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Yang Z, Zarbl H, Guo GL. Circadian Regulation of Endocrine Fibroblast Growth Factors on Systemic Energy Metabolism. Mol Pharmacol 2024; 105:179-193. [PMID: 38238100 PMCID: PMC10877735 DOI: 10.1124/molpharm.123.000831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/05/2024] [Indexed: 02/17/2024] Open
Abstract
The circadian clock is an endogenous biochemical timing system that coordinates the physiology and behavior of organisms to earth's ∼24-hour circadian day/night cycle. The central circadian clock synchronized by environmental cues hierarchically entrains peripheral clocks throughout the body. The circadian system modulates a wide variety of metabolic signaling pathways to maintain whole-body metabolic homeostasis in mammals under changing environmental conditions. Endocrine fibroblast growth factors (FGFs), namely FGF15/19, FGF21, and FGF23, play an important role in regulating systemic metabolism of bile acids, lipids, glucose, proteins, and minerals. Recent evidence indicates that endocrine FGFs function as nutrient sensors that mediate multifactorial interactions between peripheral clocks and energy homeostasis by regulating the expression of metabolic enzymes and hormones. Circadian disruption induced by environmental stressors or genetic ablation is associated with metabolic dysfunction and diurnal disturbances in FGF signaling pathways that contribute to the pathogenesis of metabolic diseases. Time-restricted feeding strengthens the circadian pattern of metabolic signals to improve metabolic health and prevent against metabolic diseases. Chronotherapy, the strategic timing of medication administration to maximize beneficial effects and minimize toxic effects, can provide novel insights into linking biologic rhythms to drug metabolism and toxicity within the therapeutical regimens of diseases. Here we review the circadian regulation of endocrine FGF signaling in whole-body metabolism and the potential effect of circadian dysfunction on the pathogenesis and development of metabolic diseases. We also discuss the potential of chrononutrition and chronotherapy for informing the development of timing interventions with endocrine FGFs to optimize whole-body metabolism in humans. SIGNIFICANCE STATEMENT: The circadian timing system governs physiological, metabolic, and behavioral functions in living organisms. The endocrine fibroblast growth factor (FGF) family (FGF15/19, FGF21, and FGF23) plays an important role in regulating energy and mineral metabolism. Endocrine FGFs function as nutrient sensors that mediate multifactorial interactions between circadian clocks and metabolic homeostasis. Chronic disruption of circadian rhythms increases the risk of metabolic diseases. Chronological interventions such as chrononutrition and chronotherapy provide insights into linking biological rhythms to disease prevention and treatment.
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Affiliation(s)
- Zhenning Yang
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy (Z.Y., G.L.G.), Environmental and Occupational Health Sciences Institute (Z.Y., H.Z., G.L.G.), Department of Environmental and Occupational Health Justice, School of Public Health (H.Z.), Rutgers Center for Lipid Research (G.L.G.), Rutgers, The State University of New Jersey, New Brunswick, New Jersey; and VA New Jersey Health Care System, Veterans Administration Medical Center, East Orange, New Jersey (G.L.G.)
| | - Helmut Zarbl
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy (Z.Y., G.L.G.), Environmental and Occupational Health Sciences Institute (Z.Y., H.Z., G.L.G.), Department of Environmental and Occupational Health Justice, School of Public Health (H.Z.), Rutgers Center for Lipid Research (G.L.G.), Rutgers, The State University of New Jersey, New Brunswick, New Jersey; and VA New Jersey Health Care System, Veterans Administration Medical Center, East Orange, New Jersey (G.L.G.)
| | - Grace L Guo
- Department of Pharmacology and Toxicology, Ernest Mario School of Pharmacy (Z.Y., G.L.G.), Environmental and Occupational Health Sciences Institute (Z.Y., H.Z., G.L.G.), Department of Environmental and Occupational Health Justice, School of Public Health (H.Z.), Rutgers Center for Lipid Research (G.L.G.), Rutgers, The State University of New Jersey, New Brunswick, New Jersey; and VA New Jersey Health Care System, Veterans Administration Medical Center, East Orange, New Jersey (G.L.G.)
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2
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Keihani A, Mayeli A, Ferrarelli F. Circadian Rhythm Changes in Healthy Aging and Mild Cognitive Impairment. Adv Biol (Weinh) 2023; 7:e2200237. [PMID: 36403250 PMCID: PMC10199146 DOI: 10.1002/adbi.202200237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/01/2022] [Indexed: 11/21/2022]
Abstract
Disruptions in circadian rhythms can occur in healthy aging; however, these changes are more severe and pervasive in individuals with age-related and neurodegenerative diseases, such as dementia. Circadian rhythm alterations are also present in preclinical stages of dementia, for example, in patients with mild cognitive impairments (MCI); thus, providing a unique window of opportunity for early intervention in neurodegenerative disorders. Nonetheless, there is a lack of studies examining the association between relevant changes in circadian rhythms and their relationship with cognitive dysfunctions in MCI individuals. In this review, circadian system alterations occurring in MCI patients are examined compared to healthy aging individuals while also considering their association with MCI neurocognitive alterations. The main findings are that abnormal circadian changes in rest-activity, core body temperature, melatonin, and cortisol rhythms appear in the MCI stage and that these circadian rhythm disruptions are associated with some of the neurocognitive deficits observed in MCI patients. In addition, preliminary evidence indicates that interventions aimed at restoring regular circadian rhythms may prevent or halt the progress of neurodegenerative diseases and mitigate their related cognitive impairments. Future longitudinal studies with repeated follow-up assessments are needed to establish the translational potential of these findings in clinical practice.
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Affiliation(s)
- Ahmadreza Keihani
- Department of Psychiatry, University of Pittsburgh, 3501 Forbes Ave, Pittsburgh, PA, 15213, USA
| | - Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh, 3501 Forbes Ave, Pittsburgh, PA, 15213, USA
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, 3501 Forbes Ave, Pittsburgh, PA, 15213, USA
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3
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Joshi A, Sundar IK. Circadian Disruption in Night Shift Work and Its Association with Chronic Pulmonary Diseases. Adv Biol (Weinh) 2023; 7:e2200292. [PMID: 36797209 DOI: 10.1002/adbi.202200292] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/08/2022] [Indexed: 02/18/2023]
Abstract
Globalization and the expansion of essential services over continuous 24 h cycles have necessitated the adaptation of the human workforce to shift-based schedules. Night shift work (NSW) causes a state of desynchrony between the internal circadian machinery and external environmental cues, which can impact inflammatory and metabolic pathways. The discovery of clock genes in the lung has shed light on potential mechanisms of circadian misalignment in chronic pulmonary disease. Here, the current knowledge of circadian clock disruption caused by NSW and its impact on lung inflammation and associated pathophysiology in chronic lung diseases, such as asthma, chronic obstructive pulmonary disease, pulmonary fibrosis, and COVID-19, is reviewed. Furthermore, the limitations of the current understanding of circadian disruption and potential future chronotherapeutic advances are discussed.
