Workers who meet the criteria for shift work disorder (SWD) have elevated levels of risk for various health and behavioral problems. However, the impact of having SWD on shiftworkers engaged in rapid-rotation schedules is unknown. Moreover, the risk factors for the occurrence of SWD remain unclear. To clarify these issues, we conducted a questionnaire-based, cross-sectional survey on a sample of shiftworking nurses. Responses were obtained from 1202 nurses working at university hospitals in Tokyo, Japan, including 727 two-shift workers and 315 three-shift workers. The questionnaire included items relevant to age, gender, family structure, work environment, health-related quality of life (QOL), diurnal type, depressive symptoms, and SWD. Participants who reported insomnia and/or excessive sleepiness for at least 1 mo that was subjectively relevant to their shiftwork schedules were categorized as having SWD. The prevalence of SWD in the sampled shiftworking nurses was 24.4%; shiftworking nurses with SWD showed lower health-related QOL and more severe depressive symptoms, with greater rates of both actual accidents/errors and near misses, than those without SWD. The results of logistic regression analyses showed that more time spent working at night, frequent missing of nap opportunities during night work, and having an eveningness-oriented chronotype were significantly associated with SWD. The present study indicated that SWD might be associated with reduced health-related QOL and decreased work performance in shiftworking nurses on rapid-rotation schedules. The results also suggested that missing napping opportunities during night work, long nighttime working hours, and the delay of circadian rhythms are associated with the occurrence of SWD among shiftworking nurses on rapid-rotation schedules.

To assess circadian preference with a score, the Morningness-Eveningness Questionnaire (MEQ) has been used for more than 3 decades now. More recently, the Munich ChronoType Questionnaire (MCTQ) was developed: it asks for sleep-wake behavior on work and free days and uses the midpoint of sleep on free days (MSF), corrected for sleep debt accumulated during the work week as an indicator of chronotype (MSFsc). In this study, we developed a Japanese version of the MCTQ by using a translation/back-translation approach including an examination of its semantic validity. In a subsequent questionnaire survey, 450 adult men and women completed the Japanese versions of the MCTQ and MEQ. Results showed that MEQ scores were significantly negatively correlated with mid-sleep parameters assessed by the MCTQ, on both, work and free days, as well as with the chronotype measure MSFsc (r = -0.580 to -0.652, all p < 0.001). As in the original German version, the strongest correlation was observed between MEQ score and MSF. A physiological validation study using dim light melatonin onset as a circadian phase marker (N = 37) showed a high correlation between chronotype as assessed with the MSFsc (r = 0.542, p < 0.001), and less so for MEQ score (r = -0.402, p = 0.055). These results demonstrate the validity of the Japanese MCTQ and provide further support of the adequacy of the MCTQ as a chronotype measure.

Working memory (WM) performance, which is an important factor for determining problem-solving and reasoning ability, has been firmly believed to be constant. However, recent findings have demonstrated that WM performance has the potential to be improved by repetitive training. Although various skills are reported to be improved by sleep, the beneficial effect of sleep on WM performance has not been clarified. Here, we show that improvement in WM performance is facilitated by posttraining naturalistic sleep. A spatial variant of the n-back WM task was performed by 29 healthy young adults who were assigned randomly to three different experimental groups that had different time schedules of repetitive n-back WM task sessions, with or without intervening sleep. Intergroup and intersession comparisons of WM performance (accuracy and response time) profiles showed that n-back accuracy after posttraining sleep was significantly improved compared with that after the same period of wakefulness, independent of sleep timing, subject's vigilance level, or circadian influences. On the other hand, response time was not influenced by sleep or repetitive training schedules. The present study indicates that improvement in n-back accuracy, which could reflect WM capacity, essentially benefits from posttraining sleep.

The purpose of this study was to formulate an algorithm for assessing sleep/waking from activity intensities measured with a waist-worn actigraphy, the Lifecorder PLUS (LC; Suzuken Co. Ltd., Nagoya, Japan), and to test the validity of the algorithm. The study consisted of 31 healthy subjects (M/F = 20/11, mean age 31.7 years) who underwent one night of simultaneous measurement of activity intensity by LC and polysomnography (PSG). A sleep(S)/wake(W) scoring algorithm based on a linear model was determined through discriminant analysis of activity intensities measured by LC over a total of 235 h and 56 min and the corresponding PSG-based S/W data. The formulated S/W scoring algorithm was then used to score S/W during the monitoring epochs (2 min each, 7078 epochs in total) for each subject. The mean agreement rate with the corresponding PSG-based S/W data was 86.9%, with a mean sensitivity (sleep detection) of 89.4% and mean specificity (wakefulness detection) of 58.2%. The agreement rates for the individual stages of sleep were 60.6% for Stage 1, 89.3% for Stage 2, 99.2% for Stage 3 + 4, and 90.1% for Stage REM. These results demonstrate that sleep/wake activity in young to middle-aged healthy subjects can be assessed with a reliability comparable to that of conventional actigraphy through LC waist actigraphy and the optimal S/W scoring algorithm.

These results suggest that the polysomnographic manifestations of REM sleep are not required for dream experiences but that the mechanisms driving REM sleep alter experiences during NREM sleep in the morning. A subcortical activation similar to REM sleep may occur in human NREM sleep during the morning when REM sleep is most likely to occur, resulting in dream experiences during NREM sleep.

To clarify the sleep habits, and predictors thereof, in Japanese high-school students, a community study was conducted. A total of 3833 students were selected randomly from the 34 full-time high schools in two suburban cities in Japan. The response rate was 90.7% ( n = 3478). The students completed the Japanese version of the Pittsburgh Sleep Questionnaire Index (PSQI-J), the Japanese version of the 12-item General Health Questionnaire (GHQ12-J), and a questionnaire on sociodemographic characteristics, daily life, domestic situations, and perceived physical health. Mean bed and rise times were found to be 00:03 and 06:33 h, respectively, resulting in a sleep duration of 380.0 min. A multivariate logistic regression analysis revealed that a short sleep duration (i.e. less than 6 h; prevalence: 25.6%) was significantly associated with a later bedtime, a higher global PSQI-J score, an earlier rise time, being female, a longer study duration outside school hours, and a longer commuting duration, but not with a higher GHQ12-J score. Short sleep duration in Japanese high-school students is associated with their lifestyle as well as sleep problems, but not with psychosomatic problems.

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