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Mercadante S, Bellastella A. Chrono-Endocrinology in Clinical Practice: A Journey from Pathophysiological to Therapeutic Aspects. Life (Basel) 2024; 14:546. [PMID: 38792568 PMCID: PMC11121809 DOI: 10.3390/life14050546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 05/26/2024] Open
Abstract
This review was aimed at collecting the knowledge on the pathophysiological and clinical aspects of endocrine rhythms and their implications in clinical practice, derived from the published literature and from some personal experiences on this topic. We chose to review, according to the PRISMA guidelines, the results of original and observational studies, reviews, meta-analyses and case reports published up to March 2024. Thus, after summarizing the general aspects of biological rhythms, we will describe the characteristics of several endocrine rhythms and the consequences of their disruption, paying particular attention to the implications in clinical practice. Rhythmic endocrine secretions, like other physiological rhythms, are genetically determined and regulated by a central hypothalamic CLOCK located in the suprachiasmatic nucleus, which links the timing of the rhythms to independent clocks, in a hierarchical organization for the regulation of physiology and behavior. However, some environmental factors, such as daily cycles of light/darkness, sleep/wake, and timing of food intake, may influence the rhythm characteristics. Endocrine rhythms are involved in important physiological processes and their disruption may cause several disorders and also cancer. Thus, it is very important to prevent disruptions of endocrine rhythms and to restore a previously altered rhythm by an early corrective chronotherapy.
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Affiliation(s)
| | - Antonio Bellastella
- Department of Cardiothoracic and Respiratory Sciences, University of Campania “Luigi Vanvitelli”, 80131 Naples, Italy;
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Mangini C, Zarantonello L, Formentin C, Giusti G, Domenie ED, Ruggerini D, Costa R, Skene DJ, Basso D, Battagliarin L, Di Bella A, Angeli P, Montagnese S. Managing Circadian Disruption due to Hospitalization: A Pilot Randomized Controlled Trial of the CircadianCare Inpatient Management System. J Biol Rhythms 2024; 39:183-199. [PMID: 38153134 DOI: 10.1177/07487304231213916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
The objective of the present study was to test the effects of an inpatient management system (CircadianCare) aimed at limiting the negative impact of hospitalization on sleep by enhancing circadian rhythmicity. Fifty inpatients were randomized to either CircadianCare (n = 25; 18 males, 62.4 ± 1.9 years) or standard of care (n = 25; 14 males, 64.5 ± 2.3 years). On admission, all underwent a full sleep-wake evaluation; they then completed daily sleep diaries and wore an actigraph for the whole length of hospitalization. On days 1 (T0), 7 (T1), and 14 (T2, if still hospitalized), salivary melatonin for dim light melatonin onset (DLMO) and 24-h skin temperature were recorded. In addition, environmental noise, temperature, and illuminance were monitored. Patients in the CircadianCare arm followed 1 of 3 schedules for light/dark, meal, and physical activity timings, based on their diurnal preference/habits. They wore short-wavelength-enriched light-emitting glasses for 45 min after awakening and short-wavelength light filter shades from 18:00 h until sleep onset. While the first, primary registered outcome (reduced sleep-onset latency on actigraphy or diary) was not met, based on sleep diaries, there was a trend (0.05 < p < 0.1) toward an advance in bedtime for CircadianCare compared to standard of care patients between T0 and T1. Similarly, DLMO time significantly advanced in the small group of patients for whom it could be computed on both occasions, with untreated ones starting from earlier baseline values. Patients sleeping near the window had significantly higher sleep efficiency, regardless of treatment arm. As noise fluctuation increased, so did the number of night awakenings, regardless of treatment arm. In conclusion, the CircadianCare management system showed positive results in terms of advancing sleep timing and the circadian rhythm of melatonin. Furthermore, our study identified a combination of environmental noise and lighting indices, which could be easily modulated to prevent hospitalization-related insomnia.
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Affiliation(s)
- Chiara Mangini
- Department of Medicine, University of Padova, Padova, Italy
| | | | | | - Gianluca Giusti
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | | | | | - Rodolfo Costa
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- Department of Biomedical Sciences, University of Padova, Padova, Italy
- Institute of Neuroscience, National Research Council, Padova, Italy
| | - Debra J Skene
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Daniela Basso
- Department of Medicine, University of Padova, Padova, Italy
| | - Lisa Battagliarin
- Department of Industrial Engineering, University of Padova, Padova, Italy
- Iuav University of Venice, Venice, Italy
| | - Antonino Di Bella
- Department of Industrial Engineering, University of Padova, Padova, Italy
| | - Paolo Angeli
- Department of Medicine, University of Padova, Padova, Italy
| | - Sara Montagnese
- Department of Medicine, University of Padova, Padova, Italy
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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Völker J, Kühnel J, Feinäugle F, Barnes CM. Being robbed of an hour of sleep: The impact of the transition to Daylight Saving Time on work engagement depends on employees' chronotype. Sleep Health 2023; 9:579-586. [PMID: 37453904 DOI: 10.1016/j.sleh.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/30/2023] [Accepted: 06/13/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE Worldwide, over 70 countries advance their clocks in spring to Daylight Saving Time. Previous research has already demonstrated that the clock change negatively impacts employees at work. However, this research implicitly assumed that the clock change affects everyone to the same extent. In the current study, we propose that the massively prevalent Daylight Saving Time transition may have an effect on employees' sleep and their work engagement that is dependent upon employees' chronotype. METHODS We conducted a longitudinal study with 155 full-time employees who filled out online surveys on three Mondays around the transition to Daylight Saving Time. RESULTS Results showed that the transition to Daylight Saving Time resulted in decreased work engagement measured 1day as well as 1week after the transition to Daylight Saving Time. Lower sleep quality (but not shorter sleep duration) partly explained this effect. The negative effect of the transition to Daylight Saving Time on work engagement 1day after the transition was more pronounced for employees with later chronotypes ("owls") than for those with earlier chronotypes ("larks"). CONCLUSION In summary, our study shows that the transition to Daylight Saving Time has an adverse short-time impact on private life and working life and should, therefore, also be considered in organizations. Because later chronotypes are especially prone to adverse effects of the transition, interventions targeted for this group might be especially helpful.
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Affiliation(s)
- Jette Völker
- Department of Psychology, University of Mannheim, Mannheim, Germany.
| | - Jana Kühnel
- Department of Occupational, Economic and Social Psychology, University of Vienna, Vienna, Austria
| | - Franziska Feinäugle
- Department of Forensic Psychiatry and Psychotherapy, Ulm University, Günzburg, Germany
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4
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Kim DW, Blackshaw S. A super Sonic circadian synchronizer. Science 2023; 380:896-897. [PMID: 37262151 DOI: 10.1126/science.adi3177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Sonic Hedgehog signaling and primary cilia control the core mammalian circadian clock.