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Affiliation(s)
- Amey Joshi
- Department of Internal Medicine, Manipal Hospitals, Bangalore, Karnataka, 560066, India
| | - Isaac Kirubakaran Sundar
- Department of Internal Medicine, Division of Pulmonary Critical Care and Sleep Medicine, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160, USA
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Cockerham M, Kang DH, Beier ME. Consecutive Shifts: A Repeated Measure Study to Evaluate Stress, Biomarkers, Social Support, and Fatigue in Medical/Surgical Nurses. Behav Sci (Basel) 2023; 13:571. [PMID: 37504018 PMCID: PMC10376272 DOI: 10.3390/bs13070571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 06/27/2023] [Accepted: 06/29/2023] [Indexed: 07/29/2023] Open
Abstract
Nurses report that they are required to work during their scheduled breaks and generally experience extended work times and heavy workloads due to staffing shortages. This study aimed to examine changes in personal, work-related, and overall stress, as well as biological responses and fatigue experienced by nurses during three consecutive 12 h workdays (i.e., the typical "three-twelves" schedule). We also considered the moderating effects of social resources. This prospective study of 81 medical/surgical nurses who completed questionnaires and provided saliva samples at four designated intervals (i.e., pre-shift and post-shift on workdays 1 and 3). Fatigue reported by night shift nurses increased significantly over three consecutive workdays (p = 0.001). Day shift nurses said they encountered more social support than those on the night shift (p = 0.05). Social support moderated the relationship between work-related stress at baseline and reported fatigue on day 3.
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Affiliation(s)
- Mona Cockerham
- School of Nursing, Sam Houston State University, The Woodlands, TX 77380, USA
- Houston Methodist, Willowbrook Hospital, Houston, TX 77030, USA
| | - Duck-Hee Kang
- Cizik School of Nursing, University of Texas Health Science Center, Houston, TX 77355, USA
| | - Margaret E Beier
- Department of Psychological Sciences, Rice University, Houston, TX 77005, USA
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Caruso CC, Arbour MW, Berger AM, Hittle BM, Tucker S, Patrician PA, Trinkoff AM, Rogers AE, Barger LK, Edmonson JC, Landrigan CP, Redeker NS, Chasens ER. Research priorities to reduce risks from work hours and fatigue in the healthcare and social assistance sector. Am J Ind Med 2022; 65:867-877. [PMID: 35596665 PMCID: PMC10165664 DOI: 10.1002/ajim.23363] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 04/03/2022] [Accepted: 04/14/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND The services of Healthcare and Social Assistance (HCSA) workers are needed by society around the clock. As a result, these workers are exposed to shift work and long work hours. The combination of demanding work schedules and other hazards in the HCSA work environment increases the health and safety risks to these workers, as well as to their patients/clients and the public. METHODS This paper has three aims: (1) provide an overview of the burden of shift work, long hours, and related sleep and fatigue problems in this sector; (2) suggest research priorities that would improve these; and (3) discuss potential positive impacts of addressing these research priorities for the health and safety of workers and the public. The authors used a modified Delphi approach to anonymously rank-order priorities for improving HCSA worker health and safety and public safety. Input was also obtained from attendees at the 2019 National Institute for Occupational Safety and Health (NIOSH) Work Hours, Sleep, and Fatigue Forum. RESULTS The highest rated research priorities were developing better designs for work schedules, and improving the HCSA culture and leadership approaches to shift work and long work hours. Additional priorities are identified. CONCLUSION Research in these priority areas has the potential to benefit HCSA workers as well as their patients/clients, employers, and society.
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Affiliation(s)
- Claire C. Caruso
- Division of Science Integration, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Megan W. Arbour
- Department of Midwifery, Frontier Nursing University, Versailles, Kentucky, USA
| | - Ann M. Berger
- College of Nursing- Omaha, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | | | - Sharon Tucker
- College of Nursing, The Ohio State University, Columbus, Ohio, USA
| | | | | | - Ann E. Rogers
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Laura K. Barger
- Department of Medicine, Brigham and Women’s Hospital, Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - J. Cole Edmonson
- Department of Administration, AMN Healthcare, Dallas, Texas, USA
| | - Christopher P. Landrigan
- Department of Pediatrics, Boston Children’s Hospital, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Eileen R. Chasens
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Pariollaud M, Ibrahim LH, Irizarry E, Mello RM, Chan AB, Altman BJ, Shaw RJ, Bollong MJ, Wiseman RL, Lamia KA. Circadian disruption enhances HSF1 signaling and tumorigenesis in Kras-driven lung cancer. SCIENCE ADVANCES 2022; 8:eabo1123. [PMID: 36170373 PMCID: PMC9519049 DOI: 10.1126/sciadv.abo1123] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 08/12/2022] [Indexed: 05/04/2023]
Abstract
Disrupted circadian rhythmicity is a prominent feature of modern society and has been designated as a probable carcinogen by the World Health Organization. However, the biological mechanisms that connect circadian disruption and cancer risk remain largely undefined. We demonstrate that exposure to chronic circadian disruption [chronic jetlag (CJL)] increases tumor burden in a mouse model of KRAS-driven lung cancer. Molecular characterization of tumors and tumor-bearing lung tissues revealed that CJL enhances the expression of heat shock factor 1 (HSF1) target genes. Consistently, exposure to CJL disrupted the highly rhythmic nuclear trafficking of HSF1 in the lung, resulting in an enhanced accumulation of HSF1 in the nucleus. HSF1 has been shown to promote tumorigenesis in other systems, and we find that pharmacological or genetic inhibition of HSF1 reduces the growth of KRAS-mutant human lung cancer cells. These findings implicate HSF1 as a molecular link between circadian disruption and enhanced tumorigenesis.
