a b i p h a s i c (about 12 hours) p a t t e r n , and a
f u r t h e r decrease r e v e a l s a polyphasic (about 4 hours) p a t t e r n .
In our d a i l y l i f e , we are a b l e t o f u n c t i o n w e l l without napping. This
does not diminish the relevance of naps i n understanding the nature and
f u n c t i o n s of s l e e p . I t might be assumed t h a t v a r i a t i o n s i n the s l e e p t h r e s -
h o l d p a r t i a l l y have the f u n c t i o n of adapting t o environmental and i n d i v i d u a l
needs. T h i s can c l e a r l y be seen i n childhood and o l d age. I n t h i s sense, the
present study f o r c e d the subjects t o sleep more than they a c t u a l l y needed.
The consequence was a decrease i n a l e r t n e s s and mood as w e l l as i n perfor-
mance. Such e f f e c t s can a l s o be seen i n cases where subjects oversleep (Taub
et a l . , 1971). I n c o n d i t i o n S i t i s obvious t h a t enforced bedrest a f t e r a
normal n i g h t s l e e p causes oversleeping. In c o n d i t i o n TSD i t can be assumed
that, after the f i r s t long s l e e p episode, the subjects had recovered from
sleep d e p r i v a t i o n and t h a t the subsequent s l e e p again caused oversleeping.
V i g i l a n c e i s n e g a t i v e l y i n f l u e n c e d by oversleeping (Taub e t a l . , 1971). T h i s
was also seen i n the present study. In d a i l y l i f e such oversleeping is
limited by s o c i a l and occupational pressure, keeping not o n l y an e f f e c t i v e
time schedule but a l s o more e f f i c i e n t v i g i l a n c e .
If, however, the normal amount o r sequence of s l e e p i n g and waking cannot
be continued, a s i g n i f i c a n t l y b e n e f i c i a l e f f e c t o f napping has been found
(Dinges et a l . , 1986). By assuming a p o l y p h a s i c o r g a n i z a t i o n of s l e e p and
wakefulness, i t can be hypothesized t h a t a scheduling o f s l e e p and wakeful-
ness w i t h regard t o the u n d e r l y i n g s l e e p p r o p e n s i t y may be b e n e f i c i a l under
circumstances which do not a l l o w a normal amount o f s l e e p .
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