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Affiliation(s)
- Dong Won Kim
- Danish Research Institute of Translational Neuroscience (DANDRITE), Nordic EMBL Partnership for Molecular Medicine, Aarhus University, Aarhus, Denmark
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Seth Blackshaw
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Institute for Cell Engineering, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Kavli Neuroscience Discovery Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Garbellotto L, Petit E, Brunet E, Guirronnet S, Clolus Y, Gillet V, Bourdin H, Mougin F. Gradual Advance of Sleep-Wake Schedules Before an Eastward Flight and Phase Adjustment After Flight in Elite Cross-Country Mountain Bikers: Effects on Sleep and Performance. J Strength Cond Res 2023; 37:872-880. [PMID: 36165935 DOI: 10.1519/jsc.0000000000004348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/10/2022] [Indexed: 11/08/2022]
Abstract
ABSTRACT Garbellotto, L, Petit, E, Brunet, E, Guirronnet, S, Clolus, Y, Gillet, V, Bourdin, H, and Mougin, F. Gradual advance of sleep-wake schedules before an eastward flight and phase adjustment after flight in elite cross-country mountain bikers: effects on sleep and performance. J Strength Cond Res 37(4): 872-880, 2023-Strategies, for alleviating jet lag, specifically targeted to competitive athletes have never been studied, in ecological conditions. This study aimed to assess the effects of a phase advance before a 7-hour eastward flight followed by a strategy of resynchronization at destination on sleep and physical performance in professional mountain bikers. Six athletes participated in this study divided into 4 periods: (i) baseline (usual sleep-wake rhythm); (ii) phase advance (advance sleep-wake schedules of 3 hours for 6 days); (iii) travel (flight: Paris-Tokyo); and (iv) phase adjustment (resynchronization of sleep-wake schedules). Melatonin pills and light therapy were administrated during the phase advance and phase adjustment. Sleep was recorded by polysomnography and actigraphy, core body temperature (CBT) rhythm was assessed by ingestible capsules, and physical performances were tested by the Wingate and 5-minute maximal exercise tests. Results showed that bedtime was advanced by 2.9 hours at the end of the phase advance ( p ≤ 0.01) with a batyphase of CBT advanced by 2.5 hours ( p = 0.07). Bedtime was similar at destination compared with baseline. Total sleep time and sleep composition were unchanged at the end of the phase advance or at destination, compared with baseline. Physical performances were maintained after phase advance and at destination. The phase advance enabled to preshift part of the time zones without disturbing sleep and physical performances and contributed to preserving them once at destination. A phase advance before eastward travel represents an effective strategy to counter harmful effects of jet lag.
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Affiliation(s)
- Lucas Garbellotto
- Research Unit EA 3920 and Exercise Performance, Health, Innovation Platform, University of Bourgogne Franche-Comte, 25000 Besançon, France
- French Cycling Federation, 78180 Montigny-le-Bretonneux, France
| | - Elisabeth Petit
- Research Unit EA 3920 and Exercise Performance, Health, Innovation Platform, University of Bourgogne Franche-Comte, 25000 Besançon, France
| | - Emmanuel Brunet
- French Cycling Federation, 78180 Montigny-le-Bretonneux, France
| | | | - Yvan Clolus
- French Cycling Federation, 78180 Montigny-le-Bretonneux, France
| | | | - Hubert Bourdin
- Research Unit EA 481, University of Bourgogne Franche-Comte; and
- Sleep Disorder Unit Hospital, 25000 Besançon, France
| | - Fabienne Mougin
- Research Unit EA 3920 and Exercise Performance, Health, Innovation Platform, University of Bourgogne Franche-Comte, 25000 Besançon, France
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6
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Kim R, Nijhout HF, Reed MC. Mathematical insights into the role of dopamine signaling in circadian entrainment. Math Biosci 2023; 356:108956. [PMID: 36581152 DOI: 10.1016/j.mbs.2022.108956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/15/2022] [Accepted: 12/16/2022] [Indexed: 12/27/2022]
Abstract
The circadian clock in the mammalian brain comprises interlocked molecular feedback loops that have downstream effects on important physiological functions such as the sleep-wake cycle and hormone regulation. Experiments have shown that the circadian clock also modulates the synthesis and breakdown of the neurotransmitter dopamine. Imbalances in dopamine are linked to a host of neurological conditions including Parkinson's disease, attention-deficit/hyperactivity disorder, and mood disorders, and these conditions are often accompanied by circadian disruptions. We have previously created a mathematical model using nonlinear ordinary differential equations to describe the influences of the circadian clock on dopamine at the molecular level. Recent experiments suggest that dopamine reciprocally influences the circadian clock. Dopamine receptor D1 (DRD1) signaling has been shown to aid in the entrainment of the clock to the 24-hour light-dark cycle, but the underlying mechanisms are not well understood. In this paper, we use our mathematical model to support the experimental hypothesis that DRD1 signaling promotes circadian entrainment by modulating the clock's response to light. We model the effects of a phase advance or delay, as well as the therapeutic potential of a REV-ERB agonist. In addition to phase shifts, we study the influences of photoperiod, or day length, in the mathematical model, connect our findings with the experimental and clinical literature, and determine the parameter that affects the critical photoperiod that signals seasonal changes to physiology.
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Affiliation(s)
- Ruby Kim
- Department of Mathematics, University of Michigan, 530 Church Street, Ann Arbor, 48109, MI, USA.
| | - H Frederik Nijhout
- Department of Biology, Duke University, 130 Science Drive, Durham, 27708, NC, USA
| | - Michael C Reed
- Department of Mathematics, Duke University, 120 Science Drive, Durham, 27708, NC, USA
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Dai HR, Guo HL, Hu YH, Xu J, Ding XS, Cheng R, Chen F. Precision caffeine therapy for apnea of prematurity and circadian rhythms: New possibilities open up. Front Pharmacol 2022; 13:1053210. [DOI: 10.3389/fphar.2022.1053210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Accepted: 11/18/2022] [Indexed: 12/04/2022] Open
Abstract
Caffeine is the globally consumed psychoactive substance and the drug of choice for the treatment of apnea of prematurity (AOP), but its therapeutic effects are highly variable among preterm infants. Many of the molecular underpinnings of the marked individual response have remained elusive yet. Interestingly, the significant association between Clock gene polymorphisms and the response to caffeine therapy offers an opportunity to advance our understanding of potential mechanistic pathways. In this review, we delineate the functions and mechanisms of human circadian rhythms. An up-to-date advance of the formation and ontogeny of human circadian rhythms during the perinatal period are concisely discussed. Specially, we summarize and discuss the characteristics of circadian rhythms in preterm infants. Second, we discuss the role of caffeine consumption on the circadian rhythms in animal models and human, especially in neonates and preterm infants. Finally, we postulate how circadian-based therapeutic initiatives could open new possibilities to promote precision caffeine therapy for the AOP management in preterm infants.
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Polymeropoulos CM, Polymeropoulos VM, Czeisler EL, Fisher MA, Smieszek SP, Xiao C, Birznieks G, Polymeropoulos MH. Once-daily tasimelteon (VEC-162) for jet lag following transmeridian travel: A multicenter, randomized, double-blind, placebo-controlled trial. Front Neurol 2022; 13:901467. [PMID: 36188367 PMCID: PMC9521676 DOI: 10.3389/fneur.2022.901467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Jet Lag Disorder is a Circadian Rhythm Sleep-Wake Disorder resulting from a misalignment of the endogenous circadian clock and the sleep and wake pattern required by a change in time zone. Jet lag is most severe following eastward travel. This multicenter, randomized, placebo-controlled clinical trial (JET) assessed the physiological mechanism of jet lag induced by a real-life transmeridian flight and evaluated the efficacy of tasimelteon—a circadian regulator acting as a dual melatonin receptor agonist, in the treatment of Jet Lag Disorder (JLD). Tasimelteon-treated participants slept 76 min longer on Night 3 during their second trip (evaluation phase) as compared to their first (observational phase). Over the three travel nights evaluated, transmeridian jet travelers in the tasimelteon group slept 131 min more (TST2/3) than those in the placebo group. The JET study demonstrated clinically meaningful improvements in nighttime sleep and daytime alertness in both objective and subjective measures as well as global functioning after a real-world flight. These results suggest that tasimelteon can be an effective therapeutic tool to treat JLD in the context of transmeridian travel.
