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Flink CC, Hobohm RE, Zhang B, Jacobson DL, England EB. Effects of night-float shifts on cognitive function among radiology residents. Emerg Radiol 2024:10.1007/s10140-024-02269-3. [PMID: 39046634 DOI: 10.1007/s10140-024-02269-3] [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: 04/16/2024] [Accepted: 07/08/2024] [Indexed: 07/25/2024]
Abstract
BACKGROUND Many radiology programs utilize a night-float system to mitigate the effects of fatigue, improve patient care, and provide faster report turnaround times. Prior studies have demonstrated an increase in discrepancy rates during night-float shifts. OBJECTIVES This study was performed to examine the effects of night-float shift work on radiology resident cognition. We hypothesized that there would be diminished cognitive function on testing following night-float shifts when compared to testing following day shifts. METHODS Diagnostic radiology residents in their second to fifth years of residency at a single institution were recruited to participate in this pilot study. Cognitive function was evaluated using the Lumosity Neurocognitive Performance Tests (NCPT), standardized performance tests that provide real-time, objective measurements of cognitive function. Study participants completed the NCPT in 5 sessions following 5 consecutive day shifts to evaluate their baseline cognitive function. The tests were re-administered at the end of consecutive night-float shifts to assess for any changes. Sleep was objectively monitored using actigraphy devices worn around the wrist during all study weeks. Descriptive and summary statistics were performed. RESULTS 23 prospectively recruited diagnostic radiology residents working night-float shifts took a mean 13.6 (± 5.1) neurocognitive performance tests during the study period. There was a statistically significant decline in 2 of the 6 cognitive tests administered, signifying a decrease in attention, speed, and complex reasoning ability. Night-float shifts were significantly longer than the day shifts and associated with a significantly higher study volume and cross-sectional study volume. Fitbit data demonstrated that there were no significant differences in level of activity while awake. However, participants slept significantly longer during day shifts. CONCLUSIONS A sample of 23 radiology residents working night-float shifts demonstrated declines in attention, speed, and complex reasoning ability following sequential administration of standardized neurocognitive performance tests. While the sample size is small, these findings demonstrate the potential deleterious effects of night-float shift work and provide evidence to support further inquiry into this phenomenon.
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Affiliation(s)
- Carl C Flink
- Department of Radiology, University of Cincinnati Medical Center, CARE/Crawley Building, Suite E-870, 3230 Eden Avenue, Cincinnati, OH, 45267, USA.
| | - Robert E Hobohm
- Department of Radiology, University of Cincinnati Medical Center, CARE/Crawley Building, Suite E-870, 3230 Eden Avenue, Cincinnati, OH, 45267, USA
| | - Bin Zhang
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Deborah L Jacobson
- Division of Urology, Department of Surgery, University of Utah Medical Center, Salt Lake City, Utah, USA
| | - Eric B England
- Department of Radiology, University of Cincinnati Medical Center, CARE/Crawley Building, Suite E-870, 3230 Eden Avenue, Cincinnati, OH, 45267, USA
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2
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Yan R, Liu X, Dutcher JM, Tumminia MJ, Villalba D, Cohen S, Creswell JD, Creswell K, Mankoff J, Dey AK, Doryab A. Identifying Links Between Productivity and Biobehavioral Rhythms Modeled From Multimodal Sensor Streams: Exploratory Quantitative Study. JMIR AI 2024; 3:e47194. [PMID: 38875675 PMCID: PMC11066747 DOI: 10.2196/47194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Revised: 10/31/2023] [Accepted: 02/15/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Biobehavioral rhythms are biological, behavioral, and psychosocial processes with repeating cycles. Abnormal rhythms have been linked to various health issues, such as sleep disorders, obesity, and depression. OBJECTIVE This study aims to identify links between productivity and biobehavioral rhythms modeled from passively collected mobile data streams. METHODS In this study, we used a multimodal mobile sensing data set consisting of data collected from smartphones and Fitbits worn by 188 college students over a continuous period of 16 weeks. The participants reported their self-evaluated daily productivity score (ranging from 0 to 4) during weeks 1, 6, and 15. To analyze the data, we modeled cyclic human behavior patterns based on multimodal mobile sensing data gathered during weeks 1, 6, 15, and the adjacent weeks. Our methodology resulted in the creation of a rhythm model for each sensor feature. Additionally, we developed a correlation-based approach to identify connections between rhythm stability and high or low productivity levels. RESULTS Differences exist in the biobehavioral rhythms of high- and low-productivity students, with those demonstrating greater rhythm stability also exhibiting higher productivity levels. Notably, a negative correlation (C=-0.16) was observed between productivity and the SE of the phase for the 24-hour period during week 1, with a higher SE indicative of lower rhythm stability. CONCLUSIONS Modeling biobehavioral rhythms has the potential to quantify and forecast productivity. The findings have implications for building novel cyber-human systems that align with human beings' biobehavioral rhythms to improve health, well-being, and work performance.
