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Jiao H, Kalsbeek A, Yi CX. Microglia, circadian rhythm and lifestyle factors. Neuropharmacology 2024; 257:110029. [PMID: 38852838 DOI: 10.1016/j.neuropharm.2024.110029] [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: 02/19/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 06/11/2024]
Abstract
Microglia, a vital homeostasis-keeper of the central nervous system, perform critical functions such as synaptic pruning, clearance of cellular debris, and participation in neuroinflammatory processes. Recent research has shown that microglia exhibit strong circadian rhythms that not only actively regulate their own immune activity, but also affect neuronal function. Disruptions of the circadian clock have been linked to a higher risk of developing a variety of diseases. In this article we will provide an overview of how lifestyle factors impact microglial function, with a focus on disruptions caused by irregular sleep-wake patterns, reduced physical activity, and eating at the wrong time-of-day. We will also discuss the potential connection between these lifestyle factors, disrupted circadian rhythms, and the role of microglia in keeping brain health. This article is part of the Special Issue on "Microglia".
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Affiliation(s)
- Han Jiao
- Department of Endocrinology and Metabolism, Amsterdam University Medical Center, location AMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, the Netherlands; Department of Clinical Chemistry, Laboratory of Endocrinology, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands; Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
| | - Andries Kalsbeek
- Department of Endocrinology and Metabolism, Amsterdam University Medical Center, location AMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, the Netherlands; Department of Clinical Chemistry, Laboratory of Endocrinology, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands; Netherlands Institute for Neuroscience, Amsterdam, the Netherlands
| | - Chun-Xia Yi
- Department of Endocrinology and Metabolism, Amsterdam University Medical Center, location AMC, University of Amsterdam, Amsterdam, the Netherlands; Amsterdam Gastroenterology Endocrinology and Metabolism, Amsterdam, the Netherlands; Department of Clinical Chemistry, Laboratory of Endocrinology, Amsterdam University Medical Center, location AMC, Amsterdam, the Netherlands; Netherlands Institute for Neuroscience, Amsterdam, the Netherlands.
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Hoyniak CP, Donohue MR, Luby JL, Barch DM, Zhao P, Smyser CD, Warner B, Rogers CE, Herzog ED, England SK. The association between maternal sleep and circadian rhythms during pregnancy and infant sleep and socioemotional outcomes. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02571-y. [PMID: 39180688 DOI: 10.1007/s00787-024-02571-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 08/19/2024] [Indexed: 08/26/2024]
Abstract
Studies have established that maternal sleep and circadian rhythm disturbances during pregnancy are associated with poor prenatal and perinatal outcomes for mothers and offspring. However, little work has explored its effects on infant sleep or socioemotional outcomes. The current study examined the relationship between maternal sleep and circadian rhythm disturbances during pregnancy and infant sleep and socioemotional outcomes in a diverse sample of N = 193 mothers and their infants (51% White; 52% Female; Mage = 11.95 months). Maternal sleep and circadian rhythms during pregnancy were assessed using self-reports and actigraphy. Mothers reported on infants' sleep and socioemotional outcomes when infants were one year old. When controlling for infant sex, age, gestational age at birth, family income-to-needs ratios, and maternal depression, mothers who reported more sleep problems during pregnancy had infants with more sleep disturbances when they were one year old. Moreover, mothers who had later sleep timing (i.e., went to bed and woke up later, measured via actigraphy) during pregnancy had infants with more dysregulation (e.g., increased feeding difficulties, sensory sensitivities) and externalizing problems, and mothers with increased intra-daily variability in rest-activity rhythms (as measured via actigraphy) had infants with more externalizing problems. Findings suggest that maternal sleep and circadian rhythm disturbances during pregnancy may be a risk factor for infant sleep problems and socioemotional difficulties.
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Affiliation(s)
- Caroline P Hoyniak
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave, Suite 2100, St. Louis, MO, 63108, USA.
| | - Meghan R Donohue
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave, Suite 2100, St. Louis, MO, 63108, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave, Suite 2100, St. Louis, MO, 63108, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave, Suite 2100, St. Louis, MO, 63108, USA
- The Program in Neuroscience, Washington University in St. Louis, St. Louis, MO, USA
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Christopher D Smyser
- Department of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Department of Neurology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Barbara Warner
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine in St. Louis, 4444 Forest Park Ave, Suite 2100, St. Louis, MO, 63108, USA
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Erik D Herzog
- Department of Biology, Washington University in St. Louis, St. Louis, MO, USA
| | - Sarah K England
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
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Smagula SF, Zhang G, Krafty RT, Ramos A, Sotres-Alvarez D, Rodakowski J, Gallo LC, Lamar M, Gujral S, Fischer D, Tarraf W, Mossavar-Rahmani Y, Redline S, Stone KL, Gonzalez HM, Patel SR. Sleep-wake behaviors associated with cognitive performance in middle-aged participants of the Hispanic Community Health Study/Study of Latinos. Sleep Health 2024; 10:500-507. [PMID: 38693044 PMCID: PMC11309910 DOI: 10.1016/j.sleh.2024.02.002] [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: 10/02/2023] [Revised: 01/26/2024] [Accepted: 02/20/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES Many sleep-wake behaviors have been associated with cognition. We examined a panel of sleep-wake/activity characteristics to determine which are most robustly related to having low cognitive performance in midlife. Secondarily, we evaluate the predictive utility of sleep-wake measures to screen for low cognitive performance. METHODS The outcome was low cognitive performance defined as being >1 standard deviation below average age/sex/education internally normalized composite cognitive performance levels assessed in the Hispanic Community Health Study/Study of Latinos. Analyses included 1006 individuals who had sufficient sleep-wake measurements about 2years later (mean age=54.9, standard deviation= 5.1; 68.82% female). We evaluated associations of 31 sleep-wake variables with low cognitive performance using separate logistic regressions. RESULTS In individual models, the strongest sleep-wake correlates of low cognitive performance were measures of weaker and unstable 24-hour rhythms; greater 24-hour fragmentation; longer time-in-bed; and lower rhythm amplitude. One standard deviation worse on these sleep-wake factors was associated with ∼20%-30% greater odds of having low cognitive performance. In an internally cross-validated prediction model, the independent correlates of low cognitive performance were: lower Sleep Regularity Index scores; lower pseudo-F statistics (modellability of 24-hour rhythms); lower activity rhythm amplitude; and greater time in bed. Area under the curve was low/moderate (64%) indicating poor predictive utility. CONCLUSION The strongest sleep-wake behavioral correlates of low cognitive performance were measures of longer time-in-bed and irregular/weak rhythms. These sleep-wake assessments were not useful to identify previous low cognitive performance. Given their potential modifiability, experimental trials could test if targeting midlife time-in-bed and/or irregular rhythms influences cognition.
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Affiliation(s)
- Stephen F Smagula
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
| | - Gehui Zhang
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Robert T Krafty
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Alberto Ramos
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Juleen Rodakowski
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Linda C Gallo
- Department of Psychology, University of California San Diego, San Diego, California, USA
| | - Melissa Lamar
- Institute of Minority Health Research, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Swathi Gujral
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dorothee Fischer
- Department of Sleep and Human Factors Research, Institute for Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, New York, USA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Katie L Stone
- California Pacific Medical Center Research Institute, San Francisco, California, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Hector M Gonzalez
- Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, California, USA
| | - Sanjay R Patel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Hoyniak CP, Whalen DJ, Luby JL, Barch DM, Miller JP, Zhao P, Triplett RL, Ju YE, Smyser CD, Warner B, Rogers CE, Herzog ED, England SK. Sleep and circadian rhythms during pregnancy, social disadvantage, and alterations in brain development in neonates. Dev Sci 2024; 27:e13456. [PMID: 37902111 PMCID: PMC10997484 DOI: 10.1111/desc.13456] [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: 03/16/2023] [Revised: 09/26/2023] [Accepted: 10/02/2023] [Indexed: 10/31/2023]
Abstract
Pregnant women in poverty may be especially likely to experience sleep and circadian rhythm disturbances, which may have downstream effects on fetal neurodevelopment. However, the associations between sleep and circadian rhythm disturbances, social disadvantage during pregnancy, and neonatal brain structure remains poorly understood. The current study explored the association between maternal sleep and circadian rhythm disturbances during pregnancy and neonatal brain outcomes, examining sleep and circadian rhythm disturbances as a mediator of the effect of social disadvantage during pregnancy on infant structural brain outcomes. The study included 148 mother-infant dyads, recruited during early pregnancy, who had both actigraphy and neuroimaging data. Mothers' sleep was assessed throughout their pregnancy using actigraphy, and neonates underwent brain magnetic resonance imaging in the first weeks of life. Neonatal structural brain outcomes included cortical gray matter, subcortical gray matter, and white matter volumes along with a measure of the total surface area of the cortex. Neonates of mothers who experienced greater inter-daily deviations in sleep duration had smaller total cortical gray and white matter volumes and reduced cortical surface areas. Neonates of mothers who had higher levels of circadian misalignment and later sleep timing during pregnancy showed smaller subcortical gray matter volumes. Inter-daily deviations in sleep duration during pregnancy mediated the association between maternal social disadvantage and neonatal structural brain outcomes. Findings highlight the importance of regularity and rhythmicity in sleep schedules during pregnancy and bring to light the role of chronodisruption as a potential mechanism underlying the deleterious neurodevelopmental effects of prenatal adversity. RESEARCH HIGHLIGHTS: Social disadvantage was associated with sleep and circadian rhythm disturbances during pregnancy, including later sleep schedules, increased variability in sleep duration, circadian misalignment, and a higher proportion of the sleep period spent awake. Maternal sleep and circadian rhythm disturbances during pregnancy were associated with decreased brain volume and reduced cortical surface area in neonates. Maternal inter-daily deviations in sleep duration during pregnancy mediated the association between social disadvantage and neonatal brain volume and cortical surface area.
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Affiliation(s)
- Caroline P Hoyniak
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Diana J Whalen
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Joan L Luby
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, USA
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, USA
- The Program in Neuroscience, Washington University in St. Louis, St Louis, USA
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St Louis, USA
- Department of Radiology, Washington University School of Medicine in St. Louis, St Louis, USA
| | - J Philip Miller
- Department of Biostatistics, Washington University in St. Louis, St Louis, USA
| | - Peinan Zhao
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Regina L Triplett
- Department of Neurology, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Yo-El Ju
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Neurology, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Christopher D Smyser
- Department of Radiology, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Neurology, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Barbara Warner
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St Louis, USA
| | - Erik D Herzog
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Biology, Washington University in St. Louis, St Louis, USA
| | - Sarah K England
- Center on Biological Rhythms and Sleep, Washington University School of Medicine in St. Louis, St Louis, USA
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St Louis, USA
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Yan X, Li Y, Li S, Liang C, Wang L, Kong J, Zhao Y, Chen Q, Xu H. Validation of the Chinese version of the Sleep Regularity Questionnaire (SRQ) and analysis of influencing factors. Sleep Med 2024; 114:73-81. [PMID: 38157623 DOI: 10.1016/j.sleep.2023.12.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 12/03/2023] [Accepted: 12/14/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Currently, there is no instrument to measure sleep regularity in China. In this study, the Sleep Regularity Questionnaire(SRQ) was translated into Chinese, tested for reliability and validity, and analyzed for factors affecting sleep regularity. METHODS The English version of the SRQ was translated into Chinese, and a total of 3642 individuals were included in this research. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to examine the underlying factor structure of the Chinese version of the SRQ and to measure its reliability and validity. In addition, the correlations between sleep regularity and general information, personal habits, self-control, stress, anxiety, and depression were explored. RESULTS The Cronbach's α of the Chinese SRQ was 0.858, supporting the two-factor structure. Sleep regularity was statistically different between gender and ethnicity (p < 0.05), and personal habits (exercise, continued eating after dinner, smoking and drinking) had an effect on sleep regularity. Sleep regularity was positively associated with individual self-control and negatively associated with stress, anxiety, and depression. CONCLUSIONS The Chinese version of the SRQ has excellent reliability and validity. There are two dimensions, namely circadian regularity and sleep continuity regularity, which can be used to assess the sleep regularity of Chinese adults. The results of this study showed that males and Han Chinese having better sleep regularity. And people with good lifestyle habits and greater self-control sleep more regularly, while stress, anxiety and depression can affect individuals' sleep regularity.