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Kuula L, Halonen R, Lipsanen J, Pesonen AK. Adolescent circadian patterns link with psychiatric problems: A multimodal approach. J Psychiatr Res 2022; 150:219-226. [PMID: 35397335 DOI: 10.1016/j.jpsychires.2022.03.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/04/2022] [Accepted: 03/31/2022] [Indexed: 11/20/2022]
Abstract
Circadian rhythms orchestrate brain function and mental wellbeing. We compared circadian patterns derived from continuous measurements of body temperature, sleep actigraphy and self-reported circadian preference in relation to different psychiatric disorders. 342 adolescents (70% females) aged 17.4y underwent M.I.N.I. psychiatric interviews, wore Ibutton 1922L skin temperature loggers (n = 281; 3 days), completed one-week GeneActiv Original actigraphy measurements (n = 306) and responded to Morningness-Eveningness Questionnaire (MEQ; n = 330). We derived circadian period length and amplitude from the temperature loggers. Actigraphy measures included sleep duration, midpoint, efficiency, and irregularity as well as Delayed Sleep Phase (DSP) characteristics (bedtime after 1 a.m. 3 times/week). M.I.N.I. psychiatric interviews suggested that 36% of participants had one or more psychiatric problem, with 21% suffering from comorbidity. Severe depression was associated with longer circadian period (p = 0.002). Suicidality was associated with later midpoint (p = 0.007) and more irregular sleep (p = 0.007). Those with agoraphobia slept longer (p = 0.013). Manic episodes and psychotic disorders were associated with irregular sleep (p-values <0.02). DSP was related to suicidality (p = 0.026), panic disorder (p = 0.022), and greater comorbidity (p = 0.026). Preference for eveningness was similarly related to higher prevalence of Generalized Anxiety Disorder (p = 0.014), social anxiety (p = 0.03), agoraphobia (p = 0.026), panic disorder (p = 0.004), suicidality (p = 0.018), severe depression (p < 0.001), and comorbidity (p < 0.001). Deviations in circadian rhythms were widely associated with psychiatric problems, whereas sleep duration was not. Especially suicidality linked with several markers of circadian disruption: later sleep midpoint, irregular sleep, and DSP characteristics. Longer circadian period length was associated with severe depression.
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Affiliation(s)
- Liisa Kuula
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland.
| | - Risto Halonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland
| | - Jari Lipsanen
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anu-Katriina Pesonen
- SleepWell Research Program, Faculty of Medicine, University of Helsinki, Finland
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10
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Melatonin in ventricular and subarachnoid cerebrospinal fluid: Its function in the neural glymphatic network and biological significance for neurocognitive health. Biochem Biophys Res Commun 2022; 605:70-81. [DOI: 10.1016/j.bbrc.2022.03.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 03/02/2022] [Accepted: 03/04/2022] [Indexed: 12/13/2022]
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Beh SF, Holdik EN, Bin YS, Cheung JMY. Air travellers' experiences and understanding of jetlag and perceptions of management strategies: a qualitative study. ERGONOMICS 2022; 65:642-658. [PMID: 34615442 DOI: 10.1080/00140139.2021.1980112] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 09/08/2021] [Indexed: 06/13/2023]
Abstract
Jetlag is largely self-managed by the individual traveller. This paper explores the lived experiences of air travellers, their understanding of jetlag, and their perceptions of management strategies. 32 international travellers (mean age = 31, SD: 15 years; 47% female, mean flight duration = 16, SD: 6 hours) were interviewed. Interviews were recorded, transcribed verbatim and analysed using the Framework Approach. Analysis of the qualitative data revealed three emergent themes: Travel beliefs and experiences, Impact of jetlag, and Approaches to jetlag management. Participants' experience of jetlag was described in terms of the entire journey with no distinction made between circadian disruption and travel fatigue. Management strategies revolved around needs for comfort and avoiding fatigue, and were mostly guided by somatic symptom cues, prior travel experiences, or the experiential advice from others. Our findings highlight the need for traveller involvement in co-designing evidence-based interventions for jetlag to enhance their transferability into the real world. Practitioner summaryQualitative findings highlighted jetlag as encapsulating the entire journey, and not limited to post-flight circadian disruptions during international travel. Jetlag management interventions need to address issues of circadian misalignment together with travel fatigue and in-flight discomfort through behavioural and nutritional strategies. Travel context and environmental factors such as airport facilities also influenced perceived jetlag severity.
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Affiliation(s)
- Su Fern Beh
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Elisa Nicola Holdik
- The Brain and Mind Centre, The University of Sydney, Sydney, Australia
- Sleep Research Group, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Yu Sun Bin
- Sleep Research Group, Charles Perkins Centre, The University of Sydney, Sydney, Australia
- Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Janet M Y Cheung
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Sleep Research Group, Charles Perkins Centre, The University of Sydney, Sydney, Australia
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12
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Støre SJ. Swedish Internet forum users’ views and experiences of melatonin treatments for troubled sleep. Sleep Health 2022; 8:225-229. [DOI: 10.1016/j.sleh.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 12/08/2021] [Accepted: 12/12/2021] [Indexed: 11/30/2022]
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Pohanka M. New uses of Melatonin as a Drug, a Review. Curr Med Chem 2022; 29:3622-3637. [PMID: 34986763 DOI: 10.2174/0929867329666220105115755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 10/25/2021] [Accepted: 11/21/2021] [Indexed: 11/22/2022]
Abstract
Melatonin is a simple compound with a proper chemical name N-acetyl-5-methoxy tryptamine and known as a hormone controlling circadian rhythm. Humans produce melatonin at night which is the reason for sleeping in the night and awakening over the day. Melatonin interacts with melatonin receptors MT1 and MT2 but it was also revealed that melatonin is a strong antioxidant and it also has a role in regulation of cell cycle. Currently, melatonin is used as a drug for some types of sleep disorder but the recent research points to the fact that melatonin can also serve for the other purposes including prophylaxis or therapy of lifestyle diseases, cancer, neurodegenerative disorders and exposure to chemicals. This review summarizes basic facts and direction of the current research on melatonin. The actual literature was scrutinized for the purpose of this review.
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Affiliation(s)
- Miroslav Pohanka
- Faculty of Military Health Sciences, University of Defense, Trebesska 1575, Hradec Kralove CZ-50001, Czech Republic
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14
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Beros A, Farquhar C, Nagels HE, Showell MG, Fernando A, Jordan V. Pharmacological interventions for jet lag. Hippokratia 2021. [DOI: 10.1002/14651858.cd014611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Angela Beros
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences; The University of Auckland; Auckland New Zealand
| | - Cindy Farquhar
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences; The University of Auckland; Auckland New Zealand
| | - Helen E Nagels
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences; The University of Auckland; Auckland New Zealand
| | - Marian G Showell
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences; The University of Auckland; Auckland New Zealand
| | | | - Vanessa Jordan
- Department of Obstetrics and Gynaecology, Faculty of Medical and Health Sciences; The University of Auckland; Auckland New Zealand
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15
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Rose K, Iking-Konert C. [Medications when travelling with underlying inflammatory rheumatic disease]. Z Rheumatol 2021; 80:611-619. [PMID: 34387713 DOI: 10.1007/s00393-021-01061-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2021] [Indexed: 10/20/2022]
Abstract
Travelling poses particular challenges for patients with rheumatic diseases. This article provides specific guidance on how best to manage medication while away from home. Besides outlining advice on basic logistic issues, such as the transportation, importation and storage of drugs, the article concentrates on travelling while receiving immunosuppressive therapy and carrying narcotics. Especially when transporting narcotics, travel requires careful planning in advance in close collaboration with physicians on account of the strict and internationally diverse import restrictions on controlled substances. While travelling, all drugs should be kept in the original packaging, including the package insert and stored in carry-on luggage. A specific medical passport may be needed. Immunosuppressive and narcotic drugs require medical certificates issued by the prescribing physician, which may need to be certified by the responsible national agencies. Patients receiving glucocorticoid treatment who travel in or across multiple time zones should also be aware of how the medication impacts and interacts with circadian rhythms so as to optimize the anti-inflammatory effects of the drugs and to avoid unnecessary complications. Given the significant discrepancies in medical care and availability of medication worldwide, the article further stresses the importance of a comprehensive medical kit tailored to the patient's individual medicinal needs. Finally, as immunocompromised travellers are at increased risk of infections, advice is given on the use of anti-infective drugs and chemoprophylaxis for patients travelling to areas in which malaria is endemic as well as on their possible interactions with immunosuppressive treatment.
