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Publications (10 of 96) Show all publications
Sundelin, T., Landry, S. & Axelsson, J. (2024). Is snoozing losing? Why intermittent morning alarms are used and how they affect sleep, cognition, cortisol, and mood. Journal of Sleep Research, 33(3), Article ID e14054.
Open this publication in new window or tab >>Is snoozing losing? Why intermittent morning alarms are used and how they affect sleep, cognition, cortisol, and mood
2024 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 33, no 3, article id e14054Article in journal (Refereed) Published
Abstract [en]

Pressing the snooze button is a common way to start the day, but little is known about this behaviour. Through two studies we determined predictors and effects of snoozing. In Study 1 (n = 1732) respondents described their waking habits, confirming that snoozing is widespread, especially in younger individuals and later chronotypes. Morning drowsiness and shorter sleep were also more common for those who snooze. Study 2 was a within-subjects laboratory study (with polysomnography) on habitual snoozers (n = 31), showing that 30 min of snoozing improved or did not affect performance on cognitive tests directly upon rising compared to an abrupt awakening. Bayes factors indicate varying strengths of this evidence. Snoozing resulted in about 6 min of lost sleep, while preventing awakenings from slow-wave sleep (N3). There were no clear effects of snoozing on the cortisol awakening response, morning sleepiness, mood, or overnight sleep architecture. A brief snooze period may thus help alleviate sleep inertia, without substantially disturbing sleep, for late chronotypes and those with morning drowsiness.

Keywords
cognitive function, drowsiness, intermittent alarms, mood, sleep inertia, snooze
National Category
Otorhinolaryngology Neurology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-223879 (URN)10.1111/jsr.14054 (DOI)001087320500001 ()37849039 (PubMedID)2-s2.0-85174239331 (Scopus ID)
Available from: 2023-11-21 Created: 2023-11-21 Last updated: 2024-05-14Bibliographically approved
Balter, L. J. T. & Axelsson, J. (2024). Sleep and subjective age: protect your sleep if you want to feel young. Proceedings of the Royal Society of London. Biological Sciences, 291(2019), Article ID 20240171.
Open this publication in new window or tab >>Sleep and subjective age: protect your sleep if you want to feel young
2024 (English)In: Proceedings of the Royal Society of London. Biological Sciences, ISSN 0962-8452, E-ISSN 1471-2954, Vol. 291, no 2019, article id 20240171Article in journal (Refereed) Published
Abstract [en]

The current studies examined the impact of insufficient sleep and sleepiness on the subjective experience of age. Study 1, a cross-sectional study of 429 participants (282 females (66%), 144 males, 3 other gender; age range 18-70), showed that for each additional day of insufficient sleep in the last 30 days, subjective age increased by 0.23 years. Study 2, an experimental crossover sleep restriction study (n = 186; 102 females (55%), 84 males; age range 18-46), showed that two nights of sleep restriction (4 h in bed per night) made people feel 4.44 years older compared to sleep saturation (9 h in bed per night). Additionally, moving from feeling extremely alert (Karolinska Sleepiness Scale (KSS) score of 1) to feeling extremely sleepy (KSS score of 9) was associated with feeling 10 years older in both studies. These findings provide compelling support for insufficient sleep and sleepiness to exert a substantial influence on how old we feel, and that safeguarding sleep is probably a key factor in feeling young.

Keywords
sleep, subjective age, experimental sleep restriction, sleepiness
National Category
Neurosciences Evolutionary Biology
Identifiers
urn:nbn:se:su:diva-228121 (URN)10.1098/rspb.2024.0171 (DOI)001190937300006 ()38531399 (PubMedID)2-s2.0-85189109426 (Scopus ID)
Available from: 2024-04-10 Created: 2024-04-10 Last updated: 2024-04-10Bibliographically approved
Johansson, P. J., Crowley, P., Axelsson, J., Franklin, K., Garde, A. H., Hettiarachchi, P., . . . Svartengren, M. (2023). Development and performance of a sleep estimation algorithm using a single accelerometer placed on the thigh: an evaluation against polysomnography. Journal of Sleep Research, 32(2), Article ID e13725.
Open this publication in new window or tab >>Development and performance of a sleep estimation algorithm using a single accelerometer placed on the thigh: an evaluation against polysomnography
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2023 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 32, no 2, article id e13725Article in journal (Refereed) Published
Abstract [en]

