Circasemidian sleep propensity and the phase-amplitude maintenance model of human sleep/wake regulation

Evidence for ~12-h ultradian gene programs in humans

Mice and many marine organisms exhibit ~12-h ultradian rhythms, however, direct evidence of ~12-h ultradian rhythms in humans is lacking. Here, we performed prospective, temporal transcriptome profiling of peripheral white blood cells from three healthy humans. All three participants independently exhibited robust ~12-h transcriptional rhythms in molecular programs involved in RNA and protein metabolism, with strong homology to circatidal gene programs previously identified in Cnidarian marine species.

Benefits and risks of napping in older adults: A systematic review

A growing body of evidence indicates that napping is common among older adults. However, a systematic review on the effect of napping on the elderly is lacking. The aim of this systematic review was to (i) determine how studies evaluated napping behavior in older adults (frequency, duration and timing); (ii) explore how napping impacts perceptual measures, cognitive and psychomotor performance, night-time sleep and physiological parameters in the elderly (PROSPERO CRD42022299805). A total of 738 records were screened by two researchers using the PICOS criteria. Fifteen studies met our inclusion criteria with a mean age ranging from 60.8 to 78.3 years and a cumulative sample size of n = 326. Daytime napping had an overall positive impact on subjective measures (i.e., sleepiness and fatigue), psychomotor performances (i.e., speed and accuracy) and learning abilities (i.e., declarative and motor learning). Additionally, studies showed (i) consistency between nap and control conditions regarding sleep duration, efficiency and latency, and proportion of sleep stages, and (ii) increase of 24 h sleep duration with nap compared to control condition. Based on the findings of the present review, there is minimal evidence to indicate that napping is detrimental for older adults' nighttime sleep. Future studies should consider involving repeated naps during a micro-cycle in order to investigate the chronic effect of napping on older adults.

Systematic review registration

identifier: CRD42022299805.

Circadian Regulation and Clock-Controlled Mechanisms of Glycerophospholipid Metabolism from Neuronal Cells and Tissues to Fibroblasts

Along evolution, living organisms developed a precise timekeeping system, circadian clocks, to adapt life to the 24-h light/dark cycle and temporally regulate physiology and behavior. The transcriptional molecular circadian clock and metabolic/redox oscillator conforming these clocks are present in organs, tissues, and even in individual cells, where they exert circadian control over cellular metabolism. Disruption of the molecular clock may cause metabolic disorders and higher cancer risk. The synthesis and degradation of glycerophospholipids (GPLs) is one of the most highly regulated metabolisms across the 24-h cycle in terms of total lipid content and enzyme expression and activity in the nervous system and individual cells. Lipids play a plethora of roles (membrane biogenesis, energy sourcing, signaling, and the regulation of protein-chromatin interaction, among others), making control of their metabolism a vital checkpoint in the cellular organization of physiology. An increasing body of evidence clearly demonstrates an orchestrated and sequential series of events occurring in GPL metabolism across the 24-h day in diverse retinal cell layers, immortalized fibroblasts, and glioma cells. Moreover, the clock gene Per1 and other circadian-related genes are tightly involved in the regulation of GPL synthesis in quiescent cells. However, under proliferation, the metabolic oscillator continues to control GPL metabolism of brain cancer cells even after molecular circadian clock disruption, reflecting the crucial role of the temporal metabolism organization in cell preservation. The aim of this review is to examine the control exerted by circadian clocks over GPL metabolism, their synthesizing enzyme expression and activities in normal and tumorous cells of the nervous system and in immortalized fibroblasts.

