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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Earth-based analogue missions simulate aspects of space missions in a controlled&#44; low-risk&#44; and cost-effective environment&#44; crucial for astronaut preparation&#46; Sleep is a fundamental aspect for astronauts due to its impact on health&#44; performance&#44; and alertness&#46; Disrupted sleep can significantly affect mission success and safety&#44; causing exhaustion&#44; excessive daytime sleepiness&#44; mood alterations&#44; and impaired concentration&#46;<a class="elsevierStyleCrossRefs" href="#bib0105"><span class="elsevierStyleSup">1&#8211;3</span></a> Long-term consequences of sleep disorders are also well-documented&#46;<a class="elsevierStyleCrossRefs" href="#bib0120"><span class="elsevierStyleSup">4&#8211;7</span></a> Despite numerous studies&#44; analogue missions often involve few participants and vary significantly in design and duration&#46;<a class="elsevierStyleCrossRef" href="#bib0140"><span class="elsevierStyleSup">8</span></a> The lack of women&#39;s representation reflects broader underrepresentation in space missions&#44; with only 11&#37; of astronauts and 7&#37; of women having performed spacewalks &#40;UNOOSA&#41;&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">This observational prospective study was conducted in April 2023 during a 2-week simulation mission at the Mars Desert Research Station &#40;MDRS&#41;&#44; operated by The Mars Society in a remote location in southern Utah&#46; The facility comprises an enclosed habitat&#44; greenhouse&#44; science dome&#44; two telescopes&#44; maintenance pod&#44; and vehicles for simulated surface activities&#46; Although MDRS cannot replicate Martian gravity&#44; solar radiation&#44; circadian rhythm or atmospheric composition&#44; it accurately mimics social factors&#44; isolation&#44; Extra-Vehicular Activities &#40;EVAs&#41; protocols&#44; conserving limited resources of food&#44; water and energy&#44; and structured communication with mission control&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The Hypatia I crew comprised 7 adult women from Catalonia&#44; Spain &#40;age&#58; 36&#46;86<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>7&#46;67 yr&#59; weight&#58; 59&#46;71<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>5&#46;68<span class="elsevierStyleHsp" style=""></span>kg&#59; BMI&#58; 21&#46;03<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;66<span class="elsevierStyleHsp" style=""></span>kg&#47;m<span class="elsevierStyleSup">2</span>&#41; with diverse academic backgrounds&#46; Informed consent was obtained and the Ethics Committee on Clinical Investigation of the Hospital Universitari Germans Trias i Pujol approved the study &#40;code&#58; PI-23-270&#41;&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Participants wore the Fitbit Sense 2 &#40;Fitbit Inc&#44; San Francisco&#44; CA&#44; USA by Google&#41; smartwatch on their non-dominant wrist throughout designated 24-h periods&#44; collecting data synced via the Fitbit app and stored on Fitbit services&#46; Although Fitbit Sense 2 provides a great deal of data&#44; we focused on the following key variables&#58; sleep time&#44; wake time &#40;&#8220;WASO&#8221;&#44; for wake after sleep onset&#41; and rest time&#59; REM&#44; light and deep sleep duration&#59; and number of awakenings&#46; Additionally&#44; participants maintained a daily self-reported sleep log noting sleep time&#44; instances of daytime sleepiness and subjective sleep quality&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">We defined two assessment periods&#58; simulation and baseline&#44; each of which divided to account for specific characteristics &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; For instance&#44; the first night pre-simulation considered jet lag effects&#46; No sleep data were recorded on April 29&#8211;30&#44; as most of the participants had early morning international flights home&#46; Separate analyses were conducted for weekends&#44; acknowledging potential variations in activity and routines&#46; Due to extensive pre-mission preparations&#44; the baseline period was measured one month after the mission to better reflect participants&#8217; regular routines&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0030" class="elsevierStylePara elsevierViewall">Sleep&#44; WASO and rest time and REM&#44; light and deep sleep time have been used for the intra and inter groups analysis&#46; <span class="elsevierStyleItalic">T</span>-Student test for parametric samples and Wilcoxon test for non-parametric variables were used to determine statistically significant differences between groups &#40;simulation and baseline&#41; for each night&#46; For the intra-groups analysis &#40;comparison between nights of the same group&#41;&#44; repeated