You are on page 1of 20

WID 3.31.2016 I would give myself somewhere between a 82-87%.

Personally I think this is

90% worthy, but I have to look at this through the eyes of someone else grading it.
Annotated Bibliography 1: Peer-reviewed
Porc, S., M. Casagrande, M. Ferrara, and A. Bellatreccia. "Sleep & Alertness During Alternating
Monophasic & Polyphasic Rest-Activity Cycles." International Journal of Neuroscience
95 (1998): 43-50. Informal Healthcare E-Journals. Web. 17 Mar. 2016.

M. Casagrande, one of the contributing authors

M. Casagrande is a professor in the Department of Psychology at the Sapienza University
of Rome. She began to publish her work in 1996, but this specific study was published in 1998
along with three other people. The sleep study on alternating monophasic and polyphasic sleep
cycles was conducted through nine healthy males of the Italian Air Force base defense service.
The experiment consisted of these nine men completing two hours of activity and four hours of
rest through a 24 hour day on duty beginning at 9 a.m. four times a day. The rest cycles are
identified as:

This schedule alternated between the subjects being on-duty and off-duty. The psychologists
included a well-informed thesis on every step they took in order for their work to be considered.
They studied those who already worked in alternating shifts. Insight was received from other
neurologists who also studied polyphasic sleep cycles. After the study was completed the
comprised a table of the means analysis of variance and trend analysis results of each
polysomnographic variable for the 2nd, 3rd and 4th rest cycles.

It was concluded that the increase in total Total Sleep Time (TST/Time in Sleep) was due to a
linear increase in Stage 2 and REM Sleep. Trend analysis indicated a linear increase of Stage 2
across the three cycles. Other importances can be found within the table. Results showed that the
mean time of sleep was reduced to 5 hours, compared to the usual monophasic nocturnal sleep of
7-8 hours. The fourth cycle showed shorter sleep latencies, less percentage of wake and a
distribution of sleep stages very similar to that of nocturnal sleep. The rest/activity schedule did
not cause a relevant impairment of vigilance. The results of the study confirmed that it is
possible to adapt to a usual sleep-wake regimen, alternating between polyphasic and monophasic
sleep schedules.
Alertness management strategies can minimize the adverse effects of sleep loss
and circadian rhythm desynchronization and promote optimal vigilance and performance
in operational settings (44).
Sleep behavior is considered polyphasic if less than 50% percent of total sleep
time is obtained in one continuous episode (44).
A basic and practical question in sleep research concerns the search for a sleep
quantum, i.e.,the minimal sleep to maintain acceptable levels of performance during
sustained operations (Naitoh, 1992) (49).
Through this study I have confirmed that this topic is researchable and will give confident
evidence to back me up. This study does have its flaws pertaining to gender and performance
being that it is neither stated nor evident in this study. There would most likely be a difference in
sleep between males and females because of the way our brains work. It may be possible for
humans to eventually conform to a way of polyphasic sleep where we have periods of rest and
periods of work, but we have to include performance quality into the process.

Annotated Bibliography 2:
Graham, Mary G. "Sleep Needs, Patterns, and Difficulties of Adolescents." Sleep Needs, Patterns,
and Difficulties of Adolescents: Summary of a Workshop: Forum on Adolescence.
Washington D.C.: National Academy, 2000. 1-30. Print.

Cover of the book

Mary G. Graham is the editor of Sleep Needs, Patterns, and Difficulties of Adolescents, a
forum comprised physically into a book. Sleep is a necessity for survival, but in todays society,
sleep has been placed on the back burner. A lack of sleep affects our mood and performance. On
September 22, 1999, the Forum on Adolescence of the Board on Children, Youth, and Families
held a workshop entitled, Sleep Needs, Patterns and Difficulties of Adolescents. David A.
Hamburg, chair of the Forum on Adolescence, stated at the beginning of the workshop that,
adolescence is the time of greatest vulnerability from the standpoint of sleep. People who
participated in the workshop were medical researchers, teachers, parents, and young people.
How much sleep do adolescents require? What factors contribute to sleep loss in adolescence?

