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Comai S, Gobbi G. Melatonin, Melatonin Receptors and Sleep: Moving Beyond Traditional Views. J Pineal Res 2024; 76:e13011. [PMID: 39400423 DOI: 10.1111/jpi.13011] [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: 03/22/2024] [Revised: 09/24/2024] [Accepted: 09/25/2024] [Indexed: 10/15/2024]
Abstract
Sleep, constituting approximately one-third of the human lifespan, is a crucial physiological process essential for physical and mental well-being. Normal sleep consists of an orderly progression through wakefulness, non-rapid eye movement (NREM) sleep, and rapid eye movement (REM) sleep, all of which are tightly regulated. Melatonin, often referred to as the "hormone of sleep," plays a pivotal role as a regulator of the sleep/wake cycle and exerts its effects through high-affinity G-protein coupled receptors known as MT1 and MT2. Selective modulation of these receptors presents a promising therapeutic avenue for sleep disorders. This review examines research on the multifaceted role of melatonin in sleep regulation, focusing on selective ligands targeting MT1 and MT2 receptors, as well as studies involving MT1 and MT2 knockout mice. Contrary to common beliefs, growing evidence suggests that melatonin, through MT1 and MT2 receptors, might not only influence circadian aspects of sleep but likely, also modulate the homeostatic process of sleep and sleep architecture, or could be the molecule linking the homeostatic and circadian regulation of sleep. Furthermore, the distinct brain localization of MT1 and MT2 receptors, with MT1 receptors primarily regulating REM sleep and MT2 receptors regulating NREM sleep, is discussed. Collectively, sleep regulation extends beyond the circulating levels and circadian peak of melatonin; it also critically involves the expression, molecular activation, and regulatory functions of MT1 and MT2 receptors across various brain regions and nuclei involved in the regulation of sleep. This research underscores the importance of ongoing investigation into the selective roles of MT1 and MT2 receptors in sleep. Such research efforts are expected to pave the way for the development of targeted MT1 or MT2 receptors ligands, thereby optimizing therapeutic interventions for sleep disorders.
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Affiliation(s)
- Stefano Comai
- Department of Pharmaceutical and Pharmacological Sciences, University of Padua, Padua, Italy
- Department of Biomedical Sciences, University of Padua, Padua, Italy
- Department of Psychiatry, McGill University and McGill University Health Center, Montreal, Québec, Canada
- IRCSS San Raffaele Scientific Institute, Milan, Italy
| | - Gabriella Gobbi
- Department of Psychiatry, McGill University and McGill University Health Center, Montreal, Québec, Canada
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2
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Tir S, White R, Spitschan M. Inclusion, reporting and analysis of demographic variables in chronobiology and sleep research. Front Neurosci 2024; 18:1421026. [PMID: 39351394 PMCID: PMC11439876 DOI: 10.3389/fnins.2024.1421026] [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: 04/21/2024] [Accepted: 08/07/2024] [Indexed: 10/04/2024] Open
Abstract
Many aspects of sleep and circadian physiology are sensitive to participant-level characteristics. While recent research robustly highlights the importance of considering participant-level demographic information, the extent to which this information is consistently collected, and reported in the literature, remains unclear. This article investigates study sample characteristics within the published sleep and chronobiology research over the past 40 years. 6,777 articles were identified and a random sample of 20% was included. The reporting of sample size, age, sex, gender, ethnicity, level of education, socio-economic status, and profession of the study population was scored, and any reported aggregate summary statistics for these variables were recorded. We observed a significant upward trend in the reporting and analysis of demographic variables in sleep and chronobiology research. However, we found that while > 90% of studies reported age or sex, all other variables were reported in < 25% of cases. Reporting quality was highly variable, indicating an opportunity to standardize reporting guidelines for participant-level characteristics to facilitate Meta analyses.
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Affiliation(s)
- Selma Tir
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Rhiannon White
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Warwick Medical School, University of Warwick, Coventry, United Kingdom
| | - Manuel Spitschan
- Department of Health and Sport Sciences, TUM School of Medicine and Health, Technical University of Munich, Munich, Germany
- Translational Sensory and Circadian Neuroscience, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- TUM Institute of Advanced Study (TUM-IAS), Technical University of Munich, Garching, Germany
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3
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Best J, Kim R, Reed M, Nijhout HF. A mathematical model of melatonin synthesis and interactions with the circadian clock. Math Biosci 2024; 377:109280. [PMID: 39243938 DOI: 10.1016/j.mbs.2024.109280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 08/13/2024] [Indexed: 09/09/2024]
Abstract
A new mathematical model of melatonin synthesis in pineal cells is created and connected to a slightly modified previously created model of the circadian clock in the suprachiasmatic nucleus (SCN). The SCN influences the production of melatonin by upregulating two key enzymes in the pineal. The melatonin produced enters the blood and the cerebrospinal fluid and thus the SCN, influencing the circadian clock. We show that the model of melatonin synthesis corresponds well with extant experimental data and responds similarly to clinical experiments on bright light in the middle of the night. Melatonin is widely used to treat jet lag and sleep disorders. We show how the feedback from the pineal to the SCN causes phase resetting of the circadian clock. Melatonin doses early in the evening advance the clock and doses late at night delay the clock with a dead zone in between where the phase of the clock does not change.
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Affiliation(s)
- Janet Best
- Department of Mathematics, The Ohio State University, 231 W. 18th Ave., Columbus, 43210, OH, USA.
| | - Ruby Kim
- Department of Mathematics, University of Michigan, 2074 East Hall, 530 Church St., Ann Arbor, 48109, MI, USA
| | - Michael Reed
- Department of Mathematics, Duke University, 120 Science Drive, Campus box 90338, Durham, 27708, NC, USA
| | - H Frederik Nijhout
- Department of Biology, Duke University, Biological Sciences Building, Campus box 90320, Durham, 27708, NC, USA
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4
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Moon C, Hoth KF, Perkhounkova Y, Zhang M, Lee J, Hein M, Hopkins L, Magnotta V, Burgess HJ. Circadian timing, melatonin and hippocampal volume in later-life adults. J Sleep Res 2024; 33:e14090. [PMID: 37940373 PMCID: PMC11076415 DOI: 10.1111/jsr.14090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 11/10/2023]
Abstract
Hippocampal atrophy is a prominent neurodegenerative feature of Alzheimer's disease and related dementias. Alterations in circadian rhythms can exacerbate cognitive aging and neurodegeneration. This study aimed to examine how dim light melatonin onset and melatonin levels are associated with hippocampal volume in cognitively healthy individuals. We studied data from 52 later-life adults (mean age ± SD = 70.0 ± 6.3 years). T1-weighted anatomical images from 3.0 T magnetic resonance imaging data were collected and processed using the BRAINSTools toolbox. Dim light melatonin onset was used to assess circadian timing. The area under the curve was calculated to quantify melatonin concentration levels 6 hr before bedtime, and 14-day wrist actigraphy data were used to assess habitual bedtime. Multiple linear regression modelling with hippocampal volume as the dependent variable was used to analyse the data adjusting for age and sex. The average dim light melatonin onset was 19:45 hours (SD = 84 min), and area under the curve of melatonin levels 6 hr before habitual bedtime was 38.4 pg ml-1 × hr (SD = 29.3). We found that later dim light melatonin onset time (b = 0.16, p = 0.005) and greater area under the curve of melatonin levels 6 hr before habitual bedtime (b = 0.05, p = 0.046) were associated with greater adjusted hippocampal volume. The time between dim light melatonin onset and the midpoint of sleep timing was not associated with hippocampal volume. The findings suggest that earlier circadian timing (dim light melatonin onset) and reduced melatonin may be associated with reduced hippocampal volume in older adults. Future research will help researchers utilize circadian rhythm information to delay brain aging.
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Affiliation(s)
- Chooza Moon
- University of Iowa College of Nursing, Iowa, Iowa, USA
| | - Karin F Hoth
- Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA
| | | | - Meina Zhang
- University of Iowa College of Nursing, Iowa, Iowa, USA
| | - Jihye Lee
- University of Iowa College of Nursing, Iowa, Iowa, USA
| | - Maria Hein
- University of Iowa College of Nursing, Iowa, Iowa, USA
| | - Lauren Hopkins
- Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA
| | - Vincent Magnotta
- Department of Psychiatry, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA
- Department of Radiology, University of Iowa Roy J. and Lucille A. Carver College of Medicine, Iowa City, Iowa, USA
| | - Helen J Burgess
- Department of Psychiatry, Sleep and Circadian Research Laboratory, University of Michigan, Ann Arbor, Michigan, USA
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5
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Cruz-Sanabria F, Bruno S, Crippa A, Frumento P, Scarselli M, Skene DJ, Faraguna U. Optimizing the Time and Dose of Melatonin as a Sleep-Promoting Drug: A Systematic Review of Randomized Controlled Trials and Dose-Response Meta-Analysis. J Pineal Res 2024; 76:e12985. [PMID: 38888087 DOI: 10.1111/jpi.12985] [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: 05/25/2023] [Revised: 01/03/2024] [Accepted: 05/30/2024] [Indexed: 06/20/2024]
Abstract
Previous studies have reported inconsistent results about exogenous melatonin's sleep-promoting effects. A possible explanation relies on the heterogeneity in administration schedule and dose, which might be accountable for differences in treatment efficacy. In this paper, we undertook a systematic review and meta-analysis of double-blind, randomized controlled trials performed on patients with insomnia and healthy volunteers, evaluating the effect of melatonin administration on sleep-related parameters. The standardized mean difference between treatment and placebo groups in terms of sleep onset latency and total sleep time were used as outcomes. Dose-response and meta-regression models were estimated to explore how time of administration, dose, and other treatment-related parameters might affect exogenous melatonin's efficacy. We included 26 randomized controlled trials published between 1987 and 2020, for a total of 1689 observations. Dose-response meta-analysis showed that melatonin gradually reduces sleep onset latency and increases total sleep time, peaking at 4 mg/day. Meta-regression models showed that insomnia status (β = 0.50, p < 0.001) and time between treatment administration and the sleep episode (β = -0.16, p = 0.023) were significant predictors of sleep onset latency, while the time of day (β = -0.086, p < 0.01) was the only significant predictor of total sleep time. Our results suggest that advancing the timing of administration (3 h before the desired bedtime) and increasing the administered dose (4 mg/day), as compared to the exogenous melatonin schedule most used in clinical practice (2 mg 30 min before the desired bedtime), might optimize the efficacy of exogenous melatonin in promoting sleep.
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Affiliation(s)
- Francy Cruz-Sanabria
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
| | - Simone Bruno
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Alessio Crippa
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Paolo Frumento
- Department of Political Sciences, University of Pisa, Pisa, Italy
| | - Marco Scarselli
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
| | - Debra J Skene
- Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Ugo Faraguna
- Department of Developmental Neuroscience, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Stella Maris, Pisa, Italy
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa, Italy
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6
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Fedele B, Williams G, McKenzie D, Giles R, McKay A, Olver J. Sleep Disturbance During Post-Traumatic Amnesia and Early Recovery After Traumatic Brain Injury. J Neurotrauma 2024; 41:e1961-e1975. [PMID: 38553904 DOI: 10.1089/neu.2023.0656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024] Open
Abstract
After moderate to severe traumatic brain injury (TBI), sleep disturbance commonly emerges during the confused post-traumatic amnesia (PTA) recovery stage. However, the evaluation of early sleep disturbance during PTA, its recovery trajectory, and influencing factors is limited. This study aimed to evaluate sleep outcomes in patients experiencing PTA using ambulatory gold-standard polysomnography (PSG) overnight and salivary endogenous melatonin (a hormone that influences the sleep-wake cycle) assessment at two time-points. The relationships between PSG-derived sleep-wake parameters and PTA symptoms (i.e., agitation and cognitive disturbance) were also evaluated. In a patient subset, PSG was repeated after PTA had resolved to assess the trajectory of sleep disturbance. Participants with PTA were recruited from Epworth HealthCare's inpatient TBI Rehabilitation Unit. Trained nurses administered overnight PSG at the patient bedside using the Compumedics Somté portable PSG device (Compumedics, Ltd., Australia). Two weeks after PTA had resolved, PSG was repeated. On a separate evening, two saliva specimens were collected (at 24:00 and 06:00) for melatonin testing. Results of routine daily hospital measures (i.e., Agitated Behavior Scale and Westmead PTA Scale) were also collected. Twenty-nine patients were monitored with PSG (mean: 41.6 days post-TBI; standard deviation [SD]: 28.3). Patients' mean sleep duration was reduced (5.6 h, SD: 1.2), and was fragmented with frequent awakenings (mean: 27.7, SD: 15.0). Deep, slow-wave restorative sleep was reduced, or completely absent (37.9% of patients). The use of PSG did not appear to exacerbate patient agitation or cognitive disturbance. Mean melatonin levels at both time-points were commonly outside of normal reference ranges. After PTA resolved, patients (n = 11) displayed significantly longer mean sleep time (5.3 h [PTA]; 6.5 h [out of PTA], difference between means: 1.2, p = 0.005). However, disturbances to other sleep-wake parameters (e.g., increased awakenings, wake time, and sleep latency) persisted after PTA resolved. This is the first study to evaluate sleep disturbance in a cohort of patients as they progressed through the early TBI recovery phases. There is a clear need for tailored assessment of sleep disturbance during PTA, which currently does not form part of routine hospital assessment, to suggest new treatment paradigms, enhance patient recovery, and reduce its long-term impacts.