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Affiliation(s)
- Xiangru Yan
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China; Jining No.1 People's Hospital, 272000, Jining, China.
| | - Yanhui Li
- Department of Stomatology, Shandong Medical College, 276000, Linyi, China.
| | - Sisi Li
- Department of Nursing, Panjin Vocational and Technical College, 124000, Panjin, China.
| | - Chunguang Liang
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Liying Wang
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Jie Kong
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Ying Zhao
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Qing Chen
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
| | - Huameng Xu
- Department of Nursing, Jinzhou Medical University, 121001, Jinzhou, China.
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Mul Fedele ML, López Gabeiras MDP, Simonelli G, Diez JJ, Bellone GJ, Cagliani J, Larrateguy L, Eiguchi K, Golombek DA, Cardinali DP, Pérez-Chada D, Vigo DE. "Multivariate analysis of the impact of sleep and working hours on medical errors: a MICE approach". BMC Public Health 2023; 23:2317. [PMID: 37996804 PMCID: PMC10666331 DOI: 10.1186/s12889-023-17130-4] [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: 06/09/2023] [Accepted: 11/01/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The main objective of this study was to describe the relationship between working conditions, sleep and psycho-affective variables and medical errors. METHODS This was an observational, analytical and cross-sectional study in which 661 medical residents answered questionnaires about working conditions, sleep and psycho-affective variables. Actigraphic sleep parameters and peripheral temperature circadian rhythm were measured in a subgroup of 38 subjects. Bivariate and multivariate predictors of medical errors were assessed. RESULTS Medical residents reported working 66.2 ± 21.9 weekly hours. The longest continuous shift was of 28.4 ± 10.9 h. They reported sleeping 6.1 ± 1.6 h per day, with a sleep debt of 94 ± 129 min in workdays. A high percentage of them reported symptoms related to psycho-affective disorders. The longest continuous shift duration (OR = 1.03 [95% CI, 1.00-1.05], p = 0.01), working more than six monthly on-call shifts (OR = 1.87 [95% CI, 1.16-3.02], p = 0.01) and sleeping less than six hours per working day (OR = 1.66 [95% CI, 1.10-2.51], p = 0.02) were independently associated with self-reported medical errors. The report of medical errors was associated with an increase in the percentage of diurnal sleep (2.2% [95% CI, 0.1-4.3] vs 14.5% [95% CI, 5.9-23.0]; p = 0.01) in the actigraphic recording. CONCLUSIONS Medical residents have a high working hour load that affect their sleep opportunities, circadian rhythms and psycho-affective health, which are also related to the report of medical errors. These results highlight the importance of implementing multidimensional strategies to improve medical trainees' sleep and wellbeing, increasing in turn their own and patients' safety.
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Affiliation(s)
- Malena Lis Mul Fedele
- Chronophysiology Lab, Institute for Biomedical Research (UCA-CONICET), Buenos Aires, Argentina
| | | | - Guido Simonelli
- Centre d'études Avancées en Médecine du Sommeil, Hôpital du Sacré-Coeur de Montréal, CIUSSS du Nord de L'Île-de-Montréal, Montreal, Canada
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Canada
- Department of Neuroscience, Faculty of Medicine, University of Montreal, Montreal, Canada
| | - Joaquín José Diez
- Pan-American Institute of Sleep Medicine and Chronobiology, Buenos Aires, Argentina
| | - Giannina Julieta Bellone
- Pontifical Catholic University of Argentina, Buenos Aires, Argentina
- Chronobiology Lab, Department of Science and Technology, National University of Quilmes, Bernal, Argentina
| | - Joaquín Cagliani
- Anesthesiology Department, North Shore University Hospital, Manhasset, NY, USA
| | - Luis Larrateguy
- Private Center of Respiratory Medicine of Paraná, Entre Ríos, Argentina
| | | | - Diego Andrés Golombek
- Chronobiology Lab, Department of Science and Technology, National University of Quilmes, Bernal, Argentina
- Interdisciplinary Time Lab, San Andrés University, Buenos Aires, Argentina
| | | | | | - Daniel Eduardo Vigo
- Chronophysiology Lab, Institute for Biomedical Research (UCA-CONICET), Buenos Aires, Argentina.
- Katholieke Universiteit Leuven, Leuven, Belgium.
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Matre D, Sallinen M, Phillips AJK, Moen LV, Nilsen KB, Haugen F. Night work, season and alertness as occupational safety hazards in the Arctic: protocol for the Noralert observational crossover study among Norwegian process operators. BMJ Open 2023; 13:e075107. [PMID: 37793926 PMCID: PMC10551971 DOI: 10.1136/bmjopen-2023-075107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 09/11/2023] [Indexed: 10/06/2023] Open
Abstract
INTRODUCTION The objective of this study is to determine the effects of night work, Arctic seasonal factors and cold working environments on human functions relevant to safety. The study aims to quantify the contribution of (1) several consecutive night shifts, (2) seasonal variation on sleepiness, alertness and circadian rhythm and (3) whether a computational model of sleep, circadian rhythms and cognitive performance can accurately predict the observed sleepiness and alertness. METHODS AND ANALYSIS In an observational crossover study of outdoor and indoor workers (n=120) on a three-shift schedule from an industrial plant in Norway (70 °N), measurements will be conducted during the summer and winter. Sleep duration and quality will be measured daily by smartphone questionnaire, aided by actigraphy and heart rate measurements. Sleepiness and alertness will be assessed at regular intervals by the Karolinska Sleepiness Scale and the psychomotor vigilance test, respectively. Saliva samples will assess melatonin levels, and a blood sample will measure circadian time. Thermal exposures and responses will be measured by sensors and by thermography. ETHICS AND DISSEMINATION All participants will give written informed consent to participate in the study, which will be conducted in accordance with the Declaration of Helsinki. The Norwegian Regional Committee for Medical Research Ethics South-East D waivered the need for ethics approval (reference 495816). Dissemination plans include academic and lay publications, and partnerships with national and regional policymakers.
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Affiliation(s)
- Dagfinn Matre
- National Institute of Occupational Health, Oslo, Norway
| | - Mikael Sallinen
- Finnish Institute of Occupational Health, Työterveyslaitos, Finland
| | | | | | | | - Fred Haugen
- National Institute of Occupational Health, Oslo, Norway
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Erickson ML, North R, Counts J, Wang W, Porter Starr KN, Wideman L, Pieper C, Dunn J, Kraus WE. Nightshift imposes irregular lifestyle behaviors in police academy trainees. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad038. [PMID: 38020732 PMCID: PMC10630191 DOI: 10.1093/sleepadvances/zpad038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 08/11/2023] [Indexed: 12/01/2023]
Abstract
Study Objective Shiftwork increases risk for numerous chronic diseases, which is hypothesized to be linked to disruption of circadian timing of lifestyle behaviors. However, empirical data on timing of lifestyle behaviors in real-world shift workers are lacking. To address this, we characterized the regularity of timing of lifestyle behaviors in shift-working police trainees. Methods Using a two-group observational study design (N = 18), we compared lifestyle behavior timing during 6 weeks of in-class training during dayshift, followed by 6 weeks of field-based training during either dayshift or nightshift. Lifestyle behavior timing, including sleep-wake patterns, physical activity, and meals, was captured using wearable activity trackers and mobile devices. The regularity of lifestyle behavior timing was quantified as an index score, which reflects day-to-day stability on a 24-hour time scale: Sleep Regularity Index, Physical Activity Regularity Index, and Mealtime Regularity Index. Logistic regression was applied to these indices to develop a composite score, termed the Behavior Regularity Index (BRI). Results Transitioning from dayshift to nightshift significantly worsened the BRI, relative to maintaining a dayshift schedule. Specifically, nightshift led to more irregular sleep-wake timing and meal timing; physical activity timing was not impacted. In contrast, maintaining a dayshift schedule did not impact regularity indices. Conclusions Nightshift imposed irregular timing of lifestyle behaviors, which is consistent with the hypothesis that circadian disruption contributes to chronic disease risk in shift workers. How to mitigate the negative impact of shiftwork on human health as mediated by irregular timing of sleep-wake patterns and meals deserves exploration.
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Affiliation(s)
| | - Rebecca North
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
| | - Julie Counts
- Duke Molecular Physiology Institute, Duke University, Durham, NC, USA
| | - Will Wang
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
| | - Kathryn N Porter Starr
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
- Geriatric Research, Education, Clinical Center, Durham VA Health Care System, Durham, NC, USA
| | - Laurie Wideman
- Department of Kinesiology, University of North Carolina at Greensboro, Greensboro, NC, USA
| | - Carl Pieper
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - Jessilyn Dunn
- Department of Biomedical Engineering, Duke University, Durham, NC, USA
- Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA
| | - William E Kraus
- Center for the Study of Aging and Human Development, Duke University, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University, Durham, NC, USA
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Erickson ML, North R, Counts J, Wang W, Porter Starr KN, Wideman L, Pieper C, Dunn J, Kraus WE. Nightshift Imposes Irregular Lifestyle Behaviors in Police Academy Trainees. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.07.07.23292363. [PMID: 37461704 PMCID: PMC10350160 DOI: 10.1101/2023.07.07.23292363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
Study Objective Shiftwork increases risk for numerous chronic diseases, which is hypothesized to be linked to disruption of circadian timing of lifestyle behaviors. However, empirical data on timing of lifestyle behaviors in real-world shift workers are lacking. To address this, we characterized the regularity of timing of lifestyle behaviors in shift-working police trainees. Methods Using a two-group observational study design (N=18), we compared lifestyle behavior timing during 6 weeks of in-class training during dayshift, followed by 6 weeks of field-based training during either dayshift or nightshift. Lifestyle behavior timing, including sleep/wake patterns, physical activity, and meals, was captured using wearable activity trackers and mobile devices. The regularity of lifestyle behavior timing was quantified as an index score, which reflects day-to-day stability on a 24h time scale: Sleep Regularity Index (SRI), Physical Activity Regularity Index (PARI) and Mealtime Regularity Index (MRI). Logistic regression was applied to these indices to develop a composite score, termed the Behavior Regularity Index (BRI). Results Transitioning from dayshift to nightshift significantly worsened the BRI, relative to maintaining a dayshift schedule. Specifically, nightshift led to more irregular sleep/wake timing and meal timing; physical activity timing was not impacted. In contrast, maintaining a dayshift schedule did not impact regularity indices. Conclusion Nightshift imposed irregular timing of lifestyle behaviors, which is consistent with the hypothesis that circadian disruption contributes to chronic disease risk in shift workers. How to mitigate the negative impact of shiftwork on human health as mediated by irregular timing of sleep/wake patterns and meals deserves exploration.
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10
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Baum L, Johns M, Poikela M, Möller R, Ananthasubramaniam B, Prasser F. Data integration and analysis for circadian medicine. Acta Physiol (Oxf) 2023; 237:e13951. [PMID: 36790321 DOI: 10.1111/apha.13951] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 02/04/2023] [Accepted: 02/12/2023] [Indexed: 02/16/2023]
Abstract
Data integration, data sharing, and standardized analyses are important enablers for data-driven medical research. Circadian medicine is an emerging field with a particularly high need for coordinated and systematic collaboration between researchers from different disciplines. Datasets in circadian medicine are multimodal, ranging from molecular circadian profiles and clinical parameters to physiological measurements and data obtained from (wearable) sensors or reported by patients. Uniquely, data spanning both the time dimension and the spatial dimension (across tissues) are needed to obtain a holistic view of the circadian system. The study of human rhythms in the context of circadian medicine has to confront the heterogeneity of clock properties within and across subjects and our inability to repeatedly obtain relevant biosamples from one subject. This requires informatics solutions for integrating and visualizing relevant data types at various temporal resolutions ranging from milliseconds and seconds to minutes and several hours. Associated challenges range from a lack of standards that can be used to represent all required data in a common interoperable form, to challenges related to data storage, to the need to perform transformations for integrated visualizations, and to privacy issues. The downstream analysis of circadian rhythms requires specialized approaches for the identification, characterization, and discrimination of rhythms. We conclude that circadian medicine research provides an ideal environment for developing innovative methods to address challenges related to the collection, integration, visualization, and analysis of multimodal multidimensional biomedical data.