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Affiliation(s)
- K Rose
- III. Medizinische Klinik, Sektion Rheumatologie, Zentrum für Innere Medizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - C Iking-Konert
- III. Medizinische Klinik, Sektion Rheumatologie, Zentrum für Innere Medizin, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland
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Paragliola RM, Corsello A, Troiani E, Locantore P, Papi G, Donnini G, Pontecorvi A, Corsello SM, Carrozza C. Cortisol circadian rhythm and jet-lag syndrome: evaluation of salivary cortisol rhythm in a group of eastward travelers. Endocrine 2021; 73:424-430. [PMID: 33543430 PMCID: PMC8263446 DOI: 10.1007/s12020-021-02621-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 01/08/2021] [Indexed: 02/05/2023]
Abstract
PURPOSE The activity of the hypothalamus-pituitary-adrenal axis plays a crucial role as an endogenous stress-reactive system. Lifestyle and work often interfere with the endogenous circadian rhythms and can modify the physiological patterns of stress-hormones secretion, including cortisol. We evaluated the cortisol circadian rhythm in the "jet-lag syndrome" that is the most known condition associated with the desynchronization of the circadian rhythm. METHODS To assess the modifications of cortisol secretion after a long-haul flight, we compared baseline and post-travel salivary cortisol rhythm in a group of 28 healthy eastward travelers (from the U.S.A. or Canada to Italy). The salivary samples were collected about 1 week before the departure at 11 p.m. on day 0 and at 8 a.m., 12 a.m. (midday) and 11 p.m. on day 1 (R0). The same samples were obtained after the landing, the day they flew back home (R1). RESULTS Statistical analysis showed a significant difference between R0 and R1 for each sample considered (p < 0.005). In particular, the post-travel salivary cortisol levels detected at 11 p.m. both on day 0 and on day 1, were significantly higher than at baseline. Post-travel morning salivary cortisol levels were lower compared with basal rhythm and increased during the morning, reaching the acrophase at 12 a.m. CONCLUSIONS In eastward travelers, crossing more than five time zones, the cortisol circadian rhythm after the return to the East "remained behind," being synchronized with the West time. This impaired cortisol secretion can contribute to the pathogenesis of the jet-lag syndrome.
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Affiliation(s)
- Rosa Maria Paragliola
- Unit of Endocrinology, Università Cattolica del Sacro Cuore, Fondazione Policlinico "Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Andrea Corsello
- Unit of Endocrinology, Università Cattolica del Sacro Cuore, Fondazione Policlinico "Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
| | - Eliana Troiani
- Unit of Chemistry, Biochemistry and Clinical Molecular Biology, Università Cattolica del Sacro Cuore, Fondazione Policlinico "Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Pietro Locantore
- Unit of Endocrinology, Università Cattolica del Sacro Cuore, Fondazione Policlinico "Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Giampaolo Papi
- Unit of Endocrinology, Università Cattolica del Sacro Cuore, Fondazione Policlinico "Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Giulia Donnini
- Unit of Endocrinology, Università Cattolica del Sacro Cuore, Fondazione Policlinico "Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Alfredo Pontecorvi
- Unit of Endocrinology, Università Cattolica del Sacro Cuore, Fondazione Policlinico "Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Salvatore Maria Corsello
- Unit of Endocrinology, Università Cattolica del Sacro Cuore, Fondazione Policlinico "Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Cinzia Carrozza
- Unit of Chemistry, Biochemistry and Clinical Molecular Biology, Università Cattolica del Sacro Cuore, Fondazione Policlinico "Gemelli" IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
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17
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Abstract
The objective of chronotherapy is to optimize medical treatments taking into account the body's circadian rhythms. Chronotherapy is referred to and practiced in two different ways: (1) to alter the sleep-wake rhythms of patients to improve the sequels of several pathologies; (2) to take into account the circadian rhythms of patients to improve therapeutics. Even minor dysfunction of the biological clock can greatly affect sleep/wake physiology causing excessive diurnal somnolence, increase in sleep onset latency, phase delays or advances in sleep onset, frequent night awakenings, reduced sleep efficiency, delayed and shortened rapid eye movement sleep, or increased periodic leg movements. Chronotherapy aims to restore the proper circadian pattern of the sleep-wake cycle, through adequate sleep hygiene, timed light exposure, and the use of chronobiotic medications, such as melatonin, that affect the output phase of circadian rhythms, thus controlling the clock. Concerning the second use of chronotherapy, therapeutic outcomes as diverse as the survival after open-heart surgery or the efficacy and tolerance to chemotherapy vary according to the time of day. However, humans are heterogeneous concerning the timing of their internal clocks. Not only different chronotypes exist but also the endogenous human circadian period (τ) is not a stable trait as it depends on many internal and external factors. If any scheduled therapeutic intervention is going to be optimized, a tool is needed for simple diagnostic and objectively measurement of an individual's internal time at any given time. Methodologic advances like the use of single-sample gene expression and metabolomics are discussed.
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Affiliation(s)
- Daniel P Cardinali
- Faculty of Medical Sciences, Pontificia Universidad Católica Argentina, Buenos Aires, Argentina
| | - Gregory M Brown
- Department of Psychiatry, Centre for Addiction and Mental Health, University of Toronto, Toronto, ON, Canada
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18
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Balachandran DD, Miller MA, Faiz SA, Yennurajalingam S, Innominato PF. Evaluation and Management of Sleep and Circadian Rhythm Disturbance in Cancer. Curr Treat Options Oncol 2021; 22:81. [PMID: 34213651 DOI: 10.1007/s11864-021-00872-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2021] [Indexed: 12/16/2022]
Abstract
OPINION STATEMENT Sleep and circadian rhythm disturbance are among the most commonly experienced symptoms in patients with cancer. These disturbances occur throughout the spectrum of cancer care from diagnosis, treatment, and long into survivorship. The pathogenesis of these symptoms and disturbances is based on common inflammatory pathways related to cancer and its' treatments. The evaluation of sleep and circadian disorders requires an understanding of how these symptoms cluster with other cancer-related symptoms and potentiate each other. A thorough evaluation of these symptoms and disorders utilizing validated diagnostic tools, directed review of clinical information, and diagnostic testing is recommended. Treatment of sleep and circadian disturbance in cancer patients should be based on the findings of a detailed evaluation, including specific treatment of primary sleep and circadian disorders, and utilize integrative and personalised management of cancer-related symptoms through multiple pharmacologic and non-pharmacologic modalities. Recognition, evaluation, and treatment of sleep and circadian rhythm disturbance in cancer may lead to improved symptom management, quality of life, and outcomes.
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Affiliation(s)
- Diwakar D Balachandran
- Department of Pulmonary Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street. Unit 1462, Houston, TX, 77030-4009, USA.
| | - Michelle A Miller
- Division of Health Sciences (Mental Health & Wellbeing), University of Warwick, Warwick Medical School, Gibbet Hill, Coventry, UK
| | - Saadia A Faiz
- Department of Pulmonary Medicine, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, 1400 Pressler Street. Unit 1462, Houston, TX, 77030-4009, USA
| | - Sriram Yennurajalingam
- Department of Palliative, Rehabilitation, and Integrative Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Pasquale F Innominato
- North Wales Cancer Treatment Centre, Ysbyty Gwynedd, Betsi Cadwaladr University Health Board, Bangor, UK
- Cancer Chronotherapy Team, Warwick Medical School, Coventry, UK
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19
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Light cycle phase advance as a model for jet lag reprograms the circadian rhythms of murine extraorbital lacrimal glands. Ocul Surf 2021; 20:95-114. [PMID: 33582293 DOI: 10.1016/j.jtos.2021.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 01/07/2021] [Accepted: 02/01/2021] [Indexed: 02/06/2023]
Abstract
PURPOSE Jet lag causes a disruption in physiological rhythms in humans. This study aims to explore the extent to which jet lag affects the circadian rhythmicity in the lacrimal glands. METHODS C57BL/6J mice were subjected to a 12-h light/12-h dark (LD) cycle and an 8-h advanced LD schedule as a model for jet lag. On day 5 after the LD advance, the extraorbital lacrimal glands (ELGs) were collected at 3-h intervals during a 24-h cycle. Total mRNA was extracted from normal and advanced LD-treated ELGs and assayed using high-throughput RNA sequencing. The rhythmic transcripts were identified, analyzed, and visualized by bioinformatics techniques. Finally, (i) animal behavior; (ii) the mass, cell size, and secretion response of ELGs; and (iii) circadian migration of immune cells to ELGs were also assayed. RESULTS Jet lag treatment drastically altered the phase and composition of the rhythmic transcripts compared to that of normal ELGs. The key biological processes, signaling pathways, and protein-protein association networks were also dramatically altered in a spatiotemporal pattern. Furthermore, the circadian migration of neutrophils, T cells, B cells, and macrophages to the ELGs increased and shifted later by 6-h. Finally, the circadian rhythms of the ELGs with respect to mass, cell size, and secretion response were also impaired in jet lag-treated animals. CONCLUSIONS Jet lag impairs the circadian rhythm of the transcriptomic profile, structure, and secretion function of the lacrimal glands. This information provides novel insight into the negative effects of jet lag on ELGs.