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Affiliation(s)
- Bianca Fedele
- Department of Rehabilitation, Department of Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Australia
- Department of Rehabilitation, Epworth Monash Rehabilitation Medicine (EMReM) Unit, Melbourne, Australia
- School of Clinical Sciences, Monash University, Melbourne, Australia
| | - Gavin Williams
- Department of Rehabilitation, Department of Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Australia
- Department of Rehabilitation, Epworth Monash Rehabilitation Medicine (EMReM) Unit, Melbourne, Australia
- Department of Physiotherapy, The University of Melbourne, Melbourne, Australia
| | - Dean McKenzie
- Research Development and Governance Unit, Department of Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Robert Giles
- Sleep Unit, Department of Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Australia
| | - Adam McKay
- Department of Rehabilitation, Department of Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Australia
- School of Psychological Sciences, Monash University, Melbourne, Australia
- Monash Epworth Rehabilitation Research Centre, Melbourne, Australia
| | - John Olver
- Department of Rehabilitation, Department of Rehabilitation and Mental Health, Epworth HealthCare, Melbourne, Australia
- Department of Rehabilitation, Epworth Monash Rehabilitation Medicine (EMReM) Unit, Melbourne, Australia
- School of Clinical Sciences, Monash University, Melbourne, Australia
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7
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Lanfermeijer M, van Winden LJ, Starreveld DEJ, Razab-Sekh S, Faassen MV, Bleiker EMA, van Rossum HH. An LC-MS/MS-based method for the simultaneous quantification of melatonin, cortisol and cortisone in saliva. Anal Biochem 2024; 689:115496. [PMID: 38431140 DOI: 10.1016/j.ab.2024.115496] [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: 01/05/2024] [Revised: 02/23/2024] [Accepted: 02/24/2024] [Indexed: 03/05/2024]
Abstract
Disturbances in the diurnal pattern are associated with several clinical and psychological conditions, including depression and fatigue. Salivary sampling for melatonin, cortisol and cortisone provides a non-invasive method for frequent sampling and obtaining biochemical insight into the diurnal pattern of individuals. Therefore, a new liquid chromatography-tandem mass spectrometry-based method for the measurement of salivary melatonin, cortisol and cortisone was developed and validated. The method required 250 μl saliva, used isotope dilution methodology and was based on a liquid-liquid extraction for sample preparation, reversed-phase chromatography and multiple reaction monitoring on a mass spectrometer for quantitation. The lower limits of quantification obtained were 0.010 nmol/L for melatonin, 0.5 nmol/L for cortisol and 1.00 nmol/L for cortisone and the limits of detection were 0.003 nmol/L, 0.15 nmol/L and 0.1 nmol/L respectively. The method imprecision was ≤14% for all measurands, and the method comparison showed highly comparable results with high correlation coefficients (all ≥0.964). Potential interference of cortisol and cortisone by prednisolone was observed and could be detected by chromatogram review. Typical diurnal patterns for melatonin, cortisol and cortisone were observed in the saliva of 20 cancer survivors who collected saliva throughout the day.
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Affiliation(s)
- Mirthe Lanfermeijer
- Department of Laboratory Medicine, Netherlands Cancer Institute Amsterdam, the Netherlands.
| | - Lennart J van Winden
- Department of Laboratory Medicine, Netherlands Cancer Institute Amsterdam, the Netherlands
| | - Danielle E J Starreveld
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute Amsterdam, the Netherlands
| | - Serry Razab-Sekh
- Department of Laboratory Medicine, Netherlands Cancer Institute Amsterdam, the Netherlands
| | - Martijn van Faassen
- Department of Laboratory Medicine, University Medical Center Groningen, University of Groningen, the Netherlands
| | - Eveline M A Bleiker
- Department of Psychosocial Research and Epidemiology, Netherlands Cancer Institute Amsterdam, the Netherlands
| | - Huub H van Rossum
- Department of Laboratory Medicine, Netherlands Cancer Institute Amsterdam, the Netherlands
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8
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Martinez-Cayuelas E, Gavela-Pérez T, Rodrigo-Moreno M, Losada-Del Pozo R, Moreno-Vinues B, Garces C, Soriano-Guillén L. Sleep Problems, Circadian Rhythms, and Their Relation to Behavioral Difficulties in Children and Adolescents with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:1712-1726. [PMID: 36869970 PMCID: PMC9984759 DOI: 10.1007/s10803-023-05934-7] [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] [Accepted: 02/13/2023] [Indexed: 03/05/2023]
Abstract
This was an exploratory cross-sectional study comparing 45 children with ASD to 24 typically developing drug-naïve controls, group-matched on age, sex, and body mass index. Objective data was obtained using the following: an ambulatory circadian monitoring device; saliva samples to determine dim light melatonin onset (DLMO): and three parent-completed measures: the Child Behavior Checklist (CBCL); the Repetitive Behavior Scale-Revised (RBS-R); and the General Health Questionnaire (GHQ28). The CBCL and RBS-R scales showed the highest scores amongst poor sleepers with ASD. Sleep fragmentation was associated with somatic complaints and self-injury, leading to a higher impact on family life. Sleep onset difficulties were associated with withdrawal, anxiety, and depression. Those with phase advanced DLMO had lower scores for "somatic complaints"; "anxious/depressed" state; and "social problems", suggesting that this phenomenon has a protective role.
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Affiliation(s)
- Elena Martinez-Cayuelas
- Department of Pediatrics, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
- Hospital Universitario Fundación Jiménez Díaz, Avenida Reyes Católicos n2, 28040 Madrid, Spain
| | - Teresa Gavela-Pérez
- Department of Pediatrics, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Rodrigo-Moreno
- Department of Pediatrics, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Rebeca Losada-Del Pozo
- Department of Pediatrics, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Beatriz Moreno-Vinues
- Department of Pediatrics, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Carmen Garces
- Lipid Laboratory, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Leandro Soriano-Guillén
- Department of Pediatrics, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
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9
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Gabaldón-Estevan D, Carmona-Talavera D, Catalán-Gregori B, Mañas-García E, Martin-Carbonell V, Monfort L, Martinez-Besteiro E, González-Carrasco M, Hernández-Jiménez MJ, Täht K, Talavera M, Ancheta-Arrabal A, Sáez G, Estany N, Pin-Arboledas G, Reis C. Kairos study protocol: a multidisciplinary approach to the study of school timing and its effects on health, well-being and students' performance. Front Public Health 2024; 12:1336028. [PMID: 38525330 PMCID: PMC10957785 DOI: 10.3389/fpubh.2024.1336028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/26/2024] [Indexed: 03/26/2024] Open
Abstract
Recent evidence from chronobiology, chssronomedicine and chronopsychology shows that the organisation of social time (e.g., school schedules) generally does not respect biological time. This raises concerns about the impact of the constant mismatch between students' social and internal body clocks on their health, well-being and academic performance. The present paper describes a protocol used to investigate the problem of (de) synchronisation of biological times (chronotypes) in childhood and youth in relation to school times. It studies the effects of student chronotype vs. school schedule matches/mismatches on health behaviours (e.g., how many hours students sleep, when they sleep, eat, do physical activity, spend time outdoors in daylight) and learning (verbal expression, spatial structuring, operations) and whether alert-fatigue levels mediate this effect alignments/misalignments on learning (verbal expression, spatial structuring, operations) and their mediation by alert-fatigue levels. The novelty of our protocol lies in its multidisciplinary and mixed methodology approach to a relevant and complex issue. It draws on up-to-date knowledge from the areas of biology, medicine, psychology, pedagogy and sociology. The methods employed include a varied repertoire of techniques from hormonal analysis (cortisol and melatonin), continuous activity and light monitoring, self-registration of food intake, sleep timings, exercise and exposure to screens, alongside with systematic application of cognitive performance tests (e.g., memory, reasoning, calculation, attention) and self-reported well-being. This comprehensive and interdisciplinary protocol should support evidence-based education policy measures related to school time organisation. Appropriate and healthier school timetables will contribute to social change, healthier students and with more efficient learning. The results of studies using a similar methodology in other countries would ensure replication and comparability of results and contribute to knowledge to support policy making.
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Affiliation(s)
| | | | | | - Elena Mañas-García
- Department of Sociology and Social Anthropology, University of Valencia, Valencia, Spain
| | | | - Lucía Monfort
- Department of Pediatrics, Clinical University Hospital, Valencia, Spain
| | - Elvira Martinez-Besteiro
- Department of Personality, Assessment and Psychological Treatments, University of Valencia, Valencia, Spain
| | | | | | - Kadri Täht
- Institute of International Social Studies, School of Governance, Law and Society, Tallinn University, Tallinn, Estonia
| | - Marta Talavera
- Department of Experimental and Social Sciences Teaching, University of Valencia, Valencia, Spain
| | - Ana Ancheta-Arrabal
- Department of Comparative Education and History of Education, University of Valencia, Valencia, Spain
| | - Guillermo Sáez
- Service of Clinical Analysis, University Hospital Dr. Peset, Valencia, Spain
- Department of Biochemistry and Molecular Biology, Faculty of Medicine and Dentistry, University of Valencia, Valencia, Spain
| | - Nuria Estany
- Service of Clinical Analysis, University Hospital Dr. Peset, Valencia, Spain
| | - Gonzalo Pin-Arboledas
- Grupo de Sueño y Cronobiologia de la Asociación Española de Pediatría, Valencia, Spain
| | - Catia Reis
- CRC-W - Faculdade de Ciências Humanas, Universidade Católica Portuguesa, Lisbon, Portugal
- Instituto de Medicina Molecular João Lobo Antunes, IMM, Lisboa, Lisbon, Portugal
- ISAMB - Faculdade de Medicina Universidade de Lisboa, Lisbon, Portugal
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10
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Easton DF, Gupta CC, Vincent GE, Ferguson SA. Move the night way: how can physical activity facilitate adaptation to shift work? Commun Biol 2024; 7:259. [PMID: 38431743 PMCID: PMC10908783 DOI: 10.1038/s42003-024-05962-8] [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: 10/26/2023] [Accepted: 02/22/2024] [Indexed: 03/05/2024] Open
Abstract
Shift work, involving night work, leads to impaired sleep, cognition, health and wellbeing, and an increased risk of occupational incidents. Current countermeasures include circadian adaptation to phase shift circadian biomarkers. However, evidence of real-world circadian adaptation is found primarily in occupations where light exposure is readily controlled. Despite this, non-photic adaptation to shift work remains under researched. Other markers of shift work adaptation exist (e.g., improvements in cognition and wellbeing outcomes) but are relatively unexplored. Timeframes for shift work adaptation involve changes which occur over a block of shifts, or over a shift working career. We propose an additional shift work adaptation timeframe exists which encompasses acute within shift changes in markers of adaptation. We also propose that physical activity might be an accessible and cost-effective countermeasure that could influence multiple markers of adaptation across three timeframes (Within Shift, Within Block, Within Work-span). Finally, practical considerations for shift workers, shift work industries and future research are identified.
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Affiliation(s)
- Dayna F Easton
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Wayville, SA, Australia.
| | - Charlotte C Gupta
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Wayville, SA, Australia
| | - Grace E Vincent
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Wayville, SA, Australia
| | - Sally A Ferguson
- Appleton Institute, Central Queensland University, Wayville, SA, Australia
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11
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Cho E, Lee H, Shin J, Kim S, Heo SJ, Park H, Seok JW. Salivary Cortisol and Melatonin, Sleep, and Behavioral Patterns in Older Adults Living With Dementia. Nurs Res 2024; 73:E11-E20. [PMID: 38112608 DOI: 10.1097/nnr.0000000000000709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
BACKGROUND Over half of the older adults living with dementia have behavioral and psychological symptoms of dementia (BPSD), including sleep disturbance; however, little is known about physiological markers. Salivary cortisol and melatonin have been identified as potential biomarkers of BPSD, with evidence suggesting a relationship between these biomarkers and various behavioral factors, as well as sleep and activity patterns. OBJECTIVES The aim of this study was to investigate the time-dependent changes in salivary cortisol and melatonin levels in older adults with dementia, their relationship with the sleep-wake cycle, and their correlation with BPSD symptoms and behavioral factors. METHODS This observational study conducted in Seoul and Gyeonggi-do, South Korea, used data from 172 older adults with dementia, measuring sleep and activity patterns for 2 weeks using a wearable device, in addition to administering questionnaires for neuropsychiatric and psychological symptoms-the Neuropsychiatric Inventory, Cohen-Mansfield Agitation Inventory, and Cornell Scale for Depression in Dementia. Salivary cortisol and melatonin levels were measured at four time points and divided into four groups based on a dual-trajectory model. Differences among the groups were analyzed using one-way analysis of variance. RESULTS The participants showed normal but heterogeneous patterns of salivary cortisol and melatonin levels. Dual-trajectory pattern analysis showed that higher levels of melatonin during the daytime were correlated with poor nighttime sleep efficiency and decreased disinhibited behaviors, and higher levels of cortisol at all four time points were associated with decreased physical activity. DISCUSSION Measuring and analyzing periodic changes in cortisol and melatonin levels can predict various behavioral symptoms (e.g., sleep disturbances, activity counts, and disinhibition) in older adults with dementia. A study with an experimental design is needed to discover the direct physiological interactions between cortisol, melatonin, and these symptoms.
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12
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Cox RC, Blumenstein AB, Burke TM, Depner CM, Guerin MK, Hay-Arthur E, Higgins J, Knauer OA, Lanza SM, Markwald RR, Melanson EL, McHill AW, Morton SJ, Ritchie HK, Smith MR, Smits AN, Sprecher KE, Stothard ER, Withrow D, Wright KP. Distribution of dim light melatonin offset (DLMOff) and phase relationship to waketime in healthy adults and associations with chronotype. Sleep Health 2024; 10:S76-S83. [PMID: 37777359 DOI: 10.1016/j.sleh.2023.08.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 10/02/2023]
Abstract
OBJECTIVES Dim light melatonin onset, or the rise in melatonin levels representing the beginning of the biological night, is the gold standard indicator of circadian phase. Considerably less is known about dim light melatonin offset, or the decrease in melatonin to low daytime levels representing the end of the biological night. In the context of insufficient sleep, morning circadian misalignment, or energy intake after waketime but before dim light melatonin offset, is linked to impaired insulin sensitivity, suggesting the need to characterize dim light melatonin offset and identify risk for morning circadian misalignment. METHODS We examined the distributions of dim light melatonin offset clock hour and the phase relationship between dim light melatonin offset and waketime, and associations between dim light melatonin offset, phase relationship, and chronotype in healthy adults (N = 62) who completed baseline protocols measuring components of the circadian melatonin rhythm and chronotype. RESULTS 74.4% demonstrated dim light melatonin offset after waketime, indicating most healthy adults wake up before the end of biological night. Later chronotype (morningness-eveningness, mid-sleep on free days corrected, and average mid-sleep) was associated with later dim light melatonin offset clock hour. Later chronotype was also associated with a larger, positive phase relationship between dim light melatonin offset and waketime, except for morningness-eveningness. CONCLUSIONS These findings suggest morning circadian misalignment risk among healthy adults, which would not be detected if only dim light melatonin onset were assessed. Chronotype measured by sleep timing may better predict this risk in healthy adults keeping a consistent sleep schedule than morningness-eveningness preferences. Additional research is needed to develop circadian biomarkers to predict dim light melatonin offset and evaluate appropriate dim light melatonin offset timing to promote health.