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Affiliation(s)
- Lena Baum
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Marco Johns
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Maija Poikela
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ralf Möller
- Institute of Information Systems, University of Lübeck, Lübeck, Germany
| | | | - Fabian Prasser
- Berlin Institute of Health at Charité-Universitätsmedizin Berlin, Berlin, Germany
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11
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Zhang C, Qin G. Irregular sleep and cardiometabolic risk: Clinical evidence and mechanisms. Front Cardiovasc Med 2023; 10:1059257. [PMID: 36873401 PMCID: PMC9981680 DOI: 10.3389/fcvm.2023.1059257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 01/31/2023] [Indexed: 02/19/2023] Open
Abstract
Sleep regularity is an essential part of the multidimensional sleep health framework. The phenomenon of irregular sleep patterns is widespread in contemporary lifestyles. This review synthesizes clinical evidence to summarize the measures of sleep regularity and discusses the role of different sleep regularity indicators in developing cardiometabolic diseases (coronary heart disease, hypertension, obesity, and diabetes). Existing literature has proposed several measurements to assess sleep regularity, mainly including the standard deviation (SD) of sleep duration and timing, sleep regularity index (SRI), interdaily stability (IS), and social jetlag (SJL). Evidence on associations between sleep variability and cardiometabolic diseases varies depending on the measure used to characterize variability in sleep. Current studies have identified a robust association between SRI and cardiometabolic diseases. In comparison, the association between other metrics of sleep regularity and cardiometabolic diseases was mixed. Meanwhile, the associations of sleep variability with cardiometabolic diseases differ across the population. SD of sleep characteristics or IS may be more consistently associated with HbA1c in patients with diabetes compared with the general population. The association between SJL and hypertension for patients with diabetes was more accordant than in the general population. Interestingly, the age-stratified association between SJL and metabolic factors was observed in the present studies. Furthermore, the relevant literature was reviewed to generalize the potential mechanisms through which irregular sleep increases cardiometabolic risk, including circadian dysfunction, inflammation, autonomic dysfunction, hypothalamic-pituitary-adrenal (HPA) axis disorder, and gut dysbiosis. Health-related practitioners should give more attention to the role of sleep regularity on human cardiometabolic in the future.
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Affiliation(s)
- Chengjie Zhang
- First School of Clinical Medicine, Shanxi Medical University, Taiyuan, China
| | - Gang Qin
- Department of Cardiology, First Hospital of Shanxi Medical University, Taiyuan, China
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12
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Borisenkov MF, Tserne TA, Bakutova LA, Gubin DG. Food addiction and emotional eating are associated with intradaily rest-activity rhythm variability. Eat Weight Disord 2022; 27:3309-3316. [PMID: 35932417 DOI: 10.1007/s40519-022-01461-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 07/23/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE The aim of the present investigation was to study the associations among parameters characterizing eating behavior and actimetry-derived indices of circadian rhythm of motor activity. METHODS The study involved 81 healthy participants (average age: 21.5 ± 9.6 y, women: 77.8%). Each study participant provided personal data, filled out the Yale Food Addiction Scale and the Dutch Eating Behavior Questionnaire, and wore a wrist actimeter for 7 consecutive days to record motor activity. Using time series treatments, we obtained: (a) three cosinor-derived parametric indices [Medline Estimating Statistics of Rhythm (MESOR), amplitude, and acrophase], and (b) four non-parametric indices [interdaily stability, intradaily variability (I.V.), most active 10-h period (M10), and least active 5-h period] characterizing the 24-h rhythm of motor activity. A multiple regression analysis adjusted for age, sex, and BMI was performed to assess the associations among the studied indicators. RESULTS It was shown that I.V. is a predictor of symptoms of food addiction (β = 0.242, P = 0.037) and emotional eating (β = 0.390, P = 0.004), MESOR is a predictor of symptoms of food addiction (β = 0.342, P = 0.003), and M10 predicts restraint (β = 0.257, P = 0.015) and emotional eating (β = 0.464, P = 0.001). CONCLUSION It was shown for the first time that an increase in symptom counts of food addiction is associated with an increase in the average level and fragmentation of 24-h rhythm of motor activity. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Mikhail F Borisenkov
- Institute of Physiology of Komi Science Center of the Ural Branch of the, Russian Academy of Sciences, Syktyvkar, Russia.
| | - Tatyana A Tserne
- Institute of Physiology of Komi Science Center of the Ural Branch of the, Russian Academy of Sciences, Syktyvkar, Russia
| | - Larisa A Bakutova
- Institute of Physiology of Komi Science Center of the Ural Branch of the, Russian Academy of Sciences, Syktyvkar, Russia
| | - Denis G Gubin
- Tyumen Medical University, Tyumen, Russia.,Tyumen Cardiology Research Centre, Tomsk National Research Medical Center, Russian Academy of Science, Tyumen, Russia
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13
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Zhu B, Wang Y, Yuan J, Mu Y, Chen P, Srimoragot M, Li Y, Park CG, Reutrakul S. Associations between sleep variability and cardiometabolic health: A systematic review. Sleep Med Rev 2022; 66:101688. [PMID: 36081237 DOI: 10.1016/j.smrv.2022.101688] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 12/13/2022]
Abstract
This review explored the associations between sleep variability and cardiometabolic health. It was performed following PRISMA guidelines. We identified 63 studies. Forty-one studies examined the association between sleep variability and body composition, with 29 examined body mass index (BMI). Thirteen studies used social jet lag (SJL), n = 30,519, with nine reporting a null association. Eight studies used variability in sleep duration (n = 33,029), with five reporting a correlation with BMI. Fourteen studies (n = 133,403) focused on overweight/obesity; significant associations with sleep variability were found in 11 (n = 120,168). Sleep variability was associated with weight gain (seven studies; n = 79,522). Twenty-three studies examined glucose outcomes. The association with hemoglobin A1c (16 studies, n = 11,755) differed depending on populations, while associations with diabetes or glucose were mixed, and none were seen with insulin resistance (five studies; n = 6416). Sixteen studies examined cardiovascular-related outcomes, with inconsistent results. Overall significant associations were found in five studies focusing on metabolic syndrome (n = 7413). In summary, sleep variability was likely associated with obesity, weight gain, and metabolic syndrome. It might be associated with hemoglobin A1c in people with type 1 diabetes. The associations with other outcomes were mixed. This review highlighted the possible association between sleep variability and cardiometabolic health.
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Affiliation(s)
- Bingqian Zhu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yueying Wang
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jinjin Yuan
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Yunping Mu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Pei Chen
- Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | | | - Yan Li
- School of Nursing, Hong Kong Polytechnic University, Hong Kong, China
| | - Chang G Park
- College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Sirimon Reutrakul
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, University of Illinois Chicago, Chicago, IL, USA.
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Wang L, Chan V, Allman-Farinelli M, Davies A, Wellard-Cole L, Rangan A. Wearable Cameras Reveal Large Intra-Individual Variability in Timing of Eating among Young Adults. Nutrients 2022; 14:nu14204349. [PMID: 36297030 PMCID: PMC9611808 DOI: 10.3390/nu14204349] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/13/2022] [Accepted: 10/16/2022] [Indexed: 11/16/2022] Open
Abstract
Studies have shown that young adults follow less structured eating patterns compared with older cohorts. This may have implications for dietary assessment methods which rely on memory and structured meal patterns. Our aim was to describe the intra-individual variation of eating times in young adults aged 18−30 years. Participants (n = 41) wore an Autographer camera that captured first-person perspective images every 30 s for three consecutive days. All images were timestamped and those showing food consumption were used to extract data such as the timing of the first and last eating occasions (EOs), number of EOs per day, and length of eating window. Intra-individual variability was calculated from these data using composite phase deviation (CPD) and coefficient of variation (CV). The number of individuals with high or very high variability was 28 and 18 for timing of first and last EOs, respectively (CPD > 1.70), and 27 and 17 for number of EOs and eating window, respectively (CV > 20%). In this sample of young adults, the lack of regularity in eating patterns should be considered when selecting a dietary assessment method.
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Affiliation(s)
- Leanne Wang
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Virginia Chan
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Margaret Allman-Farinelli
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Alyse Davies
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
| | - Lyndal Wellard-Cole
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Cancer Prevention and Advocacy Division, Cancer Council NSW, Sydney, NSW 2011, Australia
| | - Anna Rangan
- Discipline of Nutrition and Dietetics, Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW 2006, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
- Correspondence:
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15
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Nogueira LFR, Crispim CA, Cipolla-Neto J, de Castro Moreno CR, Marqueze EC. The Effect of Exogenous Melatonin on Eating Habits of Female Night Workers with Excessive Weight. Nutrients 2022; 14:3420. [PMID: 36014925 PMCID: PMC9412377 DOI: 10.3390/nu14163420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND AND AIMS Melatonin is a pineal hormone that plays an important role as an endogenous synchronizer of circadian rhythms and energy metabolism. As this circadian component has been closely related to eating behavior, an important question on this topic would be whether melatonin administration could influence eating habits. However, this topic has been rarely studied in the literature in individuals with excessive weight and chronic circadian misalignment, such as shift workers. Therefore, the present study aims to evaluate the effects of exogenous melatonin administration on the quali/quantitative aspects and temporal distribution of food intake in female night workers with excessive weight (overweight and obesity). An additional aim is to evaluate the association of the referred outcomes with circadian misalignment and chronotype. METHODS A randomized, double-blind, placebo-controlled, crossover clinical trial was conducted with 27 female nursing professionals with excessive weight who worked permanent night shifts. The protocol was implemented under real-life conditions for 24 weeks, in two randomly allocated conditions (12 weeks of melatonin and 12 weeks of placebo). The quali/quantitative aspects of food intake (NOVA classification, total energy intake and the proportion of calories from macronutrients) and meal timing were assessed using food diaries. Timing for every meal recorded in the diaries was assessed to evaluate the temporal distribution of food intake. Generalized estimating equations were performed for each dependent variable. RESULTS No significant modifications in total energy intake, macronutrient distribution, types of foods consumed, and meal timing were observed after melatonin administration. Different levels of circadian misalignment and chronotype did not interfere with these results. CONCLUSION Eating habits of female night workers with excessive weight remained unchanged after melatonin administration, and no association of these results with circadian misalignment and chronotype was found. These results suggest that the metabolic effects of melatonin may occur independently of food intake.
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Affiliation(s)
- Luciana Fidalgo Ramos Nogueira
- Department of Epidemiology, Public Health Graduate Program, Catholic University of Santos, Av. Conselheiro Nébias 300, Vila Mathias, Santos 11015-001, Brazil
| | - Cibele Aparecida Crispim
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Av. Pará, 1720, Bloco 2U, Uberlandia 38405-320, Brazil
| | - José Cipolla-Neto
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, Av. Lineu Prestes 1524, Cidade Universitária, Butantã, Sao Paulo 05508-000, Brazil
| | - Claudia Roberta de Castro Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, Cerqueira César, Sao Paulo 01246-904, Brazil
- Department of Psychology, Stress Research Institute, Stockholm University, 16 Frescati Hagväg, 10405 Stockholm, Sweden
| | - Elaine Cristina Marqueze
- Department of Epidemiology, Public Health Graduate Program, Catholic University of Santos, Av. Conselheiro Nébias 300, Vila Mathias, Santos 11015-001, Brazil
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, Av. Dr. Arnaldo 715, Cerqueira César, Sao Paulo 01246-904, Brazil
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16
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Jung S, Son KL, Jung S, Moon JY, Oh GH, Yeom CW, Lee KM, Kim WH, Jung D, Kim TY, Im SA, Lee KH, Spiegel D, Hahm BJ. The longitudinal effects of chronotype on chemotherapy-induced nausea and vomiting in patients with breast cancer receiving neoadjuvant chemotherapy. J Psychosom Res 2022; 157:110804. [PMID: 35381494 DOI: 10.1016/j.jpsychores.2022.110804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE The object of this longitudinal cohort study was to investigate whether chronotype affects the incidence of chemotherapy-induced nausea and vomiting (CINV) among patients with breast cancer. METHODS The study included a total of 203 breast cancer patients who received neoadjuvant chemotherapy using a regimen of doxorubicin and cyclophosphamide with high emetogenicity. Patients received four cycles of chemotherapy in approximately three months. Patients completed questionnaires including the Munich Chronotype Questionnaire (MCTQ) before the first chemotherapy and the Multinational Association of Supportive Care in Cancer Antiemesis Tool (MAT) after each of the four chemotherapy sessions. To confirm the effect of chronotype on CINV during the four cycles, we performed statistical analyses using a generalized estimating equation (GEE). RESULTS CINV occurred in 108 (53.2%), 112 (55.2%), 102 (50.3%), and 62 (30.5%) patients during four cycles of treatment. In the GEE approach, late and early chronotypes (vs. intermediate chronotype) were associated with an increased risk of CINV (late chronotype: odds ratio [OR], 2.06; 95% confidence interval [CI], 1.41-2.99; p < 0.001, early chronotype: OR, 1.84; CI, 1.25-2.73; p = 0.002), which remained significant even after adjusting for age, BMI, antiemetic treatment, history of nausea and vomiting, anxiety, and sleep quality. CONCLUSION Chronotype affected CINV across the four cycles of neoadjuvant chemotherapy in patients with breast cancer, suggesting the need to consider chronotype in predicting and managing CINV.