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Affiliation(s)
- Runze Yan
- University of Virginia, Charlottesville, VA, United States
| | - Xinwen Liu
- Carnegie Mellon University, Pittsburgh, PA, United States
| | | | | | | | - Sheldon Cohen
- Carnegie Mellon University, Pittsburgh, PA, United States
| | | | - Kasey Creswell
- Carnegie Mellon University, Pittsburgh, PA, United States
| | | | - Anind K Dey
- University of Washington, Seattle, WA, United States
| | - Afsaneh Doryab
- University of Virginia, Charlottesville, VA, United States
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3
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Eastman C. Stories from a life studying circadian rhythms and sleep. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad040. [PMID: 38084297 PMCID: PMC10710544 DOI: 10.1093/sleepadvances/zpad040] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 09/06/2023] [Indexed: 06/27/2024]
Affiliation(s)
- Charmane Eastman
- Biological Rhythms Research Laboratory, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
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4
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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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5
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Bessman SC, Harrison EM, Easterling AP, Snider MN, Preilipper SMM, Glickman GL. Hybrid effectiveness-implementation study of two novel spectrally engineered lighting interventions for shiftworkers on a high-security watchfloor. SLEEP ADVANCES : A JOURNAL OF THE SLEEP RESEARCH SOCIETY 2023; 4:zpad051. [PMID: 38084298 PMCID: PMC10710545 DOI: 10.1093/sleepadvances/zpad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/13/2023] [Indexed: 06/26/2024]
Abstract
Shiftwork leads to myriad negative health and safety outcomes. Lighting countermeasures can benefit shiftworkers via physiological effects of light (e.g. alerting, circadian adjustment), and short-wavelength light is the most potent for eliciting those responses; however, limited work indicates it may not be required for alerting. We developed similar-appearing light boxes (correlated color temperature: 3000-3375 K; photopic illuminance: 260-296 lux), enriched (SW+, melanopic EDI: 294 lux) or attenuated (SW-, melanopic EDI: 103 lux) in short-wavelength energy, and implemented them on a high-security watchfloor. Efficacy and feasibility of these two novel lighting interventions were assessed in personnel working 12-hour night shifts (n = 47) in this within-participants, crossover study. For each intervention condition, light boxes were arranged across the front of the watchfloor and illuminated the entire shift; blue-blocking glasses were worn post-shift and before sleep; and sleep masks were used while sleeping. Comparisons between baseline and intervention conditions included alertness, sleep, mood, quality of life (QOL), and implementation measures. On-shift alertness (Karolinska Sleepiness Scale) increased in SW- compared to baseline, while changes in SW+ were more limited. Under SW+, both mood and sleep improved. Psychomotor vigilance task performance did not vary by condition; however, perceived performance and QOL were higher, and reported caffeine consumption and sleep onset latency were lower, under SW-. For both interventions, satisfaction and comfort were high, and fewer symptoms and negative feelings were reported. The addition of spectrally engineered lights to this unique work environment improved sleep, alertness, and mood without compromising visual comfort and satisfaction. This paper is part of the Sleep and Circadian Rhythms: Management of Fatigue in Occupational Settings Collection.