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Affiliation(s)
- Rebecca C Cox
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Alivia B Blumenstein
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Tina M Burke
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA; Walter Reed Army Institute of Research, Silver Spring, Maryland, USA
| | - Christopher M Depner
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA; Department of Health and Kinesiology, University of Utah, Salt Lake City, Utah, USA
| | - Molly K Guerin
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Emily Hay-Arthur
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Janine Higgins
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Oliver A Knauer
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Shannon M Lanza
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Rachel R Markwald
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA; Naval Health Research Center, San Diego, California, USA
| | - Edward L Melanson
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA; Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Andrew W McHill
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA; Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, Oregon, USA
| | - Sarah J Morton
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Hannah K Ritchie
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Mark R Smith
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Alexandra N Smits
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Kate E Sprecher
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Ellen R Stothard
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA; Colorado Sleep Institute, Boulder, Colorado, USA
| | - Dana Withrow
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Kenneth P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA; Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.
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13
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Ye Y, Zhong Z, Wu X, Tian Y, Wei Z, Han S, Wu P, Dai H, Shen L, Wang H, Li Y. MR Spectroscopy Assessment of Daily Variations of GABA Levels within the Parietal Lobe and Anterior Cingulate Gyrus Regions of Healthy Young Adults. J Magn Reson Imaging 2024. [PMID: 38284542 DOI: 10.1002/jmri.29255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/21/2023] [Accepted: 12/22/2023] [Indexed: 01/30/2024] Open
Abstract
BACKGROUND The changes that occur in the gamma-aminobutyric acid (GABA) levels within specific brain regions throughout the day are less clear. PURPOSE To evaluate the daily fluctuations of GABA levels within the parietal lobe (PL) and anterior cingulate gyrus (ACC) regions and explore their association with melatonin (MT) levels, heart rate (HR), and blood pressure. STUDY TYPE Prospective. SUBJECTS 26 healthy young adults (15 males and 11 females aged 22-27 years). FIELD STRENGTH/SEQUENCE 3.0T, T1-weighted imaging, Mescher-Garwood point resolved spectroscopy (MEGA-PRESS) sequence. ASSESSMENT The acquired GABA signal contained the overlapping signals of macromolecules and homocarnosine, hence expressed as GABA+. The creatine (Cr) signal was applied as an endogenous reference. The GABA+, GABA+/Cr were measured at six different time points (1:00, 5:00, 9:00, 13:00, 17:00, and 21:00 hours) using MEGA-PRESS. The blood pressure, HR and sputum MT levels, were also acquired. STATISTICAL TESTS The one-way repeated-measures analysis of variance (ANOVA) was used to evaluate the GABA, blood pressure, HR, and MT levels throughout the day. A general linear model was used to find the correlation between GABA and blood pressure, HR, and MT. P < 0.05 was statistically significant. RESULTS Significant variations in GABA+/Cr and GABA+ levels were observed throughout the day within the PL region. The lowest levels were recorded at 9:00 hour (GABA+/Cr: 0.100 ± 0.003,GABA+:1.877 ± 0.051 i.u) and the highest levels were recorded at 21:00 hour (GABA+/Cr: 0.115 ± 0.003, GABA+:2.122 ± 0.052 i.u). The MT levels were positively correlated with GABA+/Cr (r = 0.301) and GABA+ (r = 0.312) within the ACC region. DATA CONCLUSION GABA+/Cr and GABA+ in ACC are positively correlated with MT. GABA levels in the PL have diurnal differences. These findings may indicate that the body's GABA level change in response to the light-dark cycle. LEVEL OF EVIDENCE 1 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Yujie Ye
- Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Zhaomin Zhong
- Center for Circadian Clocks, Soochow University, Suzhou, People's Republic of China
| | - Xiaojuan Wu
- Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Yangyang Tian
- Department of Urology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Zifan Wei
- Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Shuting Han
- Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Peng Wu
- Philips Healthcare, Shanghai, People's Republic of China
| | - Hui Dai
- Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
| | - Lan Shen
- Department of Traditional Chinese Medicine, First Affiliated Hospital of Soochow University, Suzhou, People's Republic of China
| | - Han Wang
- Center for Circadian Clocks, Soochow University, Suzhou, People's Republic of China
| | - Yonggang Li
- Department of Radiology, First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, People's Republic of China
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Wilcox H, Paz V, Saxena R, Winkelman JW, Garfield V, Dashti HS. The Role of Circadian Rhythms and Sleep in Anorexia Nervosa. JAMA Netw Open 2024; 7:e2350358. [PMID: 38175645 PMCID: PMC10767597 DOI: 10.1001/jamanetworkopen.2023.50358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 11/16/2023] [Indexed: 01/05/2024] Open
Abstract
Importance Observational studies have associated anorexia nervosa with circadian rhythms and sleep traits. However, the direction of causality and the extent of confounding by psychosocial comorbidities in these associations are unknown. Objectives To investigate the association between anorexia nervosa and circadian and sleep traits through mendelian randomization and to test the associations between a polygenic risk score (PRS) for anorexia nervosa and sleep disorders in a clinical biobank. Design, Setting, and Participants This genetic association study used bidirectional 2-sample mendelian randomization with summary-level genetic associations between anorexia nervosa (from the Psychiatric Genomics Consortium) and chronotype and sleep traits (primarily from the UK Biobank). The inverse-variance weighted method, in addition to other sensitivity approaches, was used. From the clinical Mass General Brigham (MGB) Biobank (n = 47 082), a PRS for anorexia nervosa was calculated for each patient and associations were tested with prevalent sleep disorders derived from electronic health records. Patients were of European ancestry. All analyses were performed between February and August 2023. Exposures Genetic instruments for anorexia nervosa, chronotype, daytime napping, daytime sleepiness, insomnia, and sleep duration. Main Outcomes and Measures Chronotype, sleep traits, risk of anorexia nervosa, and sleep disorders derived from a clinical biobank. Results The anorexia nervosa genome-wide association study included 16 992 cases (87.7%-97.4% female) and 55 525 controls (49.6%-63.4% female). Genetic liability for anorexia nervosa was associated with a more morning chronotype (β = 0.039; 95% CI, 0.006-0.072), and conversely, genetic liability for morning chronotype was associated with increased risk of anorexia nervosa (β = 0.178; 95% CI, 0.042-0.315). Associations were robust in sensitivity and secondary analyses. Genetic liability for insomnia was associated with increased risk of anorexia nervosa (β = 0.369; 95% CI, 0.073-0.666); however, sensitivity analyses indicated bias due to horizontal pleiotropy. The MGB Biobank analysis included 47 082 participants with a mean (SD) age of 60.4 (17.0) years and 25 318 (53.8%) were female. A PRS for anorexia nervosa was associated with organic or persistent insomnia in the MGB Biobank (odds ratio, 1.10; 95% CI, 1.03-1.17). No associations were evident for anorexia nervosa with other sleep traits. Conclusions and Relevance The results of this study suggest that in contrast to other metabo-psychiatric diseases, anorexia nervosa is a morningness eating disorder and further corroborate findings implicating insomnia in anorexia nervosa. Future studies in diverse populations and with subtypes of anorexia nervosa are warranted.
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Affiliation(s)
- Hannah Wilcox
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Valentina Paz
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
- Instituto de Psicología Clínica, Facultad de Psicología, Universidad de la República, Montevideo, Uruguay
- MRC Unit for Lifelong Health & Ageing, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Richa Saxena
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
- Broad Institute, Cambridge, Massachusetts
| | - John W. Winkelman
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
- Sleep Disorders Clinical Research Program, Massachusetts General Hospital and Harvard Medical School, Boston
| | - Victoria Garfield
- MRC Unit for Lifelong Health & Ageing, Institute of Cardiovascular Science, University College London, London, United Kingdom
| | - Hassan S. Dashti
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
- Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
- Broad Institute, Cambridge, Massachusetts
- Division of Nutrition, Harvard Medical School, Boston, Massachusetts
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15
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Burgess HJ, Kagan D, Rizvydeen M, Swanson LM, Kim HM. An independent comparison of the Novolytix salivary melatonin radioimmunoassay with the new Novolytix salivary melatonin enzyme-linked immunosorbent assay. J Pineal Res 2024; 76:e12933. [PMID: 38108222 PMCID: PMC10872290 DOI: 10.1111/jpi.12933] [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: 08/25/2023] [Revised: 12/04/2023] [Accepted: 12/06/2023] [Indexed: 12/19/2023]
Abstract
The dim light melatonin onset (DLMO) is the current gold standard biomarker of the timing of the central circadian clock in humans and is often assessed from saliva samples. To date, only one commercially available salivary melatonin assay is considered accurate at the low daytime levels required to accurately detect the DLMO (Novolytix RIA RK-DSM2). The aim of this study was to conduct the first independent evaluation of a newly improved enzyme-linked immunosorbent assay (ELISA; Novolytix MLTN-96) and compare it with the recommended radioimmunoassay (RIA)-both in terms of melatonin concentrations and derived DLMOs. Twenty participants (15 females, 18-59 years old) provided saliva samples every 30 min in dim light starting 6 h before their habitual bedtime, yielding a total of 260 saliva samples. Both the RIA and ELISA yielded daytime melatonin concentrations <2 pg/mL, indicating adequate accuracy to detect the DLMO. The melatonin concentrations from the two assays were highly correlated (r = .94, p < .001), although the RIA yielded lower levels of melatonin concentration than the ELISA, on average by 0.70 pg/mL (p = .006). Seventeen DLMOs were calculated from the melatonin profiles and the DLMOs from both assays were not statistically different (p = .36) and were highly correlated (r = .97, p < .001). Two DLMOs derived from the RIA occurred more than 30 min earlier than the DLMO derived from the ELISA. These results indicate that the new Novolytix ELISA is an appropriate assay to use if the Novolytix RIA is not feasible or available.
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Affiliation(s)
- Helen J. Burgess
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan USA
| | - David Kagan
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan USA
| | - Muneer Rizvydeen
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan USA
| | - Leslie M. Swanson
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan USA
| | - Hyungjin Myra Kim
- Consulting for Statistics, Computing and Analytics Research, University of Michigan, Ann Arbor, Michigan USA
- Department of Biostatistics, University of Michigan, Ann Arbor, Michigan, USA
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Sajjadpour Z, Hoseini Tavassol Z, Aghaei Meybodi HR, Eskandarynasab M, Pejman Sani M, Hasani-Ranjbar S, Larijani B. Evaluating the effectiveness of melatonin in reducing the risk of foot ulcers in diabetic patients. J Diabetes Metab Disord 2023; 22:1073-1082. [PMID: 37975123 PMCID: PMC10638255 DOI: 10.1007/s40200-023-01289-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/22/2023] [Indexed: 11/19/2023]
Abstract
Objectives Diabetes and its complications, as a major health concern, are associated with morbidity and mortality around the world. One of these complications is diabetic foot ulcer. Factors such as hyperglycemia, neuropathy, vascular damage and impaired immune system can cause foot ulcers. The present review aims to study the potential effects of melatonin, the main product of pineal glands, on diabetic foot ulcers. Methods A narrative review was performed using present literature in an attempt to identify the different aspects of melatonin's impact on diabetic foot ulcers by searching related keywords in electronic databases without any restriction. Results This review shows that, melatonin has anti-diabetic effects. It is effective in reducing the risk of hyperglycemia, neuropathy, vascular damage and immune system impairment in diabetic patients. By reducing these complications with melatonin, correspondingly, the incidence of diabetic foot ulcers may also decrease in these patients. Conclusions The results of this study indicate promising properties of melatonin while dealing with diabetic foot ulcers and their common underlying conditions, but still, it needs to be investigated more in future studies.
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Affiliation(s)
- Zahra Sajjadpour
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Hoseini Tavassol
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Aghaei Meybodi
- Evidence Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Eskandarynasab
- Department of Pharmacology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
- Experimental Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Pejman Sani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shirin Hasani-Ranjbar
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Witt RM, Byars KC, Decker K, Dye TJ, Riley JM, Simmons D, Smith DF. Current Considerations in the Diagnosis and Treatment of Circadian Rhythm Sleep-Wake Disorders in Children. Semin Pediatr Neurol 2023; 48:101091. [PMID: 38065634 PMCID: PMC10710539 DOI: 10.1016/j.spen.2023.101091] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 09/29/2023] [Indexed: 12/18/2023]
Abstract
Circadian Rhythm Sleep-Wake Disorders (CRSWDs) are important sleep disorders whose unifying feature is a mismatch between the preferred or required times for sleep and wakefulness and the endogenous circadian drives for these. Their etiology, presentation, and treatment can be different in pediatric patients as compared to adults. Evaluation of these disorders must be performed while viewed through the lens of a patient's comorbid conditions. Newer methods of assessment promise to provide greater diagnostic clarity and critical insights into how circadian physiology affects overall health and disease states. Effective clinical management of CRSWDs is multimodal, requiring an integrated approach across disciplines. Therapeutic success depends upon appropriately timed nonpharmacologic and pharmacologic interventions. A better understanding of the genetic predispositions for and causes of CRSWDs has led to novel clinical opportunities for diagnosis and improved therapeutics.
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Affiliation(s)
- Rochelle M Witt
- Division of Child Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Pulmonary Medicine and the Sleep Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Center for Circadian Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Kelly C Byars
- Division of Pulmonary Medicine and the Sleep Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Center for Circadian Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Kristina Decker
- Division of Pulmonary Medicine and the Sleep Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Center for Circadian Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Thomas J Dye
- Division of Child Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Pulmonary Medicine and the Sleep Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Center for Circadian Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jessica M Riley
- Center for Circadian Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Danielle Simmons
- Division of Pulmonary Medicine and the Sleep Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Center for Circadian Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - David F Smith
- Division of Pulmonary Medicine and the Sleep Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Center for Circadian Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Pediatric Otolaryngology-Head and Neck Surgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Otolaryngology- Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH.