Accelerometers placed on the thigh provide accurate measures of daily physical activity types, postures and sedentary behaviours, over 24 h and across consecutive days. However, the ability to estimate sleep duration or quality from thigh-worn accelerometers is uncertain and has not been evaluated in comparison with the 'gold-standard' measurement of sleep polysomnography. This study aimed to develop an algorithm for sleep estimation using the raw data from a thigh-worn accelerometer and to evaluate it in comparison with polysomnography. The algorithm was developed and optimised on a dataset consisting of 23 single-night polysomnography recordings, collected in a laboratory, from 15 asymptomatic adults. This optimised algorithm was then applied to a separate evaluation dataset, in which, 71 adult males (mean [SD] age 57 [11] years, height 181 [6] cm, weight 82 [13] kg) wore ambulatory polysomnography equipment and a thigh-worn accelerometer, simultaneously, whilst sleeping at home. Compared with polysomnography, the algorithm had a sensitivity of 0.84 and a specificity of 0.55 when estimating sleep periods. Sleep intervals were underestimated by 21 min (130 min, Limits of Agreement Range [LoAR]). Total sleep time was underestimated by 32 min (233 min LoAR). Our results evaluate the performance of a new algorithm for estimating sleep and outline the limitations. Based on these results, we conclude that a single device can provide estimates of the sleep interval and total sleep time with sufficient accuracy for the measurement of daily physical activity, sedentary behaviour, and sleep, on a group level in free-living settings.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
actigraphy, activity tracker, wearables, physical activity, sedentary behaviour
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-210313 (URN)10.1111/jsr.13725 (DOI)000860314300001 ()36167935 (PubMedID)2-s2.0-85139070466 (Scopus ID)
Note

This research was partly financed by grants from: the Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (1040232); FORTE, Swedish Research Council for Health, Working Life and Welfare (2021–01561); The Danish Work Environment Research Fund (November 03 2017); National Health and Medical Research Council Investigator Grant, Leadership second level (APP1194510); British Heart Foundation, Special Grant (SP/F/20/150002); National Health and Medical Research Council Ideas Grant (APP1180812); Swedish Heart Lung Foundation (20160343); Funding from Stockholm Stress Center – a centre of excellence for research on work-related stress and health Stress Research; AFA-insurance (150159).

Available from: 2022-10-13 Created: 2022-10-13 Last updated: 2024-01-12Bibliographically approved
Tognetti, A., Thunell, E., Zakrzewska, M., Olofsson, J. K., Lekander, M., Axelsson, J. & Olsson, M. J. (2023). Discriminating between sick and healthy faces based on early sickness cues: an exploratory analysis of sex differences. Evolution, Medicine, and Public Health, 11(1), 386-396
Open this publication in new window or tab >>Discriminating between sick and healthy faces based on early sickness cues: an exploratory analysis of sex differences
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2023 (English)In: Evolution, Medicine, and Public Health, E-ISSN 2050-6201, Vol. 11, no 1, p. 386-396Article in journal (Refereed) Published
Abstract [en]

Background and objectives: It has been argued that sex and disease-related traits should influence how observers respond to sensory sickness cues. In fact, there is evidence that humans can detect sensory cues related to infection in others, but lack of power from earlier studies prevents any firm conclusion regarding whether perception of sickness cues is associated with sex and disease-related personality traits. Here, we tested whether women (relative to men), individuals with poorer self-reported health, and who are more sensitive to disgust, vulnerable to disease, and concerned about their health, overestimate the presence of, and/or are better at detecting sickness cues.

Methodology: In a large online study, 343 women and 340 men were instructed to identify the sick faces from a series of sick and healthy photographs of volunteers with an induced acute experimental inflammation. Participants also completed several disease-related questionnaires.