The Effect of Experimental Recuperative and Appetitive Post-lunch Nap Opportunities, With or Without Caffeine, on Mood and Reaction Time in Highly Trained Athletes

Purpose: To investigate the effects of placebo (PLA), 20 min nap opportunity (N20), 5mg·kg-1 of caffeine (CAF), and their combination (CAF+N20) on sleepiness, mood and reaction-time after partial sleep deprivation (PSD; 04h30 of time in bed; study 1 ) or after normal sleep night (NSN; 08h30 of time in bed; study 2 ). Methods: Twenty-three highly trained athletes ( study 1 ; 9 and study 2 ; 14) performed four test sessions (PLA, CAF, N20 and CAF+N20) in double-blind, counterbalanced and randomized order. Simple (SRT) and two-choice (2CRT) reaction time, subjective sleepiness (ESS) and mood state (POMS) were assessed twice, pre- and post-intervention. Results: SRT was lower (i.e., better performance) during CAF condition after PSD (pre: 336 ± 15 ms vs. post: 312 ± 9 ms; p < 0.001; d = 2.07; Δ% = 7.26) and NSN (pre: 350 ± 39 ms vs. post: 323 ± 32 ms; p < 0.001; d = 0.72; Δ% = 7.71) compared to pre-intervention. N20 decreased 2CRT after PSD (pre: 411 ± 13 ms vs. post: 366 ± 20 ms; p < 0.001; d = 2.89; Δ% = 10.81) and NSN (pre: 418 ± 29 ms vs. post: 375 ± 40 ms; p < 0.001; d = 1.23; Δ% = 10.23). Similarly, 2CRT was shorter during CAF+N20 sessions after PSD (pre: 406 ± 26 ms vs. post: 357 ± 17 ms; p < 0.001; d = 2.17; Δ% = 12.02) and after NSN (pre: 386 ± 33 ms vs. post: 352 ± 30 ms; p < 0.001; d = 1.09; Δ% = 8.68). After PSD, POMS score decreased after CAF (p < 0.001; d = 2.38; Δ% = 66.97) and CAF+N20 (p < 0.001; d = 1.68; Δ% = 46.68). However, after NSN, only N20 reduced POMS (p < 0.001; d = 1.05; Δ% = 78.65) and ESS (p < 0.01; d = 0.71; Δ% = 19.11). Conclusion: After PSD, all interventions reduced sleepiness and only CAF enhanced mood with or without napping. However, only N20 enhanced mood and reduced sleepiness after NSN. Caffeine ingestion enhanced SRT performance regardless of sleep deprivation. N20, with or without caffeine ingestion, enhanced 2CRT independently of sleep deprivation. This suggests a different mode of action of napping and caffeine on sleepiness, mood and reaction time.

Revealing the hidden reality of the mammalian 12-h ultradian rhythms

Biological oscillations often cycle at different harmonics of the 24-h circadian rhythms, a phenomenon we coined "Musica Universalis" in 2017. Like the circadian rhythm, the 12-h oscillation is also evolutionarily conserved, robust, and has recently gained new traction in the field of chronobiology. Originally thought to be regulated by the circadian clock and/or environmental cues, recent new evidences support the notion that the majority of 12-h rhythms are regulated by a distinct and cell-autonomous pacemaker that includes the unfolded protein response (UPR) transcription factor spliced form of XBP1 (XBP1s). 12-h cycle of XBP1s level in turn transcriptionally generates robust 12-h rhythms of gene expression enriched in the central dogma information flow (CEDIF) pathway. Given the regulatory and functional separation of the 12-h and circadian clocks, in this review, we will focus our attention on the mammalian 12-h pacemaker, and discuss our current understanding of its prevalence, evolutionary origin, regulation, and functional roles in both physiological and pathological processes.