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Affiliation(s)
- Marie Pariollaud
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, CA 92037, USA
| | - Lara H. Ibrahim
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, CA 92037, USA
- Department of Chemistry, Scripps Research Institute, La Jolla, CA 92037, USA
| | - Emanuel Irizarry
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, CA 92037, USA
| | - Rebecca M. Mello
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, CA 92037, USA
| | - Alanna B. Chan
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, CA 92037, USA
| | - Brian J. Altman
- Department of Biomedical Genetics and Wilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Reuben J. Shaw
- Molecular and Cell Biology Laboratory, Salk Institute for Biological Studies, La Jolla, CA 92037, USA
| | - Michael J. Bollong
- Department of Chemistry, Scripps Research Institute, La Jolla, CA 92037, USA
| | - R. Luke Wiseman
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, CA 92037, USA
| | - Katja A. Lamia
- Department of Molecular Medicine, Scripps Research Institute, La Jolla, CA 92037, USA
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Damato AR, Herzog ED. Circadian clock synchrony and chronotherapy opportunities in cancer treatment. Semin Cell Dev Biol 2022; 126:27-36. [PMID: 34362656 PMCID: PMC8810901 DOI: 10.1016/j.semcdb.2021.07.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 06/09/2021] [Accepted: 07/27/2021] [Indexed: 01/29/2023]
Abstract
Cell-autonomous, tissue-specific circadian rhythms in gene expression and cellular processes have been observed throughout the human body. Disruption of daily rhythms by mistimed exposure to light, food intake, or genetic mutation has been linked to cancer development. Some medications are also more effective at certain times of day. However, a limited number of clinical studies have examined daily rhythms in the patient or drug timing as treatment strategies. This review highlights advances and challenges in cancer biology as a function of time of day. Recent evidence for daily rhythms and their entrainment in tumors indicate that personalized medicine should include understanding and accounting for daily rhythms in cancer patients.
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Affiliation(s)
- Anna R Damato
- Department of Biology, Washington University, Box 1137, St. Louis, MO 63130, USA
| | - Erik D Herzog
- Department of Biology, Washington University, Box 1137, St. Louis, MO 63130, USA.
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Silva AF, Dalri RDCDMB, Eckeli AL, Uva ANPDS, Mendes AMDOC, Robazzi MLDCC. Calidad de sueño, variables personales, laborales y estilo de vida de enfermeros de hospital. Rev Lat Am Enfermagem 2022. [DOI: 10.1590/1518-8345.5756.3576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Resumen Objetivo: identificar posibles asociaciones entre la calidad de sueño, las variables personales y laborales y los estilo de vida de los enfermeros de hospital. Método: estudio transversal, exploratorio, correlacional, cuantitativo, realizado de octubre a diciembre de 2019. Los datos fueron recolectados mediante un cuestionario que abordó las características personales, estilo de vida y condiciones de trabajo de los encuestados. Para evaluar la calidad de sueño, se utilizó el Pittsburgh Sleep Quality Index (PCSI), versión en portugués de Brasil. Resultados: participaron 42 profesionales, 31 (73,8%) mujeres, con edad entre 26 y 66 años (media 40,2); el 61,9% trabajaba horas extras; el 26,2% tenía dos vínculos laborales y el 40,5% faltó al trabajo. La calidad de sueño fue considerada buena por el 9,5% de los participantes, mala por el 64,3% y con trastornos del sueño por el 26,2%. El 26,2% de la población que hacía turnos rotativos, calificó la calidad como mala. Los peores resultados se encontraron en la franja etaria de 30 a 39 años y hubo significación estadística en la variable “vive en pareja”. Conclusión: la calidad de sueño de los enfermeros se vio afectada; es necesario monitorear a estos trabajadores, en particular a los que trabajan por turnos, a fin de implementar medidas preventivas que reduzcan los daños a su salud.
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Affiliation(s)
- Andressa Fernanda Silva
- Universidade de São Paulo, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Silva AF, Dalri RDCDMB, Eckeli AL, Uva ANPDS, Mendes AMDOC, Robazzi MLDCC. Sleep quality, personal and work variables and life habits of hospital nurses. Rev Lat Am Enfermagem 2022; 30:e3577. [PMID: 35584413 PMCID: PMC9109468 DOI: 10.1590/1518-8345.5756.3577] [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] [Received: 09/27/2021] [Accepted: 02/13/2022] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE to identify the possible associations between sleep quality, personal and work variables and the life habits of hospital nurses. METHOD a cross-sectional, exploratory, correlational and quantitative study, carried out from October to December 2019. The data were collected with the application of a questionnaire that addressed the respondents' personal characteristics, life habits and working conditions. The Pittsburgh Sleep Quality Index (PSQI), Brazilian Portuguese version, was used to assess sleep quality. RESULTS the participants were 42 professionals: 31 (73.8%) women, aged between 26 and 66 years old (mean of 40.2); 61.9% worked overtime; 26.2% had two employment contracts and 40.5% had absences from work. Sleep quality was considered good by 9.5% of the participants, poor by 64.3% and categorized as with sleep disorders by 26.2%. In the population that worked rotating shifts, this quality was identified as poor by 26.2%. The worst results were found in the age group from 30 to 39 years old and there was a statistical significance in the "living with a partner" variable. CONCLUSION there was impairment in the nurses' sleep quality and there is a need to monitor these workers, particularly those who work in shifts, in order to provide preventive measures to mitigate the harms to their health.