What are the consequences of chronic sleep loss in young people? What can be done about it?
These were all questions that were to be considered throughout the workshop. A panel of
researchers reviewed findings from the United States and abroad on sleep patterns and problems
in adolescents. Data from cross-sectional studies of students show that, from age 10 to 17,
students self-reported bedtimes become later and later on weekdays and weekends. Results
from a longitudinal Multiple Sleep Latency Test (MSLT) showed that it became harder to stay
awake throughout the day as test subjects got older. Carskadon described some research on
college students that restricted their sleep to 5 hours a night for several nights. It found that
daytime sleepiness increased with each night of restricted sleep. During adolescence, social
obligations and opportunities increase, academic requirements become more demanding, and
opportunities for work expand. The effects of insufficient sleep leads to involuntary napping
or microsleeps and gaps in processing information and in behaving reliably. Tasks like studying
for an exam or paying attention in class become more tedious. Adolescents are estimated to
drink 153 billion ounces of caffeine a year, which is used to compensate for inadequate sleep.
Chronic Fatigue Syndrome affects more girls than boys. One way to alleviate some adolescent
sleep problems is to change school start times. As the workshop came to a close it was discussed
that things needed to come into light about how much of an effect it would take on adolescents
in the long run.
Additional Quotes:
Research on adolescents and sleep has been under way for more than two
decades, and there is growing evidence that adolescents are developmentally vulnerable to
sleep difficulties (1).

One is the biological timing systemthe circadian rhythms of approximately 24hour intervals that influence when and how much we sleep. The second is the internal
system that tallies the balance of sleeping and wakingthe sleep/wake homeostasis
system: when sleep is deprived, more sleep is needed (6).
During adolescence, social obligations and opportunities increase, academic
requirements become more demanding, and opportunities for work expand. Young people
themselves often point to homework as a contributing factor; however, many adolescents
actually spend little time on academic pursuits, Carskadon said (8).
This doesnt answer the questions about naps, but it does give a background to how it can
lead into the benefits of naps (i.e.: taking a 30 minute nap in place of caffeine wasting your
money). The studies shown in this workshop easily show that quick nap can come in handy.
Like when college students were restricted to 5 hours of sleep at night; during the day time,
naps can occur whenever they are possible giving students that little boost to make through the

Annotated Bibliography 3:
"Science and Technology: Siesta Time; Power Napping." The Economist 363.8275 (2002): 97.
ArticleFirst [OCLC]. Web. 24 Mar. 2016.

Not the exact journal from the day it was published, but a front cover
of The Economist in which it was recently published.
The Economist is a weekly newspaper owned by the Economist Group. Dr. Sara C.
Mednick is a sleep researcher at the University of California, Riverside, where she focuses on
napping and performance. Dr. Sara Mednick and her colleagues at Harvard had proven that an
hour long nap can leave someone feeling rejuvenated, just like when they woke up that
morning. The thing is that in order to feel that rejuvenation, it has to be pure sleep and not just
rest. Mednick tested the power napping had on perception by having 30 students come in four
times a day to stare at a computer for an hour to identify whether a vertical or horizontal line
was present on a striped background. The students were to remain off of alcohol and caffeine.
She noticed that ten of her volunteers that went through the day without napping, deteriorated
rapidly. There was second set of ten that was able to nap for 30 minutes and a third set for 60.
The 30 minute nappers remained the same in their scores, while the 60 minute nappers had an

increase in scores. When she tried to test resting over napping, there was no success for those
who volunteered or for those who were paid, they could not control they decay.
The title was a little misleading, but I was still able to find some useful information out of
it. Hopefully, I can find Dr. Mednicks study to get a more in depth feel of her research. I have
now re-confirmed to myself that this is the topic for me to study, as I am someone who tends to
not get as much sleep as I should. I hope to continue to grow in this knowledge.

Annotated Bibliography 4: Peer-reviewed

Mcdevitt, Elizabeth A., William A. Alaynick, and Sara C. Mednick. "The Effect of Nap
Frequency on Daytime Sleep Architecture." Physiology & Behavior 107.1 (2012): 40-44. Web.
30 Mar 2016.

Elizabeth A. McDevitt
Elizabeth McDevitt is a graduate student at the University of California, Riverside, who
works alongside Dr. Sara Mednick in the Sleep and Cognition (SaC) Lab. In 2012, with the
help of William Alaynick and Dr. Mednick, McDevitt published The Effect of Nap Frequency
on Daytime Sleep Architecture. The aim of the study was to examine how the number of naps
taken during a seven-day period affects the sleep architecture of a polysomnographicallyrecorded daytime nap. Using two measures of daytime sleep (i.e. actigraphy and sleep diaries),
they correlated nap frequency and minutes of napping with sleep architecture. They predicted a