XBP1 links the 12-hour clock to NAFLD and regulation of membrane fluidity and lipid homeostasis

A distinct 12-hour clock exists in addition to the 24-hour circadian clock to coordinate metabolic and stress rhythms. Here, we show that liver-specific ablation of X-box binding protein 1 (XBP1) disrupts the hepatic 12-hour clock and promotes spontaneous non-alcoholic fatty liver disease (NAFLD). We show that hepatic XBP1 predominantly regulates the 12-hour rhythmicity of gene transcription in the mouse liver and demonstrate that perturbation of the 12-hour clock, but not the core circadian clock, is associated with the onset and progression of this NAFLD phenotype. Mechanistically, we provide evidence that the spliced form of XBP1 (XBP1s) binds to the hepatic 12-hour cistrome to directly regulate the 12-hour clock, with a periodicity paralleling the harmonic activation of the 12-hour oscillatory transcription of many rate-limiting metabolic genes known to have perturbations in human metabolic disease. Functionally, we show that Xbp1 ablation significantly reduces cellular membrane fluidity and impairs lipid homeostasis via rate-limiting metabolic processes in fatty acid monounsaturated and phospholipid remodeling pathways. These findings reveal that genetic disruption of the hepatic 12-hour clock links to the onset and progression of NAFLD development via transcriptional regulator XBP1, and demonstrate a role for XBP1 and the 12-hour clock in the modulation of phospholipid composition and the maintenance of lipid homeostasis.

Unveiling "Musica Universalis" of the Cell: A Brief History of Biological 12-Hour Rhythms

"Musica universalis" is an ancient philosophical concept claiming the movements of celestial bodies follow mathematical equations and resonate to produce an inaudible harmony of music, and the harmonious sounds that humans make were an approximation of this larger harmony of the universe. Besides music, electromagnetic waves such as light and electric signals also are presented as harmonic resonances. Despite the seemingly universal theme of harmonic resonance in various disciplines, it was not until recently that the same harmonic resonance was discovered also to exist in biological systems. Contrary to traditional belief that a biological system is either at stead-state or cycles with a single frequency, it is now appreciated that most biological systems have no homeostatic "set point," but rather oscillate as composite rhythms consisting of superimposed oscillations. These oscillations often cycle at different harmonics of the circadian rhythm, and among these, the ~12-hour oscillation is most prevalent. In this review, we focus on these 12-hour oscillations, with special attention to their evolutionary origin, regulation, and functions in mammals, as well as their relationship to the circadian rhythm. We further discuss the potential roles of the 12-hour clock in regulating hepatic steatosis, aging, and the possibility of 12-hour clock-based chronotherapy. Finally, we posit that biological rhythms are also musica universalis: whereas the circadian rhythm is synchronized to the 24-hour light/dark cycle coinciding with the Earth's rotation, the mammalian 12-hour clock may have evolved from the circatidal clock, which is entrained by the 12-hour tidal cues orchestrated by the moon.

Seasonal and geographical impact on human resting periods

We study the influence of seasonally and geographically related daily dynamics of daylight and ambient temperature on human resting or sleeping patterns using mobile phone data of a large number of individuals. We observe two daily inactivity periods in the people's aggregated mobile phone calling patterns and infer these to represent the resting times of the population. We find that the nocturnal resting period is strongly influenced by the length of daylight, and that its seasonal variation depends on the latitude, such that for people living in two different cities separated by eight latitudinal degrees, the difference in the resting periods of people between the summer and winter in southern cities is almost twice that in the northern cities. We also observe that the duration of the afternoon resting period is influenced by the temperature, and that there is a threshold from which this influence sets in. Finally, we observe that the yearly dynamics of the afternoon and nocturnal resting periods appear to be counterbalancing each other. This also lends support to the notion that the total daily resting time of people is more or less conserved across the year.