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Affiliation(s)
- Sanghyup Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kyung-Lak Son
- Department of Psychiatry, Dongguk University Ilsan Hospital, Goyang, Republic of Korea.
| | - Saim Jung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jung Yoon Moon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Gyu Han Oh
- Public Health Medical Service, Seoul National University Hospital, Seoul, Republic of Korea
| | - Chan-Woo Yeom
- Department of Psychiatry, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu-si, Gyeonggi-do, Republic of Korea
| | | | - Won-Hyoung Kim
- Department of Psychiatry, Inha University Hospital, Incheon, Republic of Korea
| | - Dooyoung Jung
- Department of Human Factors Engineering, Ulsan National Institute of Science and Technology, Ulsan, Republic of Korea
| | - Tae-Yong Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Seock-Ah Im
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - Kyung-Hun Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
| | - David Spiegel
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Bong-Jin Hahm
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Psychiatry and Behavioral Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
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17
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Yap Y, Tung NYC, Collins J, Phillips A, Bei B, Wiley JF. Daily Relations Between Stress and Electroencephalography-Assessed Sleep: A 15-Day Intensive Longitudinal Design With Ecological Momentary Assessments. Ann Behav Med 2022; 56:1144-1156. [PMID: 35568984 DOI: 10.1093/abm/kaac017] [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: 11/13/2022] Open
Abstract
BACKGROUND Recent studies have found bi-directional relations between stress and sleep. However, few studies have examined the daily associations between stress and electroencephalography (EEG) measured sleep. PURPOSE This study examined the temporal associations between repeated ecological momentary assessments of stress and EEG-estimated sleep. METHODS Ninety-eight international or interstate undergraduate students (Mage = 20.54 ± 1.64, 76.5% female, 84.7% Asian) reported their stress levels four times daily at morning awakening, afternoon, evening, and pre-bedtime across 15 consecutive days (>4,000 total observations). Next-day stress was coded as an average of morning, afternoon, and evening stress. Z-Machine Insight+ recorded over 1,000 nights EEG total sleep time (TST), sleep onset latency, wake after sleep onset, sleep efficiency (SE), slow-wave sleep (SWS), and rapid eye movement (REM) sleep duration. Multilevel models, adjusted for covariates (i.e., sociodemographic, health factors, and daily covariates) and lagged outcomes, tested the daily within- and between-level stress-sleep associations. RESULTS After adjusting for covariates, within-person shorter TST (b = -0.11 [-0.21, -0.01], p = .04), lower SE (b = -0.02 [-0.03, 0.00], p = .04), less SWS (b = -0.38 [-0.66, -0.10], p = .008), and less REM sleep (b = -0.32 [-0.53, -0.10], p = .004) predicted higher next-day stress. Pre-bedtime stress did not predict same-night sleep. No significant results emerged at the between-person level. CONCLUSIONS These findings demonstrate that poor or short sleep, measured by EEG, is predictive of higher next-day stress. Results for sleep architecture support the role of SWS and REM sleep in regulating the perception of stress. Given that only within-person effects were significant, these findings highlight the importance of examining night-to-night fluctuations in sleep affecting next-day stress and its impact on daytime functioning.
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Affiliation(s)
- Yang Yap
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Natasha Yan Chi Tung
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Jorja Collins
- Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia
| | - Andrew Phillips
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Bei Bei
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| | - Joshua F Wiley
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
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18
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Glasgow TE, Adams EL, Ksinan A, Barsell DJ, Lunsford-Avery J, Chen S, Kollins S, Schechter JC, Maguire R, Engelhard M, Fuemmeler BF. Sleep onset, duration, or regularity: which matters most for child adiposity outcomes? Int J Obes (Lond) 2022; 46:1502-1509. [PMID: 35551259 DOI: 10.1038/s41366-022-01140-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Sleep measures, such as duration and onset timing, are associated with adiposity outcomes among children. Recent research among adults has considered variability in sleep and wake onset times, with the Sleep Regularity Index (SRI) as a comprehensive metric to measure shifts in sleep and wake onset times between days. However, little research has examined regularity and adiposity outcomes among children. This study examined the associations of three sleep measures (i.e., sleep duration, sleep onset time, and SRI) with three measures of adiposity (i.e., body mass index [BMI], waist circumference, and waist-to-height ratio [WHtR]) in a pediatric sample. SUBJECTS/METHODS Children (ages 4-13 years) who were part of the U.S. Newborn Epigenetic STudy (NEST) participated. Children (N = 144) wore an ActiGraph for 1 week. Sleep measures were estimated from actigraphy data. Weight, height, and waist circumference were measured by trained researchers. BMI and WHtR was calculated with the objectively measured waist and height values. Multiple linear regression models examined associations between child sleep and adiposity outcomes, controlling for race/ethnicity, child sex, age, mothers' BMI and sleep duration. RESULTS When considering sleep onset timing and duration, along with demographic covariates, sleep onset timing was not significantly associated with any of the three adiposity measures, but a longer duration was significantly associated with a lower BMI Z-score (β = -0.29, p < 0.001), waist circumference (β = -0.31, p < 0.001), and WHtR (β = -0.38, p < 0.001). When considering SRI and duration, duration remained significantly associated with the adiposity measures. The SRI and adiposity associations were in the expected direction, but were non-significant, except the SRI and WHtR association (β = -0.16, p = 0.077) was marginally non-significant. CONCLUSIONS Sleep duration was consistently associated with adiposity measures in children 4-13 years of age. Pediatric sleep interventions should focus first on elongating nighttime sleep duration, and examine if this improves child adiposity outcomes.
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Affiliation(s)
- Trevin E Glasgow
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Elizabeth L Adams
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Albert Ksinan
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - D Jeremy Barsell
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA
| | - Jessica Lunsford-Avery
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Shanshan Chen
- Department of Biostatistics, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Julia C Schechter
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Rachel Maguire
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, USA.,Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matthew Engelhard
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA
| | - Bernard F Fuemmeler
- Department of Health Behavior and Policy, Virginia Commonwealth University, Richmond, VA, USA.
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19
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Chao Y, Wang Y, Yang J, Guo K, Ma K, Ding P, Geng M, Tao F, Wu X. Associations of social jetlag and emotional and behavioral problems among Chinese preschoolers. Chronobiol Int 2022; 39:1110-1117. [PMID: 35491850 DOI: 10.1080/07420528.2022.2071157] [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] [Indexed: 11/03/2022]
Abstract
To describe the prevalence of social jetlag among preschoolers and explore its association with emotional and behavioral problems, we conducted a cross-sectional survey of healthy development among preschool children in 11 cities in October and November 2017. The study included 27 200 children aged 3-6 years and the questionnaires were completed exclusively by their parents or main caregivers. Social jetlag was calculated by difference of sleep midpoint between weekdays and weekends. Emotional and behavioral problems (emotional symptoms, conduct problems, hyperactivity, peer interaction, and prosocial behavior) among preschoolers were assessed by the Strengths and Difficulties Questionnaire (SDQ). The binary logistic regression model was used to examine the association between social jetlag and emotional/behavioral problems in preschool children. The social jetlag was 0.60 hours in boys and 0.64 hours in girls. After adjusting for confounding factors as children' s gender, age, only child, living area, family economic status, mother's age and education, father's education, screen time and full-day sleep time, we found that longer social jetlag (≥1 h/d) was positively associated with overall emotional and behavioral problems (OR = 1.20, 95%CI: 1.10-1.32; P < .001), emotional symptoms (OR = 1.23, 95% CI: 1.11-1.15, P < .001), hyperactivity (OR = 1.20, 95%CI: 1.11-1.30, P < .001) and conduct problems (OR = 1.18, 95%CI: 1.07-1.31, P < .01). We found that social jetlag is prevalent among Chinese preschool children and is positively associated with emotional and behavioral problems.
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Affiliation(s)
- Yuqing Chao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yu Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Juan Yang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Keke Guo
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Kai Ma
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Peng Ding
- MOE Key Laboratory of Population Health across Life Cycle, Hefei, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Menglong Geng
- MOE Key Laboratory of Population Health across Life Cycle, Hefei, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,MOE Key Laboratory of Population Health across Life Cycle, Hefei, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
| | - Xiaoyan Wu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China.,MOE Key Laboratory of Population Health across Life Cycle, Hefei, Anhui, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, Anhui, China.,Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui Medical University, Hefei, Anhui, China
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20
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Spitschan M, Santhi N, Ahluwalia A, Fischer D, Hunt L, Karp N, Lévi F, Pineda-Torra I, Vidafar P, White R. Science Forum: Sex differences and sex bias in human circadian and sleep physiology research. eLife 2022; 11:65419. [PMID: 35179486 PMCID: PMC8963875 DOI: 10.7554/elife.65419] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/18/2022] [Indexed: 11/13/2022] Open
Abstract
Growing evidence shows that sex differences impact many facets of human biology. Here we review and discuss the impact of sex on human circadian and sleep physiology, and we uncover a data gap in the field investigating the non-visual effects of light in humans. A virtual workshop on the biomedical implications of sex differences in sleep and circadian physiology then led to the following imperatives for future research: (1) design research to be inclusive and accessible, (2) implement recruitment strategies that lead to a sex-balanced sample, (3) use data visualization to grasp the effect of sex, (4) implement statistical analyses that include sex as a factor and/or perform group analyses by sex, where possible, (5) make participant-level data open and available to facilitate future meta-analytic efforts.
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Affiliation(s)
| | - Nayantara Santhi
- Department of Psychology, Northumbria University, Newcastle, United Kingdom
| | - Amrita Ahluwalia
- William Harvey Research Institute, Queen Mary University of London, London, United Kingdom
| | - Dorothee Fischer
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | | | - Natasha Karp
- Data Sciences and Quantitative Biology, AstraZeneca, Hinxton, United Kingdom
| | - Francis Lévi
- Warwick Medical School, University of Warwick, Warwick, United Kingdom
| | - Ines Pineda-Torra
- Centre for Cardiometabolic and Vascular Science, University College London, London, United Kingdom
| | - Parisa Vidafar
- Department of Psychiatry, University of Michigan, Ann Arbor, United States
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21
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Panchal P, de Queiroz Campos G, Goldman DA, Auerbach RP, Merikangas KR, Swartz HA, Sankar A, Blumberg HP. Toward a Digital Future in Bipolar Disorder Assessment: A Systematic Review of Disruptions in the Rest-Activity Cycle as Measured by Actigraphy. Front Psychiatry 2022; 13:780726. [PMID: 35677875 PMCID: PMC9167949 DOI: 10.3389/fpsyt.2022.780726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Disruptions in rest and activity patterns are core features of bipolar disorder (BD). However, previous methods have been limited in fully characterizing the patterns. There is still a need to capture dysfunction in daily activity as well as rest patterns in order to more holistically understand the nature of 24-h rhythms in BD. Recent developments in the standardization, processing, and analyses of wearable digital actigraphy devices are advancing longitudinal investigation of rest-activity patterns in real time. The current systematic review aimed to summarize the literature on actigraphy measures of rest-activity patterns in BD to inform the future use of this technology. METHODS A comprehensive systematic review using PRISMA guidelines was conducted through PubMed, MEDLINE, PsycINFO, and EMBASE databases, for papers published up to February 2021. Relevant articles utilizing actigraphy measures were extracted and summarized. These papers contributed to three research areas addressed, pertaining to the nature of rest-activity patterns in BD, and the effects of therapeutic interventions on these patterns. RESULTS Seventy articles were included. BD was associated with longer sleep onset latency and duration, particularly during depressive episodes and with predictive value for worsening of future manic symptoms. Lower overall daily activity was also associated with BD, especially during depressive episodes, while more variable activity patterns within a day were seen in mania. A small number of studies linked these disruptions with differential patterns of brain functioning and cognitive impairments, as well as more adverse outcomes including increased suicide risk. The stabilizing effect of therapeutic options, including pharmacotherapies and chronotherapies, on activity patterns was supported. CONCLUSION The use of actigraphy provides valuable information about rest-activity patterns in BD. Although results suggest that variability in rhythms over time may be a specific feature of BD, definitive conclusions are limited by the small number of studies assessing longitudinal changes over days. Thus, there is an urgent need to extend this work to examine patterns of rhythmicity and regularity in BD. Actigraphy research holds great promise to identify a much-needed specific phenotypic marker for BD that will aid in the development of improved detection, treatment, and prevention options.