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18
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Fulton JM, Flanagan SC, Sittlington JJ, Cobice D, Dobbin S, McCullough SJ, Orr G, Richardson P, Saunders KJ. A Cross-Sectional Study of Myopia and Morning Melatonin Status in Northern Irish Adolescent Children. J Ophthalmol 2023; 2023:7961623. [PMID: 37946723 PMCID: PMC10632006 DOI: 10.1155/2023/7961623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 10/13/2023] [Accepted: 10/16/2023] [Indexed: 11/12/2023] Open
Abstract
Purpose Previous studies have demonstrated an association between melatonin status and both refractive error and axial length in young adult myopes. This study aimed to determine if this relationship extends to a younger adolescent cohort. Methods Healthy children aged 12-15 years provided morning saliva samples before attending Ulster University (55°N) for cycloplegic autorefraction and axial length measures. Participants completed questionnaires describing recent sleep habits and physical activity. Salivary melatonin was quantified using high-performance liquid chromatography-tandem mass spectrometry. Data collection for all participants occurred over a 1-week period (April 2021). Results Seventy participants aged 14.3 (95% CI: 14.2-14.5) years were categorised by spherical equivalent refraction [SER] (range: -5.38DS to +1.88DS) into two groups; myopic SER ≤ -0.50DS (n = 22) or nonmyopic -0.50DS < SER ≤ +2.00DS (n = 48). Median morning salivary melatonin levels were 4.52 pg/ml (95% CI: 2.60-6.02) and 4.89 pg/ml (95% CI: 3.18-5.66) for myopic and nonmyopic subjects, respectively, and did not differ significantly between refractive groups (P = 0.91). Melatonin levels were not significantly correlated with SER, axial length, sleep, or activity scores (Spearman's rank, all P > 0.39). Higher levels of physical activity were associated with higher sleep quality (Spearman's rank, ρ = -0.28, P = 0.02). Conclusion The present study found no significant relationship between morning salivary melatonin levels and refractive error or axial length in young adolescents. This contrasts with outcomes from a previous study of adults with comparable methodology, season of data collection, and geographical location. Prospective studies are needed to understand the discrepancies between adult and childhood findings and evaluate whether melatonin levels in childhood are indicative of an increased risk for future onset of myopia and/or faster axial growth trajectories and myopia progression in established myopes. Future work should opt for a comprehensive dim-light melatonin onset protocol to determine circadian phase.
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Affiliation(s)
- Jane M. Fulton
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sarah C. Flanagan
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Julie J. Sittlington
- Nutrition Innovation Centre for Food and Health (NICHE), Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Diego Cobice
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sara Dobbin
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Sara J. McCullough
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Gareth Orr
- Mass Spectrometry Centre, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Patrick Richardson
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
| | - Kathryn J. Saunders
- Centre for Optometry and Vision Science, Biomedical Science Research Institute, Ulster University, Coleraine, UK
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Burgess HJ, Weber KM, Morack R, Yohannes T, Xing J, Xue X, Gustafson D, Sharma A, Daubert E, Rogando AC, French AL. Overnight urinary melatonin levels in women with and without HIV: An observational cohort study. Brain Behav 2023; 13:e3206. [PMID: 37548505 PMCID: PMC10570498 DOI: 10.1002/brb3.3206] [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: 05/10/2023] [Revised: 07/21/2023] [Accepted: 07/22/2023] [Indexed: 08/08/2023] Open
Abstract
INTRODUCTION Despite significant improvements in longevity and quality of life associated with antiretroviral therapy, individuals with HIV still suffer from a higher burden of sleep and circadian disruption and inflammatory-based diseases than individuals without HIV. While melatonin is a hormone that has a role in sleep and circadian regulation and has anti-inflammatory properties, the overnight concentration of the urinary melatonin metabolite has not yet been reported in people with HIV. METHODS The aim of this study was to compare the overnight urinary melatonin metabolite levels in women aged 35-70 years with HIV (n = 151) to a well-matched comparison group of women without HIV (n = 147). All women wore a wrist actigraphy monitor and completed daily diaries documenting sleep timing and use of medications and drugs or alcohol for 10 days. Participants collected their overnight urine near the end of the monitoring period. RESULTS Melatonin levels did not differ between women with or without HIV, but more than 40% of women had low levels of melatonin. Higher body mass index predicted lower levels of melatonin, and lower levels of melatonin were associated with lower sleep efficiency as assessed with wrist actigraphy. CONCLUSION These data lay the foundation for exploration of the longitudinal consequences of endogenous melatonin levels for inflammatory-based diseases in aging women with and without HIV. Future studies should consider the use of supplemental melatonin to improve sleep in women with lower levels of melatonin.
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Affiliation(s)
- Helen J. Burgess
- Department of PsychiatryUniversity of MichiganAnn ArborMichiganUSA
| | - Kathleen M. Weber
- Hektoen Institute of Medicine/CORE Center of Cook County HealthChicagoIllinoisUSA
| | - Ralph Morack
- Hektoen Institute of Medicine/CORE Center of Cook County HealthChicagoIllinoisUSA
| | - Tsion Yohannes
- Hektoen Institute of Medicine/CORE Center of Cook County HealthChicagoIllinoisUSA
| | - Jiaqian Xing
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Xiaonan Xue
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Deborah Gustafson
- Department of NeurologyState University of New York Downstate Health Sciences UniversityBrooklynNew YorkUSA
| | - Anjali Sharma
- Department of MedicineAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Elizabeth Daubert
- Hektoen Institute of Medicine/CORE Center of Cook County HealthChicagoIllinoisUSA
| | - Andrea C. Rogando
- Hektoen Institute of Medicine/CORE Center of Cook County HealthChicagoIllinoisUSA
- College of Science and HealthCharles R. Drew University of Medicine and ScienceLos AngelesCaliforniaUSA
| | - Audrey L. French
- Department of MedicineStroger Hospital of Cook County HealthChicagoIllinoisUSA
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Larriba Y, Mason IC, Saxena R, Scheer FAJL, Rueda C. CIRCUST: A novel methodology for temporal order reconstruction of molecular rhythms; validation and application towards a daily rhythm gene expression atlas in humans. PLoS Comput Biol 2023; 19:e1011510. [PMID: 37769026 PMCID: PMC10564179 DOI: 10.1371/journal.pcbi.1011510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 10/10/2023] [Accepted: 09/12/2023] [Indexed: 09/30/2023] Open
Abstract
The circadian system drives near-24-h oscillations in behaviors and biological processes. The underlying core molecular clock regulates the expression of other genes, and it has been shown that the expression of more than 50 percent of genes in mammals displays 24-h rhythmic patterns, with the specific genes that cycle varying from one tissue to another. Determining rhythmic gene expression patterns in human tissues sampled as single timepoints has several challenges, including the reconstruction of temporal order of highly noisy data. Previous methodologies have attempted to address these challenges in one or a small number of tissues for which rhythmic gene evolutionary conservation is assumed to be preserved. Here we introduce CIRCUST, a novel CIRCular-robUST methodology for analyzing molecular rhythms, that relies on circular statistics, is robust against noise, and requires fewer assumptions than existing methodologies. Next, we validated the method against four controlled experiments in which sampling times were known, and finally, CIRCUST was applied to 34 tissues from the Genotype-Tissue Expression (GTEx) dataset with the aim towards building a comprehensive daily rhythm gene expression atlas in humans. The validation and application shown here indicate that CIRCUST provides a flexible framework to formulate and solve the issues related to the analysis of molecular rhythms in human tissues. CIRCUST methodology is publicly available at https://github.com/yolandalago/CIRCUST/.
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Affiliation(s)
- Yolanda Larriba
- Department of Statistics and Operational Research, University of Valladolid, Valladolid, Spain
- Mathematics Research Institute of the University of Valladolid, University of Valladolid, Valladolid, Spain
| | - Ivy C. Mason
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Richa Saxena
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Center for Genomic Medicine and Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts, United States of America
- Division of Anesthesia, Harvard Medical School, Boston, Massachusetts, United States of America
- Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, United States of America
| | - Frank A. J. L. Scheer
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, United States of America
- Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts, United States of America
| | - Cristina Rueda
- Department of Statistics and Operational Research, University of Valladolid, Valladolid, Spain
- Mathematics Research Institute of the University of Valladolid, University of Valladolid, Valladolid, Spain
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21
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Esquivel-Mendoza J, Burgess HJ, Gren LH, Shoaf K, Baron KG. What a difference a year makes: Objective rest/activity patterns, circadian phase markers, and sleep quality before and during the COVID-19 pandemic. Sleep Health 2023; 9:544-550. [PMID: 37270395 PMCID: PMC10234465 DOI: 10.1016/j.sleh.2023.04.002] [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: 06/28/2022] [Revised: 03/24/2023] [Accepted: 04/11/2023] [Indexed: 06/05/2023]
Abstract
OBJECTIVES The COVID-19 pandemic led to numerous changes in sleep duration, quality, and timing. The goal of this study was to examine objective and self-reported changes in sleep and circadian timing before and during the pandemic. METHODS Data were utilized from an ongoing longitudinal study of sleep and circadian timing with assessments at baseline and 1-year follow-up. Participants had baseline assessment between 2019 and March 2020 (before pandemic) and 12-month follow-up between September 2020 and March 2021 (during pandemic). Participants completed 7 days of wrist actigraphy, self-report questionnaires, and laboratory-collected circadian phase assessment (dim light melatonin onset). RESULTS Actigraphy and questionnaire data were available for 18 participants (11 women and 7 men, Mean = 38.8 years, SD = 11.8). Dim light melatonin onset was available for 11 participants. Participants demonstrated statistically significant decreases in sleep efficiency (Mean = -4.11%, SD = 3.22, P = .001), worse scores on Patient-Reported Outcome Measurement Information System sleep disturbance scale (Mean increase = 4.48, SD = 6.87, P = .017), and sleep end time delay (Mean = 22.4 mins, SD = 44.4 mins, P = .046). Chronotype was significantly correlated with change in dim light melatonin onset (r = 0.649, P = .031). This suggests that a later chronotype is associated with a greater delay in dim light melatonin onset. There were also non-significant increases in total sleep time (Mean = 12.4 mins, SD = 44.4 mins, P = .255), later dim light melatonin onset (Mean = 25.2 mins, SD = 1.15 hrs, P = .295), and earlier sleep start time (Mean = 11.4 mins, SD = 48 mins, P = .322). CONCLUSION Our data demonstrate objective and self-reported changes to sleep during the COVID-19 pandemic. Future studies should look at whether some individuals will require intervention to phase advance sleep when returning to previous routines such as returning to office and school settings.
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Affiliation(s)
- Juan Esquivel-Mendoza
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, USA.
| | - Helen J Burgess
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Lisa H Gren
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, USA
| | - Kimberley Shoaf
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, USA
| | - Kelly G Baron
- Division of Public Health, Department of Family and Preventive Medicine, University of Utah, Salt Lake City, USA
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22
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Cui S, Lin Q, Gui Y, Zhang Y, Lu H, Zhao H, Wang X, Li X, Jiang F. CARE as a wearable derived feature linking circadian amplitude to human cognitive functions. NPJ Digit Med 2023; 6:123. [PMID: 37433859 DOI: 10.1038/s41746-023-00865-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 06/26/2023] [Indexed: 07/13/2023] Open
Abstract
Circadian rhythms are crucial for regulating physiological and behavioral processes. Pineal hormone melatonin is often used to measure circadian amplitude but its collection is costly and time-consuming. Wearable activity data are promising alternative, but the most commonly used measure, relative amplitude, is subject to behavioral masking. In this study, we firstly derive a feature named circadian activity rhythm energy (CARE) to better characterize circadian amplitude and validate CARE by correlating it with melatonin amplitude (Pearson's r = 0.46, P = 0.007) among 33 healthy participants. Then we investigate its association with cognitive functions in an adolescent dataset (Chinese SCHEDULE-A, n = 1703) and an adult dataset (UK Biobank, n = 92,202), and find that CARE is significantly associated with Global Executive Composite (β = 30.86, P = 0.016) in adolescents, and reasoning ability, short-term memory, and prospective memory (OR = 0.01, 3.42, and 11.47 respectively, all P < 0.001) in adults. Finally, we identify one genetic locus with 126 CARE-associated SNPs using the genome-wide association study, of which 109 variants are used as instrumental variables in the Mendelian Randomization analysis, and the results show a significant causal effect of CARE on reasoning ability, short-term memory, and prospective memory (β = -59.91, 7.94, and 16.85 respectively, all P < 0.0001). The present study suggests that CARE is an effective wearable-based metric of circadian amplitude with a strong genetic basis and clinical significance, and its adoption can facilitate future circadian studies and potential intervention strategies to improve circadian rhythms and cognitive functions.
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Affiliation(s)
- Shuya Cui
- State Key Laboratory of Microbial metabolism, Joint International Research Laboratory of Metabolic & Developmental Sciences, Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- SJTU-Yale Joint Center of Biostatistics and Data Science, National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qingmin Lin
- Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yuanyuan Gui
- State Key Laboratory of Microbial metabolism, Joint International Research Laboratory of Metabolic & Developmental Sciences, Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- SJTU-Yale Joint Center of Biostatistics and Data Science, National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yunting Zhang
- Developmental and Behavioral Pediatrics, Child Health Advocacy Institute, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Lu
- State Key Laboratory of Microbial metabolism, Joint International Research Laboratory of Metabolic & Developmental Sciences, Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
- SJTU-Yale Joint Center of Biostatistics and Data Science, National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Hongyu Zhao
- Department of Biostatistics, Yale University, New Haven, CT, USA
| | - Xiaolei Wang
- State Key Laboratory of Microbial metabolism, Joint International Research Laboratory of Metabolic & Developmental Sciences, Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China.
- SJTU-Yale Joint Center of Biostatistics and Data Science, National Center for Translational Medicine, Shanghai Jiao Tong University, Shanghai, China.
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong SAR, China.
| | - Fan Jiang
- Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institution, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
- Shanghai Center for Brain Science and Brain-Inspired Technology, Shanghai, China.
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23
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Eto T, Higuchi S. Review on age-related differences in non-visual effects of light: melatonin suppression, circadian phase shift and pupillary light reflex in children to older adults. J Physiol Anthropol 2023; 42:11. [PMID: 37355647 DOI: 10.1186/s40101-023-00328-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023] Open
Abstract
Physiological effects of light exposure in humans are diverse. Among them, the circadian rhythm phase shift effect in order to maintain a 24-h cycle of the biological clock is referred to as non-visual effects of light collectively with melatonin suppression and pupillary light reflex. The non-visual effects of light may differ depending on age, and clarifying age-related differences in the non-visual effects of light is important for providing appropriate light environments for people of different ages. Therefore, in various research fields, including physiological anthropology, many studies on the effects of age on non-visual functions have been carried out in older people, children and adolescents by comparing the effects with young adults. However, whether the non-visual effects of light vary depending on age and, if so, what factors contribute to the differences have remained unclear. In this review, results of past and recent studies on age-related differences in the non-visual effects of light are presented and discussed in order to provide clues for answering the question of whether non-visual effects of light actually vary depending on age. Some studies, especially studies focusing on older people, have shown age-related differences in non-visual functions including differences in melatonin suppression, circadian phase shift and pupillary light reflex, while other studies have shown no differences. Studies showing age-related differences in the non-visual effects of light have suspected senile constriction and crystalline lens opacity as factors contributing to the differences, while studies showing no age-related differences have suspected the presence of a compensatory mechanism. Some studies in children and adolescents have shown that children's non-visual functions may be highly sensitive to light, but the studies comparing with other age groups seem to have been limited. In order to study age-related differences in non-visual effects in detail, comparative studies should be conducted using subjects having a wide range of ages and with as much control as possible for intensity, wavelength component, duration, circadian timing, illumination method of light exposure, and other factors (mydriasis or non-mydriasis, cataracts or not in the older adults, etc.).
