Studies suggest that avoiding sleep periods ending during the circadian low 5, 15 ), and keeping naps to less than 30 min 4, 16, 17, 18 ) to avoid waking from deep sleep 15 ) can minimise sleep inertia magnitude. Much of this research has focussed on establishing the best length and timing of sleep to minimise sleep inertia. Sleep inertia has been measured under a variety of conditions ranging from a full night’s sleep, to short naps at different times of day. Test batteries are often administered immediately after waking and repeated intermittently for up to one hour. Consequently, the severity of sleep inertia observed can depend on the task used to measure it. However, the sensitivity of these cognitive tasks to sleep inertia varies 13, 14 ). Sleep inertia is typically measured in laboratory settings using a combination of sleepiness scales and cognitive tests. In the meantime, it is recommended that proactive sleep inertia countermeasures are used, and that safety-critical tasks are avoided immediately after waking. Future research in this area would benefit from study design features highlighted in this review. Investigations into light and temperature have found promising results for improving subjective alertness further research is needed to determine whether these countermeasures can also attenuate performance impairment. Caffeine is perhaps the best option, although it is most effective when administered prior to sleep and is therefore not strictly reactive. Current literature does not provide a convincing evidence-base for a reactive countermeasure. This structured review summarises current literature on reactive countermeasures to sleep inertia such as caffeine, light, and temperature and discusses evidence for the effectiveness and operational viability of each approach. While several studies have investigated the best sleep timing and length to minimise sleep inertia effects, few have focused on countermeasures -especially those that can be implemented after waking (i.e. This period of impairment is of concern to workers who are on-call, or nap during work hours, and need to perform safety-critical tasks soon after waking. Sleep inertia is the period of impaired performance and grogginess experienced after waking.
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