Results: While both men and women could discriminate between sick and healthy individuals above chance level, exploratory analyses revealed that women outperformed men in accuracy and speed of discrimination. Furthermore, we demonstrated that higher disgust sensitivity to body odors is associated with a more liberal decision criterion for categorizing faces as sick.

Conclusion: Our findings give strong support for the human ability to discriminate between sick and healthy individuals based on early facial cues of sickness and suggest that women are significantly, although only slightly, better at this task. If this finding is replicated, future studies should determine whether women’s better performance is related to increased avoidance of sick individuals.

Place, publisher, year, edition, pages
Oxford University Press, 2023
Keywords
sex differences, sickness detection, behavioral immune system, disease-related personality traits, facial cues of sickness
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-224206 (URN)10.1093/emph/eoad032 (DOI)001095978600001 ()37941735 (PubMedID)
Note

The behavioral experiment in the present paper was supported by Swedish Research Council Grants 2016-02742 (MO), 2020-02567 (MO), and 2021-03184 (AT) and Swedish Foundation for Humanities and Social Sciences Grant P12-1017 (MO).

Available from: 2023-12-06 Created: 2023-12-06 Last updated: 2024-01-30Bibliographically approved
Gordon, A. R., Lundström, J. N., Kimball, B. A., Karshikoff, B., Sorjonen, K., Axelsson, J., . . . Olsson, M. J. (2023). Human scent as a first-line defense against disease. Scientific Reports, 13(1), Article ID 16709.
Open this publication in new window or tab >>Human scent as a first-line defense against disease
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2023 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 13, no 1, article id 16709Article in journal (Refereed) Published
Abstract [en]

Individuals may have a different body odor, when they are sick compared to healthy. In the non-human animal literature, olfactory cues have been shown to predict avoidance of sick individuals. We tested whether the mere experimental activation of the innate immune system in healthy human individuals can make an individuals' body odor be perceived as more aversive (intense, unpleasant, and disgusting). Following an endotoxin injection (lipopolysaccharide; 0.6 ng/kg) that creates a transient systemic inflammation, individuals smelled more unpleasant compared to a placebo group (saline injection). Behavioral and chemical analyses of the body odor samples suggest that the volatile components of samples from sick individuals changed qualitatively rather than quantitatively. Our findings support the hypothesis that odor cues of inflammation in axillary sweat are detectable just a few hours after experimental activation of the innate immune system. As such, they may trigger behavioral avoidance, hence constituting a first line of defense against pathogens of infected conspecifics.

Place, publisher, year, edition, pages
Springer Nature, 2023
Keywords
human scent, first-line defense, disease, olfactory cues
National Category
Neurosciences
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-223785 (URN)10.1038/s41598-023-43145-3 (DOI)001083919900012 ()37794120 (PubMedID)2-s2.0-85173732154 (Scopus ID)
Note

This study was supported by grants from the Swedish Research Council (2012-1125, 2016-02742, 2020-02567) and Bank of Sweden Tercentenary Foundation (P12-1017), awarded to MJO).

Available from: 2023-11-15 Created: 2023-11-15 Last updated: 2024-05-22Bibliographically approved
Tognetti, A., Williams, M. N., Lybert, N., Lekander, M., Axelsson, J. & Olsson, M. J. (2023). Humans can detect axillary odor cues of an acute respiratory infection in others. Evolution medicine and public health, 11(1), 219-228
Open this publication in new window or tab >>Humans can detect axillary odor cues of an acute respiratory infection in others
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2023 (English)In: Evolution medicine and public health, ISSN 2050-6201, Vol. 11, no 1, p. 219-228Article in journal (Refereed) Published
Abstract [en]