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Affiliation(s)
- Sara C Bessman
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), Bethesda, USA
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, USA
| | - Elizabeth M Harrison
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), Bethesda, USA
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, USA
| | - Alexandra P Easterling
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), Bethesda, USA
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, USA
| | - Michelle N Snider
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), Bethesda, USA
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, USA
| | - Sebastian M M Preilipper
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc. (HJF), Bethesda, USA
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, USA
| | - Gena L Glickman
- Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, USA
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Kalkanis A, Demolder S, Papadopoulos D, Testelmans D, Buyse B. Recovery from shift work. Front Neurol 2023; 14:1270043. [PMID: 38020633 PMCID: PMC10651732 DOI: 10.3389/fneur.2023.1270043] [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: 07/31/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
One fifth of today's workforce is engaged in shift work and exposed to various mental and physical health risks including shift work disorder. Efficiently recovering from shift work through physical and mental interventions allows us to mitigate negative effects on health, enables a better work-life balance and enhances our overall wellbeing. The aim of this review is to provide a state-of-the-art overview of the available literature. The role of sleep timing and naps, light therapy and psychotherapy, diet and exercise in recovery from shift work is presented here. We further review the impact of shift schedules and social support on post-shift unwinding.
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Affiliation(s)
- Alexandros Kalkanis
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Saartje Demolder
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Dimitrios Papadopoulos
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Dries Testelmans
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Laboratory of Respiratory Disease and Thoracic Surgery (BREATH), KU Leuven-University, Leuven, Belgium
| | - Bertien Buyse
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Laboratory of Respiratory Disease and Thoracic Surgery (BREATH), KU Leuven-University, Leuven, Belgium
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7
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Aránguiz Bravo C. [Towards a healthier night shift: the need for nutritional, well-being, and organizational strategies]. NUTR HOSP 2023; 40:1112-1113. [PMID: 37705446 DOI: 10.20960/nh.04831] [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: 09/15/2023] Open
Abstract
Introduction
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8
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Huang Y, Zhang Y, Braun R. A minimal model of peripheral clocks reveals differential circadian re-entrainment in aging. CHAOS (WOODBURY, N.Y.) 2023; 33:093104. [PMID: 37669108 PMCID: PMC10482494 DOI: 10.1063/5.0157524] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/27/2023] [Indexed: 09/07/2023]
Abstract
The mammalian circadian system comprises a network of endogenous oscillators, spanning from the central clock in the brain to peripheral clocks in other organs. These clocks are tightly coordinated to orchestrate rhythmic physiological and behavioral functions. Dysregulation of these rhythms is a hallmark of aging, yet it remains unclear how age-related changes lead to more easily disrupted circadian rhythms. Using a two-population model of coupled oscillators that integrates the central clock and the peripheral clocks, we derive simple mean-field equations that can capture many aspects of the rich behavior found in the mammalian circadian system. We focus on three age-associated effects that have been posited to contribute to circadian misalignment: attenuated input from the sympathetic pathway, reduced responsiveness to light, and a decline in the expression of neurotransmitters. We find that the first two factors can significantly impede re-entrainment of the clocks following perturbation, while a weaker coupling within the central clock does not affect the recovery rate. Moreover, using our minimal model, we demonstrate the potential of using the feed-fast cycle as an effective intervention to accelerate circadian re-entrainment. These results highlight the importance of peripheral clocks in regulating the circadian rhythm and provide fresh insights into the complex interplay between aging and the resilience of the circadian system.
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Affiliation(s)
- Yitong Huang
- Author to whom correspondence should be addressed:
| | - Yuanzhao Zhang
- Santa Fe Institute, 1399 Hyde Park Road, Santa Fe, New Mexico 87501, USA
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9
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Zolfaghari S, Cyr M, Pelletier A, Postuma RB. Effects of Season and Daylight Saving Time Shifts on Sleep Symptoms: Canadian Longitudinal Study on Aging. Neurology 2023; 101:e74-e82. [PMID: 37137725 PMCID: PMC10351306 DOI: 10.1212/wnl.0000000000207342] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 03/09/2023] [Indexed: 05/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES There has been conflicting evidence regarding the association between seasonal changes and daylight saving time (DST) and sleep disorders. This topic is of particular interest currently because the United States and Canada are considering the elimination of seasonal clock changes. The aim of this study was to compare sleep symptoms among participants who were interviewed in different seasons and before/after the transition into DST and standard time (ST). METHODS A total of 30,097 people aged 45-85 years taking part in the Canadian Longitudinal Study on Aging were studied. Participants completed a questionnaire on sleep duration, satisfaction, sleep-onset insomnia, sleep-maintenance insomnia, and hypersomnolence symptoms. Sleep disorders were compared between participants who were interviewed during different seasons and at different times of the year (DST/ST). Data were analyzed using χ2, analysis of variance, binary logistic, and linear regression tests. RESULTS Among participants interviewed in different seasons, we found no difference in dissatisfaction with sleep, sleep onset, sleep maintenance, and hypersomnolence. Those interviewed in summer had slightly shorter sleep duration compared with those in winter (6.76 ± 1.2 vs 6.84 ± 1.3 hours). Participants interviewed 1 week before vs 1 week after DST transition showed no difference in sleep symptoms, except for a 9-minute decrease in sleep duration a week after transition. However, those who were interviewed a week after transition to ST compared with a week before reported more dissatisfaction with sleep (28% vs 22.6%, adjusted odds ratio [aOR] 1.34, 95% CI 1.02-1.76), higher sleep-onset insomnia (7.1% vs 3.3%, aOR 2.26, 95% CI 1.19-4.27), higher sleep-maintenance insomnia (12.9% vs 8.2%, aOR 1.64, 95% CI 1.02-2.66), and more hypersomnolence with adequate sleep (7.3% vs 3.6%, aOR 2.08, 95% CI 1.14-3.79). DISCUSSION We found small seasonal variations in sleep duration but no difference in other sleep symptoms. The transition from DST to ST was associated with a transient increase in sleep disorders.