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Affiliation(s)
- Andressa Fernanda Silva
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
- Bolsista da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
| | - Rita de Cássia de Marchi Barcellos Dalri
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
| | - Alan Luiz Eckeli
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brasil
| | | | | | - Maria Lúcia do Carmo Cruz Robazzi
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Centro Colaborador da OPAS/OMS para o Desenvolvimento da Pesquisa em Enfermagem, Ribeirão Preto, SP, Brasil
- Universidade Federal da Paraíba, João Pessoa, PB, Brasil
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Silva AF, Dalri RDCDMB, Eckeli AL, Uva ANPDS, Mendes AMDOC, Robazzi MLDCC. Sleep quality, personal and work variables and life habits of hospital nurses. Rev Lat Am Enfermagem 2022. [PMID: 35584413 PMCID: PMC9109468 DOI: 10.1590/1518-8345.5756.3538] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Abstract Objective: to identify the possible associations between sleep quality, personal and work variables and the life habits of hospital nurses. Method: a cross-sectional, exploratory, correlational and quantitative study, carried out from October to December 2019. The data were collected with the application of a questionnaire that addressed the respondents’ personal characteristics, life habits and working conditions. The Pittsburgh Sleep Quality Index (PSQI), Brazilian Portuguese version, was used to assess sleep quality. Results: the participants were 42 professionals: 31 (73.8%) women, aged between 26 and 66 years old (mean of 40.2); 61.9% worked overtime; 26.2% had two employment contracts and 40.5% had absences from work. Sleep quality was considered good by 9.5% of the participants, poor by 64.3% and categorized as with sleep disorders by 26.2%. In the population that worked rotating shifts, this quality was identified as poor by 26.2%. The worst results were found in the age group from 30 to 39 years old and there was a statistical significance in the “living with a partner” variable. Conclusion: there was impairment in the nurses’ sleep quality and there is a need to monitor these workers, particularly those who work in shifts, in order to provide preventive measures to mitigate the harms to their health.
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Affiliation(s)
- Andressa Fernanda Silva
- Universidade de São Paulo, Brazil; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES), Brasil
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Boivin DB, Boudreau P, Kosmadopoulos A. Disturbance of the Circadian System in Shift Work and Its Health Impact. J Biol Rhythms 2021; 37:3-28. [PMID: 34969316 PMCID: PMC8832572 DOI: 10.1177/07487304211064218] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The various non-standard schedules required of shift workers force abrupt changes in the timing of sleep and light-dark exposure. These changes result in disturbances of the endogenous circadian system and its misalignment with the environment. Simulated night-shift experiments and field-based studies with shift workers both indicate that the circadian system is resistant to adaptation from a day- to a night-oriented schedule, as determined by a lack of substantial phase shifts over multiple days in centrally controlled rhythms, such as those of melatonin and cortisol. There is evidence that disruption of the circadian system caused by night-shift work results not only in a misalignment between the circadian system and the external light-dark cycle, but also in a state of internal desynchronization between various levels of the circadian system. This is the case between rhythms controlled by the central circadian pacemaker and clock genes expression in tissues such as peripheral blood mononuclear cells, hair follicle cells, and oral mucosa cells. The disruptive effects of atypical work schedules extend beyond the expression profile of canonical circadian clock genes and affects other transcripts of the human genome. In general, after several days of living at night, most rhythmic transcripts in the human genome remain adjusted to a day-oriented schedule, with dampened group amplitudes. In contrast to circadian clock genes and rhythmic transcripts, metabolomics studies revealed that most metabolites shift by several hours when working nights, thus leading to their misalignment with the circadian system. Altogether, these circadian and sleep-wake disturbances emphasize the all-encompassing impact of night-shift work, and can contribute to the increased risk of various medical conditions. Here, we review the latest scientific evidence regarding the effects of atypical work schedules on the circadian system, sleep and alertness of shift-working populations, and discuss their potential clinical impacts.
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Affiliation(s)
- Diane B Boivin
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Philippe Boudreau
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Anastasi Kosmadopoulos
- Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, QC, Canada
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Trinkoff AM, Baldwin CM, Chasens ER, Dunbar-Jacob J, Geiger-Brown J, Imes CC, Landis CA, Patrician PA, Redeker NS, Rogers AE, Scott LD, Todero CM, Tucker SJ, Weinstein SM. CE: Nurses Are More Exhausted Than Ever: What Should We Do About It? Am J Nurs 2021; 121:18-28. [PMID: 34743129 DOI: 10.1097/01.naj.0000802688.16426.8d] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
ABSTRACT For nurses, the challenges posed by demanding work environments and schedules often lead to fatigue, and this can be exacerbated during crises like the COVID-19 pandemic. In this article, the authors discuss causes and challenges of nurse fatigue and consider several evidence-based strategies and solutions for individual nurses and organizations. Barriers to implementation, including a negative workplace culture and inadequate staffing, are also described, and several resources are presented.
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Affiliation(s)
- Alison M Trinkoff
- Alison M. Trinkoff is a professor at the University of Maryland School of Nursing, Baltimore. Carol M. Baldwin is professor emeritus and a Southwest Borderlands Scholar at Arizona State University's Edson College of Nursing and Health Innovation, Phoenix. Eileen R. Chasens is a professor and chair of the Department of Health and Community Systems, University of Pittsburgh School of Nursing, Pittsburgh, PA, where Jacqueline Dunbar-Jacob is dean and a distinguished service professor and Christopher C. Imes is an assistant professor. Now retired, at the time of this writing Jeanne Geiger-Brown was a professor and associate dean for research at the George Washington University School of Nursing, Washington, DC. Carol A. Landis is a professor emeritus at the University of Washington School of Nursing, Seattle. Patricia A. Patrician is a professor and the Rachel Z. Booth Endowed Chair at the University of Alabama at Birmingham School of Nursing, and a retired U.S. Army colonel. Nancy S. Redeker is the Beatrice Renfield Term Professor of Nursing at the Yale University School of Nursing, New Haven, CT. Ann E. Rogers is a professor at the Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta. Linda D. Scott is a professor and dean of the University of Wisconsin-Madison School of Nursing. Catherine M. Todero is dean of the College of Nursing and vice provost of Health Sciences at Creighton University, Omaha, NE, and Phoenix, AZ. Sharon J. Tucker is the Grayce Sills Endowed Professor in Psychiatric-Mental Health Nursing and director of the Translational/Implementation Research Core at the Ohio State University College of Nursing, Columbus. Sharon M. Weinstein is chief executive officer of the Global Education Development Institute, and SMW Group LLC, North Bethesda, MD, and a clinical assistant professor at the College of Nursing, University of Illinois, Chicago. This article was a collaborative effort by the Fatigue Subgroup of the Health Behavior Expert Panel, American Academy of Nursing. The authors acknowledge Claire C. Caruso, PhD, RN, a research health scientist at the National Institute for Occupational Safety and Health, for her help in reviewing the manuscript. Contact author: Alison M. Trinkoff, . The authors and planners have disclosed no potential conflicts of interest, financial or otherwise. A podcast with the authors is available at www.ajnonline.com
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Lovos A, Bottrill K, Sakhon S, Nyhuis C, Egleson E, Luongo A, Murphy M, Thurman AJ, Abbeduto L, Lee NR, Hughes K, Edgin J. Circadian Sleep-Activity Rhythm across Ages in Down Syndrome. Brain Sci 2021; 11:brainsci11111403. [PMID: 34827402 PMCID: PMC8615672 DOI: 10.3390/brainsci11111403] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 10/05/2021] [Accepted: 10/17/2021] [Indexed: 11/16/2022] Open
Abstract
Across all ages, individuals with Down syndrome (DS) experience high rates of sleep problems as well as cognitive impairments. This study sought to investigate whether circadian rhythm disruption was also experienced by people with DS and whether this kind of sleep disorder may be correlated with cognitive performance. A cross-sectional study of 101 participants (58 with DS, 43 with typical development) included individuals in middle childhood (6–10 years old), adolescence (11–18 years old), and young adulthood (19–26 years old). Sleep and markers of circadian timing and robustness were calculated using actigraphy. Cognitive and behavioral data were gathered via a novel touchscreen battery (A-MAPTM, Arizona Memory Assessment for Preschoolers and Special Populations) and parent questionnaire. Results indicated that children and adolescents with DS slept the same amount as peers with typical development, but significant group differences were seen in phase timing. The circadian robustness markers, interdaily stability and intradaily variability of sleep-wake rhythms, were healthiest for children regardless of diagnostic group and worst for adults with DS. Amplitude of the 24-h activity profile was elevated for all individuals with DS. In analyses of the correlations between sleep quality, rhythms, and cognition in people with DS, interdaily stability was positively correlated with reaction time and negatively correlated with verbal and scene recall, a finding that indicates increased stability may paradoxically correlate with poorer cognitive outcomes. Further, we found no relations with sleep efficiency previously found in preschool and adult samples. Therefore, the current findings suggest that a thorough examination of sleep disorders in DS must take into account age as well as circadian robustness to better understand sleep-cognitive correlations in this group.