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Affiliation(s)
- Priyanka Panchal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | | | - Danielle A Goldman
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Interdepartmental Neuroscience Program, Yale School of Medicine, New Haven, CT, United States
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, United States
| | - Kathleen R Merikangas
- Genetic Epidemiology Research Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, United States
| | - Holly A Swartz
- Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Anjali Sankar
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Neurobiology Research Unit, Rigshospitalet, Copenhagen, Denmark
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States.,Department of Radiology and Biomedical Imaging, and the Child Study Center, Yale School of Medicine, New Haven, CT, United States
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22
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Cable J, Schernhammer E, Hanlon EC, Vetter C, Cedernaes J, Makarem N, Dashti HS, Shechter A, Depner C, Ingiosi A, Blume C, Tan X, Gottlieb E, Benedict C, Van Cauter E, St-Onge MP. Sleep and circadian rhythms: pillars of health-a Keystone Symposia report. Ann N Y Acad Sci 2021; 1506:18-34. [PMID: 34341993 PMCID: PMC8688158 DOI: 10.1111/nyas.14661] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 06/21/2021] [Indexed: 12/24/2022]
Abstract
The human circadian system consists of the master clock in the suprachiasmatic nuclei of the hypothalamus as well as in peripheral molecular clocks located in organs throughout the body. This system plays a major role in the temporal organization of biological and physiological processes, such as body temperature, blood pressure, hormone secretion, gene expression, and immune functions, which all manifest consistent diurnal patterns. Many facets of modern life, such as work schedules, travel, and social activities, can lead to sleep/wake and eating schedules that are misaligned relative to the biological clock. This misalignment can disrupt and impair physiological and psychological parameters that may ultimately put people at higher risk for chronic diseases like cancer, cardiovascular disease, and other metabolic disorders. Understanding the mechanisms that regulate sleep circadian rhythms may ultimately lead to insights on behavioral interventions that can lower the risk of these diseases. On February 25, 2021, experts in sleep, circadian rhythms, and chronobiology met virtually for the Keystone eSymposium "Sleep & Circadian Rhythms: Pillars of Health" to discuss the latest research for understanding the bidirectional relationships between sleep, circadian rhythms, and health and disease.
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Affiliation(s)
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, and Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Erin C Hanlon
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Chicago, Chicago, Illinois
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado at Boulder, Boulder, Colorado
- Broad Institute of MIT and Harvard, Cambridge, Massachusetts
| | - Jonathan Cedernaes
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Nour Makarem
- Department of Epidemiology, Mailman School of Public Health, Columbia University Irving Medical Center, New York, New York
| | - Hassan S Dashti
- Department of Integrative Physiology, University of Colorado at Boulder, Boulder, Colorado
- Center for Genomic Medicine, Massachusetts General Hospital, and Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Ari Shechter
- Department of Medicine and Sleep Center of Excellence, Columbia University Irving Medical Center, New York, New York
| | - Christopher Depner
- Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah
| | - Ashley Ingiosi
- Department of Biomedical Sciences, Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington
| | - Christine Blume
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, and Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland
| | - Xiao Tan
- Department of Neuroscience (Sleep Science, BMC), Uppsala University, Uppsala, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Solna, Sweden
| | - Elie Gottlieb
- The Florey Institute of Neuroscience and Mental Health, and University of Melbourne, Melbourne, Victoria, Australia
| | - Christian Benedict
- Department of Neuroscience (Sleep Science, BMC), Uppsala University, Uppsala, Sweden
| | - Eve Van Cauter
- Department of Medicine, Section of Endocrinology, Diabetes and Metabolism, University of Chicago, Chicago, Illinois
| | - Marie-Pierre St-Onge
- Sleep Center of Excellence, Columbia University Irving Medical Center, New York, New York
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23
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O'Loughlin J, Casanova F, Jones SE, Hagenaars SP, Beaumont RN, Freathy RM, Watkins ER, Vetter C, Rutter MK, Cain SW, Phillips AJK, Windred DP, Wood AR, Weedon MN, Tyrrell J. Using Mendelian Randomisation methods to understand whether diurnal preference is causally related to mental health. Mol Psychiatry 2021; 26:6305-6316. [PMID: 34099873 PMCID: PMC8760058 DOI: 10.1038/s41380-021-01157-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 04/29/2021] [Accepted: 05/05/2021] [Indexed: 12/13/2022]
Abstract
Late diurnal preference has been linked to poorer mental health outcomes, but the understanding of the causal role of diurnal preference on mental health and wellbeing is currently limited. Late diurnal preference is often associated with circadian misalignment (a mismatch between the timing of the endogenous circadian system and behavioural rhythms), so that evening people live more frequently against their internal clock. This study aims to quantify the causal contribution of diurnal preference on mental health outcomes, including anxiety, depression and general wellbeing and test the hypothesis that more misaligned individuals have poorer mental health and wellbeing using an actigraphy-based measure of circadian misalignment. Multiple Mendelian Randomisation (MR) approaches were used to test causal pathways between diurnal preference and seven well-validated mental health and wellbeing outcomes in up to 451,025 individuals. In addition, observational analyses tested the association between a novel, objective measure of behavioural misalignment (Composite Phase Deviation, CPD) and seven mental health and wellbeing outcomes. Using genetic instruments identified in the largest GWAS for diurnal preference, we provide robust evidence that early diurnal preference is protective for depression and improves wellbeing. For example, using one-sample MR, a twofold higher genetic liability of morningness was associated with lower odds of depressive symptoms (OR: 0.92, 95% CI: 0.88, 0.97). It is possible that behavioural factors including circadian misalignment may contribute in the chronotype depression relationship, but further work is needed to confirm these findings.
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Affiliation(s)
- Jessica O'Loughlin
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Francesco Casanova
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Samuel E Jones
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Saskia P Hagenaars
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robin N Beaumont
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Rachel M Freathy
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Edward R Watkins
- Psychology, Mood Disorders Centre, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Céline Vetter
- Circadian and Sleep Epidemiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Martin K Rutter
- Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Manchester Diabetes Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Sean W Cain
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Andrew J K Phillips
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Daniel P Windred
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Andrew R Wood
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Michael N Weedon
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK
| | - Jessica Tyrrell
- Genetics of Complex Traits, The College of Medicine and Health, University of Exeter, The RILD Building, RD&E Hospital, Exeter, UK.
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24
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Marqueze EC, Nogueira LFR, Vetter C, Skene DJ, Cipolla-Neto J, Moreno CRC. Exogenous melatonin decreases circadian misalignment and body weight among early types. J Pineal Res 2021; 71:e12750. [PMID: 34091954 DOI: 10.1111/jpi.12750] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/11/2021] [Accepted: 06/03/2021] [Indexed: 02/06/2023]
Abstract
Shift workers experience chronic circadian misalignment, which can manifest itself in reduced melatonin production, and has been associated with metabolic disorders. In addition, chronotype modulates the effect of night shift work, with early types presenting greater circadian misalignment when working night shift as compared to late types. Melatonin supplementation has shown positive results reducing weight gain in animal models, but the effect of exogenous melatonin in humans on body weight in the context of shift work remains inconsistent. The aim of this study was thus to evaluate the effects of exogenous melatonin on circadian misalignment and body weight among overweight night shift workers, according to chronotype, under real-life conditions. We conducted a double-blind, randomized, placebo-controlled, crossover trial where melatonin (3 mg) or placebo was administered on non-night shift nights for 12 weeks in 27 female nurses (37.1 yo, ±5.9 yo; BMI 29.9 kg/m2 , ±3.3 kg/m2 ). Melatonin (or placebo) was only taken on nights when the participants did not work night shifts, that is, on nights when they slept (between night shifts and on days off). Composite Phase Deviations (CPD) of actigraphy-based mid-sleep timing were calculated to measure circadian misalignment. The analyses were performed for the whole group and by chronotype. We found approximately 20% reduction in circadian misalignment after exogenous melatonin administration considering all chronotypes. Moreover, melatonin supplementation in those who presented high circadian misalignment, as observed in early chronotypes, reduced body weight, BMI, waist circumference, and hip circumference, without any change in the participants' calorie intake or physical activity levels.
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Affiliation(s)
- Elaine C Marqueze
- Department of Epidemiology, Public Health Graduate Program, Catholic University of Santos, São Paulo, Brazil
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Luciana F R Nogueira
- Department of Epidemiology, Public Health Graduate Program, Catholic University of Santos, São Paulo, Brazil
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Debra J Skene
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - José Cipolla-Neto
- Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
- College of Health Sciences, Abu Dhabi University, Abu Dhabi, United Arab Emirates
| | - Claudia R C Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, São Paulo, Brazil
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
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25
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Von Behren J, Hurley S, Goldberg D, Clague DeHart J, Wang S, Reynolds P. Chronotype and risk of post-menopausal endometrial cancer in the California Teachers Study. Chronobiol Int 2021; 38:1151-1161. [PMID: 33902365 PMCID: PMC9172273 DOI: 10.1080/07420528.2021.1912073] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/09/2021] [Accepted: 03/27/2021] [Indexed: 12/12/2022]
Abstract
Working at night causes circadian disruption and it has been classified as a probable carcinogen. An evening chronotype, or preference for late day activity, has been shown to increase risk for several adverse health effects, such as metabolic disorders and recently, breast cancer. To further explore this emerging area of interest, we examined the association between endometrial cancer (EC) risk, another common cancer in women, and chronotype. The women in this study were members of the California Teachers Study cohort, which was established in 1995. Chronotype was reported on a subsequent questionnaire (Q5), administered in 2012-2013. The women included in this analysis were under age 90 years, were post-menopausal at Q5, and had no hysterectomy. The cancer cases, identified through linkages to the California Cancer Registry, were diagnosed between 1996 and 2014. We used unconditional logistic regression models to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) of the associations between chronotype and EC diagnosis. There were 437 EC cases and 26,753 cancer-free controls included in this analysis. Controls were more likely to classify themselves as current morning chronotypes than were cases (39% and 34%, respectively). Compared to morning types, women who were definite evening types had a statistically significantly elevated OR of 1.44 (95% CI 1.09-1.91). This association was more pronounced among obese women as compared to non-obese women. For evening type compared to morning type, the OR among obese women was 2.01 (95% CI 1.23, 3.29) while the OR for non-obese women was 1.12 (95% CI 0.77, 1.63). To our knowledge, the association between EC risk and evening chronotype has not been previously reported, but is consistent with the small body of literature which suggests increased breast cancer risks among evening chronotypes. Because this study was based on a retrospective analysis in a cohort of mostly white female teachers in California, further analysis of chronotype as a potential EC risk factor should be considered in other cohorts and in prospective analyses in order to further explore this relationship.