positive, linear relationship between nap frequency and lighter stages of sleep, such that people
who napped more often had more Stage 1 and Stage 2 sleep and less SWS during a daytime
nap. They examined nocturnal sleep from a week prior to the experimental nap, to examine
how nap frequency affects subsequent nocturnal sleep and how nocturnal sleep affects
subsequent daytime nap architecture in our sample. They also predicted greater nap frequency
would be associated with increased daytime sleepiness, but not with nocturnal sleep variables.
27 healthy, non-smoking university students between the ages of 18 and 35 participated in this
study. On the experimental day, subjects reported to the Laboratory for Sleep and Behavioral
Neuroscience at the San Diego Veterans Affairs Medical Center at 09:00. Subjective sleepiness
was measured with the Karolinska Sleepiness Scale (KSS) at 09:00 (KSS1), 11:00 (KSS2),
16:30 (KSS3), and 18:30 (KSS4). The KSS assesses subjects' momentary state of
alertness/sleepiness [15]. At 12:30, electrodes were applied for standard polysomnographic
recording. Subjects were in bed by 13:30 and allowed to nap for a maximum of 90 min, but
given no more than 120 min in bed. The mean nap sleep time was 74 min and the range of nap
total sleep time (TSTnap) was 38 to 90 min. All subjects napped at the same time of the day to
control for circadian influences on sleep architecture. Results showed that frequent napping is
associated with systematic differences in daytime sleep architecture in the university student
population. Napping has been shown to be an effective tool for managing sleep deprivation and
dysrhythmia brought about by chronic or acute circadian disruption. The negative physical and
psychological symptoms of disrupted sleep are improved by naps during the day or night shifts.
Additionally, in healthy, well-rested subjects, napping has been shown to improve performance
across a range of memory tasks. Despite these benefits of napping,many people do not nap.

Anecdotally, the three most-cited reasons non-nappers in our lab avoided daytime sleep
1) they are not tired
2) insufficient time
3)they wake up confused or groggy
Although this is a correlational study and any causal inference is a matter of speculation,
the present results suggest two possible pathways that may drive nap behavior in individuals
who choose to nap compared to those who do not.
Additional Quotes:
Prior studies examining the effects of habitual napping on both daytime and
nighttime sleep provide evidence that frequent napping alters sleep architecture. However,
these studies used short naps (2040 min), which curtailed the ability to determine the
effect of prior napping on SWS and rapid eye movement (REM) sleep. Longer sleep
periods (6090 min) are required to complete a full sleep cycle (40).
In other words, sleep pressure and subjective sleepiness appear to be dissociated,
whereby subjective sleepiness follows circadian fluctuations and sleep pressure is a
reflection of the homeostatic process (44).


It was kind of hard to understand what was being said in this study and I had to go and
search some terms for some better understanding. This source has stabilized my question, but I
may change it in the future due to its difficult content.

Annotated Bibliography 5:
Ficca, Gianluca, John Axelsson, Daniel J. Mollicone, Vincenzo Muto, and Michael V. Vitiello.
"Naps, Cognition and Performance." Sleep Medicine Reviews 14.4 (2010): 249-58. Web.
31 Mar. 2016.

Gianluca Ficca, contributing author to this clinical review

Dr. Gianluca Ficca is a professor at the Second University of Naples, Caserta. His main
focuses of study are behavioral science, biological psychology and cognitive psychology. Naps,
cognition and performance is a clinical review written by Dr. Ficca and his colleagues that was
published in 2009. Influential research on naps, has tried to address the regulatory mechanisms
sustaining polyphasic sleep structure, as well as to identify the determinants of napping, on both
the psychobiological and the psychosocial level. This review sought to raise interest in these
theoretically and clinically fundamental aspects of napping. It is the outgrowth of a
symposium,The Effect of Naps on Health and Cognition, held by the authors at the 5th
Congress of the World Federation of Sleep Research and Sleep Medicine Societies in Cairns,
Australia in September 2007, specifically conceived to pay thorough attention to the relationships
between daytime napping and cognitive processes, in light.There will be four specific contexts

that will help examine the interrelationships of napping, cognition and performance. First, the
hypothesis that a split-sleep schedule provides more recovery than a single consolidated sleep
period of the same total duration is examined. Of the very recent advances in the study of naps,
memory and performance. Second, the advantages and disadvantages of napping in the work
environment are examined. Third,the professed benefits of napping for the learning of new
material, either declarative (e.g., lists of words)or procedural (e.g., perceptual or motor tasks) are
explored, including a discussion of why daytime naps, due to their peculiar sleep infrastructure,
might represent a useful model of memory consolidation mechanisms during sleep. Finally,the
prevalence of regular napping in the elderly and its association with sleep complaints, excessive
daytime sleepiness, and mental and physical health problems are examined,with a focus on
whether regular napping among older adults, particularly those in good health, may be beneficial
to daytime wakefulness or detrimental to night-time sleep propensity. Evidence from both
laboratory experiments and field studies appears to indicate an overall beneficial role of
napping for neurocognitive functions. First, all studies to date demonstrate that correctly timed
split-sleep either had a positive effect or no effect on subsequent neurobehavioral performance
supporting the hypothesis that the restorative effects of sleep on performance may be maintained
when splitting the overall sleep episode into multiple naps. However, whether or not performance
differences between consolidated and split-sleep schedules were observed, all of the experiments
that measured sleep with PSG reported significant differences in the architecture of sleep stages in
terms of the proportion of slow wave sleep and REM. This raises the theoretical question of why
split-sleep schedule induced differences in sleep architecture do not translate into differences in
subsequent neurobehavioral performance.
Additional Quotes:

Daytime napping is a frequent habit in many individuals, whether healthy or not,

and may occur in a wide variety of contexts (249).
It was an okay read and it is nice to have solid evidence to back me up shown through
actual studies performed on real people. I hope to continue on this path of research success.