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Affiliation(s)
- Annalysa Lovos
- Department of Psychology, School of Mind, Brain and Behavior, College of Science, The University of Arizona, Tucson, AZ 85721, USA; (K.B.); (E.E.); (A.L.); (J.E.)
- Correspondence:
| | - Kenneth Bottrill
- Department of Psychology, School of Mind, Brain and Behavior, College of Science, The University of Arizona, Tucson, AZ 85721, USA; (K.B.); (E.E.); (A.L.); (J.E.)
| | - Stella Sakhon
- Statistics Department, Los Angeles Valley College, Van Nuys, Los Angeles, CA 91401, USA;
| | - Casandra Nyhuis
- College of Medicine, Pennsylvania State University, Hershey, PA 17033, USA;
| | - Elizabeth Egleson
- Department of Psychology, School of Mind, Brain and Behavior, College of Science, The University of Arizona, Tucson, AZ 85721, USA; (K.B.); (E.E.); (A.L.); (J.E.)
| | - Alison Luongo
- Department of Psychology, School of Mind, Brain and Behavior, College of Science, The University of Arizona, Tucson, AZ 85721, USA; (K.B.); (E.E.); (A.L.); (J.E.)
| | - Melanie Murphy
- Department of Physiology and Buiphysics, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, USA;
| | - Angela John Thurman
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis Health, Sacramento, CA 95817, USA; (A.J.T.); (L.A.)
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California Davis Health, Sacramento, CA 95817, USA; (A.J.T.); (L.A.)
| | - Nancy Raitano Lee
- Department of Psychological and Brain Sciences, Drexel University, Philadelphia, PA 19104, USA;
| | | | - Jamie Edgin
- Department of Psychology, School of Mind, Brain and Behavior, College of Science, The University of Arizona, Tucson, AZ 85721, USA; (K.B.); (E.E.); (A.L.); (J.E.)
- Sonoran University Center for Excellence in Developmental Disabilities (UCEDD), University of Arizona, Farmington, CT 06032, USA
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Juan-García C, Plaza-Carmona M, Fernández-Martínez N. Sleep analysis in emergency nurses’ department. Rev Assoc Med Bras (1992) 2021; 67:862-867. [DOI: 10.1590/1806-9282.20210183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 04/24/2021] [Indexed: 11/22/2022] Open
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Jang TW. Work-Fitness Evaluation for Shift Work Disorder. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18031294. [PMID: 33535523 PMCID: PMC7908582 DOI: 10.3390/ijerph18031294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 01/07/2021] [Accepted: 01/28/2021] [Indexed: 01/02/2023]
Abstract
Shift work disorder (SWD), which is characterized by insomnia and excessive sleepiness related with shift work, is one of the most common health problems in shift workers. Shift work disorder causes insomnia, fatigue, worse work performance, an increased likelihood of accidents, and a poor quality of life. In addition, SWD is associated with decreased productivity and increased economic costs. The correct management of SWD is important to prevent sleep disturbances and maintain work performance in shift workers. To diagnose and evaluate SWD, it is necessary to take detailed medical histories, assess the severity of sleep disturbances, and evaluate shift workers’ sleep using a sleep diary and actigraphy. The work-fitness evaluation should include recommendations on how shift workers can reduce their sleep disturbances and increase work performance, as well as the assessment of work performance. This paper reviews previous research on the evaluation, diagnosis, and management of SWD and summarizes the work-fitness evaluation of SWD.
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Affiliation(s)
- Tae-Won Jang
- Department of Occupational and Environmental Medicine, Hanyang University, Seoul 04763, Korea
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16
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Esmaily A, Jambarsang S, Mohammadian F, Mehrparvar AH. Effect of shift work on working memory, attention and response time in nurses. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1085-1090. [PMID: 33308103 DOI: 10.1080/10803548.2020.1863656] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective. The present study aimed to investigate the relationship between shift work and cognitive performance in nurses. Methods. The present before-after study included 35 female nurses 25-40 years old with similar mental and physical workload. Working memory, response time and attention were assessed using Wechsler and Stroop tests. The variables were measured at the beginning and the end of three working shifts (morning, afternoon and night). An interval of 3 days was considered for performing an after-shift test to eliminate the learning effect. Data were analyzed using repeated-measures analysis of variance (ANOVA). Results. At the end of all three shifts, nurses' working memory (p = 0.039) and interference score (p = 0.04) were significantly decreased, but their response time was not significantly affected during a shift. The decrease in working memory after the night shift was significantly higher than after the morning and evening shifts (p < 0.001). Conclusion. The results of this study showed that shift work can affect some aspects of cognitive function (working memory and attention) in nurses, and this effect was more prominent after a night shift.