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20
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Ruan W, Yuan X, Eltzschig HK. Circadian rhythm as a therapeutic target. Nat Rev Drug Discov 2021; 20:287-307. [PMID: 33589815 DOI: 10.1038/s41573-020-00109-w] [Citation(s) in RCA: 158] [Impact Index Per Article: 52.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 12/20/2022]
Abstract
The circadian clock evolved in diverse organisms to integrate external environmental changes and internal physiology. The clock endows the host with temporal precision and robust adaptation to the surrounding environment. When circadian rhythms are perturbed or misaligned, as a result of jet lag, shiftwork or other lifestyle factors, adverse health consequences arise, and the risks of diseases such as cancer, cardiovascular diseases or metabolic disorders increase. Although the negative impact of circadian rhythm disruption is now well established, it remains underappreciated how to take advantage of biological timing, or correct it, for health benefits. In this Review, we provide an updated account of the circadian system and highlight several key disease areas with altered circadian signalling. We discuss environmental and lifestyle modifications of circadian rhythm and clock-based therapeutic strategies, including chronotherapy, in which dosing time is deliberately optimized for maximum therapeutic index, and pharmacological agents that target core clock components and proximal regulators. Promising progress in research, disease models and clinical applications should encourage a concerted effort towards a new era of circadian medicine.
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Affiliation(s)
- Wei Ruan
- Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.,Department of Anesthesiology, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Xiaoyi Yuan
- Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Holger K Eltzschig
- Department of Anesthesiology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
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21
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Moroni I, Garcia-Bennett A, Chapman J, Grunstein RR, Gordon CJ, Comas M. Pharmacokinetics of exogenous melatonin in relation to formulation, and effects on sleep: A systematic review. Sleep Med Rev 2021; 57:101431. [PMID: 33549911 DOI: 10.1016/j.smrv.2021.101431] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 11/25/2022]
Abstract
There is conflicting evidence on the clinical efficacy of exogenous melatonin for the treatment of sleep disorders. This may be due to differences in the pharmacokinetic (PK) properties of melatonin formulations used in clinical trials. The aim of this systematic review was to understand the relationship between melatonin formulations and PK parameters and, where possible, the effects on sleep outcomes. To this purpose, we conducted a systematic review and nineteen papers were included. The studies included three melatonin transdermal formulation, thirteen oral formulations, one topical, two buccal, two intravenous and two nasogastric formulations. Seven studies investigated the effect of the melatonin formulation on sleep and six of them found a significant improvement in one or more sleep parameters. The potential for an improved controlled release formulation that delays maximum concentration (Cmax) was identified. The different formulations and doses affect melatonin PK, suggesting that treatment efficacy maybe affected. Based on the current evidence, we are unable to provide recommendations of specific melatonin formulations and PK parameters for specific sleep disorders. Future studies should systematically investigate how different PK parameters of melatonin formulations affect efficacy treatment of sleep as well as circadian disorders.
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Affiliation(s)
- Irene Moroni
- Department of Molecular Sciences, Macquarie University, Sydney, NSW, Australia
| | - Alfonso Garcia-Bennett
- Department of Molecular Sciences, Macquarie University, Sydney, NSW, Australia; ARC Centre for Nanoscale BioPhotonics, Macquarie University, Sydney, NSW, Australia
| | - Julia Chapman
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, NSW, Australia; Sydney Local Health District, Sydney, NSW, Australia
| | - Ronald R Grunstein
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, NSW, Australia; Sydney Local Health District, Sydney, NSW, Australia; Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia
| | - Christopher J Gordon
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, NSW, Australia; Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, The University of Sydney, Sydney, NSW, Australia
| | - Maria Comas
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, Sydney, NSW, Australia; Central Clinical School, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia.
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22
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Sleep, Circadian Rhythmicity and Response to Chronotherapy in University Students: Tips from Chronobiology Practicals. J Circadian Rhythms 2021; 19:1. [PMID: 33552216 PMCID: PMC7824979 DOI: 10.5334/jcr.202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Chronobiology is not routinely taught to biology or medical students in most European countries. Here we present the results of the chronobiology practicals of a group of students of the University of Padova, with a view to highlight some interesting features of this group, and to share a potentially interesting cross-faculty teaching experience. Thirty-eight students (17 males; 22.9 ± 1.6 yrs) completed a set of self-administered electronic sleep quality [Pittsburgh Sleep Quality Index (PSQI)], chronotype and sleepiness [Epworth Sleepiness Scale (ESS)] questionnaires. They then went on to complete sleep diaries for two weeks. Sixteen also wore an actigraph, 8 wore wireless sensors for skin temperature, and 8 underwent a course of chronotherapy aimed at anticipating their sleep-wake timing. Analyses were performed as practicals, together with the students. Average PSQI score was 5.4 ± 1.9, with 15 (39%) students being poor sleepers. Average ESS score was 6.5 ± 3.3, with 3 (8%) students exhibiting excessive daytime sleepiness. Seven classified themselves as definitely/moderately morning, 25 as intermediates, 6 as moderately/definitely evening. Students went to bed/fell asleep significantly later on weekends, it took them less to fall asleep and they woke up/got up significantly later. Diary-reported sleep onset time coincided with the expected decrease in proximal skin temperature. Finally, during chronotherapy they took significantly less time to fall asleep. In conclusion, significant abnormalities in the sleep-wake patterns of a small group of university students were observed, and the students seemed to benefit from chronotherapy. We had a positive impression of our teaching experience, and the chronobiology courses obtained excellent student feedback.
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23
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Melatonin (MEL) and its use in circadian rhythm sleep-wake disorders: Recommendations of the French Medical and Research Sleep Society (SFRMS). Rev Neurol (Paris) 2021; 177:235-244. [PMID: 33446328 DOI: 10.1016/j.neurol.2020.07.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 06/24/2020] [Accepted: 07/07/2020] [Indexed: 11/20/2022]
Abstract
The French society of medical research on sleep (SFRMS) appointed a group of experts to conduct a consensus conference in order to study the indications and prescription status of exogenous melatonin (MEL). Eleven sleep physicians/researchers investigated in subgroups the use of MEL in different domains of healthcare in line with their subspecialties (circadian sleep/wake rhythm disorders, psychiatric disorders, neurological disorders, pediatric and neurodevelopmental disorders). In this article we present a summary of the main conclusions of the expert group on MEL therapy in circadian sleep/wake rhythm disorders such us delayed sleep-wake disorder, non-24-hour sleep wake rhythm disorder and jet lag.
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24
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Managing Travel Fatigue and Jet Lag in Athletes: A Review and Consensus Statement. Sports Med 2021; 51:2029-2050. [PMID: 34263388 PMCID: PMC8279034 DOI: 10.1007/s40279-021-01502-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 02/07/2023]
Abstract
Athletes are increasingly required to travel domestically and internationally, often resulting in travel fatigue and jet lag. Despite considerable agreement that travel fatigue and jet lag can be a real and impactful issue for athletes regarding performance and risk of illness and injury, evidence on optimal assessment and management is lacking. Therefore 26 researchers and/or clinicians with knowledge in travel fatigue, jet lag and sleep in the sports setting, formed an expert panel to formalise a review and consensus document. This manuscript includes definitions of terminology commonly used in the field of circadian physiology, outlines basic information on the human circadian system and how it is affected by time-givers, discusses the causes and consequences of travel fatigue and jet lag, and provides consensus on recommendations for managing travel fatigue and jet lag in athletes. The lack of evidence restricts the strength of recommendations that are possible but the consensus group identified the fundamental principles and interventions to consider for both the assessment and management of travel fatigue and jet lag. These are summarised in travel toolboxes including strategies for pre-flight, during flight and post-flight. The consensus group also outlined specific steps to advance theory and practice in these areas.