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Affiliation(s)
- J Von Behren
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - S Hurley
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - D Goldberg
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - J Clague DeHart
- School of Community and Global Health, Claremont Graduate University, Claremont, CA, USA
| | - S Wang
- Division of Health Analytics, Department of Computational and Quantitative Medicine, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA, USA
| | - P Reynolds
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
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26
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Abstract
The study aimed to explore chronotype-specific effects of two versus four consecutive morning or night shifts on sleep-wake behavior. Sleep debt and social jetlag (a behavioral proxy of circadian misalignment) were estimated from sleep diary data collected for 5 weeks in a within-subject field study of 30 rotating night shift workers (29.9 ± 7.3 years, 60% female). Mixed models were used to examine whether effects of shift sequence length on sleep are dependent on chronotype, testing the interaction between sequence length (two vs. four) and chronotype (determined from sleep diaries). Analyses of two versus four morning shifts showed no significant interaction effects with chronotype. In contrast, increasing the number of night shifts from two to four increased sleep debt in early chronotypes, but decreased sleep debt in late types, with no change in intermediate ones. In early types, the higher sleep debt was due to accumulated sleep loss over four night shifts. In late types, sleep duration did not increase over the course of four night shifts, so that adaptation is unlikely to explain the observed lower sleep debt. Late types instead had increased sleep debt after two night shifts, which was carried over from two preceding morning shifts in this schedule. Including naps did not change the findings. Social jetlag was unaffected by the number of consecutive night shifts. Our results suggest that consecutive night shifts should be limited in early types. For other chronotypes, working four night shifts might be a beneficial alternative to working two morning and two night shifts. Studies should record shift sequences in rotating schedules.
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Affiliation(s)
- Dorothee Fischer
- Department of Sleep and Human Factors, Institute for Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Till Roenneberg
- Institute of Medical Psychology, Ludwig Maximilian University of Munich, Munich, Germany
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
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27
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Fischer D, Klerman EB, Phillips AJK. Measuring sleep regularity: Theoretical properties and practical usage of existing metrics. Sleep 2021; 44:6232042. [PMID: 33864369 PMCID: PMC8503839 DOI: 10.1093/sleep/zsab103] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 02/18/2021] [Indexed: 01/06/2023] Open
Abstract
STUDY OBJECTIVES Sleep regularity predicts many health-related outcomes. Currently, however, there is no systematic approach to measuring sleep regularity. Traditionally, metrics have assessed deviations in sleep patterns from an individual's average. Traditional metrics include intra-individual standard deviation (StDev), Interdaily Stability (IS), and Social Jet Lag (SJL). Two metrics were recently proposed that instead measure variability between consecutive days: Composite Phase Deviation (CPD) and Sleep Regularity Index (SRI). Using large-scale simulations, we investigated the theoretical properties of these five metrics. METHODS Multiple sleep-wake patterns were systematically simulated, including variability in daily sleep timing and/or duration. Average estimates and 95% confidence intervals were calculated for six scenarios that affect measurement of sleep regularity: 'scrambling' the order of days; daily vs. weekly variation; naps; awakenings; 'all-nighters'; and length of study. RESULTS SJL measured weekly but not daily changes. Scrambling did not affect StDev or IS, but did affect CPD and SRI; these metrics, therefore, measure sleep regularity on multi-day and day-to-day timescales, respectively. StDev and CPD did not capture sleep fragmentation. IS and SRI behaved similarly in response to naps and awakenings but differed markedly for all-nighters. StDev and IS required over a week of sleep-wake data for unbiased estimates, whereas CPD and SRI required larger sample sizes to detect group differences. CONCLUSIONS Deciding which sleep regularity metric is most appropriate for a given study depends on a combination of the type of data gathered, the study length and sample size, and which aspects of sleep regularity are most pertinent to the research question.
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Affiliation(s)
- Dorothee Fischer
- Sleep and Human Factors Research, Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany.,Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Andrew J K Phillips
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
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28
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Goto Y, Fujiwara K, Sumi Y, Matsuo M, Kano M, Kadotani H. Work Habit-Related Sleep Debt; Insights From Factor Identification Analysis of Actigraphy Data. Front Public Health 2021; 9:630640. [PMID: 33777884 PMCID: PMC7987935 DOI: 10.3389/fpubh.2021.630640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/12/2021] [Indexed: 11/25/2022] Open
Abstract
The present study investigates the factors of “Weekday sleep debt (WSD)” by comparing activity data collected from persons with and without WSD. Since it has been reported that the amount of sleep debt as well the difference between the social clock and the biological clock is associated with WSD, specifying the factors of WSD other than chronotype may contribute to sleep debt prevention. We recruited 324 healthy male employees working at the same company and collected their 1-week wrist actigraphy data and answers to questionnaires. Because 106 participants were excluded due to measurement failure of the actigraphy data, the remaining 218 participants were included in the analysis. All participants were classified into WSD or non-WSD groups, in which persons had WDS if the difference between their weekend sleep duration and the mean weekday sleep duration was more than 120 min. We evaluated multiple measurements derived from the collected actigraphy data and trained a classifier that predicts the presence of WSD using these measurements. A support vector machine (SVM) was adopted as the classifier. In addition, to evaluate the contribution of each indicator to WSD, permutation feature importance was calculated based on the trained classifier. Our analysis results showed significant importance of the following three out of the tested 32 factors: (1) WSD was significantly related to persons with evening tendency. (2) Daily activity rhythms and sleep were less stable in the WSD group than in the non-WSD group. (3) A specific day of the week had the highest importance in our data, suggesting that work habit contributes to WSD. These findings indicate some WSD factors: evening chronotype, instability of the daily activity rhythm, and differences in work habits on the specific day of the week. Thus, it is necessary to evaluate the rhythms of diurnal activities as well as sleep conditions to identify the WSD factors. In particular, the diurnal activity rhythm influences WSD. It is suggested that proper management of activity rhythm may contribute to the prevention of sleep debt.
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Affiliation(s)
- Yuki Goto
- Department of Systems Science, Kyoto University, Kyoto, Japan
| | - Koichi Fujiwara
- Department of Material Process Engineering, Nagoya University, Nagoya, Japan
| | - Yukiyoshi Sumi
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Masahiro Matsuo
- Department of Psychiatry, Shiga University of Medical Science, Otsu, Japan
| | - Manabu Kano
- Department of Systems Science, Kyoto University, Kyoto, Japan
| | - Hiroshi Kadotani
- Department of Sleep and Behavioural Sciences, Shiga University of Medical Science, Otsu, Japan
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Vetter C, Winnebeck EC, Roenneberg T. Asking the Clock: How to Use Information from Questionnaires for Circadian Phenotyping. Methods Mol Biol 2021; 2130:79-85. [PMID: 33284437 DOI: 10.1007/978-1-0716-0381-9_6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
With the emergence of big data science, the question how we can easily collect meaningful information about circadian clock phenotypes in large human cohorts imposes itself. Here, we describe potentials and limitations of using questionnaires, specifically the Munich ChronoType Questionnaire (MCTQ), to characterize such circadian phenotypes. We also discuss scenarios when alternative methods might be more appropriate.
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Affiliation(s)
- Céline Vetter
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Eva C Winnebeck
- Institute of Medical Psychology, Ludwig-Maximilian-University, Munich, Germany
| | - Till Roenneberg
- Institute of Medical Psychology, Ludwig-Maximilian-University, Munich, Germany.
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McHill AW, Hilditch CJ, Fischer D, Czeisler CA, Garaulet M, Scheer FAJL, Klerman EB. Stability of the timing of food intake at daily and monthly timescales in young adults. Sci Rep 2020; 10:20849. [PMID: 33257712 PMCID: PMC7705740 DOI: 10.1038/s41598-020-77851-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 11/17/2020] [Indexed: 12/19/2022] Open
Abstract
Cross-sectional observations have shown that the timing of eating may be important for health-related outcomes. Here we examined the stability of eating timing, using both clock hour and relative circadian time, across one semester (n = 14) at daily and monthly time-scales. At three time points ~ 1 month apart, circadian phase was determined during an overnight in-laboratory visit and eating was photographically recorded for one week to assess timing and composition. Day-to-day stability was measured using the Composite Phase Deviation (deviation from a perfectly regular pattern) and intraclass correlation coefficients (ICC) were used to determine individual stability across months (weekly average compared across months). Day-to-day clock timing of caloric events had poor stability within individuals (~ 3-h variation; ICC = 0.12-0.34). The timing of eating was stable across months (~ 1-h variation, ICCs ranging from 0.54-0.63), but less stable across months when measured relative to circadian timing (ICC = 0.33-0.41). Our findings suggest that though day-to-day variability in the timing of eating has poor stability, the timing of eating measured for a week is stable across months within individuals. This indicates two relevant timescales: a monthly timescale with more stability in eating timing than a daily timescale. Thus, a single day's food documentation may not represent habitual (longer timescale) patterns.
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Affiliation(s)
- Andrew W McHill
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA.
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA.
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA.
| | - Cassie J Hilditch
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
- Fatigue Countermeasures Laboratory, Department of Psychology, San José State University, San José, CA, 95192, USA
| | - Dorothee Fischer
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
- Department of Sleep and Human Factors Research, Institute for Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Marta Garaulet
- Department of Physiology, University of Murcia, 30100, Murcia, Spain
| | - Frank A J L Scheer
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Ave, Boston, MA, 02115, USA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, 221 Longwood Ave, Boston, MA, 02115, USA
- Department of Neurology, Massachusetts General Hospital, 100 Cambridge St, 20th Floor, Boston, MA, 02114, USA
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Imam A, Winnebeck EC, Buchholz N, Froguel P, Bonnefond A, Solimena M, Ivanova A, Bouvier M, Plouffe B, Charpentier G, Karamitri A, Jockers R, Roenneberg T, Vetter C. Circadian, Sleep and Caloric Intake Phenotyping in Type 2 Diabetes Patients With Rare Melatonin Receptor 2 Mutations and Controls: A Pilot Study. Front Physiol 2020; 11:564140. [PMID: 33162895 PMCID: PMC7583701 DOI: 10.3389/fphys.2020.564140] [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] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 09/07/2020] [Indexed: 01/27/2023] Open
Abstract
Background Melatonin modulates circadian rhythms in physiology and sleep initiation. Genetic variants of the MTNR1B locus, encoding the melatonin MT2 receptor, have been associated with increased type 2 diabetes (T2D) risk. Carriers of the common intronic MTNR1B rs10830963 T2D risk variant have modified sleep and circadian traits such as changes of the melatonin profile. However, it is currently unknown whether rare variants in the MT2 coding region are also associated with altered sleep and circadian phenotypes, including meal timing. Materials and Methods In this pilot study, 28 individuals [50% male; 46–82 years old; 50% with rare MT2 mutations (T2D MT2)] wore actigraphy devices and filled out daily food logs for 4 weeks. We computed circadian, sleep, and caloric intake phenotypes, including sleep duration, timing, and regularity [assessed by the Sleep Regularity Index (SRI)]; composite phase deviations (CPD) as well a sleep timing-based proxy for circadian misalignment; and caloric intake patterns throughout the day. Using regression analyses, we estimated age- and sex-adjusted mean differences (MD) and 95% confidence intervals (95%CI) between the two patient groups. Secondary analyses also compare T2D MT2 to 15 healthy controls. Results Patients with rare MT2 mutations had a later sleep onset (MD = 1.23, 95%CI = 0.42;2.04), and midsleep time (MD = 0.91, 95%CI = 0.12;1.70), slept more irregularly (MD in SRI = −8.98, 95%CI = −16.36;−1.60), had higher levels of behavioral circadian misalignment (MD in CPD = 1.21, 95%CI = 0.51;1.92), were more variable in regard to duration between first caloric intake and average sleep offset (MD = 1.08, 95%CI = 0.07;2.08), and had more caloric episodes in a 24 h day (MD = 1.08, 95%CI = 0.26;1.90), in comparison to T2D controls. Secondary analyses showed similar patterns between T2D MT2 and non-diabetic controls. Conclusion This pilot study suggests that compared to diabetic controls, T2D MT2 patients display a number of adverse sleep, circadian, and caloric intake phenotypes, including more irregular behavioral timing. A prospective study is needed to determine the role of these behavioral phenotypes in T2D onset and severity, especially in view of rare MT2 mutations.