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Affiliation(s)
- Azam Esmaily
- School of Public Health, Shahid Sadoughi University of Medical Sciences, Iran
| | - Sara Jambarsang
- School of Public Health, Shahid Sadoughi University of Medical Sciences, Iran
| | - Farough Mohammadian
- Research Institute for Health Development, Kurdistan University of Medical Sciences, Iran
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17
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McMartin L, Kiraly M, Heller HC, Madison DV, Ruby NF. Disruption of circadian timing increases synaptic inhibition and reduces cholinergic responsiveness in the dentate gyrus. Hippocampus 2021; 31:422-434. [PMID: 33439521 PMCID: PMC8048473 DOI: 10.1002/hipo.23301] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 12/28/2020] [Accepted: 01/02/2021] [Indexed: 12/11/2022]
Abstract
We investigated synaptic mechanisms in the hippocampus that could explain how loss of circadian timing leads to impairments in spatial and recognition memory. Experiments were performed in hippocampal slices from Siberian hamsters (Phodopus sungorus) because, unlike mice and rats, their circadian rhythms are easily eliminated without modifications to their genome and without surgical manipulations, thereby leaving neuronal circuits intact. Recordings of excitatory postsynaptic field potentials and population spikes in area CA1 and dentate gyrus granule cells revealed no effect of circadian arrhythmia on basic functions of synaptic circuitry, including long-term potentiation. However, dentate granule cells from circadian-arrhythmic animals maintained a more depolarized resting membrane potential than cells from circadian-intact animals; a significantly greater proportion of these cells depolarized in response to the cholinergic agonist carbachol (10 μM), and did so by increasing their membrane potential three-fold greater than cells from the control (entrained) group. Dentate granule cells from arrhythmic animals also exhibited higher levels of tonic inhibition, as measured by the frequency of spontaneous inhibitory postsynaptic potentials. Carbachol also decreased stimulus-evoked synaptic excitation in dentate granule cells from both intact and arrhythmic animals as expected, but reduced stimulus-evoked synaptic inhibition only in cells from control hamsters. These findings show that loss of circadian timing is accompanied by greater tonic inhibition, and increased synaptic inhibition in response to muscarinic receptor activation in dentate granule cells. Increased inhibition would likely attenuate excitation in dentate-CA3 microcircuits, which in turn might explain the spatial memory deficits previously observed in circadian-arrhythmic hamsters.
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Affiliation(s)
- Laura McMartin
- Department of Molecular and Cellular Physiology, Stanford University, Stanford, California, USA
| | - Marianna Kiraly
- Department of Molecular and Cellular Physiology, Stanford University, Stanford, California, USA
| | - H Craig Heller
- Biology Department, Stanford University, Stanford, California, USA
| | - Daniel V Madison
- Department of Molecular and Cellular Physiology, Stanford University, Stanford, California, USA
| | - Norman F Ruby
- Biology Department, Stanford University, Stanford, California, USA
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18
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Hao C, Li M, Luo W, Ma N. Dissociation of Subjective and Objective Alertness During Prolonged Wakefulness. Nat Sci Sleep 2021; 13:923-932. [PMID: 34234597 PMCID: PMC8254410 DOI: 10.2147/nss.s312808] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/16/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Although the deterioration of subjective and objective alertness during prolonged wakefulness has been investigated rigorously, whether perceived sleepiness and fatigue are consistent with actual decrements in behavioral performance in the time course is still disputed. The present study examined the dissociation between decrements of subjective alertness and performance deficits during prolonged wakefulness of one night and explored the relationship between body temperature and the impairments of subjective and objective alertness. PARTICIPANTS AND METHODS Thirty-eight participants (27 females; age: 21.76 ± 2.37 years old) underwent prolonged wakefulness for one night at habitual bedtime (0:00-6:00 am). Participants completed a 10-min PVT to assess objective alertness, fatigue, and sleepiness ratings to assess subjective alertness every 2 hours, and body temperature was measured every hour during scheduled wakefulness. RESULTS Subjective alertness reflected a linear decline with time, but the magnitudes of objective performance deterioration increased significantly between 4:00 and 6:00 am. The increasing magnitudes of performance deficits were associated with the change of body temperature between 4:00 and 6:00 am. CONCLUSION These results indicate that the perceived degree of decline in alertness is temporally dissociated with the actual decline in objective vigilance with increased duration of wakefulness. The dissociation of magnitudes of subjective and objective alertness decrements mainly occurs between 4:00 and 6:00 am, and the changes of performance deficits have a relationship with body temperature.
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Affiliation(s)
- Chao Hao
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education; Center for Sleep Research, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China
| | - Mingzhu Li
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education; Center for Sleep Research, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China
| | - Wei Luo
- School of Architecture and Urban Planning, Shenzhen University, Shenzhen, 518060, People's Republic of China
| | - Ning Ma
- Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education; Center for Sleep Research, Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, School of Psychology, South China Normal University, Guangzhou, 510631, People's Republic of China
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19
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Davis JA, Paul JR, McMeekin LJ, Nason SR, Antipenko JP, Yates SD, Cowell RM, Habegger KM, Gamble KL. High-Fat and High-Sucrose Diets Impair Time-of-Day Differences in Spatial Working Memory of Male Mice. Obesity (Silver Spring) 2020; 28:2347-2356. [PMID: 33043637 PMCID: PMC7686286 DOI: 10.1002/oby.22983] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 07/10/2020] [Accepted: 07/16/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE This study aimed to investigate both the long-term and short-term impacts of high-fat diets (HFD) or high-sucrose diets (HSD) on the normal diurnal pattern of cognitive function, protein expression, and the molecular clock in mice. METHODS This study used both 6-month and 4-week feeding strategies by providing male C57BL/6J mice access to either a standard chow, HFD, or HSD. Spatial working memory and synaptic plasticity were assessed both day and night, and hippocampal tissue was measured for changes in NMDA and AMPA receptor subunits (GluN2B, GluA1), as well as molecular clock gene expression. RESULTS HFD and HSD both disrupted normal day/night fluctuations in spatial working memory and synaptic plasticity. Mice fed HFD altered their food intake to consume more calories during the day. Both diets disrupted normal hippocampal clock gene expression, and HFD reduced GluN2B levels in hippocampal tissue. CONCLUSIONS Taken together, these results suggest that both HFD and HSD induce a loss of day/night performance in spatial working memory and synaptic plasticity as well as trigger a cascade of changes that include disruption to the hippocampal molecular clock.