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Affiliation(s)
- Taisuke Eto
- Research Fellow of the Japan Society for the Promotion of Science, Kodaira, Japan
- Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Kodaira, Japan
| | - Shigekazu Higuchi
- Department of Human Life Design and Science, Faculty of Design, Kyushu University, Fukuoka, Japan.
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24
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Maurer JJ, Choi A, An I, Sathi N, Chung S. Sleep disturbances in autism spectrum disorder: Animal models, neural mechanisms, and therapeutics. Neurobiol Sleep Circadian Rhythms 2023; 14:100095. [PMID: 37188242 PMCID: PMC10176270 DOI: 10.1016/j.nbscr.2023.100095] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 03/16/2023] [Accepted: 04/08/2023] [Indexed: 05/17/2023] Open
Abstract
Sleep is crucial for brain development. Sleep disturbances are prevalent in children with autism spectrum disorder (ASD). Strikingly, these sleep problems are positively correlated with the severity of ASD core symptoms such as deficits in social skills and stereotypic behavior, indicating that sleep problems and the behavioral characteristics of ASD may be related. In this review, we will discuss sleep disturbances in children with ASD and highlight mouse models to study sleep disturbances and behavioral phenotypes in ASD. In addition, we will review neuromodulators controlling sleep and wakefulness and how these neuromodulatory systems are disrupted in animal models and patients with ASD. Lastly, we will address how the therapeutic interventions for patients with ASD improve various aspects of sleep. Together, gaining mechanistic insights into the neural mechanisms underlying sleep disturbances in children with ASD will help us to develop better therapeutic interventions.
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25
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Ishihara A, Courville AB, Chen KY. The Complex Effects of Light on Metabolism in Humans. Nutrients 2023; 15:nu15061391. [PMID: 36986120 PMCID: PMC10056135 DOI: 10.3390/nu15061391] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 03/08/2023] [Accepted: 03/10/2023] [Indexed: 03/15/2023] Open
Abstract
Light is an essential part of many life forms. The natural light–dark cycle has been the dominant stimulus for circadian rhythms throughout human evolution. Artificial light has restructured human activity and provided opportunities to extend the day without reliance on natural day–night cycles. The increase in light exposure at unwanted times or a reduced dynamic range of light between the daytime and nighttime has introduced negative consequences for human health. Light exposure is closely linked to sleep–wake regulation, activity and eating patterns, body temperature, and energy metabolism. Disruptions to these areas due to light are linked to metabolic abnormalities such as an increased risk of obesity and diabetes. Research has revealed that various properties of light influence metabolism. This review will highlight the complex role of light in human physiology, with a specific emphasis on metabolic regulation from the perspective of four main properties of light (intensity, duration, timing of exposure, and wavelength). We also discuss the potential influence of the key circadian hormone melatonin on sleep and metabolic physiology. We explore the relationship between light and metabolism through circadian physiology in various populations to understand the optimal use of light to mitigate short and long-term health consequences.
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26
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Melatonin Prescription in Children and Adolescents in Relation to Body Weight and Age. Pharmaceuticals (Basel) 2023; 16:ph16030396. [PMID: 36986495 PMCID: PMC10058986 DOI: 10.3390/ph16030396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 02/28/2023] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
The prescription of melatonin to children and adolescents has increased dramatically in Sweden and internationally during the last ten years. In the present study we aimed to evaluate the prescribed melatonin dose in relation to body weight and age in children. The population-based BMI Epidemiology Study Gothenburg cohort has weight available from school health care records, and information on melatonin prescription through linkage with high-quality national registers. We included prescriptions of melatonin to individuals below 18 years of age where a weight measurement not earlier than three months before, or later than six months after the dispensing date, was available (n = 1554). Similar maximum doses were prescribed to individuals with overweight orobesity as to individuals with normal weight, and to individuals below and above 9 years of age. Age and weight only explained a marginal part of the variance in maximum dose, but were inversely associated and explained a substantial part of the variance in maximum dose per kg. As a result, individuals overweight or with obesity, or age above 9 years, received lower maximum dose per kg of body weight, compared with individuals with normal weight or below 9 years of age. Thus, the prescribed melatonin dose to individuals under 18 years of age is not primarily informed by body weight or age, resulting in substantial differences in prescribed dose per kg of body weight across BMI and age distribution.
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27
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Chauhan S, Norbury R, Faßbender KC, Ettinger U, Kumari V. Beyond sleep: A multidimensional model of chronotype. Neurosci Biobehav Rev 2023; 148:105114. [PMID: 36868368 DOI: 10.1016/j.neubiorev.2023.105114] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/09/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023]
Abstract
Chronotype can be defined as an expression or proxy for circadian rhythms of varied mechanisms, for example in body temperature, cortisol secretion, cognitive functions, eating and sleeping patterns. It is influenced by a range of internal (e.g., genetics) and external factors (e.g., light exposure), and has implications for health and well-being. Here, we present a critical review and synthesis of existing models of chronotype. Our observations reveal that most existing models and, as a consequence, associated measures of chronotype have focused solely or primarily on the sleep dimension, and typically have not incorporated social and environmental influences on chronotype. We propose a multidimensional model of chronotype, integrating individual (biological and psychological), environmental and social factors that appear to interact to determine an individual's true chronotype with potential feedback loops between these factors. This model could be beneficial not only from a basic science perspective but also in the context of understanding health and clinical implications of certain chronotypes as well as designing preventive and therapeutic approaches for related illnesses.
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Affiliation(s)
- Satyam Chauhan
- Department of Psychology, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom.
| | - Ray Norbury
- Department of Psychology, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom
| | | | | | - Veena Kumari
- Department of Psychology, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom; Centre for Cognitive and Clinical Neuroscience, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom.
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28
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Vidafar P, Spitschan M. Light on Shedding: A Review of Sex and Menstrual Cycle Differences in the Physiological Effects of Light in Humans. J Biol Rhythms 2023; 38:15-33. [PMID: 36367137 PMCID: PMC9902977 DOI: 10.1177/07487304221126785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The human circadian system responds to light as low as 30 photopic lux. Furthermore, recent evidence shows that there are huge individual differences in light sensitivity, which may help to explain why some people are more susceptible to sleep and circadian disruption than others. The biological mechanisms underlying the differences in light sensitivity remain largely unknown. A key variable of interest in understanding these individual differences in light sensitivity is biological sex. It is possible that in humans, males and females differ in their sensitivity to light, but the evidence is inconclusive. This is in part due to the historic exclusion of women in biomedical research. Hormonal fluctuations across the menstrual cycle in women has often been cited as a confound by researchers. Attitudes, however, are changing with funding and publication agencies advocating for more inclusive research frameworks and mandating that women and minorities participate in scientific research studies. In this article, we distill the existing knowledge regarding the relationship between light and the menstrual cycle. There is some evidence of a relationship between light and the menstrual cycle, but the nature of this relationship seems dependent on the timing of the light source (sunlight, moonlight, and electric light at night). Light sensitivity may be influenced by biological sex and menstrual phase but there might not be any effect at all. To better understand the relationship between light, the circadian system, and the menstrual cycle, future research needs to be designed thoughtfully, conducted rigorously, and reported transparently.
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Affiliation(s)
- Parisa Vidafar
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
- Translational Sensory and Circadian Neuroscience, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
| | - Manuel Spitschan
- Translational Sensory and Circadian Neuroscience, Max Planck Institute for Biological Cybernetics, Tübingen, Germany
- TUM Department of Sport and Health Sciences, Technical University of Munich, Munich, Germany
- TUM Institute for Advanced Study, Technical University of Munich, Garching, Germany
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29
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Moon C, Benson CJ, Albashayreh A, Perkhounkova Y, Burgess HJ. Sleep, circadian rhythm characteristics, and melatonin levels in later life adults with and without coronary artery disease. J Clin Sleep Med 2023; 19:283-292. [PMID: 36148612 PMCID: PMC9892726 DOI: 10.5664/jcsm.10308] [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: 04/25/2022] [Revised: 09/17/2022] [Accepted: 09/19/2022] [Indexed: 02/04/2023]
Abstract
STUDY OBJECTIVES The purpose of this study was to conduct a comprehensive assessment of sleep and circadian rhythms in individuals with and without coronary artery disease (CAD). METHODS This was a cross-sectional study. Participants were 32 individuals, mean age = 70.9, female 46.9%, 19 with CAD, and 13 without CAD. We assessed sleep quality and 24-hour rest-activity rhythms for 14 days using wrist actigraphy and self-report measures, and circadian rhythm using dim light melatonin onset. RESULTS Melatonin levels prior to habitual bedtime were significantly lower in individuals with CAD than in those without CAD (median area under the curve = 12.88 vs 26.33 pg/ml × h, P = .049). The median circadian timing measured by dim light melatonin onset was the same for the 2 groups with 20:26 [hours:minutes] for individuals with CAD and 19:53 for the control group (P = .64, r = .14). Compared to the control group, the CAD group had significantly lower amplitude (P = .03, r =-.48), and lower overall rhythmicity (pseudo-F-statistic P = .004, r = -.65) in their 24-hour rest-activity rhythms. CONCLUSIONS This is one of the first studies to comprehensively assess both sleep and circadian rhythm in individuals with CAD. Compared to non-CAD controls, individuals with CAD had lower levels of melatonin prior to habitual bedtime and a lower 24-hour rest-activity rhythm amplitude and overall rhythmicity. Future studies using larger sample sizes should further investigate the possibility of suppressed circadian rhythmicity in individuals with CAD. CITATION Moon C, Benson CJ, Albashayreh A, Perkhounkova Y, Burgess HJ. Sleep, circadian rhythm characteristics, and melatonin levels in later life adults with and without coronary artery disease. J Clin Sleep Med. 2023;19(2):283-292.
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Affiliation(s)
- Chooza Moon
- University of Iowa College of Nursing, Iowa City, Iowa
| | - Christopher J. Benson
- University of Iowa Carver College of Medicine, Department of Internal Medicine, Iowa City, Iowa
| | | | | | - Helen J. Burgess
- University of Michigan, Sleep and Circadian Research Laboratory, Department of Psychiatry, Ann Arbor, Michigan
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30
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Souissi A, Dergaa I, Romdhani M, Ghram A, Irandoust K, Chamari K, Ben Saad H. Can melatonin reduce the severity of post-COVID-19 syndrome? EXCLI JOURNAL 2023; 22:173-187. [PMID: 36998709 PMCID: PMC10043401 DOI: 10.17179/excli2023-5864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 01/30/2023] [Indexed: 04/01/2023]
Abstract
This short review aimed at (i) providing an update on the health benefits associated with melatonin supplementation, while (ii) considering future potential research directions concerning melatonin supplementation use relative to Coronavirus disease of 2019 (COVID-19). A narrative review of the literature was undertaken to ascertain the effect of exogenous melatonin administration on humans. Night-time melatonin administration has a positive impact on human physiology and mental health. Indeed, melatonin (i) modulates the circadian components of the sleep-wake cycle; (ii) improves sleep efficiency and mood status; (iii) improves insulin sensitivity; and (iv) reduces inflammatory markers and oxidative stress. Melatonin has also remarkable neuroprotective and cardioprotective effects and may therefore prevent deterioration caused by COVID-19. We suggest that melatonin could be used as a potential therapy in the post-COVID-19 syndrome, and therefore call for action the research community to investigate on the potential use of exogenous melatonin to enhance the quality of life in patients with post-COVID-19 syndrome. See also Figure 1(Fig. 1).
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Affiliation(s)
- Amine Souissi
- Université de Sousse, Faculté de Médecine de Sousse, Hôpital Farhat HACHED, Laboratoire de Recherche (Insuffisance Cardiaque, LR12SP09), Sousse, Tunisie
- *To whom correspondence should be addressed: Amine Souissi, Université de Sousse, Faculté de Médecine de Sousse, Hôpital Farhat HACHED, Laboratoire de Recherche (Insuffisance Cardiaque, LR12SP09), Sousse, Tunisie, E-mail:
| | - Ismail Dergaa
- Primary Health Care Corporation (PHCC), Doha, P.O. Box 26555, Qatar
| | - Mohamed Romdhani
- Research Unit: Physical Activity, Sport, and Health, UR18JS01, National Observatory of Sport, Tunis, Tunisia
- Motricité-Interactions-Performance, MIP, UR4334, Le Mans Université, Le Mans, France
| | - Amine Ghram
- Université de Sousse, Faculté de Médecine de Sousse, Hôpital Farhat HACHED, Laboratoire de Recherche (Insuffisance Cardiaque, LR12SP09), Sousse, Tunisie
| | - Khadijeh Irandoust
- Department of Sport Sciences, Imam Khomeini International University, Qazvin, Iran
| | - Karim Chamari
- Aspetar, Orthopedic and Sports Medicine Hospital, FIFA Medical Center of Excellence, Doha, Qatar
| | - Helmi Ben Saad
- Université de Sousse, Faculté de Médecine de Sousse, Hôpital Farhat HACHED, Laboratoire de Recherche (Insuffisance Cardiaque, LR12SP09), Sousse, Tunisie
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Cruz-Sanabria F, Carmassi C, Bruno S, Bazzani A, Carli M, Scarselli M, Faraguna U. Melatonin as a Chronobiotic with Sleep-promoting Properties. Curr Neuropharmacol 2023; 21:951-987. [PMID: 35176989 PMCID: PMC10227911 DOI: 10.2174/1570159x20666220217152617] [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: 12/23/2021] [Revised: 01/26/2022] [Accepted: 02/10/2022] [Indexed: 11/22/2022] Open
Abstract
The use of exogenous melatonin (exo-MEL) as a sleep-promoting drug has been under extensive debate due to the lack of consistency of its described effects. In this study, we conduct a systematic and comprehensive review of the literature on the chronobiotic, sleep-inducing, and overall sleep-promoting properties of exo-MEL. To this aim, we first describe the possible pharmacological mechanisms involved in the sleep-promoting properties and then report the corresponding effects of exo-MEL administration on clinical outcomes in: a) healthy subjects, b) circadian rhythm sleep disorders, c) primary insomnia. Timing of administration and doses of exo-MEL received particular attention in this work. The exo-MEL pharmacological effects are hereby interpreted in view of changes in the physiological properties and rhythmicity of endogenous melatonin. Finally, we discuss some translational implications for the personalized use of exo-MEL in the clinical practice.