measures analysis of variance &#40;ANOVA&#41; for normally distributed variables and Friedman test for non-normally distributed variables were used&#46; Bonferroni correction was applied for multiple groups comparison&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall"><a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a> shows the evolution in sleep time&#44; WASO&#44; rest time&#44; REM time&#44; light sleep time and deep sleep time parameters during simulation &#40;orange&#41; and baseline &#40;blue&#41; periods&#44; with error bars representing standard deviation for each night&#46; Intra-group differences &#40;differences in sleep parameters between nights for both&#44; simulation and baseline periods&#41; were evaluated&#44; revealing no significant differences during the baseline period&#46; In simulation&#44; significant differences were found in sleep time &#40;first night sim vs&#46; last night post-sim&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; WASO and rest time &#40;last night pre-sim vs&#46; last night post-sim&#44; <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05 and <span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01 respectively&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Significant differences were observed between simulation and baseline periods in various sleep parameters &#40;<a class="elsevierStyleCrossRef" href="#sec0005">Tables S1 and S2</a>&#41;&#46; Notably&#44; participants experienced decreased REM sleep and less light sleep &#40;<span class="elsevierStyleItalic">P</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41; in late night during simulation&#46; The analysis of self-reported sleep logs reveals an average sleep quality rating of 7&#46;2 during simulation and 7&#46;1 at baseline&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Our investigation revealed differences in sleep quantity and quality during the simulation compared to baseline&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Participants experienced shorter sleep duration&#44; reduced WASO&#44; and overall decreased rest time during the analogue mission&#46; These findings parallel those reported by Chen et al&#46;<a class="elsevierStyleCrossRef" href="#bib0145"><span class="elsevierStyleSup">9</span></a> in a study involving a three-member&#44; all-male crew during a 15-day spaceflight&#59; a temporal window comparable to our study&#46; However&#44; they contrast with the Mars-500 study&#44;<a class="elsevierStyleCrossRef" href="#bib0150"><span class="elsevierStyleSup">10</span></a> where participants showed increased lethargy and decreased movement during waking hours as the mission progressed&#59; these trends were not evident during the first three months and the last 20 days of the mission&#46; A closer analysis of our study data revealed an initial upward trend in sleep and rest duration during the first half of the mission&#44; followed by a decline in the latter half&#46; A more protracted study duration might yield results similar to those observed in the Mars-500 study&#46; Despite shorter sleep&#44; relative values found a sleep efficiency &#40;89&#46;94&#37;&#41; and a WASO &#40;10&#46;05&#37;&#41; within normal ranges&#46; This finding suggests that participants adjust to a more efficient sleep pattern in response to their reduced sleep duration during the simulation&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Furthermore&#44; our results revealed reduced REM sleep during simulation&#44; but with an acceptable mean percentage of 22&#46;71&#37;&#46; Self-reported sleep logs showed no significant differences in sleep quality between simulation and baseline periods&#46; Sleep deprivation&#44; particularly REM sleep reduction and circadian rhythms disturbances&#44; can impair alertness and performance&#46;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">11&#44;12</span></a> In previous studies&#44; astronauts report lower subjective rating of sleep quality during missions&#44;<a class="elsevierStyleCrossRefs" href="#bib0155"><span class="elsevierStyleSup">11&#44;13</span></a> difficulty falling asleep and frequent sleep interruptions while in orbit&#46;<a class="elsevierStyleCrossRef" href="#bib0170"><span class="elsevierStyleSup">14</span></a> In Flynn-Evans et al&#46;&#8217;s study<a class="elsevierStyleCrossRef" href="#bib0175"><span class="elsevierStyleSup">15</span></a> astronauts attributed these difficulties to the demanding workload&#46; Diverse roles within the mission likely contributed to interpersonal sleep pattern differences and shows that subjective sleep quality not only depends on sleep duration and percentage of sleep phases&#44; but also on various other factors&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Women respond differently to sleep disorders and deprivation compared to men&#44; contributing