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Affiliation(s)
- Jennifer A. Davis
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jodi R. Paul
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Shelly R. Nason
- Department of Medicine, Division of Endocrinology, Diabetes& Metabolism, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jessica P. Antipenko
- Department of Medicine, Division of Endocrinology, Diabetes& Metabolism, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Stefani D. Yates
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rita M. Cowell
- Department of Neuroscience, Southern Research, Birmingham, AL
- Department of Cell, Developmental, and Integrative Biology, University of Alabama at Birmingham, Birmingham, AL
| | - Kirk M. Habegger
- Department of Medicine, Division of Endocrinology, Diabetes& Metabolism, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Karen L. Gamble
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
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20
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Di Muzio M, Diella G, Di Simone E, Novelli L, Alfonsi V, Scarpelli S, Annarumma L, Salfi F, Pazzaglia M, Giannini AM, De Gennaro L. Nurses and Night Shifts: Poor Sleep Quality Exacerbates Psychomotor Performance. Front Neurosci 2020; 14:579938. [PMID: 33154716 PMCID: PMC7591770 DOI: 10.3389/fnins.2020.579938] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/10/2020] [Indexed: 02/05/2023] Open
Abstract
In Europe, 40% of health-care employees are involved in shift work. The altered sleep/wake rhythm of night-shift nurses is also associated with deteriorated cognitive efficiency. In this study, we examine the effects of the night shift on psychomotor performance, sleepiness, and tiredness in a large sample of shift-working nurses and evaluated if poor sleep quality, sex, age, or years on the job could impact on a better adaptation to shift work. Eighty-six nurses with 8-h-rapidly-rotating-shifts were evaluated at the end of three shifts (morning/afternoon/night) for sleepiness and tiredness. Sleepiness, as measured by the Karolinska Sleepiness Scale, and tiredness, as measured by the Tiredness Symptoms Scale, were more pronounced after the night shift. These increases were paralleled by lower attentional performance on the psychomotor vigilance task (PVT) after the night shift. While sex, age, and years on the job did not affect PVT performance after the night shift, lower sleep quality (Pittsburgh Sleep Quality, PSQI > 5) was associated with decreased performance. The high prevalence of altered sleep quality showed that nurses, and shift workers in general, are at risk for a poor sleep quality. The evaluation of sleep quality through PSQI could represent a rapid, inexpensive tool to assess health-care workers assigned to rotating night shifts or to evaluate nurses who coped poorly with night-shift work.
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Affiliation(s)
- Marco Di Muzio
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Giulia Diella
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Emanuele Di Simone
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Luana Novelli
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | | | | | - Federico Salfi
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Mariella Pazzaglia
- Department of Psychology, Sapienza University of Rome, Rome, Italy.,IRCCS Fondazione Santa Lucia, Rome, Italy
| | | | - Luigi De Gennaro
- Department of Psychology, Sapienza University of Rome, Rome, Italy
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21
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Hou Y, Liu L, Chen X, Li Q, Li J. Association between circadian disruption and diseases: A narrative review. Life Sci 2020; 262:118512. [PMID: 33010281 DOI: 10.1016/j.lfs.2020.118512] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/15/2020] [Accepted: 09/24/2020] [Indexed: 02/06/2023]
Abstract
Circadian rhythms play an important role in a wide range of human physiology and pathology. Individuals increasingly experience situations such as night-shift work schedules, likely leading to circadian disruption. Recent studies have also demonstrated that patients with other diseases often show symptoms of circadian disruption as manifested by the sleep-wake cycle and other biological rhythms. Circadian disruption often results in changes to the phase, period, and amplitude of the sleep-wake cycle, melatonin rhythm, and core body temperature. Several cardiometabolic, psychiatric, and neurodegenerative diseases are closely related to circadian disruption. Several interventions are also available, including phototherapy, exogenous melatonin, and exercise. The cumulative findings suggest that circadian disruption can increase risk for some cardiometabolic diseases. Circadian disruption also acts as a concomitant symptom of several psychiatric and neurodegenerative diseases. More attention should be paid to evaluating the impact of circadian disruption on these related diseases, as well as the benefits of the mitigation interventions for both circadian disruption and related diseases.
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Affiliation(s)
- Yuchao Hou
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Lumin Liu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Xiaotong Chen
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Qi Li
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China
| | - Jing Li
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 200437, China.
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22
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Using Circadian Rhythm Patterns of Continuous Core Body Temperature to Improve Fertility and Pregnancy Planning. J Circadian Rhythms 2020; 18:5. [PMID: 33024445 PMCID: PMC7518073 DOI: 10.5334/jcr.200] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective Review relationships among circadian clocks, core body temperature (CBT), and fertility in women. Methods Scoping literature review. Results Circadian clocks are a ubiquitous adaptation to the most predictable environmental events - the daily cycles of light and dark. Core body temperature (CBT) also follows a circadian rhythm. Additionally, CBT is tightly controlled by a combination of neuronal circuits that begin in the hypothalamus and involve many other portions of the brain as well as a wide range of peripheral mechanisms. In women with normal reproductive function, the diurnal temperature pattern for CBT is strongly influenced by the menstrual cycle of reproductive hormones, primarily estradiol and progesterone, which modulate the activity of hypothalamic neural circuits involved in body temperature control, resulting in an infradian CBT rhythm. Conclusions Analysis of CBT via continuous recording reveals patterns in the interactions of circadian and infradian CBT rhythms capable of accurately predicting the fertility window and hormonal patterns suggesting oligo-ovulation and subfertility. New wearable technologies can facilitate employment of hormone-associated changes in CBT for pregnancy planning and offer clinical insight to infertility and menopause.
