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published_or_final_version / Community Medicine / Master / Master of Public Health

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Approved for public release; distribution is unlimited / Modeling fatigue, sleepiness, and performance is of significant interest to military leaders because military operations often provide limited sleep opportunities for many individuals. The ANAM Readiness Evaluation System (ARES) Commander Battery is under consideration as a quick, inexpensive method of testing a crewmember's level of functioning. This thesis analyzed data collected during a previous field fatigue study conducted at the Naval Officer Indoctrination School (OIS) in Newport, Rhode Island. Linear mixed-effects models were developed and ARES data were evaluated for how they vary across participants, testing sessions, and time of day. / Lieutenant, United States Navy Reserve

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Part I of the thesis contains a brief review of the clinical importance of nocturnal asthma, and an account of the methods used to study breathing during sleep. The original work of the thesis is divided into three further parts: In Part II are described studies of breathing and oxygenation during sleep in normal subjects. These studies were performed to establish a normal range of apnoea, hypopnoea and oxygenation during sleep and to determine the effects of age and sex on these variables. Part III contains the results of similar studies in patients with asthma. Breathing patterns and oxygenation during sleep in asthmatic patients were compared with those of normal subjects and those of patients with chronic bronchitis and emphysema. The studies described in Part IV were designed to explore the relationship between sleep and bronchoconstriction. I wished to establish whether sleep was essential for nocturnal bronchoconstriction and to determine whether bronchoconstriction was associated with one particular stage of sleep. The results are summarised at the end of each section, and the clinical implications of the results are discussed in Part V.

( Sleep Problems in Children and Adolescents ) The main topic of the thesis is the issue of sleep in children and adolescents. The theoretical part deals with the physiology of sleep and sleep disorders. The practical part were processed by means of qualitative and quantitative research . The aim of our thesis and our research was to determine the incidence of sleep disorders in different age categories. The aim of the qualitative part was to determine the causes and effects of sleep disorders in children and adolescents. In practice , the qualitative part certainly importance , especially for teachers , case reports indicate that some other sleep disorders affect child development , behavior and school performance. In this thesis we compare the quantitative survey targeted four designated groups of children . One group of preschool children are 1-6 years old . The second group consists of a sample of pupils of primary school 7 - 11 years . The penultimate group of children at the elementary school , aged 12 - 15 years. The last group are secondary school students aged 16-18 years . At the beginning of quantitative research, we set three hypotheses. Hypothesis 1 were not confirmed . Our research shows that pupils of primary schools suffer from sleepwalking more (9%) than children of preschool age...

Approved for public release, distribution unlimited. / This study compares an experimental watchstanding schedule derived at Naval Submarine Medical Research Laboratory (NSMRL) with the schedule currently used onboard the submarine USS HENRY M. JACKSON (SSBN 730 GOLD). It analyzes subjective and objective data to determine if the new schedule is compatible in an operational submarine environment. This study reviews sleep and fatigue literature to emphasize important concepts needed to make schedule comparisons. Results from this study indicate a need exists among the U.S. submarine force to employ an operational schedule which provides more sleep and which is in better alignment with human circadian rhythms, thus improving cognitive effectiveness. One of the experimental schedules tested in this study yielded results similar to those of the existing submarine watchstanding schedule. This experimental schedule employed a validated model of human performance and fatigue to assess individual cognitive effectiveness. However, the results also indicate that the existing schedule is better suited in its accommodation of operational scheduling constraints which, in turn, allow watchstanders to receive more sleep. Recommendations address the need for the U.S. submarine force to continue to pursue a watchstanding schedule that provides better sleep while still accommodating operational constraints. Recommendations also address improvements in experiment implementation which can be integrated into future studies. / Lieutenant, United States Navy