Background and objectives Body odor conveys information about health status to conspecifics and influences approach-avoidance behaviors in animals. Experiments that induce sickness in otherwise healthy individuals suggest that humans too can detect sensory cues to infection in others. Here, we investigated whether individuals could detect through smell a naturally occurring acute respiratory infection in others and whether sickness severity, measured via body temperature and sickness symptoms, was associated with the accuracy of detection. Methodology Body odor samples were collected from 20 donors, once while healthy and once while sick with an acute respiratory infection. Using a double-blind, two-alternative forced-choice method, 80 raters were instructed to identify the sick body odor from paired sick and healthy samples (i.e. 20 pairs). Results Sickness detection was significantly above chance, although the magnitude of the effect was low (56.7%). Raters' sex and disgust sensitivity were not associated with the accuracy of sickness detection. However, we find some indication that greater change in donor body temperature, but not sickness symptoms, between sick and healthy conditions improved sickness detection accuracy. Conclusion and implications Our findings suggest that humans can detect individuals with an acute respiratory infection through smell, albeit only slightly better than chance. Humans, similar to other animals, are likely able to use sickness odor cues to guide adaptive behaviors that decrease the risk of contagion, such as social avoidance. Further studies should determine how well humans can detect specific infections through body odor, such as Covid-19, and how multisensory cues to infection are used simultaneously. Lay Summary Researchers suggest humans evolved the ability to detect sickness in others, facilitating behavioral responses to reduce contagion risk, such as the avoidance of sick individuals. Our study suggests that humans can distinguish healthy from sick individuals with a naturally occurring respiratory infection by smelling body odors, but with limited accuracy.

Keywords
body odor, health status, approach-avoidance behaviors, induced sickness, respiratory infection
National Category
Other Medical Sciences not elsewhere specified
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-222239 (URN)10.1093/emph/eoad016 (DOI)001020032600001 ()2-s2.0-85165346899 (Scopus ID)
Note

The behavioral experiment in the present article was supported by Swedish Research Council Grants 2016-02742 (M.O.), 2020-02567 (M.O.) and 2021-03184 (A.T.), Swedish Foundation for Humanities and Social Sciences Grant P12-1017 (M.O.) and the Stockholm Stress Center (J.A. and M.L.).

Available from: 2023-10-11 Created: 2023-10-11 Last updated: 2024-01-30Bibliographically approved
Balter, L. J. T., Sundelin, T., Holding, B. C., Petrovic, P. & Axelsson, J. (2023). Intelligence predicts better cognitive performance after normal sleep but larger vulnerability to sleep deprivation. Journal of Sleep Research, 32(4), Article ID e13815.
Open this publication in new window or tab >>Intelligence predicts better cognitive performance after normal sleep but larger vulnerability to sleep deprivation
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2023 (English)In: Journal of Sleep Research, ISSN 0962-1105, E-ISSN 1365-2869, Vol. 32, no 4, article id e13815Article in journal (Refereed) Published
Abstract [en]

Fluid intelligence is seen as a beneficial attribute, protecting against stress and ill-health. Whether intelligence provides resilience to the cognitive effects of insufficient sleep was tested in the current pre-registered experimental study. Participants (N = 182) completed the Raven's test (measuring fluid intelligence) and a normal night of sleep or a night of total sleep deprivation. Sleepiness and four cognitive tests were completed at 22:30 hours (baseline), and the following day after sleep manipulation. At baseline, higher fluid intelligence was associated with faster and more accurate arithmetic calculations, and better episodic memory, but not with spatial working memory, simple attention or sleepiness. Those with higher fluid intelligence were more, not less, impacted by sleep deprivation, evident for arithmetic ability, episodic memory and spatial working memory. We need to establish a more nuanced picture of the benefits of intelligence, where intelligence is not related to cognitive advantages in all situations.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
cognitive capacity, risk factor, stress
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-225011 (URN)10.1111/jsr.13815 (DOI)000905375200001 ()36579399 (PubMedID)2-s2.0-85145298741 (Scopus ID)
Note

Research Funding: Karolinska Institutet; Nordic Mensa Fund; Riksbankens Jubileumsfond. Grant Number: 13-1159:1; Vetenskapsrådet. Grant Number: 421-2013-2083.