A Cell-Autonomous Mammalian 12 hr Clock Coordinates Metabolic and Stress Rhythms

Besides circadian rhythms, oscillations cycling with a 12 hr period exist. However, the prevalence, origin, regulation, and function of mammalian 12 hr rhythms remain elusive. Utilizing an unbiased mathematical approach identifying all superimposed oscillations, we uncovered prevalent 12 hr gene expression and metabolic rhythms in mouse liver, coupled with a physiological 12 hr unfolded protein response oscillation. The mammalian 12 hr rhythm is cell autonomous, driven by a dedicated 12 hr pacemaker distinct from the circadian clock, and can be entrained in vitro by metabolic and ER stress cues. Mechanistically, we identified XBP1s as a transcriptional regulator of the mammalian 12 hr clock. Downregulation of the 12 hr gene expression strongly correlates with human hepatic steatosis and steatohepatitis, implying its importance in maintaining metabolic homeostasis. The mammalian 12 hr rhythm of gene expression also is conserved in nematodes and crustaceans, indicating an ancient origin of the 12 hr clock. Our work sheds new light on how perturbed biological rhythms contribute to human disease.

Circadian Sleep Propensity and Alcohol Interaction at the Wheel

STUDY OBJECTIVES

The study was aimed at estimating the effect of alcohol consumption, time of day, and their interaction on traffic crashes in a real regional context.

METHODS

Blood alcohol concentration (BAC) data were collected from drivers involved in traffic accidents during one year in an Italian region and in a control group of drivers over the same road network. Mean circadian sleep propensity was estimated from a previous study as function of time of day. Accident risk was analyzed by logistic regression as function of BAC and circadian sleep propensity.

RESULTS

BAC values greater than zero were found in 72.0% of the drivers involved in crashes and in 40.4% of the controls. Among the former 23.6% of the drivers exceeded the BAC legal threshold of 0.05 g/dL, while illegal values were found in 10.4% of the controls. The relative risk showed a significant increase with both BAC and circadian sleep propensity (as estimated from time of day) and their interaction was significant.

CONCLUSIONS

Due to the significant interaction, even low BAC levels strongly increased accident risk when associated with high sleep propensity.

Circadian Rest-Activity Rhythm in Pediatric Type 1 Narcolepsy

STUDY OBJECTIVES

Pediatric type 1 narcolepsy is often challenging to diagnose and remains largely undiagnosed. Excessive daytime sleepiness, disrupted nocturnal sleep, and a peculiar phenotype of cataplexy are the prominent features. The knowledge available about the regulation of circadian rhythms in affected children is scarce. This study compared circadian rest-activity rhythm and actigraphic estimated sleep measures of children with type 1 narcolepsy versus healthy controls.

METHODS

Twenty-two drug-naïve type 1 narcolepsy children and 21 age- and sex- matched controls were monitored for seven days during the school week by actigraphy. Circadian activity rhythms were analyzed through functional linear modeling; nocturnal and diurnal sleep measures were estimated from activity using a validated algorithm.

RESULTS

Children with type 1 narcolepsy presented an altered rest-activity rhythm characterized by enhanced motor activity throughout the night and blunted activity in the first afternoon. No difference was found between children with type 1 narcolepsy and controls in the timing of the circadian phase. Actigraphic sleep measures showed good discriminant capabilities in assessing type 1 narcolepsy nycthemeral disruption.

CONCLUSIONS

Actigraphy reliably renders the nycthemeral disruption typical of narcolepsy type 1 in drug-naïve children with recent disease onset, indicating the sensibility of actigraphic assessment in the diagnostic work-up of childhood narcolepsy type 1.

Dynamical properties of the two-process model for sleep-wake cycles in infantile autism

The two-process model is a scheme for the timing of sleep that consists of homeostatic (Process S) and circadian (Process C) variables. The two-process model exhibits abnormal sleep patterns such as internal desynchronization or sleep fragmentation. Early infants with autism often experience sleep difficulties. Large day-by-day changes are found in the sleep onset and waking times in autistic children. Frequent night waking is a prominent property of their sleep. Further, the sleep duration of autistic children is often fragmented. These sleep patterns in infants with autism are not fully understood yet. In the present study, the sleep patterns in autistic children were reproduced by a modified two-process model using nonlinear analysis. A nap term was introduced into the original two-process model to reproduce the sleep patterns in early infants. The nap term and the time course of Process S are mentioned in the present study. Those parameters led to bifurcation of the sleep-wake cycle in the modified two-process model. In a certain range of these parameter sets, a small external noise was amplified, and an irregular sleep-wake cycle appeared. The short duration of sleep led to another irregular sleep onset or waking. Consequently, an irregular sleep-wake cycle appeared in early infantile autism.