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Affiliation(s)
- Akram Imam
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States
| | - Eva C Winnebeck
- Institute of Medical Psychology, Ludwig Maximilian University, Munich, Germany
| | - Nina Buchholz
- Institute of Medical Psychology, Ludwig Maximilian University, Munich, Germany
| | - Philippe Froguel
- Inserm UMR1283, CNRS UMR8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille University Hospital, Lille, France.,Department of Metabolism, Imperial College London, London, United Kingdom
| | - Amélie Bonnefond
- Inserm UMR1283, CNRS UMR8199, European Genomic Institute for Diabetes (EGID), Institut Pasteur de Lille, University of Lille, Lille University Hospital, Lille, France.,Department of Metabolism, Imperial College London, London, United Kingdom
| | - Michele Solimena
- Paul Langerhans Institute Dresden of the Helmholtz Center Munich at the Technische Universität Dresden, Dresden, Germany
| | - Anna Ivanova
- Paul Langerhans Institute Dresden of the Helmholtz Center Munich at the Technische Universität Dresden, Dresden, Germany
| | - Michel Bouvier
- Department of Biochemistry and Molecular Medicine, Institute for Research in Immunology and Cancer, Université de Montréal, Montréal, QC, Canada
| | - Bianca Plouffe
- Department of Biochemistry and Molecular Medicine, Institute for Research in Immunology and Cancer, Université de Montréal, Montréal, QC, Canada.,School of Medicine, Dentistry and Biomedical Sciences, Wellcome-Wolfson Institute for Experimental Medicine, Queen's University Belfast, Belfast, United Kingdom
| | - Guillaume Charpentier
- Centre d'Études et de Recherches pour l'Intensification du Traitement du Diabète (CERITD), Sud-Francilien Hospital, Corbeil-Essonnes, France
| | | | - Ralf Jockers
- Université de Paris, Institut Cochin, INSERM, CNRS, Paris, France
| | - Till Roenneberg
- Institute of Medical Psychology, Ludwig Maximilian University, Munich, Germany
| | - Céline Vetter
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States.,Institute of Medical Psychology, Ludwig Maximilian University, Munich, Germany
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32
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Fischer D, McHill AW, Sano A, Picard RW, Barger LK, Czeisler CA, Klerman EB, Phillips AJK. Irregular sleep and event schedules are associated with poorer self-reported well-being in US college students. Sleep 2020; 43:zsz300. [PMID: 31837266 PMCID: PMC7294408 DOI: 10.1093/sleep/zsz300] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 11/11/2019] [Indexed: 12/24/2022] Open
Abstract
STUDY OBJECTIVES Sleep regularity, in addition to duration and timing, is predictive of daily variations in well-being. One possible contributor to changes in these sleep dimensions are early morning scheduled events. We applied a composite metric-the Composite Phase Deviation (CPD)-to assess mistiming and irregularity of both sleep and event schedules to examine their relationship with self-reported well-being in US college students. METHODS Daily well-being, actigraphy, and timing of sleep and first scheduled events (academic/exercise/other) were collected for approximately 30 days from 223 US college students (37% females) between 2013 and 2016. Participants rated well-being daily upon awakening on five scales: Sleepy-Alert, Sad-Happy, Sluggish-Energetic, Sick-Healthy, and Stressed-Calm. A longitudinal growth model with time-varying covariates was used to assess relationships between sleep variables (i.e. CPDSleep, sleep duration, and midsleep time) and daily and average well-being. Cluster analysis was used to examine relationships between CPD for sleep vs. event schedules. RESULTS CPD for sleep was a significant predictor of average well-being (e.g. Stressed-Calm: b = -6.3, p < 0.01), whereas sleep duration was a significant predictor of daily well-being (Stressed-Calm, b = 1.0, p < 0.001). Although cluster analysis revealed no systematic relationship between CPD for sleep vs. event schedules (i.e. more mistimed/irregular events were not associated with more mistimed/irregular sleep), they interacted upon well-being: the poorest well-being was reported by students for whom both sleep and event schedules were mistimed and irregular. CONCLUSIONS Sleep regularity and duration may be risk factors for lower well-being in college students. Stabilizing sleep and/or event schedules may help improve well-being. CLINICAL TRIAL REGISTRATION NCT02846077.
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Affiliation(s)
- Dorothee Fischer
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Andrew W McHill
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, OR
| | - Akane Sano
- Department of Electrical and Computer Engineering, Rice University, Houston, TX
| | - Rosalind W Picard
- Media Lab, Affective Computing Group, Massachusetts Institute of Technology, Cambridge, MA
| | - Laura K Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA
- Department of Neurology, Massachusetts General Hospital, Boston, MA
| | - Andrew J K Phillips
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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Devine JK, Choynowski J, Burke T, Carlsson K, Capaldi VF, McKeon AB, Sowden WJ. Practice parameters for the use of actigraphy in the military operational context: the Walter Reed Army Institute of Research Operational Research Kit-Actigraphy (WORK-A). Mil Med Res 2020; 7:31. [PMID: 32580783 PMCID: PMC7315473 DOI: 10.1186/s40779-020-00255-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 05/12/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The Walter Reed Army Institute of Research (WRAIR) Operational Research Kit-Actigraphy (WORK-A) is a set of unique practice parameters and actigraphy-derived measures for the analysis of operational military sleep patterns. The WORK-A draws on best practices from the literature and comprises 15 additional descriptive variables. Here, we demonstrate the WORK-A with a sample of United States Army Reserve Officers' Training Corps (ROTC) cadets (n = 286) during a month-long capstone pre-commissioning training exercise. METHODS The sleep of ROTC cadets (n = 286) was measured by Philips Actiwatch devices during the 31-day training exercise. The preliminary effectiveness of the WORK-A was tested by comparing differences in sleep measures collected by Actiwatches as calculated by Philips Actiware software against WORK-A-determined sleep measures and self-report sleep collected from a subset of ROTC cadets (n = 140). RESULTS Actiware sleep summary statistics were significantly different from WORK-A measures and self-report sleep (all P ≤ 0.001). Bedtimes and waketimes as determined by WORK-A major sleep intervals showed the best agreement with self-report bedtime (22:21 ± 1:30 vs. 22:13 ± 0:40, P = 0.21) and waketime (04:30 ± 2:17 vs. 04:31 ± 0:47, P = 0.68). Though still significantly different, the discrepancy was smaller between the WORK-A measure of time in bed (TIB) for major sleep intervals (352 ± 29 min) and self-report nightly sleep duration (337 ± 57 min, P = 0.006) than that between the WORK-A major TIB and Actiware TIB (177 ± 42, P ≤ 0.001). CONCLUSIONS Default actigraphy methods are not the most accurate methods for characterizing soldier sleep, but reliable methods for characterizing operational sleep patterns is a necessary first step in developing strategies to improve soldier readiness. The WORK-A addresses this knowledge gap by providing practice parameters and a robust variety of measures with which to profile sleep behavior in service members.
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Affiliation(s)
- Jaime K Devine
- Operational Fatigue and Performance, Institutes for Behavior Resources, Baltimore, MD, 21218, USA
| | - Jake Choynowski
- Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 20910, USA
| | - Tina Burke
- Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 20910, USA
| | - Kajsa Carlsson
- Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 20910, USA
| | - Vincent F Capaldi
- Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 20910, USA
| | - Ashlee B McKeon
- Behavioral Biology Branch, Walter Reed Army Institute of Research, 503 Robert Grant Ave, Silver Spring, MD, 20910, USA.
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Diez JJ, Plano SA, Caldart C, Bellone G, Simonelli G, Brangold M, Cardinali DP, Golombek D, Pérez Chada D, Vigo DE. Sleep misalignment and circadian rhythm impairment in long-haul bus drivers under a two-up operations system. Sleep Health 2020; 6:374-386. [PMID: 32081596 DOI: 10.1016/j.sleh.2019.12.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 12/18/2019] [Accepted: 12/31/2019] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The objective of the study was to describe working and sleep conditions and to assess how sleep opportunities are associated with obtained sleep and alertness, in a sample of long-haul bus drivers working with a two-up operations system. METHODS Measures of subjective sleep and sleepiness, actigraphy, circadian temperature rhythm, and psychomotor vigilance tasks were obtained from a sample of 122 drivers from Argentina. Variables were compared between high and low fatigue risk groups, which were formed using a median split of a fatigue risk score. The score was calculated based on drivers' total working hours, maximum shift duration, minimum short break duration, maximum night work per seven days, and long break frequencies. RESULTS Considering a standardized one-day period, sleep in the bus accounted for 1.9±0.1 h of total sleep (57±1% efficiency), sleep at destination for 1.6±0.2 h of total sleep (90±1% efficiency), and sleep at home for 3.8±0.2 h of total sleep (89±1% nap efficiency and 90±1% anchor sleep efficiency). In drivers exposed to high-risk working schedules, the circadian temperature rhythm was weaker (lower % of variance explained by the model) (22.0±1.7% vs. 27.6±2.0%, p <0.05) and without a significant acrophase. CONCLUSIONS Drivers obtained a total amount of weekly sleep similar to the recommended levels for adults, but distributed at different locations and at different times during the day. High-risk working schedules were associated with disruption of circadian temperature rhythms. These results point out to the need of the implementation of shift-work scheduling strategies to minimize sleep misalignment and circadian desynchronization in long-haul bus drivers.
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Affiliation(s)
- Joaquín J Diez
- Laboratory of Chronophysiology, Institute for Biomedical Research (BIOMED), Pontifical Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), CABA, Argentina
| | - Santiago A Plano
- Laboratory of Chronophysiology, Institute for Biomedical Research (BIOMED), Pontifical Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), CABA, Argentina; Laboratory of Chronobiology, National University of Quilmes (UNQ), Bernal, Argentina
| | - Carlos Caldart
- Department of Biology, University of Washington, Seattle, USA
| | - Giannina Bellone
- Laboratory of Chronobiology, National University of Quilmes (UNQ), Bernal, Argentina; National Scientific and Technical Research Council (CONICET), CABA, Argentina
| | - Guido Simonelli
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, USA
| | - Mauro Brangold
- El Cruce High Complexity Network Hospital, Florencio Varela, Argentina
| | - Daniel P Cardinali
- Laboratory of Chronophysiology, Institute for Biomedical Research (BIOMED), Pontifical Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), CABA, Argentina
| | - Diego Golombek
- Laboratory of Chronobiology, National University of Quilmes (UNQ), Bernal, Argentina; National Scientific and Technical Research Council (CONICET), CABA, Argentina
| | - Daniel Pérez Chada
- Pulmonary and Sleep Clinic, Department of Medicine, Austral University, Pilar, Argentina
| | - Daniel E Vigo
- Laboratory of Chronophysiology, Institute for Biomedical Research (BIOMED), Pontifical Catholic University of Argentina (UCA) and National Scientific and Technical Research Council (CONICET), CABA, Argentina; Faculty of Psychology and Educational Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
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Vetter C. Circadian disruption: What do we actually mean? Eur J Neurosci 2020; 51:531-550. [PMID: 30402904 PMCID: PMC6504624 DOI: 10.1111/ejn.14255] [Citation(s) in RCA: 135] [Impact Index Per Article: 33.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 10/23/2018] [Accepted: 10/23/2018] [Indexed: 12/14/2022]
Abstract
The circadian system regulates physiology and behavior. Acute challenges to the system, such as those experienced when traveling across time zones, will eventually result in re-synchronization to local environmental time cues, but this re-synchronization is oftentimes accompanied by adverse short-term consequences. When such challenges are experienced chronically, adaptation may not be achieved, as for example in the case of rotating night shift workers. The transient and chronic disturbance of the circadian system is most frequently referred to as "circadian disruption", but many other terms have been proposed and used to refer to similar situations. It is now beyond doubt that the circadian system contributes to health and disease, emphasizing the need for clear terminology when describing challenges to the circadian system and their consequences. The goal of this review is to provide an overview of the terms used to describe disruption of the circadian system, discuss proposed quantifications of disruption in experimental and observational settings with a focus on human research, and highlight limitations and challenges of currently available tools. For circadian research to advance as a translational science, clear, operationalizable, and scalable quantifications of circadian disruption are key, as they will enable improved assessment and reproducibility of results, ideally ranging from mechanistic settings, including animal research, to large-scale randomized clinical trials.
