Sleep quality following general anaesthesia.
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Anesthesia, General↗
Biomedical subjects
M Blagrove
Publications and source records attributed to M Blagrove.
Sleep deprivation and junior doctors' performance and confidence.
PURPOSE OF STUDY: To determine whether sleep deprivation affects not only junior doctors' performance in answering medical questions but whether their ability to judge their own performance is also affected by lack of sleep. METHODS: A questionnaire based follow up study in two district general hospitals of the Carmarthenshire NHS Trust. Eleven house officers and 15 senior house officers (SHOs) within the medical directorate participating in the on-call rota were recruited between July 1999 and May 2000. RESULTS: SHOs answered significantly more questions correctly (p=0.04) and were more confident than house officers when they were either correct or incorrect (p<0.001). Length of unbroken or continuous sleep is associated with more correct answers (p=0.03) and higher energy (p=0.09) and confidence (p=0.07) scores self rated by the profile of mood states. Length of continuous sleep was not related to the appropriateness of confidence, as measured by the "within-subject confidence-accuracy correlation" (p=0.919). CONCLUSIONS: SHOs performed better than house officers even allowing for sleep loss. Sleep deprivation had adverse effects on mood and performance but junior doctors can still monitor their performance and retain insight into their own ability when sleep deprived.
Adult↗
Effects of sleep loss on confidence-accuracy relationships for reasoning and eyewitness memory.
Participants (n = 48) deprived of sleep for 29-50 hr, in comparison with controls (n = 45), underestimated their performance on logical reasoning and Raven's matrices. Such caution may ameliorate adverse practical consequences of sleep loss. In contrast, although sleep loss participants were more suggestible on the Gudjonsson Suggestibility Scale (G. H. Gudjonsson, 1984, 1987), they maintained confidence in their suggestible responses and were inaccurate when responding with the highest rating of confidence. This indicates that the increased suggestibility is internalized and is due to a cognitive deficit rather than to compliance. Eyewitness confidence-accuracy correlations were low but usually significant and were lowest after 47-50 hr of sleep loss. Repetition of leading questions led to increases in confidence for suggestible responses (with no interaction with sleep loss) but not for nonsuggestible responses, indicating a problem for jurors' evaluations of practiced testimony.
Adolescent↗
Time of day effects in, and the relationship between, sleep quality and movement.
The study aimed to measure the effects of a 27-h 'day' sleep-wake regime on actigraphic and subjective sleep variables, and to examine the relationships between these variables. Nine subjects spent 30 days and nights in the laboratory. After sleeping 8 h for each of 8 nights, the subjects had an imposed 27-h 'day', for 18 'days', remaining in bed for 9 h on each sleep period. Sleep periods therefore started 3 h later each day, although subjects' circadian rhythms stayed entrained to 24 h, because subjects were not isolated from the natural light-dark cycle. Time asleep, subjective sleep efficiency and subjective sleep quality, but not movement during sleep, were found to be significantly affected by time of going to bed. There were significant decreases in movement during recovery sleeps following each of two episodes of 26 h sleep deprivation. Over the study there were significant within-subject correlations between subjective sleep quality and subjective sleep efficiency (rav = 0.65), movement during sleep and subjective sleep efficiency (rav = -0.48), and movement during sleep and subjective sleep quality (rav = -0.26). We conclude that sleep movement, despite its low within- and between-subjects variability, is nevertheless a statistically reliable, but weak, indicator of subjective sleep efficiency and quality.
Adult↗
Dreams, images and emotions associated with propofol anaesthesia.
One hundred and twelve patients scheduled for day case varicose vein surgery were randomly allocated to one of three groups: total intravenous anaesthesia with propofol, propofol induction followed by inhalational anaesthesia with nitrous oxide and isoflurane or thiopentone induction followed by inhalational anaesthesia with nitrous oxide and isoflurane. Assessments were made in the recovery room of the incidence of dreaming, the content of the dreams and the emotional status of the patients. The groups differed significantly in reporting that they had been dreaming: patients who underwent total intravenous anaesthesia reported the most dreaming and patients who received thiopentone the least. However, despite the large number of case reports of sexual imagery following propofol anaesthesia and despite the two groups who had received propofol experiencing significantly greater happiness upon recovery than the thiopentone group, there were no appreciable differences in the sexual content of the dreams. Each group had only a small number of dreams even remotely related to sex.
Adult↗