Use of subjective and physiological indicators of sleepiness to predict performance during a vigilance task

Sleepiness is a major risk factor for serious injury and death in accidents. Although it is important to develop countermeasures to sleepiness to reduce risks, it is equally important to determine the most effective timing for these countermeasures. To determine optimum timing for necessary countermeasures, we must be able to predict performance errors. This study examined the predictability of subjective and physiological indicators of sleepiness during a vigilance task. Thirteen healthy male volunteers (mean age, 26.9 yr; SD = 5.98 yr; range 22-43 yr) participated in the study. Participants used the Karolinska sleepiness scale (KSS) to rate their subjective sleepiness every 4 min during a 40-min Mackworth clock test. Electrophysiological and performance data were divided into 10 epochs (i.e., 1 epoch lasted for 4 min). To estimate predictability, the data from the sleepiness indicators used for the correlation analysis were preceded by one epoch to the performance data. Results showed that sleepiness indicators (KSS score and electroencephalographic [EEG] alpha activity) and standard deviation of heart rate (SDNN) were significantly correlated with succeeding performance on the vigilance test. These findings suggest that the KSS score, EEG alpha activity, and SDNN could be used to predict performance errors.

Circasemidian 12 h cycle of slow wave sleep under constant darkness

OBJECTIVES

Afternoon sleepiness is a widespread phenomenon. The present study aimed to test Broughton's hypothesis (Sleep and alertness: chronobiological, behavioral, and medical aspects of napping. New York, NY: Raven Press, 1989. p. 71-98) that afternoon sleep propensity might reflect the circasemidian 12h cycle of slow wave sleep (SWS).

METHODS

Nine subjects (21-27 year) stayed alone under constant darkness (0 lux) without social contact for 72 h. They were allowed to sleep and eat freely. Their polysomnograms during 72 h of constant darkness were analyzed.

RESULTS

The total sleep time (TST) accounted for 41.6h (57.9%) of the 72 h and decreased progressively as a function of time. The reduction in TST was dependent on the decrease in sleep stage 2 and rapid eye movement (REM) sleep. The amount of SWS did not significantly change among the days. The circadian (1 cycle/day) and circasemidian (2cycles/day) cycles were observed in SWS. Those accounted for 13.9 and 11.1% of the total variance, respectively. SWS during the time corresponding to daytime occurred 9-10h before and 15-16 h after the nocturnal sleep gate. In addition, weak but significant correlations were observed between the amounts of SWS and the waking time before the sleep episodes (r=0.332) and prior REM sleep (r=-0.236).

CONCLUSIONS

The present findings suggest that SWS might occur not only always in a homeostatic manner as a function of prior wakefulness, but also as a circasemidian rhythmic function.

Critical analysis of the theories advanced to explain short REM sleep latencies and other sleep anomalies in several psychiatric conditions

One of the most consistent and most studied sleep modifications in several psychiatric conditions is the shortening of the rapid eye movement (REM) sleep latency. While its clinical usefulness is still to be proven and its meaning relatively obscure, the appearance of a short REM latency continues to be a daily fact in sleep laboratories. Many theories compete to explain what is observed, the most important being the circadian rhythm hypotheses, the homeostatic model and the reciprocal interaction model. These three are summarised and their pros and cons are exposed in a systematic manner. Points of conflict, possible convergences and limitations are discussed in the light of recent developments on the general theories of sleep regulation.