to specific health outcomes&#46;<a class="elsevierStyleCrossRefs" href="#bib0180"><span class="elsevierStyleSup">16&#44;17</span></a> Although hormonal differences may influence&#44; and menstrual cycle data was collected&#44; the study&#39;s short duration did not allow for a complete cycle to be captured&#44; so we decided not include this information&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">While polysomnography remains the gold standard for sleep studies&#44; it&#39;s impractical for real space missions&#46; Fitbit sense 2 has proven successful for monitoring sleep and wakefulness&#44;<a class="elsevierStyleCrossRef" href="#bib0190"><span class="elsevierStyleSup">18</span></a> despite the known limitations of older models in accurately determining sleep stages&#44; especially in individuals with health conditions&#46; However&#44; technology evolves rapidly&#44; and recent versions have shown improvements&#44;<a class="elsevierStyleCrossRef" href="#bib0195"><span class="elsevierStyleSup">19</span></a> with high sensitivity and accuracy in determining sleep stages&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">The Mars-500 study&#39;s findings on lethargy and reduced physical activity highlighted the importance of daily exercise routines in subsequent missions&#46; However&#44; despite conclusive scientific evidence demonstrating the relevance of sleep disturbances&#44; concrete measures to enhance sleep in real space missions have not been implemented&#46; Successful attempts to implement countermeasures were demonstrated in an experiment during the robotic Phoenix Mars Lander spacecraft&#44; where mission personnel worked on a Mars day &#40;24&#46;65<span class="elsevierStyleHsp" style=""></span>h&#41; for 78 days&#46;<a class="elsevierStyleCrossRef" href="#bib0200"><span class="elsevierStyleSup">20</span></a></p><p id="par0075" class="elsevierStylePara elsevierViewall">In conclusion&#44; our study underscores the intricate relationship between sleep quantity&#44; quality&#44; individual differences&#44; and mission demands in simulated space conditions and contributes to bridging the existing data gap on women&#39;s health in space&#46;</p></span>"
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        "texto" => "<p id="par0080" class="elsevierStylePara elsevierViewall">We sincerely thank the Innovation Unit of the Hospital Universitari Germans Trias i Pujol for their invaluable support and collaboration throughout our research&#46; Special gratitude goes to Google for providing the Fitbit Sense 2 devices&#44; essential for data collection&#46; We appreciate the Mars Society for allowing us to conduct our research at the Mars Desert Research Station&#46; Our heartfelt thanks go to the Hypatia I crew for their voluntary participation and long-term commitment to scientific research with a gender perspective&#46; We also acknowledge all individuals and institutions whose contributions were essential to the success of the Hypatia I mission&#44; emphasizing that without their support&#44; this project would not have been possible&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">The Hypatia I analogue mission received support from the Catalunya La Pedrera Foundation&#44; the Government of Catalonia&#44; the Banco Sabadell Foundation&#44; the Girls and Space Club&#44; the Catalan Foundation for Research and Innovation&#44; and isardSAT&#46; The funding sources had no involvement in the preparation of this article&#44; including the study design&#44; data collection&#44; analysis&#44; and interpretation&#44; writing of the report&#44; and the decision to submit the article for publication&#46;</p>"
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Journal Information
Vol. 60. Issue 10.
Pages 649-651 (October 2024)
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Vol. 60. Issue 10.
Pages 649-651 (October 2024)
Scientific Letter
Sleep–Wake Cycle in a Female Crew During an Earth-Based Martian Analogue Mission
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Carla Conejo-Gonzáleza,1, Georgina Company-Seb,c,1, Aida Muñoz-Ferrerd,e,
Corresponding author
amunoz.germanstrias@gencat.cat

Corresponding author.
, Ignacio Vicented,e, Anna Núñezd, Jorge Abadd,e
a Executive Officer & Crew Biologist of Hypatia I, Hypatia Mars Association, Barcelona, Spain
b Northern Metropolitan Territorial Management, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
c Department of Electronic Engineering, Universitat Politècnica de Catalunya, Barcelona, Spain
d Sleep Medicine Unit, Respiratory Medicine Department, Direcció Clínica de l’Àrea del Tòrax, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
e Fundació Institut d’Investigació en Ciències de la Salut Germans Trias i Pujol, Department of Respiratory Medicine, Badalona, Spain
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