Available from: 2024-01-04 Created: 2024-01-04 Last updated: 2024-01-31Bibliographically approved
Balter, L. J. T., Li, X., Schwieler, L., Erhardt, S., Axelsson, J., Olsson, M. J., . . . Lekander, M. (2023). Lipopolysaccharide-induced changes in the kynurenine pathway and symptoms of sickness behavior in humans. Psychoneuroendocrinology, 153, Article ID 106110.
Open this publication in new window or tab >>Lipopolysaccharide-induced changes in the kynurenine pathway and symptoms of sickness behavior in humans
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2023 (English)In: Psychoneuroendocrinology, ISSN 0306-4530, E-ISSN 1873-3360, Vol. 153, article id 106110Article in journal (Refereed) Published
Abstract [en]

Metabolites of the kynurenine pathway are hypothesized to be implicated in inflammation-associated depression, but there is a lack of experimental studies in humans assessing the kinetics of kynurenine metabolites in relation to experimentally-induced sickness. The aim of the present study was to assess changes in the kynurenine pathway and to explore its relation to symptoms of sickness behavior during an acute experimental immune challenge.

This double-blind placebo-controlled randomized cross-over study included 22 healthy human participants (n = 21 both sessions, Mage = 23.4, SD = 3.6, nine women) who received an intravenous injection of 2.0 ng/kg lipopolysaccharide (LPS) and saline (placebo) on two different occasions in a randomized order. Blood samples (0 h, 1 h, 1.5 h, 2 h, 3 h, 4 h, 5 h, 7 h post-injection) were analyzed for kynurenine metabolites and inflammatory cytokines. The intensity of symptoms of sickness behavior was assessed using the 10-item Sickness Questionnaire at 0 h, 1.5 h, 3 h, 5 h, and 7 h post-injection.

LPS induced significantly lower concentrations of plasma tryptophan (at 2 h, 4 h, 5 h, and 7 h post-injection), kynurenine (at 2 h, 3 h, 4 h, and 5 h post-injection), nicotinamide (at 4 h, 5 h, and 7 h post-injection), and higher levels for quinolinic acid at 5 h post-injection as compared to placebo. LPS did not affect kynurenic acid, 3-hydroxykynurenine, and picolinic acid. The development of the sickness symptoms was largely similar across items, with the highest levels around 1.5–3 h post-injection. Changes in plasma levels of kynurenine metabolites seem to coincide rather than precede or follow changes in subjective sickness. Exploratory analyses indicate that higher Sickness Questionnaire total scores at 1.5–5 h post-injection were correlated with lower kynurenic acid and nicotinamide levels.

These results lend further support for LPS-induced changes in the kynurenine pathway, but may not, as interpreted from blood levels, causally link to LPS-induced acute symptoms of sickness behavior. Future research may consider a larger sample to further scrutinize the role of the kynurenine pathway in the sickness response.

Keywords
kynurenine pathway, lipopolysaccharides, sickness behavior, depression, tryptophan
National Category
Neurosciences Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-217359 (URN)10.1016/j.psyneuen.2023.106110 (DOI)000984120700001 ()37075653 (PubMedID)2-s2.0-85152415270 (Scopus ID)
Note

This work was supported by Swedish Research Council Grants to MJO [2012-1125 and 2016-02742].

Available from: 2023-05-29 Created: 2023-05-29 Last updated: 2024-01-11Bibliographically approved
Hansson, L. S., Lasselin, J., Tognetti, A., Axelsson, J., Olsson, M., Sundelin, T. & Lekander, M. (2023). The walking sick: Perception of experimental sickness from biological motion. Brain, behavior, and immunity, 113, 319-327
Open this publication in new window or tab >>The walking sick: Perception of experimental sickness from biological motion
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2023 (English)In: Brain, behavior, and immunity, ISSN 0889-1591, E-ISSN 1090-2139, Vol. 113, p. 319-327Article in journal (Refereed) Published
Abstract [en]

Identification of sick conspecifics allows for avoidance of infectious threats, and is therefore an important behavioral defense against diseases. Here, we investigated if humans can identify sick individuals solely from biological motion and posture (using point-light displays). Additionally, we sought to determine which movements and sickness parameters would predict such detection. We collected video clips and derived point-light displays (one stride presented in a loop) of sick walkers (injected with lipopolysaccharide at 2.0 ng/kg body weight) and the same walkers when healthy (injected with saline). We then presented these displays to two groups, one group classified each walker as sick or healthy (study 1, n = 106), and the other group scored the walkers’ health on a visual analogue scale (study 2, n = 106). The raters were able to identify sick individuals above chance, and rated sick walkers as having worse health, both from observing video clips and point-light displays. Furthermore, both sickness detection and worse apparent health were predicted by inflammation-induced increase in rigidity and slower walking, but not other cues. Altogether, these findings indicate that biological motion can serve as a sickness cue, possibly allowing humans to identify sick conspecifics from a distance, and thereby allowing for disease avoidance.