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25
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Smolensky MH, Hermida RC, Geng YJ. Chronotherapy of cardiac and vascular disease: timing medications to circadian rhythms to optimize treatment effects and outcomes. Curr Opin Pharmacol 2020; 57:41-48. [PMID: 33279870 DOI: 10.1016/j.coph.2020.10.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 10/12/2020] [Accepted: 10/16/2020] [Indexed: 12/12/2022]
Abstract
Circadian rhythms impact cardiac and vascular pathophysiology, resulting in 24-hour patterning of symptoms and life-threatening/ending events (chronopathology), plus kinetics and dynamics of medications (chronopharmacology), resulting in administration-time differences in efficacy and safety. Scheduling medications according to circadian rhythm determinants (chronotherapy) can improve treatment effects, for example, before dinner/bedtime ingestion of cholesterol-lowering medications and acetylsalicylic acid, respectively, exerts enhanced control of hypercholesterolemia and after-awakening peak of platelet aggregation; bedtime ingestion of conventional hypertension medications optimizes normalization of sleep-time blood pressure (BP)-strongest independent BP marker of cardiovascular disease (CVD) risk-and most effectively prevents (chronoprevention) CVD morbidity and mortality. Exploration of chronotherapeutic strategies to improve management of cardiac arrhythmias and vascular pathophysiology is still awaited.
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Affiliation(s)
- Michael H Smolensky
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, TX, USA; Department of Internal Medicine, McGovern School of Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA.
| | - Ramon C Hermida
- Department of Biomedical Engineering, Cockrell School of Engineering, The University of Texas at Austin, Austin, TX, USA; Bioengineering & Chronobiology Laboratories, Atlantic Research Center for Information and Communication Technologies (atlanTTic) University of Vigo, Vigo, Spain
| | - Yong-Jian Geng
- Department of Internal Medicine, McGovern School of Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
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26
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Szechtman H, Harvey BH, Woody EZ, Hoffman KL. The Psychopharmacology of Obsessive-Compulsive Disorder: A Preclinical Roadmap. Pharmacol Rev 2020; 72:80-151. [PMID: 31826934 DOI: 10.1124/pr.119.017772] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
This review evaluates current knowledge about obsessive-compulsive disorder (OCD), with the goal of providing a roadmap for future directions in research on the psychopharmacology of the disorder. It first addresses issues in the description and diagnosis of OCD, including the structure, measurement, and appropriate description of the disorder and issues of differential diagnosis. Current pharmacotherapies for OCD are then reviewed, including monotherapy with serotonin reuptake inhibitors and augmentation with antipsychotic medication and with psychologic treatment. Neuromodulatory therapies for OCD are also described, including psychosurgery, deep brain stimulation, and noninvasive brain stimulation. Psychotherapies for OCD are then reviewed, focusing on behavior therapy, including exposure and response prevention and cognitive therapy, and the efficacy of these interventions is discussed, touching on issues such as the timing of sessions, the adjunctive role of pharmacotherapy, and the underlying mechanisms. Next, current research on the neurobiology of OCD is examined, including work probing the role of various neurotransmitters and other endogenous processes and etiology as clues to the neurobiological fault that may underlie OCD. A new perspective on preclinical research is advanced, using the Research Domain Criteria to propose an adaptationist viewpoint that regards OCD as the dysfunction of a normal motivational system. A systems-design approach introduces the security motivation system (SMS) theory of OCD as a framework for research. Finally, a new perspective on psychopharmacological research for OCD is advanced, exploring three approaches: boosting infrastructure facilities of the brain, facilitating psychotherapeutic relearning, and targeting specific pathways of the SMS network to fix deficient SMS shut-down processes. SIGNIFICANCE STATEMENT: A significant proportion of patients with obsessive-compulsive disorder (OCD) do not achieve remission with current treatments, indicating the need for innovations in psychopharmacology for the disorder. OCD may be conceptualized as the dysfunction of a normal, special motivation system that evolved to manage the prospect of potential danger. This perspective, together with a wide-ranging review of the literature, suggests novel directions for psychopharmacological research, including boosting support systems of the brain, facilitating relearning that occurs in psychotherapy, and targeting specific pathways in the brain that provide deficient stopping processes in OCD.
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Affiliation(s)
- Henry Szechtman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada (H.S.); SAMRC Unit on Risk Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, and Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University (Potchefstroom Campus), Potchefstroom, South Africa (B.H.H.); Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada (E.Z.W.); and Centro de Investigación en Reproducción Animal, CINVESTAV-Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico (K.L.H.)
| | - Brian H Harvey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada (H.S.); SAMRC Unit on Risk Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, and Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University (Potchefstroom Campus), Potchefstroom, South Africa (B.H.H.); Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada (E.Z.W.); and Centro de Investigación en Reproducción Animal, CINVESTAV-Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico (K.L.H.)
| | - Erik Z Woody
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada (H.S.); SAMRC Unit on Risk Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, and Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University (Potchefstroom Campus), Potchefstroom, South Africa (B.H.H.); Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada (E.Z.W.); and Centro de Investigación en Reproducción Animal, CINVESTAV-Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico (K.L.H.)
| | - Kurt Leroy Hoffman
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada (H.S.); SAMRC Unit on Risk Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, and Center of Excellence for Pharmaceutical Sciences, School of Pharmacy, North-West University (Potchefstroom Campus), Potchefstroom, South Africa (B.H.H.); Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada (E.Z.W.); and Centro de Investigación en Reproducción Animal, CINVESTAV-Universidad Autónoma de Tlaxcala, Tlaxcala, Mexico (K.L.H.)
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27
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Richardson MES, Parkins S, Kaneza I, Dauphin AC. Jet Lag Recovery and Memory Functions Are Correlated with Direct Light Effects on Locomotion. J Biol Rhythms 2020; 35:588-597. [PMID: 32877295 DOI: 10.1177/0748730420947589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Jet lag is a circadian disruption that affects millions of people, resulting, among other things, in extreme sleepiness and memory loss. The hazardous implications of such effects are evident in situations in which focus and attention are required. Remarkably, there is a limited understanding of how jet lag recovery and associated memory loss vary year round under different photoperiods. Here we show, using different cycles representing winter, summer, and equinox in male mice, that jet lag recovery and memory vary significantly with photoperiod changes. We uncover a positive correlation of acute light effects on circadian-driven locomotion (known as negative masking) with photoentrainment speed and memory enhancement during jet lag. Specifically, we show that enhancing or reducing negative masking is correlated with better or worse memory performance, respectively. This study indicates that in addition to timed-light exposure for phase shifting, the negative masking response could also be biologically relevant when designing effective treatments of jet lag.
