Sleep deprivation training

The pattern of adaptation to chronic sleep restriction punctuated with acute, total sleep deprivation and rapid recovery from the latter may yield the types of changes in performance depicted in Fig. 2. Across the three armed services, in combat operations and in training for combat operations, severe total sleep deprivation is rare. Much more common for all is chronic, moderate sleep restriction at levels that would be expected to produce stable, albeit degraded performance. 

Athletic performance includes not only the competitive event itself, but also optimal training and avoidance of injuries prior to and during the event. Therefore, in addition to reviewing the effects of sleep deprivation on athletic performance measures, this chapter will also examine similar observations on athletic training and injuries. 

Several elements of performance show more consistent results. Reaction time is characteristically lengthened after sleep deprivation and this result appears to include both physically well trained and untrained subjects (32,45 17). Perceived exertion is increased after sleep deprivation of 30-64 hr (19,20,26,28,31,41). Heart rate, especially peak heart rate, tends to be lower after sleep deprivation, suggestive of an alteration in autonomic drive (21,26,43). 

Athletic injuries impair performance, prolong training and, at worst, end careers or even lives. Avoiding injury is critical to athletic performance, except in those extremely rare examples where the adversity of injury propels an athlete beyond even his/her own personal best. Sleep deprivation is commonly cited as a precipitating or causal factor in accidents and injuries (see Chaps. 10, 12, 14, and 15). It is therefore curious to discover that there is essentially no scientific research on sleep deprivation and athletic injury. Lund (75) followed 12 volleyball players over 61 hr of sleep deprivation. There were 29 minor injuries, which seemed elevated, but there was no control group for comparison. 

Illness is not considered injury, but it shares similar adverse effects on athletic training and performance. It is doubtful any athlete would choose to have the flu during competition. Sleep deprivation and human immune function has been extensively researched and reviewed (79). Significant detrimental effects on immune function have been demonstrated after both complete and partial sleep deprivation (56,79). The interactions are complex. Some sleep deprivation and strenuous exercise may even enhance certain aspects of immune function (80). This represents yet another area of much-anticipated research and potential impairment to athletic performance. 

Both partial and complete sleep deprivation have plausible adverse effects on athletic performance, training, and injuries. Research conclusions range widely from no effects to very significant effects, with the absence of any study describing beneficial effects after sleep deprivation. Therefore, an optimal sleep strategy clearly represents a potential performance advantage for athletes. 

In summary, resident physicians, particularly those at more junior levels of training and those in the surgical specialties, routinely experience significant levels of sleep deprivation in the work setting, and are frequently required to function at work under conditions that are likely to lead to compromised levels of... 

Bartle EJ, Sun JH, Thompson L, Light AI, McCoolC, Heaton S. The effects of acute sleep deprivation during residency training. Surgeryl988 104 311-316. 

Ultimately, sleep deprivation limits the elfeetiveness of individuals who are unable to obtain adequate sleep on a daily basis. Humans who are deprived of sleep experience increased mental lapses, reduetiorrs in eogrtitive abilities, decrements in alertness, and decreases in motivation (Kraeger, 1989). No amount of training or experience with sleep deprivation enables someone to overcome these effects. 

Situations that chronically create fatigue (e.g., sleep deprivation during internship and residency training has been shown to significantly increase error rates)... 

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