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Affiliation(s)
- Francy Cruz-Sanabria
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa - Italy
| | - Claudia Carmassi
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa - Italy
| | - Simone Bruno
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa - Italy
| | - Andrea Bazzani
- Institute of Management, Scuola Superiore Sant’Anna, Pisa – Italy
| | - Marco Carli
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa - Italy
| | - Marco Scarselli
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa - Italy
| | - Ugo Faraguna
- Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, Pisa - Italy
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Pisa, Italy
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Melatonin for Insomnia in Medical Inpatients: A Narrative Review. J Clin Med 2022; 12:jcm12010256. [PMID: 36615056 PMCID: PMC9821578 DOI: 10.3390/jcm12010256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 12/07/2022] [Accepted: 12/15/2022] [Indexed: 12/31/2022] Open
Abstract
In this narrative review, we describe what is known about non-pharmacological and pharmacological treatments for insomnia in medical inpatients, with a focus on melatonin. Hospital-acquired insomnia is common, resulting in shortened total sleep time and more nighttime awakenings. Sleep disturbance has been shown to increase systemic inflammation, pain, and the likelihood of developing delirium in hospital. Treatment for insomnia includes both non-pharmacological and pharmacological interventions, the latter of which requires careful consideration of risks and benefits given the known adverse effects. Though benzodiazepines and non-benzodiazepine benzodiazepine receptor agonists are commonly prescribed (i.e., sedative-hypnotics), they are relatively contraindicated for patients over the age of 65 due to the risk of increased falls, cognitive decline, and potential for withdrawal symptoms after long-term use. Exogenous melatonin has a comparatively low likelihood of adverse effects and drug-drug interactions and is at least as effective as other sedative-hypnotics. Though more research is needed on both its effectiveness and relative safety for inpatients, small doses of melatonin before bedtime may be an appropriate choice for inpatients when insomnia persists despite non-pharmacological interventions.
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Kunorozva L, Rae DE, Roden LC. Dim light melatonin onset following simulated eastward travel is earlier in young males genotyped as PER35/5 than PER34/4. Chronobiol Int 2022; 39:1611-1623. [PMID: 36324294 DOI: 10.1080/07420528.2022.2139184] [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: 11/06/2022]
Abstract
Inter-individual variability exists in recovery from jetlag following travel across time zones. Part of this variation may be due to genetic differences at the variable number tandem repeat (VNTR) polymorphism of the PERIOD3 (PER3) gene as this polymorphism has been associated with chronotype and sleep, as well as sensitivity to blue light on melatonin suppression. To test this hypothesis we conducted a laboratory-based study to compare re-entrainment in males genotyped as PER34/4 (n = 8) and PER35/5 (n = 8) following simulated eastward travel across six time zones. The recovery strategy included morning blue-enriched light exposure and appropriately-timed meals during the first 24 h after simulated travel. Dim light melatonin onset (DLMO), sleep characteristics, perceived sleepiness levels (Stanford Sleepiness Scale), and resting metabolic parameters were measured during constant routine periods before and after simulated travel. While DLMO time was similar between the two groups prior to simulated eastward travel (p = .223), it was earlier in the PER35/5 group (17h23 (17h15; 17h37)) than the PER34/4 group (18h05 (17h53; 18h12)) afterwards (p = .046). During resynchronisation, perceived sleepiness and metabolic parameters were similar to pre-travel in both groups but sleep was more disturbed in the PER35/5 group (total sleep time: p = .008, sleep efficiency: p = .008, wake after sleep onset: p = .023). The PER3 VNTR genotype may influence the efficacy of re-entrainment following trans-meridian travel when blue-enriched light exposure is incorporated into the recovery strategy on the first day following travel.
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Affiliation(s)
- Lovemore Kunorozva
- Department of Molecular and Cell Biology, University of Cape Town, Private Bag Rondebosch, Cape Town, South Africa.,Division of Sleep Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Dale E Rae
- Health through Physical Activity, Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Laura C Roden
- Department of Molecular and Cell Biology, University of Cape Town, Private Bag Rondebosch, Cape Town, South Africa.,Health through Physical Activity, Lifestyle and Sport Research Centre & Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.,Centre for Sport, Exercise and Life Sciences/School of Life Sciences, Coventry University, Coventry, UK
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Klerman EB, Brager A, Carskadon MA, Depner CM, Foster R, Goel N, Harrington M, Holloway PM, Knauert MP, LeBourgeois MK, Lipton J, Merrow M, Montagnese S, Ning M, Ray D, Scheer FAJL, Shea SA, Skene DJ, Spies C, Staels B, St‐Onge M, Tiedt S, Zee PC, Burgess HJ. Keeping an eye on circadian time in clinical research and medicine. Clin Transl Med 2022; 12:e1131. [PMID: 36567263 PMCID: PMC9790849 DOI: 10.1002/ctm2.1131] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Daily rhythms are observed in humans and almost all other organisms. Most of these observed rhythms reflect both underlying endogenous circadian rhythms and evoked responses from behaviours such as sleep/wake, eating/fasting, rest/activity, posture changes and exercise. For many research and clinical purposes, it is important to understand the contribution of the endogenous circadian component to these observed rhythms. CONTENT The goal of this manuscript is to provide guidance on best practices in measuring metrics of endogenous circadian rhythms in humans and promote the inclusion of circadian rhythms assessments in studies of health and disease. Circadian rhythms affect all aspects of physiology. By specifying minimal experimental conditions for studies, we aim to improve the quality, reliability and interpretability of research into circadian and daily (i.e., time-of-day) rhythms and facilitate the interpretation of clinical and translational findings within the context of human circadian rhythms. We describe protocols, variables and analyses commonly used for studying human daily rhythms, including how to assess the relative contributions of the endogenous circadian system and other daily patterns in behaviours or the environment. We conclude with recommendations for protocols, variables, analyses, definitions and examples of circadian terminology. CONCLUSION Although circadian rhythms and daily effects on health outcomes can be challenging to distinguish in practice, this distinction may be important in many clinical settings. Identifying and targeting the appropriate underlying (patho)physiology is a medical goal. This review provides methods for identifying circadian effects to aid in the interpretation of published work and the inclusion of circadian factors in clinical research and practice.
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Affiliation(s)
- Elizabeth B. Klerman
- Department of NeurologyMassachusetts General Hospital, Brigham and Women's HospitalBostonMassachusettsUSA
- Division of Sleep MedicineHarvard Medical SchoolBostonMassachusettsUSA
| | - Allison Brager
- PlansAnalysis, and FuturesJohn F. Kennedy Special Warfare Center and SchoolFort BraggNorth CarolinaUSA
| | - Mary A. Carskadon
- Alpert Medical School of Brown UniversityDepartment of Psychiatry and Human BehaviorEP Bradley HospitalChronobiology and Sleep ResearchProvidenceRhode IslandUSA
| | | | - Russell Foster
- Sir Jules Thorn Sleep and Circadian Neuroscience InstituteNuffield Department of Clinical NeurosciencesUniversity of OxfordOxfordUK
| | - Namni Goel
- Biological Rhythms Research LaboratoryDepartment of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Mary Harrington
- Neuroscience ProgramSmith CollegeNorthamptonMassachusettsUSA
| | | | - Melissa P. Knauert
- Section of PulmonaryCritical Care, and Sleep MedicineDepartment of Internal MedicineYale School of MedicineNew HavenConnecticutUSA
| | - Monique K. LeBourgeois
- Sleep and Development LaboratoryDepartment of Integrative PhysiologyUniversity of Colorado BoulderBoulderColoradoUSA
| | - Jonathan Lipton
- Boston Children's Hospital and Kirby Neurobiology CenterBostonMassachusettsUSA
| | - Martha Merrow
- Institute of Medical PsychologyFaculty of MedicineLMUMunichGermany
| | - Sara Montagnese
- Department of MedicineUniversity of PadovaPadovaItaly
- ChronobiologyFaculty of Health and Medical SciencesUniversity of SurreyGuildfordUK
| | - Mingming Ning
- Clinical Proteomics Research Center and Cardio‐Neurology DivisionMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - David Ray
- NIHR Oxford Biomedical Research CentreJohn Radcliffe HospitalOxfordUK
- Oxford Centre for DiabetesEndocrinology and MetabolismUniversity of OxfordOxfordUK
| | - Frank A. J. L. Scheer
- Division of Sleep MedicineHarvard Medical SchoolBostonMassachusettsUSA
- Medical Chronobiology ProgramDivision of Sleep and Circadian DisordersDepartments of Medicine and NeurologyBrigham and Women's HospitalBostonMassachusettsUSA
| | - Steven A. Shea
- Oregon Institute of Occupational Health SciencesOregon Health and Science UniversityPortlandOregonUSA
| | - Debra J. Skene
- ChronobiologyFaculty of Health and Medical SciencesUniversity of SurreyGuildfordUK
| | - Claudia Spies
- Department of Anesthesiology and Intensive Care MedicineCharité – Universitaetsmedizin BerlinBerlinGermany
| | - Bart Staels
- UnivLilleInsermCHU LilleInstitut Pasteur de LilleU1011‐EGIDLilleFrance
| | - Marie‐Pierre St‐Onge
- Division of General Medicine and Center of Excellence for Sleep and Circadian ResearchDepartment of MedicineColumbia University Irving Medical CenterNew YorkNew YorkUSA
| | - Steffen Tiedt
- Institute for Stroke and Dementia ResearchUniversity HospitalLMUMunichGermany
| | - Phyllis C. Zee
- Center for Circadian and Sleep MedicineDivision of Sleep MedicineNorthwestern University Feinberg School of MedicineChicagoIllinoisUSA
| | - Helen J. Burgess
- Sleep and Circadian Research LaboratoryDepartment of PsychiatryUniversity of MichiganAnn ArborMichiganUSA
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Menczel Schrire Z, Gordon CJ, Palmer JR, Murray J, Hickie I, Rogers NL, Lewis SJG, Terpening Z, Pye JE, Naismith SL, Hoyos CM. Actigraphic and melatonin alignment in older adults with varying dementia risk. Chronobiol Int 2022; 40:91-102. [PMID: 36408793 DOI: 10.1080/07420528.2022.2144744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Circadian rhythms alter with ageing and may be aetiologically linked to neurodegeneration. This study explored the association between clinical markers and 1) dim light melatonin onset (DLMO) time and 2) phase angle derived from sleep midpoint, in older adults with varying dementia risks. Participants completed 14 days of actigraphy followed by in-lab measurement of salivary melatonin, from which DLMO time and phase angle were computed. Eighty participants (age = 65.5, SD = 9.6), 44 males (55%), MMSE (28.6, SD = 1.5) were included in the analysis. Sex (t = 2.15, p = .04), sleep onset (r = 0.49, p < .001) and midpoint (r = 0.44, p < .001) also correlated with DLMO time. Multiple linear regression showed chronotype, average actigraphy-derived light exposure during the DLMO window (window 2 h prior to DLMO to 2 h post), early biological day (6-10 h post DLMO time) and late biological day (10-14 h post DLMO time) were predictive of DLMO time (adjusted R2 = 0.75). Sleep offset, depression severity, average light exposure during the early biological night and early and late biological day were shown to be predictive variables in the estimation of phase angle (adjusted R2 = 0.78). The current study highlights the potential use of clinical variables, such as actigraphy-derived light, as circadian markers in ageing which could be easily implemented into existing clinical practice and could yield potential targets focusing on chronotherapeutic interventions.
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Affiliation(s)
- Zoe Menczel Schrire
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, the University of Sydney, Sydney, Australia
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
| | - Christopher J Gordon
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, the University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, the University of Sydney, Sydney, Australia
| | - Jake R Palmer
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
- Department of Psychology, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Jade Murray
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia
| | - Ian Hickie
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, the University of Sydney, Sydney, Australia
| | - Naomi L. Rogers
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
| | - Simon JG Lewis
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
- Faculty of Medicine and Health, the University of Sydney, Sydney, Australia
| | - Zoe Terpening
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
| | - Jonathon E Pye
- Faculty of Medicine and Health, the University of Sydney, Sydney, Australia
| | - Sharon L Naismith
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
| | - Camilla M Hoyos
- School of Psychology, Faculty of Science, Healthy Brain Ageing Program, the University of Sydney, Sydney, Australia
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, the University of Sydney, Sydney, Australia
- Brain & Mind Centre, the University of Sydney, Sydney, Australia
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Weng M, Schöllhorn I, Kazhura M, Cardini BB, Stefani O. Impact of Evening Light Exposures with Different Solid Angles on Circadian Melatonin Rhythms, Alertness, and Visual Comfort in an Automotive Setting. Clocks Sleep 2022; 4:607-622. [PMID: 36412580 PMCID: PMC9680305 DOI: 10.3390/clockssleep4040047] [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: 08/26/2022] [Revised: 10/04/2022] [Accepted: 10/21/2022] [Indexed: 12/14/2022] Open
Abstract
Future automotive interior lighting might have the potential to go beyond decorative purposes by influencing alertness, circadian physiology, and sleep. As the available space in the interior of an automobile for lighting applications is limited, understanding the impact of various luminous surface sizes on non-image-forming effects is fundamental in this field. In a laboratory study using a within-subject design, 18 participants were exposed to two bright light conditions with different solid angles and one dim light condition in a balanced, randomized order during the course of the evening. Our results demonstrate that both light conditions significantly increased subjective alertness and reduced salivary melatonin concentration but not cognitive performance compared to dim light. The solid angle of light exposure at constant corneal illuminance only affected visual comfort. While subjective alertness can be increased and melatonin can be attenuated with rather small luminaires, larger solid angles should be considered if visual comfort is a priority.