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Affiliation(s)
| | - Samuel Parkins
- Department of Biology, Johns Hopkins University, Baltimore, Maryland
| | - Isabelle Kaneza
- Department of Biological Sciences, Oakwood University, Huntsville, Alabama
| | - Amy-Claire Dauphin
- Department of Biological Sciences, Oakwood University, Huntsville, Alabama
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28
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Polymeropoulos CM, Mohrman MA, Keefe MS, Brzezynski JL, Wang J, Prokosch LS, Polymeropoulos VM, Xiao C, Birznieks G, Polymeropoulos MH. Efficacy of Tasimelteon (HETLIOZ®) in the Treatment of Jet Lag Disorder Evaluated in an 8-h Phase Advance Model; a Multicenter, Randomized, Double-Blind, Placebo-Controlled Trial. Front Neurol 2020; 11:611. [PMID: 32754110 PMCID: PMC7381312 DOI: 10.3389/fneur.2020.00611] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 05/25/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Most travelers experience Jet Lag Disorder (JLD) symptoms due to misalignment of their circadian rhythms with respect to the new time zone. We assessed the efficacy and safety of tasimelteon (HETLIOZ®) in healthy participants using a laboratory model of JLD induced by an 8-h phase advance of the sleep-wake cycle (JET8 Study). We hypothesized that tasimelteon treatment in participants experiencing JLD would cause increased sleep time, increased next-day alertness, and reduced next-day sleepiness. Methods: We undertook a randomized, double-blind, placebo-controlled trial in 12 US clinical research sleep centers. We screened healthy adults ages 18–73 years, who were eligible for the randomization phase of JET8 if they typically went to bed between 21:00 and 01:00, slept between 7 and 9 h each night, and slept at a consistent bedtime. We used block randomization stratified by site to assign participants (1:1) to receive a single oral dose of tasimelteon (20 mg) or placebo 30 min before their 8-h phase-advanced bedtime. The primary endpoint was Total Sleep Time in the first 2/3 of the night (TST2/3), which was measured by polysomnography during the 8-h sleep episode, and assessed in the intent-to-treat population. The trial is completed and registered with ClinicalTrials.gov, NCT03373201. Results: Between October 16, 2017 and January 17, 2018, we screened 607 healthy participants for JET8, of whom 320 (53%) were assigned to receive tasimelteon (n = 160) or placebo (n = 160). Tasimelteon treatment increased TST2/3 (primary endpoint) by 60.3 min (95%CI 44.0 to 76.7, P < 0.0001) and whole night TST by 85.5 min (95% CI 64.3 to 106.6, P < 0.0001), improved next day alertness, next day sleepiness, and shortened latency to persistent sleep by −15.1 min (95% CI −26.2 to −4.0, P = 0.0081). Conclusion: A single dose of tasimelteon improves the primary symptoms of JLD, including nighttime insomnia and next day functioning among participants in a laboratory model of JLD simulating eastward trans-meridian travel by inducing an 8-h phase advance of the sleep-wake cycle.
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Affiliation(s)
| | | | | | | | - Jingyuan Wang
- Vanda Pharmaceuticals Inc., Washington, CA, United States
| | | | | | - Changfu Xiao
- Vanda Pharmaceuticals Inc., Washington, CA, United States
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Photocatalytic activity of AgInS2 quantum dots upon visible light irradiation for melatonin determination through its reactive oxygen species scavenging effect. Microchem J 2020. [DOI: 10.1016/j.microc.2020.104728] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Furuto Y, Kawamura M, Namikawa A, Takahashi H, Shibuya Y. Health risk of travel for chronic kidney disease patients. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2020; 25:22. [PMID: 32419779 PMCID: PMC7213004 DOI: 10.4103/jrms.jrms_459_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 10/22/2019] [Accepted: 12/16/2019] [Indexed: 01/11/2023]
Abstract
The number of people with chronic kidney disease (CKD) has increased and so has their demand for travel. However, the health risk posed by travel in these patients is unclear. Few reports document the travel risk in CKD and dialysis patients. The aim of this study is to summarize the existing evidence of the influence of travel on risks in CKD patients. We aim to describe the association between the impact of travel risks and patients with CKD. A detailed review of recent literature was performed by reviewing PubMed, Google Scholar, and Ichushi Web from the Japan Medical Abstracts Society. Screened involved the following keywords: “traveler's thrombosis,” “venous thromboembolism,” “deep vein thrombosis,” “altitude sickness,” “traveler's diarrhea,” “jet lag syndrome,” “melatonin,” with “chronic kidney disease” only, or/and “dialysis.” We present a narrative review summary of the literature from these screenings. The increased prevalence of thrombosis among travelers with CKD is related to a decrease in the estimated glomerular filtration rate and an increase in urine protein levels. CKD patients who remain at high altitudes are at an increased risk for progression of CKD, altitude sickness, and pulmonary edema. Traveler's diarrhea can become increasingly serious in patients with CKD because of decreased immunity. Microbial substitution colitis is also common in CKD patients. Moreover, time differences and disturbances in the circadian rhythm increase cardiovascular disease events for CKD patients. The existing literature shows that travel-related conditions pose an increased risk for patients with CKD.
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Affiliation(s)
- Yoshitaka Furuto
- Department of Hypertension and Nephrology, NTT Medical Centre Tokyo, Shinagawa-ku, Tokyo, Japan
| | - Mariko Kawamura
- Department of Hypertension and Nephrology, NTT Medical Centre Tokyo, Shinagawa-ku, Tokyo, Japan
| | - Akio Namikawa
- Department of Hypertension and Nephrology, NTT Medical Centre Tokyo, Shinagawa-ku, Tokyo, Japan
| | - Hiroko Takahashi
- Department of Hypertension and Nephrology, NTT Medical Centre Tokyo, Shinagawa-ku, Tokyo, Japan
| | - Yuko Shibuya
- Department of Hypertension and Nephrology, NTT Medical Centre Tokyo, Shinagawa-ku, Tokyo, Japan
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Abstract
Caffeine is a widely utilized performance-enhancing supplement used by athletes and non-athletes alike. In recent years, a number of meta-analyses have demonstrated that caffeine's ergogenic effects on exercise performance are well-established and well-replicated, appearing consistent across a broad range of exercise modalities. As such, it is clear that caffeine is an ergogenic aid-but can we further explore the context of this ergogenic aid in order to better inform practice? We propose that future research should aim to better understand the nuances of caffeine use within sport and exercise. Here, we propose a number of areas for exploration within future caffeine research. These include an understanding of the effects of training status, habitual caffeine use, time of day, age, and sex on caffeine ergogenicity, as well as further insight into the modifying effects of genotype. We also propose that a better understanding of the wider, non-direct effects of caffeine on exercise, such as how it modifies sleep, anxiety, and post-exercise recovery, will ensure athletes can maximize the performance benefits of caffeine supplementation during both training and competition. Whilst not exhaustive, we hope that the questions provided within this manuscript will prompt researchers to explore areas with the potential to have a large impact on caffeine use in the future.
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Affiliation(s)
- Craig Pickering
- Institute of Coaching and Performance, School of Sport and Wellbeing, University of Central Lancashire, Fylde Road, Preston, PR1 2HE, UK. .,The Prenetics DNAFit Research Centre, London, UK.
| | - Jozo Grgic
- Institute for Health and Sport (IHES), Victoria University, Melbourne, Australia
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Janse van Rensburg DCC, Jansen van Rensburg A, Fowler P, Fullagar H, Stevens D, Halson S, Bender A, Vincent G, Claassen-Smithers A, Dunican I, Roach GD, Sargent C, Lastella M, Cronje T. How to manage travel fatigue and jet lag in athletes? A systematic review of interventions. Br J Sports Med 2020; 54:960-968. [PMID: 32303523 DOI: 10.1136/bjsports-2019-101635] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2020] [Indexed: 01/17/2023]
Abstract
OBJECTIVES We investigated the management of travel fatigue and jet lag in athlete populations by evaluating studies that have applied non-pharmacological interventions (exercise, sleep, light and nutrition), and pharmacological interventions (melatonin, sedatives, stimulants, melatonin analogues, glucocorticoids and antihistamines) following long-haul transmeridian travel-based, or laboratory-based circadian system phase-shifts. DESIGN Systematic review Eligibility criteria Randomised controlled trials (RCTs), and non-RCTs including experimental studies and observational studies, exploring interventions to manage travel fatigue and jet lag involving actual travel-based or laboratory-based phase-shifts. Studies included participants who were athletes, except for interventions rendering no athlete studies, then the search was expanded to include studies on healthy populations. DATA SOURCES Electronic searches in PubMed, MEDLINE, CINAHL, Google Scholar and SPORTDiscus from inception to March 2019. We assessed included articles for risk of bias, methodological quality, level of evidence and quality of evidence. RESULTS Twenty-two articles were included: 8 non-RCTs and 14 RCTs. No relevant travel fatigue papers were found. For jet lag, only 12 athlete-specific studies were available (six non-RCTs, six RCTs). In total (athletes and healthy populations), 11 non-pharmacological studies (participants 600; intervention group 290; four non-RCTs, seven RCTs) and 11 pharmacological studies (participants 1202; intervention group 870; four non-RCTs, seven RCTs) were included. For non-pharmacological interventions, seven studies across interventions related to actual travel and four to simulated travel. For pharmacological interventions, eight studies were based on actual travel and three on simulated travel. CONCLUSIONS We found no literature pertaining to the management of travel fatigue. Evidence for the successful management of jet lag in athletes was of low quality. More field-based studies specifically on athlete populations are required with a multifaceted approach, better design and implementation to draw valid conclusions. PROSPERO registration number The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO: CRD42019126852).