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Bagnis A, Caffo E, Cipolli C, De Palma A, Farina G, Mattarozzi K. Judging health care priority in emergency situations: Patient facial appearance matters. Soc Sci Med 2020; 260:113180. [PMID: 32682206 DOI: 10.1016/j.socscimed.2020.113180] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/20/2020] [Accepted: 06/27/2020] [Indexed: 12/30/2022]
Abstract
RATIONALE Extensive research has shown that implicit trait inferences from facial appearance can bias everyday life in a pervasive way, influencing our decisions in different social contexts such as mate choice, political vote and criminal sentence. In situations characterized by time pressure and scant information, decisions based on inferences from facial appearance may have particularly critical and serious consequences, such as in emergency healthcare. No studies today have investigated this aspect in an actual emergency. OBJECTIVE The aim of the present study was to go beyond this gap and to determine whether implicit inferences from patients' facial appearance could be predictive of disparities in clinical evaluations and priority of treatment. METHODS In total, 183 cases of patients were evaluated by independent judges at zero acquaintance on the basis of different implicit facial appearance-based inferences, including trustworthiness and distress. Color-based priority code (White, Green, or Yellow) attributed by the triage nurse at the end of the registration process were recorded. RESULTS Our results showed that more trustworthy- and distressed- looking patients' faces have been associated with a higher priority code. CONCLUSIONS The present study shows that specific facial appearance-based inferences influence the attribution of priority code in healthcare that require quick decisions based on scarce clinical information such as in emergency. These results suggest the importance to bring to the attention of the healthcare professionals' the possibility of being victims of implicit inferences, and prompt to design educational interventions capable to increase their awareness of this bias in clinical evaluation.
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Affiliation(s)
- Arianna Bagnis
- Department of Experimental, Diagnostic and Specialistic Medicine, Alma Mater Studiorum University of Bologna, Italy.
| | - Ernesto Caffo
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | - Carlo Cipolli
- Department of Experimental, Diagnostic and Specialistic Medicine, Alma Mater Studiorum University of Bologna, Italy
| | | | - Gabriele Farina
- Department of Emergency, Medicina d'Urgenza e Pronto Soccorso, Policlinico S. Orsola-Malpighi, Bologna, Italy
| | - Katia Mattarozzi
- Department of Experimental, Diagnostic and Specialistic Medicine, Alma Mater Studiorum University of Bologna, Italy
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24
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Ning Y, Li K, Zhang Y, Chen P, Yin D, Zhu H, Jia H. Assessing Cognitive Abilities of Patients With Shift Work Disorder: Insights From RBANS and Granger Causality Connections Among Resting-State Networks. Front Psychiatry 2020; 11:780. [PMID: 32848945 PMCID: PMC7424029 DOI: 10.3389/fpsyt.2020.00780] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/22/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Numerous studies have confirmed that long-term shift work is not only associated with increased health problems and acute impact on safety but also with impaired cognitive abilities. However, very little is known about effects of shift work on cognition-related brain resting-state networks. The aim of this study was to explore the effects of shift work disorder (SWD) on granger causality connection among resting-state brain networks. METHODS Thirty patients with SWD and 25 matched healthy subjects were recruited to undergo the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and resting-state fMRI scanning. We employed independent component analysis (ICA) to extract resting-state brain networks and granger causality analysis (GCA) to characterize the difference of granger causality connection among cognition-related resting-state brain networks. RESULTS Compared with healthy subjects, patients with SWD showed impairments on the attention and immediate memory. Seven resting-state brain networks were identified, and patients with SWD showed more numerous granger causality connections in comparison with healthy subjects. Two-sample t test results showed that there were significantly increased inflows from the anterior default mode network (aDMN) to sensorimotor network (SMN) and left frontoparietal network (LFPN) to salience network (SN). Correlation analyses showed that the increased inflows from aDMN to SMN were negatively associated with the score of attention, while LFPN to SN were negatively associated with the score of visuospatial/constructional ability. CONCLUSIONS This study indicates that SWD impairs cognitive performance, and the specific intrinsic brain granger causality connectivity among resting-state networks in SWD patients is affected after long-term shift works.
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Affiliation(s)
- Yanzhe Ning
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Kuangshi Li
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Yong Zhang
- Department of Rehabilitation, Dongzhimen Hospital, The First Affiliated Hospital of Beijing University of Chinese Medicine, Beijing, China
| | - Pei Chen
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Dongqing Yin
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Hong Zhu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Hongxiao Jia
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
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25
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Good CH, Brager AJ, Capaldi VF, Mysliwiec V. Sleep in the United States Military. Neuropsychopharmacology 2020; 45:176-191. [PMID: 31185484 PMCID: PMC6879759 DOI: 10.1038/s41386-019-0431-7] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 05/23/2019] [Accepted: 05/31/2019] [Indexed: 02/07/2023]
Abstract
The military lifestyle often includes continuous operations whether in training or deployed environments. These stressful environments present unique challenges for service members attempting to achieve consolidated, restorative sleep. The significant mental and physical derangements caused by degraded metabolic, cardiovascular, skeletomuscular, and cognitive health often result from insufficient sleep and/or circadian misalignment. Insufficient sleep and resulting fatigue compromises personal safety, mission success, and even national security. In the long-term, chronic insufficient sleep and circadian rhythm disorders have been associated with other sleep disorders (e.g., insomnia, obstructive sleep apnea, and parasomnias). Other physiologic and psychologic diagnoses such as post-traumatic stress disorder, cardiovascular disease, and dementia have also been associated with chronic, insufficient sleep. Increased co-morbidity and mortality are compounded by traumatic brain injury resulting from blunt trauma, blast exposure, and highly physically demanding tasks under load. We present the current state of science in human and animal models specific to service members during- and post-military career. We focus on mission requirements of night shift work, sustained operations, and rapid re-entrainment to time zones. We then propose targeted pharmacological and non-pharmacological countermeasures to optimize performance that are mission- and symptom-specific. We recognize a critical gap in research involving service members, but provide tailored interventions for military health care providers based on the large body of research in health care and public service workers.
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Affiliation(s)
- Cameron H. Good
- 0000 0001 2151 958Xgrid.420282.ePhysical Scientist, US Army Research Laboratory, Aberdeen Proving Ground, MD, 21005 USA
| | - Allison J. Brager
- 0000 0001 0036 4726grid.420210.5Sleep Research Center, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD 20910 USA
| | - Vincent F. Capaldi
- 0000 0001 0036 4726grid.420210.5Department of Behavioral Biology Branch, Center for Military Psychiatry and Neuroscience, Walter Reed Army Institute of Research, Silver Spring, Silver Spring, MD 20910 USA
| | - Vincent Mysliwiec
- 0000 0004 0467 8038grid.461685.8San Antonio Military Health System, Department of Sleep Medicine, JBSA, Lackland, TX 78234 USA
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