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Affiliation(s)
- Céline Vetter
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
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36
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Harrison EM, Walbeek TJ, Maggio DG, Herring AA, Gorman MR. Circadian Profile of an Emergency Medicine Department: Scheduling Practices and Their Effects on Sleep and Performance. J Emerg Med 2020; 58:130-140. [PMID: 31761463 DOI: 10.1016/j.jemermed.2019.10.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 09/23/2019] [Accepted: 10/13/2019] [Indexed: 12/31/2022]
Abstract
BACKGROUND Shiftwork causes circadian disruption and is the primary reason for attrition from Emergency Medicine. OBJECTIVES We aimed to develop concrete recommendations to mitigate negative effects of shiftwork based on measures of work, sleep, alertness, and performance in emergency physicians. METHODS Thirty-one Emergency Medicine residents were surveyed retrospectively about sleep and alertness on different shifts. Additionally, the sleep, performance, and alertness of 22 Emergency Medicine resident and attending physicians was tracked continuously over 4 weeks via sleep logs, actigraphy, real-time reported sleepiness, and performance on a vigilance task. Schedules were analyzed for circadian disruption. Physicians also predicted their sleep schedules, which were compared with actual schedules; participants tracked extensions of shifts, schedule changes, and shifts in other hospitals. RESULTS Daily rhythms were apparent in real-time performance and alertness data, with peaks at around 4 pm. Sleep difficulty was highest, sleep shortest, and alertness and performance lowest for night shifts. Emergency Medicine residents tended to cluster multiple night shifts in a row, despite evidence of accumulating sleep debt over consecutive shifts. There were many shifts that caused high circadian disruption, which could be avoided by simple amendments to scheduling practices. CONCLUSIONS Circadian principles should be applied as suggested by the American College of Emergency Physicians. Chronotype should be considered in scheduling. Night shifts, particularly, should not be extended. Clustering all night shifts in a row should probably be discouraged. The additional vulnerabilities for night shift could be mitigated by adopting napping mid- or post night shift and by providing pay differentials.
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Affiliation(s)
- Elizabeth M Harrison
- Center for Circadian Biology, University of California San Diego, La Jolla, California
| | - Thijs J Walbeek
- Center for Circadian Biology, University of California San Diego, La Jolla, California; Department of Psychology, University of California San Diego, La Jolla, California
| | - Dominick G Maggio
- Department of Emergency Medicine, Alameda Health System-Highland Hospital, Oakland, California
| | - Andrew A Herring
- Department of Emergency Medicine, Alameda Health System-Highland Hospital, Oakland, California; Department of Emergency Medicine, University of California San Francisco, San Francisco, California
| | - Michael R Gorman
- Center for Circadian Biology, University of California San Diego, La Jolla, California; Department of Psychology, University of California San Diego, La Jolla, California
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Didikoglu A, Maharani A, Payton A, Pendleton N, Canal MM. Longitudinal change of sleep timing: association between chronotype and longevity in older adults. Chronobiol Int 2019; 36:1285-1300. [PMID: 31328571 DOI: 10.1080/07420528.2019.1641111] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Evening-oriented sleep timing preferences have been associated with risk of diabetes, cardiovascular diseases, obesity, psychiatric disorders, and increased mortality. This research aims to explore the relationship between diurnal preferences (chronotype), daily habits, metabolic health, and mortality, using longitudinal data from The University of Manchester Longitudinal Study of Cognition in Normal Healthy Old Age (6375 participants at inception, recruited in the North of England) with a long follow-up period (up to 35.5 years). Mixed models were used to investigate the influence of aging, socio-demographic, and seasonal factors on sleep timing. Results show that sleep timing shifted towards earlier time with aging. Test seasons influence chronotype of older adults but working schedules challenge seasonality of sleep timing. Moreover, the season of birth may set chronotype in adulthood. Individual chronotype trajectories were clustered using latent class analysis and analyzed against metabolic health and mortality. We observed a higher risk of hypertension in the evening-type cluster compared to morning-type individuals (Odds ratio = 1.88, 95%CI = 1.02/3.47, p = .04). Evening-type cluster was also associated with traits related to lower health such as reduced sport participation, increased risk of depression and psychoticism personality, late eating, and increased smoking and alcohol usage. Finally, Cox regression of proportional hazards was used to study the effects of chronotype on longevity after adjusting for sleep duration, age, gender, smoking, alcohol usage, general health, and social class. The survival analysis (82.6% censored by death) revealed that evening-type chronotype increased the likelihood of mortality (Hazard ratio = 1.15, 95%CI = 1.04/1.26, p = .005). Taken together, chronotype is influenced by aging and seasonal effects. Evening-type preference may have detrimental outcomes for human well-being and longevity.
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Affiliation(s)
- Altug Didikoglu
- a Division of Neuroscience & Experimental Psychology, School of Biological Sciences, The University of Manchester , Manchester , UK
| | - Asri Maharani
- a Division of Neuroscience & Experimental Psychology, School of Biological Sciences, The University of Manchester , Manchester , UK
| | - Antony Payton
- b Division of Informatics, Imaging & Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester , Manchester , UK
| | - Neil Pendleton
- a Division of Neuroscience & Experimental Psychology, School of Biological Sciences, The University of Manchester , Manchester , UK
| | - Maria Mercè Canal
- a Division of Neuroscience & Experimental Psychology, School of Biological Sciences, The University of Manchester , Manchester , UK
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38
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Huang Q, Cohen D, Komarzynski S, Li XM, Innominato P, Lévi F, Finkenstädt B. Hidden Markov models for monitoring circadian rhythmicity in telemetric activity data. J R Soc Interface 2019; 15:rsif.2017.0885. [PMID: 29436510 PMCID: PMC5832732 DOI: 10.1098/rsif.2017.0885] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Accepted: 01/11/2018] [Indexed: 12/22/2022] Open
Abstract
Wearable computing devices allow collection of densely sampled real-time information on movement enabling researchers and medical experts to obtain objective and non-obtrusive records of actual activity of a subject in the real world over many days. Our interest here is motivated by the use of activity data for evaluating and monitoring the circadian rhythmicity of subjects for research in chronobiology and chronotherapeutic healthcare. In order to translate the information from such high-volume data arising we propose the use of a Markov modelling approach which (i) naturally captures the notable square wave form observed in activity data along with heterogeneous ultradian variances over the circadian cycle of human activity, (ii) thresholds activity into different states in a probabilistic way while respecting time dependence and (iii) gives rise to circadian rhythm parameter estimates, based on probabilities of transitions between rest and activity, that are interpretable and of interest to circadian research.
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Affiliation(s)
- Qi Huang
- Department of Statistics, University of Warwick, Coventry, CV4 7AL, UK
| | - Dwayne Cohen
- Department of Statistics, University of Warwick, Coventry, CV4 7AL, UK
| | | | - Xiao-Mei Li
- INSERM U935, Hospital Paul Brousse and University Paris-Saclay, Villejuif, 94800, France
| | - Pasquale Innominato
- Medical School, University of Warwick, Coventry, CV4 7AL, UK.,Department of Oncology, North Wales Cancer Treatment Centre, Bodelwyddan, LL18 5UJ, UK
| | - Francis Lévi
- Medical School, University of Warwick, Coventry, CV4 7AL, UK.,INSERM U935, Hospital Paul Brousse and University Paris-Saclay, Villejuif, 94800, France
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39
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Sleep problem but not chronotype is associated with retirement from shift work: a cross-sectional retrospective study. Sleep Biol Rhythms 2019. [DOI: 10.1007/s41105-019-00221-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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40
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LOWDEN A, ÖZTÜRK G, REYNOLDS A, BJORVATN B. Working Time Society consensus statements: Evidence based interventions using light to improve circadian adaptation to working hours. INDUSTRIAL HEALTH 2019; 57:213-227. [PMID: 30700675 PMCID: PMC6449639 DOI: 10.2486/indhealth.sw-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Interventions and strategies to improve health through the management of circadian (re) adaptation have been explored in the field, and in both human and animal laboratory manipulations of shiftwork. As part of an initiative by the Working Time Society (WTS) and International Committee on Occupational Health (ICOH), this review summarises the literature on the management of circadian (re) adaption using bright light treatment. Recommendations to maximise circadian adaptation are summarised for practitioners based on a variety of shiftwork schedules. In slowly rotating night shift schedules bright light appears most suitable when used in connection with the first three night shifts. These interventions are improved when combined with orange glasses (to block blue-green light exposure) for the commute home. Non-shifting strategies involve a lower dosage of light at night and promoting natural daylight exposure during the day (also recommended for day shifts) in acordance with the phase and amplitude response curves to light in humans.
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Affiliation(s)
- Arne LOWDEN
- Stress Research Institute, Stockholm University, Sweden
- *To whom correspondence should be addressed. E-mail:
| | - Gülcin ÖZTÜRK
- Stress Research Institute, Stockholm University, Sweden
| | | | - Bjørn BJORVATN
- Department of Global Public Health and Primary Care,
University of Bergen, Norway
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41
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Association of social jetlag with metabolic syndrome among Japanese working population: the Furukawa Nutrition and Health Study. Sleep Med 2018; 51:53-58. [DOI: 10.1016/j.sleep.2018.07.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/18/2018] [Accepted: 07/05/2018] [Indexed: 12/12/2022]
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42
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Knapen SE, Riemersma-van der Lek RF, Antypa N, Meesters Y, Penninx BWJH, Schoevers RA. Social jetlag and depression status: Results obtained from the Netherlands Study of Depression and Anxiety. Chronobiol Int 2017; 35:1-7. [DOI: 10.1080/07420528.2017.1374966] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- Stefan E. Knapen
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Research School of Behavioural and Cognitive Neurosciences (BCN), Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | | | - Niki Antypa
- Department of Clinical Psychology, Institute of Psychology, Leiden University, Leiden, the Netherlands
| | - Ybe Meesters
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Groningen, the Netherlands
| | - Brenda W. J. H. Penninx
- Amsterdam, Department of Psychiatry, Amsterdam Public Health and Amsterdam Neuroscience Research Institutes, the Netherlands
| | - Robert A. Schoevers
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Research School of Behavioural and Cognitive Neurosciences (BCN), Interdisciplinary Center for Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
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43
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Phillips AJK, Clerx WM, O'Brien CS, Sano A, Barger LK, Picard RW, Lockley SW, Klerman EB, Czeisler CA. Irregular sleep/wake patterns are associated with poorer academic performance and delayed circadian and sleep/wake timing. Sci Rep 2017; 7:3216. [PMID: 28607474 PMCID: PMC5468315 DOI: 10.1038/s41598-017-03171-4] [Citation(s) in RCA: 261] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Accepted: 04/24/2017] [Indexed: 12/20/2022] Open
Abstract
The association of irregular sleep schedules with circadian timing and academic performance has not been systematically examined. We studied 61 undergraduates for 30 days using sleep diaries, and quantified sleep regularity using a novel metric, the sleep regularity index (SRI). In the most and least regular quintiles, circadian phase and light exposure were assessed using salivary dim-light melatonin onset (DLMO) and wrist-worn photometry, respectively. DLMO occurred later (00:08 ± 1:54 vs. 21:32 ± 1:48; p < 0.003); the daily sleep propensity rhythm peaked later (06:33 ± 0:19 vs. 04:45 ± 0:11; p < 0.005); and light rhythms had lower amplitude (102 ± 19 lux vs. 179 ± 29 lux; p < 0.005) in Irregular compared to Regular sleepers. A mathematical model of the circadian pacemaker and its response to light was used to demonstrate that Irregular vs. Regular group differences in circadian timing were likely primarily due to their different patterns of light exposure. A positive correlation (r = 0.37; p < 0.004) between academic performance and SRI was observed. These findings show that irregular sleep and light exposure patterns in college students are associated with delayed circadian rhythms and lower academic performance. Moreover, the modeling results reveal that light-based interventions may be therapeutically effective in improving sleep regularity in this population.
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Affiliation(s)
- Andrew J K Phillips
- Sleep Health Institute and Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA. .,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA.
| | - William M Clerx
- Sleep Health Institute and Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Conor S O'Brien
- Sleep Health Institute and Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - Akane Sano
- Affective Computing Group, Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Laura K Barger
- Sleep Health Institute and Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Rosalind W Picard
- Affective Computing Group, Media Lab, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Steven W Lockley
- Sleep Health Institute and Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Elizabeth B Klerman
- Sleep Health Institute and Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Charles A Czeisler
- Sleep Health Institute and Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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