Place, publisher, year, edition, pages
Elsevier, 2023
Keywords
sickness detection, biological motion, point-light displays, lipopolysaccharide, experimental endotoxemia
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-225003 (URN)10.1016/j.bbi.2023.07.020 (DOI)37517742 (PubMedID)2-s2.0-85166948418 (Scopus ID)
Note

The studies were supported by a grant from the KI research foundation (2018-02347 to J.L). The study from where the stimuli were obtained was supported by the Swedish Research Council (421-2012-1125 to M.J.O), the Swedish Foundation for Humanities and Social Sciences (P12-1017 to M.J.O), and Stockholm Stress Center, a FORTE (Swedish Council for Working life and Social Research) Center of Excellence (2009-1758).

Available from: 2024-01-04 Created: 2024-01-04 Last updated: 2024-01-11Bibliographically approved
Esfahani, M. J., Weber, F. D., Boon, M., Anthes, S., Almazova, T., Hal, M. v., . . . Dresler, M. (2023). Validation of the sleep EEG headband ZMax. bioRxiv
Open this publication in new window or tab >>Validation of the sleep EEG headband ZMax
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2023 (English)In: bioRxiv, E-ISSN 2692-8205Article in journal (Other academic) Epub ahead of print
Abstract [en]

Polysomnography (PSG) is the gold standard for recording sleep. However, the standard PSG systems are bulky, expensive, and often confined to lab environments. These systems are also time-consuming in electrode placement and sleep scoring. Such limitations render standard PSG systems less suitable for large-scale or longitudinal studies of sleep. Recent advances in electronics and artificial intelligence enabled ‘wearable’ PSG systems. Here, we present a study aimed at validating the performance of ZMax, a widely-used wearable PSG that includes frontal electroencephalography (EEG) and actigraphy but no submental electromyography (EMG). We analyzed 135 nights with simultaneous ZMax and standard PSG recordings amounting to over 900 hours from four different datasets, and evaluated the performance of the headband’s proprietary automatic sleep scoring (ZLab) alongside our open-source algorithm (DreamentoScorer) in comparison with human sleep scoring. ZLab and DreamentoScorer compared to human scorers with moderate and substantial agreement and Cohen’s kappa scores of 59.61% and 72.18%, respectively. We further analyzed the competence of these algorithms in determining sleep assessment metrics, as well as shedding more lights on the bandpower computation, and morphological analysis of sleep microstructural features between ZMax and standard PSG. Relative bandpower computed by ZMax implied an error of 5.5% (delta), 4.5% (theta), 1.6% (alpha), 0.5% (sigma), 0.8% (beta), and 0.2% (gamma), compared to standard PSG. In addition, the microstructural features detected in ZMax did not represent exactly the same characteristics as in standard PSG. Besides similarities and discrepancies between ZMax and standard PSG, we measured and discussed the technology acceptance rate, feasibility of data collection with ZMax, and highlighted essential factors for utilizing ZMax as a reliable tool for both monitoring and modulating sleep.

Place, publisher, year, edition, pages
Cold Spring Harbor Laboratory Press (CSHL), 2023
Keywords
polysomnography, sleep, PSG systems, headband, ZMax
National Category
Psychology
Research subject
Psychology
Identifiers
urn:nbn:se:su:diva-225047 (URN)10.1101/2023.08.18.553744 (DOI)
Note

Preprint.

Available from: 2024-01-05 Created: 2024-01-05 Last updated: 2024-01-11
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ORCID iD: ORCID iD iconorcid.org/0000-0003-3932-7310

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