Annotated Bibliography 6:
Lau, H., M.a. Tucker, and W. Fishbein. "Daytime Napping: Effects on Human Direct Associative
and Relational Memory." Neurobiology of Learning and Memory 93.4 (2010): 554-60.
Web. 31 Mar. 2016.

Journal Cover
Dr. H. Lau is a postdoctoral researcher at New York University in the Center for
Neurology. She and colleagues published this journal article in 2010 on how daytime napping
effects our direct associative and relational memory. Most researchers have focused on how sleep
strengthens direct associative relationships, as between two words in a word pair that are directly
learned. In recent years, a case has been built for non-rapid eye movement sleep (NREM sleep,
Stages 2, 3 and 4) to be a particularly optimal brain state for declarative memory processing, with
slow-wave sleep (SWS, Stages 3 and 4) being the key contributor. Slow-wave sleep is
characterized by physiological and neurochemical properties hypothesized to optimize declarative
memory processing during this sleep stage. 31 healthy people around the age of 21 participated in
this study. Seven males and seven females were in the nap group and ten males and seven females
in the no-nap group. Participants of this study completed three subtests of the Multidimensional
Aptitude Battery-II (MAB-II). The MAB-II is a standardized paper-and-pencil test commonly

used to assess intelligence. The three selected subtests were arithmetic, picture arrangement, and
picture completion, which have the highest correlations with intelligence measured by the
Wechsler Adult Intelligence Scale. Participants learned the two sets of picture pairs (AB and BC
pairs). The objects (B) were the common elements shared by the two sets of photograph pairs. All
objects were associated with two faces. The sex of the two faces associated with the same object
was random. The positions (left or right) of the pictures (face or object) were also randomized.
Afterward, participants were randomly assigned to the nap group and no-nap group. Nap
participants were taken to a sound-attenuated bedroom for the nap. No-nap participants were
taken to a second bedroom, where they sat in a semi-recumbent position and watched a boring
video about marine life during the period the nap group slept. The results show
that participants who napped exhibited better direct associative memory and relational memory,
than their counterparts that did not have the advantage of a nap.
Additional Quotes:
Clearly, relational memory is built upon direct associative memory and thus
depends on adequate encoding of directly learned materials (559).
Ample behavioral and neurobiological evidence indicates that sleep facilitates the
processing of declarative memories (554).
I am having issues negating that naps affect one's work ethic. Yes, there are parts of a
study that have not always been proven true, but I guess I would just like some more in-depth
insight on it. Maybe with the survey I will make I can have average peoples opinion.
Annotated Bibliography 7:

Ulmer, Cheryl, Dianne Miller. Wolman, and Michael M. E. Johns. "7 Strategies to Reduce
Fatigue Risk in Resident Work Schedules." Resident Duty Hours: Enhancing Sleep,
Supervision, and Safety. Washington, D.C.: National Academies, 2009. 217-62. Print.

Book Cover
Cheryl Ulmer and her colleagues at the Institute of Medicine wrote this book in order to
stress the importance of keeping workers and patients healthy while in the hospital. The authors
rationalize that residents should not being working after 16 hours of wakefulness, a full period of
rest is required and that when residents begin training, they should have a period of protected
sleep to enhance performance and reduce sleep loss. Fatigue It occurs as performance demands
increase because of work intensity and work duration, but it is also a product of the quantity and
quality of sleep and the time of day work occurs. It has been empahsized that prevention of sleep
deprivation in resident workers is the best way to reduce fatigue. Both realistic patient simulator
studies and field studies of residents working extended duty periods (24+ hours) have often found
performance deficits. The Harvard Work Hours, Health and Safety Group found that mainly firstyear resident interns are more sleep deprived than other interns or resident workers. Industries
have reviewed that exceeding 12 hours of work will create in increase in risks.

This was another great example of sleep loss in order to emphasize how
important naps are. I may read more into this but not everyone has time to read 47 pages.
This was a good way to end my annotated bibs.

Overall Reflection:
These were quite tedious but very beneficial to me. Would I ever do this again? Probably
not unless I had to. Hopefully these turn out to be beneficial as much as I hope they are to me in
my thesis.