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Affiliation(s)
- Michael Weng
- Volkswagen AG, 38440 Wolfsburg, Germany
- Correspondence:
| | - Isabel Schöllhorn
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, 4002 Basel, Switzerland
- Transfaculty Research Platform Molecular and Cognitive Neurosciences (MCN), University of Basel, 4001 Basel, Switzerland
| | | | - Brian B. Cardini
- Department of Applied Psychology, University of Applied Sciences and Arts Northwestern Switzerland Basel, 4600 Olten, Switzerland
| | - Oliver Stefani
- Centre for Chronobiology, Psychiatric Hospital of the University of Basel, 4002 Basel, Switzerland
- Transfaculty Research Platform Molecular and Cognitive Neurosciences (MCN), University of Basel, 4001 Basel, Switzerland
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Dim light melatonin patterns in unaffected offspring of parents with bipolar disorder: A case-control high-risk study. J Affect Disord 2022; 315:42-47. [PMID: 35878843 DOI: 10.1016/j.jad.2022.07.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/19/2022] [Accepted: 07/17/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Circadian dysregulation has long been thought to be a key component in the pathophysiology of bipolar disorder (BD). However, it remains unclear whether this dysregulation constitutes a risk factor, manifestation, or consequence of BD. This study aimed to compare dim light melatonin secretion patterns between unaffected offspring of parents with BD (OBD) and offspring of control parents (OCP). METHODS This case-control study included unaffected OBD (mean age 14.0 years; male 50.0 %) and age- and sex-matched OCP (mean age 13.0 years; male: 43.5 %). Seventeen saliva samples were collected in dim light conditions. Dim light melatonin onset (DLMO), phase angles, and area under the curve (AUC) were calculated. RESULTS 185 saliva samples from 12 OBD (n = 12) and 741 from OCP (n = 46) were collected. Unaffected OBD had a significant lower nocturnal melatonin level (14.8 ± 4.6 vs. 20.3 ± 11.7 pg/mL) and a smaller melatonin AUC within two hours after DLMO (35.5 ± 11.3 vs. 44.6 ± 18.1 pg/mL) but a significant larger phase angle between DLMO and sleep onset (2.2 ± 1.0 vs. 1.4 ± 1.2 h) than OCP. There was no significant between-group difference in DLMO. The graphic illustrations showed a considerably flattened melatonin secretion in unaffected OBD. LIMITATIONS The main limitations include lack of 24-h dim melatonin secretion measurement, large age range of participants, and small sample size. CONCLUSIONS These findings suggest that unaffected OBD already presented with circadian rhythm dysregulations. Future investigations are needed to clarify the role of abnormal melatonin secretion in the onset of BD.
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Ohashi M, Lee SI, Eto T, Uotsu N, Tarumizu C, Matsuoka S, Yasuo S, Higuchi S. Intake of l-serine before bedtime prevents the delay of the circadian phase in real life. J Physiol Anthropol 2022; 41:31. [PMID: 36028887 PMCID: PMC9413878 DOI: 10.1186/s40101-022-00306-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 08/16/2022] [Indexed: 11/10/2022] Open
Abstract
Background It has been shown in laboratory experiments using human subjects that ingestion of the non-essential amino acid l-serine before bedtime enhances the advance of circadian phase induced by light exposure the next morning. In the present study, we tested the effect of ingestion of l-serine before bedtime on circadian phase in real life and whether its effect depends on the initial circadian phase. Methods The subjects were 33 healthy male and female university students and they were divided into an l-serine group (n = 16) and a placebo group (n = 17). This study was conducted in a double-blind manner in autumn and winter. After a baseline period for 1 week, the subjects took 3.0 g of l-serine or a placebo 30 min before bedtime for 2 weeks. Saliva was collected twice a week at home every hour under a dim light condition from 20:00 to 1 h after habitual bedtime. Dim light melatonin onset (DLMO) was used as an index of phase of the circadian rhythm. Results DLMO after intervention was significantly delayed compared to the baseline DLMO in the placebo group (p = 0.02) but not in the l-serine group. There was a significant difference in the amount of changes in DLMO between the two groups (p = 0.04). There were no significant changes in sleeping habits after intervention in the two groups. There were significant positive correlations between advance of DLMO and DLMO before intervention in the l-serine group (r = 0.53, p < 0.05) and the placebo group (r = 0.69, p < 0.01). There was no significant difference in the slopes of regression lines between the two groups (p = 0.71), but the intercept in the l-serine group was significantly higher than that in the placebo group (p < 0.01). The levels of light exposure were not significantly different between the two groups. Conclusions Our findings suggest that intake of l-serine before bedtime for multiple days might attenuate the circadian phase delay in the real world and that this effect does not depend on the initial circadian phase. Trial registration This study is registered with University Hospital Medical Information Network in Japan (UMIN000024435. Registered on October 17, 2016).
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Martinez-Cayuelas E, Gavela-Pérez T, Rodrigo-Moreno M, Merino-Andreu M, Vales-Villamarín C, Pérez-Nadador I, Garcés C, Soriano-Guillén L. Melatonin Rhythm and Its Relation to Sleep and Circadian Parameters in Children and Adolescents With Autism Spectrum Disorder. Front Neurol 2022; 13:813692. [PMID: 35775056 PMCID: PMC9237227 DOI: 10.3389/fneur.2022.813692] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 05/17/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction Sleep problems are prevalent among individuals with autism spectrum disorder (ASD), and a role has been attributed to melatonin in this multifactorial comorbidity. Methods A cross-sectional study was conducted on 41 autistic children and adolescents (9.9 ± 3.02) and 24 children and adolescents with a normal intellectual function (8.42 ± 2.43) were used as controls. Subjects were matched for sex, body mass index, and pubertal stage, and all were drug-naive. Circadian and sleep parameters were studied using an ambulatory circadian monitoring (ACM) device, and saliva samples were collected around the onset of sleep to determine dim light melatonin onset (DLMO). Results Prepubertal individuals with ASD presented later DLMO and an earlier decline in melatonin during adolescence. A relationship was found between melatonin and both sleep and circadian parameters. Participants and controls with later DLMOs were more likely to have delayed sleep onset times. In the ASD group, subjects with the later daytime midpoint of temperature had a later DLMO. Later melatonin peak time and DLMO time were related to lower general motor activity and lower stability of its rhythms. Conclusion The melatonin secretion pattern was different in individuals with ASD, and it showed a relationship with sleep and circadian parameters. Alterations in DLMO have not been previously reported in ASD with the exception of more variable DLMO timing; however, high variability in the study design and sample characteristics prevents direct comparison. The ACM device enabled the measurement of circadian rhythm, a scarcely described parameter in autistic children. When studied in combination with other measures such as melatonin, ACM can offer further knowledge on sleep problems in ASD.
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Affiliation(s)
- Elena Martinez-Cayuelas
- Department of Pediatrics, Instituto de Investigaciones Sanitarias- Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
- *Correspondence: Elena Martinez-Cayuelas
| | - Teresa Gavela-Pérez
- Department of Pediatrics, Instituto de Investigaciones Sanitarias- Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - María Rodrigo-Moreno
- Department of Pediatrics, Instituto de Investigaciones Sanitarias- Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | | | - Claudia Vales-Villamarín
- Lipid Laboratory, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Iris Pérez-Nadador
- Lipid Laboratory, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Carmen Garcés
- Lipid Laboratory, Instituto de Investigaciones Sanitarias-Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
| | - Leandro Soriano-Guillén
- Department of Pediatrics, Instituto de Investigaciones Sanitarias- Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain
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Lee EK, Poon P, Yu C, Lee VW, Chung VC, Wong SY. Controlled-release oral melatonin supplementation for hypertension and nocturnal hypertension: A systematic review and meta-analysis. J Clin Hypertens (Greenwich) 2022; 24:529-535. [PMID: 35388609 PMCID: PMC9106086 DOI: 10.1111/jch.14482] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 03/26/2022] [Accepted: 03/26/2022] [Indexed: 12/16/2022]
Abstract
Oral melatonin is a potential alternative treatment for hypertension and nocturnal hypertension. However, high-quality and relevant meta-analyses are lacking. This meta-analysis aimed to investigate whether oral melatonin supplementation reduces daytime/asleep blood pressure and cardiovascular risk, improves sleep quality, and is well-tolerated compared with placebo. Relevant articles were searched in multiple databases, including MEDLINE, EMBASE, CINAHL Complete, and the Cochrane Library, from their inception to June 2021. The included studies were randomized controlled trials recruiting patients with hypertension, using oral melatonin as the sole intervention, and investigating its effect on blood pressure. The mean out-of-office (including 24-h, daytime, and asleep) systolic and diastolic blood pressures, sleep quality, and side effects were compared between the melatonin and placebo arms using pairwise random-effect meta-analyses. A risk of bias assessment was performed using the Cochrane risk-of-bias tool. Four studies were included in the analysis and only one study was considered to have a low risk of bias. No study reported on cardiovascular risk or outcomes. Only controlled-release melatonin (not an immediate-release preparation) reduced asleep systolic blood pressure by 3.57 mm Hg (95% confidence interval: -7.88 to .73; I2 = 0%). It also reduced asleep and awake diastolic blood pressure, but these differences were not statistically significant. Melatonin improves sleep efficacy and total sleep time and is safe and well-tolerated. Due to the limited number of high-quality trials, the quality of evidence was low to very low. Therefore, adequately powered randomized controlled trials on melatonin are warranted.
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Affiliation(s)
- Eric Kam‐Pui Lee
- Jockey Club School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong Kong
| | - Paul Poon
- Jockey Club School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong Kong
| | - Chun‐Pong Yu
- Li Ping Medical LibraryThe Chinese University of Hong KongHong Kong
| | - Vivian Wing‐Yan Lee
- the Centre for Learning Enhancement and Research, Faculty of MedicineThe Chinese University of Hong KongHong Kong
| | - Vincent Chi‐Ho Chung
- Jockey Club School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong Kong
- School of Chinese Medicine, Faculty of MedicineThe Chinese University of Hong KongHong Kong
| | - Samuel Yeung‐Shan Wong
- Jockey Club School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong Kong
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Wibrow B, Martinez FE, Myers E, Chapman A, Litton E, Ho KM, Regli A, Hawkins D, Ford A, van Haren FMP, Wyer S, McCaffrey J, Rashid A, Kelty E, Murray K, Anstey M. Prophylactic melatonin for delirium in intensive care (Pro-MEDIC): a randomized controlled trial. Intensive Care Med 2022; 48:414-425. [DOI: 10.1007/s00134-022-06638-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 01/28/2022] [Indexed: 12/16/2022]
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Malik R, Rafli R, Salmi S, Noer YA. Relationship of Sleep Quality and Oxidative Stress Level in Smartphone Users; Study in Faculty of Medicine Student, Universitas Baiturrahmah. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Excessive smartphones can affect sleep quality, reducing sleep duration. This lack of sleep will impact various health and increase levels of free radicals in the body, affecting various cell functions.
AIM: The aim of the study was to measure the relationship between sleep quality due to smartphone use and serum malondialdehyde (MDA) levels.
MATERIALS AND METHODS: This was a quasi-experimental with pre- and post-test group study. Sleep quality was assessed with Pittsburgh Sleep Quality Index (PSQI), and the smartphone addiction was assessed based on Smartphone Addiction Scale (SAS) score. The subjects were divided into four groups (n = 6) based on their PSQI and SAS score. The first group was the subjects with normal sleep and non-smartphone addict. The second group was the subjects with normal sleep but smartphone addict. The third group was the subjects with abnormal sleep and non-smartphone addict. Furthermore, fourth was the subjects with abnormal sleep and smartphone addiction. All the subjects were asked to sleep usually and used the smartphone as necessary a day before the study started. Blood plasma was collected from the subject before and after the study for MDA measurement. Plasma MDA was determined using the thiobarbituric acid test.
RESULTS: Smartphone use can reduce sleep quality and duration, resulting in sleep deprivation. There was no increase in MDA concentration (p > 0.05) in the ordinary and non-addictive or smartphone-addicted sleep group. Meanwhile, the group that stayed up late and was neither addictive nor addictive showed an increase in MDA levels and was statistically significant (p < 0.05).
CONCLUSION: Adequate sleep can reduce blood serum MDA levels and smartphone use does not affect MDA levels.
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Hasler BP, Graves JL, Soehner AM, Wallace ML, Clark DB. Preliminary Evidence That Circadian Alignment Predicts Neural Response to Monetary Reward in Late Adolescent Drinkers. Front Neurosci 2022; 16:803349. [PMID: 35250449 PMCID: PMC8888521 DOI: 10.3389/fnins.2022.803349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Robust evidence links sleep and circadian rhythm disturbances to alcohol use and alcohol-related problems, with a growing literature implicating reward-related mechanisms. However, the extant literature has been limited by cross-sectional designs, self-report or behavioral proxies for circadian timing, and samples without substantive alcohol use. Here, we employed objective measures of sleep and circadian rhythms, and an intensive prospective design, to assess whether circadian alignment predicts the neural response to reward in a sample of late adolescents reporting regular alcohol use. METHODS Participants included 31 late adolescents (18-22 y/o; 19 female participants) reporting weekly alcohol use. Participants completed a 14-day protocol including pre- and post-weekend (Thursday and Sunday) circadian phase assessments via the dim light melatonin onset (DLMO), in counterbalanced order. Sleep-wake timing was assessed via actigraphy. Circadian alignment was operationalized as the DLMO-midsleep interval; secondary analyses considered social jet lag based on weekday-weekend differences in midsleep or DLMO. Neural response to reward (anticipation and outcome) was assessed via a monetary reward fMRI task (Friday and Monday scans). Alcohol use was assessed at baseline and via ecological momentary assessment. Mean BOLD signal was extracted from two regions-of-interest (striatum and medial prefrontal cortex, mPFC) for analyses in regression models, accounting for age, sex, racial identity, and scan order. RESULTS In primary analyses, shorter DLMO-midsleep intervals (i.e., greater misalignment) on Thursday predicted lower striatal and mPFC responses to anticipated reward, but not reward outcome, on Friday. Lower neural (striatum and mPFC) responses to anticipated reward on Friday correlated with more binge-drinking episodes at baseline, but were not associated with alcohol use in the post-scan weekend. In secondary analyses, greater social jet lag (particularly larger weekend delays in midsleep or DLMO) was associated with lower neural responses to reward anticipation on Monday. CONCLUSION Findings provide preliminary evidence of proximal associations between objectively determined circadian alignment and the neural response to anticipated monetary reward, which is linked in turn to patterns of problematic drinking. Replication in a larger sample and experimental designs will be important next steps to determining the extent to which circadian misalignment influences risk for alcohol involvement via alterations in reward function.