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Affiliation(s)
- Dina C Christa Janse van Rensburg
- Faculty of Health Science, Section Sports Medicine & Sport Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, Gauteng, South Africa .,Medical Board Member, International Netball Federation, Manchester, UK
| | - Audrey Jansen van Rensburg
- Faculty of Health Science, Section Sports Medicine & Sport Exercise Medicine and Lifestyle Institute (SEMLI), University of Pretoria, Pretoria, Gauteng, South Africa
| | - Peter Fowler
- School of Exercise and Nutrition Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Hugh Fullagar
- Sport and Exercise Science, Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia
| | - David Stevens
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Shona Halson
- School of Behavioural and Health Sciences, McAuley at Banyo, Australian Catholic University, Brisbane, Queensland, Australia
| | - Amy Bender
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
| | - Grace Vincent
- Appleton Institute for Behavioural Science, Central Queensland University, Rockhampton, Queensland, Australia
| | | | - Ian Dunican
- Centre for Sleep Science, The University of Western Australia Faculty of Health and Medical Sciences, Perth, Western Australia, Australia
| | - Gregory Daniel Roach
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Queensland, Australia
| | - Charli Sargent
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Queensland, Australia
| | - Michele Lastella
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Queensland, Australia
| | - Tanita Cronje
- Faculty of Natural and Agricultural Sciences, Department of Statistics, University of Pretoria, Pretoria, South Africa
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34
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Ledger S, Bin YS, Nour M, Cistulli P, Bauman A, Allman-Farinelli M, Naismith SL, Stamatakis E, Caillaud C, De Chazal P, Simpson SJ. Internal consistency and convergent and divergent validity of the Liverpool jetlag questionnaire. Chronobiol Int 2020; 37:218-226. [PMID: 31934814 DOI: 10.1080/07420528.2019.1704771] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective measures of circadian disruption are difficult to capture in a free-living environment hence the importance of validating subjective measures of jetlag. We aimed to assess the internal consistency of the 15-item Liverpool Jetlag Scale and its convergent and divergent validity with indicators of fatigue and anxiety in a large sample of air passengers. Online survey of passengers was conducted after travel on a range of long-haul flights. Jetlag was captured using the Liverpool scale, fatigue was measured using the Vitality subscale of the Short-Form Health Survey (SF-36), and the presence of anxiety or worry before, during, and after flight was self-reported. Inter-item correlations and Cronbach's alpha were calculated to assess the internal consistency of the scale. Exploratory factor analysis was used to examine whether the scale was consistent with one underlying construct of circadian disruption. Correlations between fatigue and anxiety (flying, situational, symptoms) with jetlag were used to assess convergent and divergent validity. Linear regression was used to determine the most important symptoms contributing to subjective jetlag rating. N = 460 passengers (57% female, mean age 50, SD 16 years) were surveyed. Cronbach's alpha indicated high internal reliability (alpha = 0.85). Jetlag was more strongly correlated with fatigue (rho = 0.47) than any type of anxiety (rho = 0.10-0.22). Exploratory factor analysis indicated responses were consistent with four factors: (i) fatigue/daytime impairment, (ii) sleep disturbance, (iii) changes in appetite and (iv) changes in bowel function. Regression analysis indicated that only changes in concentration, sleep time, fatigue, sleep quality and frequency of bowel motions were independent correlates of subjective jetlag (R2 = 27%). The Liverpool Jetlag Scale is internally consistent and demonstrates the expected relationships with fatigue and anxiety. Patterns of response are not consistent with all items being derived from one underlying factor, i.e. circadian disruption. Further, not all items contributed to the jetlag rating, suggesting the single-item rating may be useful for capturing the subjective experience of jetlag, whilst a total jetlag score is useful for also capturing circadian symptoms considered by passengers to be unrelated to jetlag. Validation of subjective jetlag against objective measures of circadian disruption is required.
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Affiliation(s)
- Susan Ledger
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Yu Sun Bin
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Monica Nour
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Peter Cistulli
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Adrian Bauman
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | | | | | | | - Corinne Caillaud
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Philip De Chazal
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
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Bellastella G, De Bellis A, Maiorino MI, Paglionico VA, Esposito K, Bellastella A. Endocrine rhythms and sport: it is time to take time into account. J Endocrinol Invest 2019; 42:1137-1147. [PMID: 30924095 DOI: 10.1007/s40618-019-01038-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 03/20/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND Studies of time-related biological phenomena have contributed to establishing a new scientific discipline, the chronobiology, which considers biological phenomena in relation to time. Sports activity profoundly affects the temporal organization of the organism and endocrine rhythms play a key role in the chronoorganization of individuals and are particularly important for correct physical activity. Correctly reading rhythmic hormonal variations of the human organism opens new horizons to sports medicine. OBJECTIVE This review is aimed at clarifying the relationship between endocrine rhythms and sports activities on the basis of the latest data in the literature. METHOD Data acquisition was obtained from three databases (PubMed, Scopus and SPORTDiscus), paying particular attention to reviews, meta-analysis, original and observational studies on this issue. RESULTS After the description of the general characteristics and parameters of biological rhythms, the main endocrine rhythms will be described, highlighting in particular the interrelationships with sports activity and focusing on the factors which can affect negatively their characteristics and consequently the psychophysical performances of the athletes. CONCLUSION Knowledge of this issue may allow establishing the best form of competitive or amateur activity, through the collaboration of an informed athlete and a sports physician attentive to biological rhythms. By taking into account that alteration of physiological rhythmic temporal organization can favour the onset of important diseases, including cancer, this will lead to the expected performances without impairing the correct chronoorganization of the athlete.
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Affiliation(s)
- G Bellastella
- Endocrinology and Metabolic Diseases Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy.
| | - A De Bellis
- Endocrinology and Metabolic Diseases Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy
| | - M I Maiorino
- Endocrinology and Metabolic Diseases Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy
| | - V A Paglionico
- Endocrinology and Metabolic Diseases Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy
| | - K Esposito
- Endocrinology and Metabolic Diseases Unit, Department of Advanced Medical and Surgical Sciences, University of Campania "Luigi Vanvitelli", Piazza L. Miraglia 2, 80138, Naples, Italy
| | - A Bellastella
- University of Campania "Luigi Vanvitelli", Naples, Italy
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Circadian regulation of depression: A role for serotonin. Front Neuroendocrinol 2019; 54:100746. [PMID: 31002895 PMCID: PMC9826732 DOI: 10.1016/j.yfrne.2019.04.003] [Citation(s) in RCA: 90] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/13/2019] [Accepted: 04/15/2019] [Indexed: 01/11/2023]
Abstract
Synchronizing circadian (24 h) rhythms in physiology and behavior with the environmental light-dark cycle is critical for maintaining optimal health. Dysregulation of the circadian system increases susceptibility to numerous pathological conditions including major depressive disorder. Stress is a common etiological factor in the development of depression and the circadian system is highly interconnected to stress-sensitive neurotransmitter systems such as the serotonin (5-hydroxytryptamine, 5-HT) system. Thus, here we propose that stress-induced perturbation of the 5-HT system disrupts circadian processes and increases susceptibility to depression. In this review, we first provide an overview of the basic components of the circadian system. Next, we discuss evidence that circadian dysfunction is associated with changes in mood in humans and rodent models. Finally, we provide evidence that 5-HT is a critical factor linking dysregulation of the circadian system and mood. Determining how these two systems interact may provide novel therapeutic targets for depression.
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