Dynamics of slow wave activity in narcoleptic patients under bed rest conditions

Following a baseline night recording, 9 narcoleptic subjects and 9 sex- and age-matched control subjects were maintained on 16 h of diurnal sleep deprivation. Thereafter subjects were submitted to a 32 h bed rest protocol in a sound- and light-attenuated room. The EEG was recorded and processed by a Fast Fourier Transform. Narcoleptics did not differ from controls in total sleep time over the whole 32 h, but spent more time sleeping during the daytime (DT). In both groups slow wave activity (SWA) showed an exponential decaying trend during the first night (N1); a similar exponential trend during the second night (N2) was evident only in controls. In controls SWA showed a circadian-circasemidian distribution that was hardly detectable in nacroleptics. Narcoleptics showed an ultradian distribution of SWA with periodic emergence every 4 h during DT and N2. Our data confirm that a homeostatic mechanism is evident in narcolpetics when stimulated by diurnal sleep deprivation, while circadian and circasemidian mechanisms are less evident during DT and N2. These findings suggest a different coupling between homeostatic sleep regulating and circadian drives to sleep in narcoleptics. Ultradian drives to sleep seem to be predominant in these patients, thus probably acting as a means for the avoidance of stressful attempts to counteract a weaker waking state maintenance mechanism.

Chronobiological influences on fibromyalgia syndrome: theoretical and therapeutic implications

A review of the evidence from diurnal physiological, seasonal environmental and prospective studies of social-behavioural functions suggest that a chronobiological theoretical model provides a comprehensive basis for the dynamics of central nervous system mechanisms, the assessment and the management of patients with fibromyalgia. The chronobiological model stresses the importance of temporal variation and the factors that influence and govern recurrent patterns of biological functions and behaviour that determine health and illness. Finally, the theory allows for an integrated study of brain, behaviour and somatic functions over time and emphasizes that such a comprehensive approach is core to any therapeutic intervention.

Naps as integral parts of the wake time within the human sleep-wake cycle

Thirteen subjects lived singly in an isolation unit without temporal cues for an average time span of 32 days. They signaled the times when they woke up, took a meal, and retired, noting in their diaries what kind of sleep (nap or main sleep) they were going to have. In five subjects the free-running circadian rhythms remained internally synchronized. The other eight subjects became internally desynchronized, with different periods in the sleep-wake cycle and in the rhythm of body temperature, or developed a "circa-bi-dian" rhythmicity (i.e., a state of the circadian system in which the temperature rhythm regains synchrony with the sleep-wake cycle in a 2:1 ratio). The duration of naps was positively correlated with the duration of wake time (after subtraction of the nap), as well as with the duration of wakefulness preceding the nap. In contrast, the duration of main sleep was negatively correlated with the preceding wake time. It is concluded that naps are integral parts of the wake time, and that they follow the rules known from intermeal intervals and the perception of long time intervals such as 1 hr.

Concepts and models of sleep regulation: an overview

Various mathematical models have been proposed to account for circadian, ultradian and homeostatic aspects of sleep regulation. Most circadian models assume that multiple oscillators underlie the differences in period and entrainment properties of the sleep/wake cycle and other rhythms (e.g. body temperature). Interactions of the oscillators have been postulated to account for multimodal sleep/wake patterns. The ultradian models simulate the cyclic alternation of nonREM sleep and REM sleep by assuming a reciprocal interaction of two cell groups. The homeostatic models propose that a sleep/wake dependent process (Process S) underlies the rise in sleep pressure during waking and its decay during sleep. The time course of this process has been derived from EEG slow-wave activity, an indicator of nonREM sleep intensity. The predictions of homeostatic models have been most extensively tested in experiments. The interaction of Process S with a single circadian process can account for multimodal sleep/wake patterns, internal desynchronization and the time course of daytime sleepiness. Close links have emerged between the processes postulated by the various models and specific brain mechanisms. Due to its recent quantitative elaboration and experimental validation, the modelling approach has become one of the potent research strategies in sleep science.