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Affiliation(s)
- Brant P. Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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44
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Chronbiologically-based sub-groups in bipolar I disorder: A latent profile analysis. J Affect Disord 2022; 299:691-697. [PMID: 34879259 DOI: 10.1016/j.jad.2021.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND Bipolar disorder presents with significant phenotypic heterogeneity. The aim of this study was to investigate whether bipolar disorder, type I (BDI) subjects could be meaningfully classified into homogeneous groups according to activity, sleep, and circadian characteristics using latent profile analysis (LPA). We hypothesized that distinct BDI sub-groups would be identified based primarily on circadian-associated markers. MATERIALS AND METHODS 105 individuals with BDI were included in the study. Seventeen activity, sleep, and circadian characteristics were assessed via actigraphy and clinical assessments. LPA was conducted to stratify our sample into homogenous sub-groups. Differences between groups on demographic, clinical, activity, sleep, and circadian characteristics were explored. RESULTS Two distinct groups were identified, a High Chronobiological Disturbance group (HCD) (56%, N = 59) and a Low Chronobiological Disturbance group (LCD) (41%; N = 46). Circadian variables were the defining characteristics in sub-group determination. Large effect sizes and magnitudes of association were noted in circadian variables between HCD and LCD sub-groups. Several circadian rhythm variables accounted for a large percentage of the variance between HCD and LCD sub-groups. No differences were noted between sub-groups on demographic characteristics and the psychiatric medications currently in use. Mood state did not significantly impact sub-group differences. LIMITATIONS The protocol was cross-sectional in design. Longitudinal studies are required to determine the stability of the identified sub-groups. CONCLUSION LPA was able to identify sub-groups in BDI with circadian variables being the most distinguishing factors in determining sub-group class membership. Future research should explore the role that circadian characteristics can play in defining sub-phenotypes of bipolar disorder.
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Cipolla-Neto J, Amaral FG, Soares JM, Gallo CC, Furtado A, Cavaco JE, Gonçalves I, Santos CRA, Quintela T. The Crosstalk between Melatonin and Sex Steroid Hormones. Neuroendocrinology 2022; 112:115-129. [PMID: 33774638 DOI: 10.1159/000516148] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 03/24/2021] [Indexed: 11/19/2022]
Abstract
Melatonin, an indolamine mainly released from the pineal gland, is associated with many biological functions, namely, the modulation of circadian and seasonal rhythms, sleep inducer, regulator of energy metabolism, antioxidant, and anticarcinogenic. Although several pieces of evidence also recognize the influence of melatonin in the reproductive physiology, the crosstalk between melatonin and sex hormones is not clear. Here, we review the effects of sex differences in the circulating levels of melatonin and update the current knowledge on the link between sex hormones and melatonin. Furthermore, we explore the effects of melatonin on gonadal steroidogenesis and hormonal control in females. The literature review shows that despite the strong evidence that sex differences impact on the circadian profiles of melatonin, reports are still considerably ambiguous, and these differences may arise from several factors, like the use of contraceptive pills, hormonal status, and sleep deprivation. Furthermore, there has been an inconclusive debate about the characteristics of the reciprocal relationship between melatonin and reproductive hormones. In this regard, there is evidence for the role of melatonin in gonadal steroidogenesis brought about by research that shows that melatonin affects multiple transduction pathways that modulate Sertoli cell physiology and consequently spermatogenesis, and also estrogen and progesterone production. From the outcome of our research, it is possible to conclude that understanding the correlation between melatonin and reproductive hormones is crucial for the correction of several complications occurring during pregnancy, like preeclampsia, and for the control of climacteric symptoms.
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Affiliation(s)
- José Cipolla-Neto
- Department of Physiology and Biophysics, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil
| | | | - José Maria Soares
- Laboratório de Ginecologia Estrutural e Molecular (LIM 58), Disciplina de Ginecologia, Departamento de Obstetrícia e Ginecologia, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, HCFMUSP, São Paulo, Brazil
| | | | - André Furtado
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - José Eduardo Cavaco
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Isabel Gonçalves
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | | | - Telma Quintela
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
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BİLİR H, YILMAZ B. An Evaluation of The Relationship Between Self-Reported Sleep/Awake Bruxism and The Chronotype Profiles of The Dental Students. CUMHURIYET DENTAL JOURNAL 2021. [DOI: 10.7126/cumudj.1008795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Vidafar P, Yocum AK, Han P, McInnis MG, Burgess HJ. Late chronotype predicts more depressive symptoms in bipolar disorder over a 5 year follow-up period. Int J Bipolar Disord 2021; 9:28. [PMID: 34468894 PMCID: PMC8410924 DOI: 10.1186/s40345-021-00233-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 08/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND There is increasing evidence that bipolar disorder is influenced by circadian timing, including the timing of sleep and waking activities. Previous studies in bipolar disorder have shown that people with later timed daily activities, also known as late chronotypes, are at higher risk for subsequent mood episodes over the following 12-18 months. However, these studies were limited to euthymic patients and smaller sample sizes. The aim of the current study was to further examine baseline chronotype as a potentially important predictor of mood-related outcomes in a larger sample of individuals with bipolar disorder and over the longest follow up period to date, of 5 years. Participants included 318 adults diagnosed with bipolar I and II (19-86 years) who were enrolled in the Prechter Longitudinal Study of Bipolar Disorder. RESULTS Participants with a late chronotype were found to be more likely to have mild to more severe depressive symptoms (PHQ-9 ≥ 5) as captured with PHQ-9 assessments every 2 months over the 5 year follow up period. This higher risk for depressive symptoms remained even after adjusting for age, sex and mood at baseline. Additionally, late chronotypes reported fewer hypomania/mania episodes during the 5 year follow up, as derived from clinical interviews every two years. CONCLUSIONS These results highlight the potential clinical usefulness of a single self-report question, in identifying patients at risk for a more depressive mood course. The results also suggest that circadian phase advancing treatments, that can shift circadian timing earlier, should be explored as a means to reduce depressive symptoms in late chronotypes with bipolar disorder.
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Affiliation(s)
- Parisa Vidafar
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA
| | - Anastasia K Yocum
- Depression Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Peisong Han
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Melvin G McInnis
- Depression Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Helen J Burgess
- Sleep and Circadian Research Laboratory, Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Rd, Ann Arbor, MI, 48109, USA. .,Depression Center, Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA.
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Hussain A, Gopalakrishnan A, Muthuvel B, Hussaindeen JR, Narayanasamy A, Sivaraman V. Young adults with myopia have lower concentrations of neuromodulators-dopamine and melatonin in serum and tear. Exp Eye Res 2021; 209:108684. [PMID: 34175263 DOI: 10.1016/j.exer.2021.108684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 11/24/2022]
Abstract
The purpose of this experimental case-control study was to explore the association between myopia and concentration of dopamine and melatonin in serum and tear fluid among young myopic adults, compared to age matched non-myopic controls. Healthy myopic adults with Spherical equivalent refraction (SER) of ≤ -0.50 D to -6.00 D and emmetropic adults were included in the study. All participants underwent comprehensive eye examination and ocular biometric measures that included-axial length and corneal radii. Insomnia symptom questionnaire (ISQ) was used to screen the symptoms associated with the diagnostic criteria for primary insomnia. Morning serum and tear concentration of dopamine and melatonin were collected and was quantified using High performance liquid chromatography. A total number of 40 participants, 21 myopes and 19 controls, with a median (IQR) age of myopes 24 [21-34] years and controls 24 [20-29] years were studied. The Median [IQR] of SER was -2.00[-6.25-(-0.50)] D and 0 [(-0.50)-0.25] D for myopes and controls respectively. Myopes were found to have significantly lower concentration of serum dopamine (Median [IQR]) 190 [50-342] ng/mL compared to controls (Median [IQR]) 411 [84-717] ng/mL (U = 88, p < 0.002). Likewise, myopes showed significantly lower serum melatonin concentration of 40 [20-169] ng/mL compared to controls 203 [22-539] ng/mL (U = 88.50, p < 0.001). Myopes exhibited lower concentration of tear dopamine 101 [8-188] ng/mL compared to controls 136 [25-451] ng/mL (U = 103, p < 0.05). Likewise, myopes showed significantly lower tear melatonin concentration 6 [2-18] ng/mL compared to controls 9 [2-23] ng/mL (U = 104, p < 0.05). Both serum dopamine (r = 0.419, p < 0.05) and melatonin (r = 0.323, p < 0.05) showed significant positive association with increase in spherical equivalent refraction (SER). The observed changes in the decreased concentration of Dopamine and Melatonin among young adult myopes and its association with refraction indicates the role of altered circadian rhythm in the human myopia mechanism.
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Affiliation(s)
- Azfira Hussain
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India
| | - Aparna Gopalakrishnan
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India; Faculty of Health, School of Medicine, Deakin University, Australia
| | - Bharathselvi Muthuvel
- R.S.Mehta Jain Department of Biochemistry and Cell Biology, Vision Research Foundation, Sankara Nethralaya, Chennai, India
| | | | - Angayarkanni Narayanasamy
- R.S.Mehta Jain Department of Biochemistry and Cell Biology, Vision Research Foundation, Sankara Nethralaya, Chennai, India
| | - Viswanathan Sivaraman
- Myopia Clinic, Sankara Nethralaya, Unit of Medical Research Foundation, Chennai, India.
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Ishihara A, Park I, Suzuki Y, Yajima K, Cui H, Yanagisawa M, Sano T, Kido J, Tokuyama K. Metabolic responses to polychromatic LED and OLED light at night. Sci Rep 2021; 11:12402. [PMID: 34117328 PMCID: PMC8196130 DOI: 10.1038/s41598-021-91828-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/01/2021] [Indexed: 02/05/2023] Open
Abstract
Light exposure at night has various implications for human health, but little is known about its effects on energy metabolism during subsequent sleep. We investigated the effects of polychromatic white light using conventional light-emitting diodes (LED) and an alternative light source, organic light-emitting diodes (OLED), producing reduced spectral content in the short wavelength of blue light (455 nm). Ten male participants were exposed to either LED, OLED (1000 lx), or dim (< 10 lx) light for 4 h before sleep in a metabolic chamber. Following OLED exposure, energy expenditure and core body temperature during sleep were significantly decreased (p < 0.001). Fat oxidation during sleep was significantly reduced (p = 0.001) after the exposure to LED compared with OLED. Following exposure to OLED, fat oxidation positively correlated with the 6-sulfatoxymelatonin levels, suggesting that the role of melatonin in lipolysis differs depending on the light. These findings advance our knowledge regarding the role of light in energy metabolism during sleep and provide a potential alternative to mitigate the negative consequences of light exposure at night.
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Affiliation(s)
- Asuka Ishihara
- grid.20515.330000 0001 2369 4728International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki Japan ,grid.20515.330000 0001 2369 4728Ph.D. Program in Human Biology, School of Integrative Global Majors, University of Tsukuba, Tsukuba, Japan
| | - Insung Park
- grid.20515.330000 0001 2369 4728International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki Japan
| | - Yoko Suzuki
- grid.20515.330000 0001 2369 4728International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki Japan
| | - Katsuhiko Yajima
- grid.411949.00000 0004 1770 2033Faculty of Pharmaceutical Sciences, Josai University, Saitama, Japan
| | - Huiyun Cui
- grid.20515.330000 0001 2369 4728Graduate School of Comprehensive Human Sciences, University of Tsukuba, Ibaraki, Japan
| | - Masashi Yanagisawa
- grid.20515.330000 0001 2369 4728International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki Japan
| | - Takeshi Sano
- grid.268394.20000 0001 0674 7277Innovation Center for Organic Electronics, Yamagata University, Yamagata, Japan
| | - Junji Kido
- grid.268394.20000 0001 0674 7277Graduate School of Organic Materials Science, Yamagata University, Yamagata, Japan
| | - Kumpei Tokuyama
- grid.20515.330000 0001 2369 4728International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, Tsukuba, Ibaraki Japan
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Kudo N, Shinohara H, Kagabu S, Kodama H. Evaluation of salivary melatonin concentrations as a circadian phase maker of morning awakening and their association with depressive mood in postpartum mothers. Chronobiol Int 2021; 38:1409-1420. [PMID: 34100322 DOI: 10.1080/07420528.2021.1930028] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The disruption of circadian rhythm is closely related to mood disorders in night-shift workers, and a similar situation may occur in postpartum mothers. However, the situations of postpartum mothers remain largely unknown because of a lack of an appropriate circadian phase marker in the clinical setting. This study aimed to evaluate whether salivary melatonin concentration at awakening can identify misalignment between awakening time and the biological clock system, which might be associated with depressive mood in some mothers. Ninety-eight healthy mothers who were currently the primary parental caregivers were recruited at 1 month after delivery. All mothers completed the Edinburgh Postnatal Depression Scale (EPDS) and wore an actigraphy watch at home for 3 consecutive days to determine nocturnal sleep variables. While wearing the actigraphy watch, they also collected saliva samples during the awakening period for a melatonin concentration assay. The results indicated that daily salivary melatonin levels after 30 min of awakening (hereafter, melatonin levels) were positively correlated with sleep onset time and negatively correlated with sleep offset time and total sleep time. Six mothers with an EPDS score of ≥9 (the cutoff value for Japanese women at high risk for postnatal depression) had an average melatonin level of either <4 pg/ml or >16 pg/ml for 3 d. Mothers with melatonin levels <4 pg/ml or >16 pg/ml tended to have elevated EPDS scores (4.93 ± 2.95 or 4.20 ± 2.93, mean ± standard deviation) compared with mothers with melatonin levels between 4 and 16 pg/ml (3.00 ± 2.12, p = .053). Mothers whose melatonin levels were >16 pg/ml had relatively later sleep onset time and shorter nocturnal sleep duration. Backward stepwise regression demonstrated that such high/low levels of melatonin were a significant predictor of EPDS scores. These results suggest that elevated melatonin levels after 30 min of awakening could identify a phase-delayed circadian rhythm in postpartum mothers, and that relatively higher or lower melatonin levels could be associated with increased depressive mood.
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Affiliation(s)
- Naoko Kudo
- Department of Maternity Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, Akita-shi, Japan
| | - Hitomi Shinohara
- Department of Maternity Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, Akita-shi, Japan
| | | | - Hideya Kodama
- Department of Maternity Nursing, Akita University Graduate School of Medicine and Faculty of Medicine, School of Health Science, Akita-shi, Japan
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