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Affiliation(s)
- Sheida Zolfaghari
- From the Integrated Program in Neuroscience (S.Z.), McGill University; Research Institute of the McGill University Health Centre (S.Z., A.P., R.B.P.); Faculty of Medicine and Health Sciences (M.C.), McGill University; Centre for Advanced Research in Sleep Medicine (A.P., R.B.P.), Hôpital du Sacré-Coeur de Montréal; and Department of Neurology and Neurosurgery (R.B.P.), McGill University, Montreal, Quebec, Canada
| | - Mariève Cyr
- From the Integrated Program in Neuroscience (S.Z.), McGill University; Research Institute of the McGill University Health Centre (S.Z., A.P., R.B.P.); Faculty of Medicine and Health Sciences (M.C.), McGill University; Centre for Advanced Research in Sleep Medicine (A.P., R.B.P.), Hôpital du Sacré-Coeur de Montréal; and Department of Neurology and Neurosurgery (R.B.P.), McGill University, Montreal, Quebec, Canada
| | - Amélie Pelletier
- From the Integrated Program in Neuroscience (S.Z.), McGill University; Research Institute of the McGill University Health Centre (S.Z., A.P., R.B.P.); Faculty of Medicine and Health Sciences (M.C.), McGill University; Centre for Advanced Research in Sleep Medicine (A.P., R.B.P.), Hôpital du Sacré-Coeur de Montréal; and Department of Neurology and Neurosurgery (R.B.P.), McGill University, Montreal, Quebec, Canada
| | - Ronald B Postuma
- From the Integrated Program in Neuroscience (S.Z.), McGill University; Research Institute of the McGill University Health Centre (S.Z., A.P., R.B.P.); Faculty of Medicine and Health Sciences (M.C.), McGill University; Centre for Advanced Research in Sleep Medicine (A.P., R.B.P.), Hôpital du Sacré-Coeur de Montréal; and Department of Neurology and Neurosurgery (R.B.P.), McGill University, Montreal, Quebec, Canada.
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10
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Zou Y, Ma X, Chen Q, Xu E, Yu J, Tang Y, Wang D, Yu S, Qiu L. Nightshift work can induce oxidative DNA damage: a pilot study. BMC Public Health 2023; 23:891. [PMID: 37189122 DOI: 10.1186/s12889-023-15742-4] [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: 01/17/2023] [Accepted: 04/24/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Regular sleep is very important for human health; however, the short-term and long-term effects of nightshift with sleep deprivation and disturbance on human metabolism, such as oxidative stress, have not been effectively evaluated based on a realistic cohort. We conducted the first long-term follow-up cohort study to evaluate the effect of nightshift work on DNA damage. METHODS We recruited 16 healthy volunteers (aged 33 ± 5 years) working night shifts at the Department of Laboratory Medicine at a local hospital. Their matched serum and urine samples were collected at four time points: before, during (twice), and after the nightshift period. The levels of 8-oxo-7,8-dihydroguanosine (8-oxoG) and 8-oxo-7,8-dihydro-2'-deoxyguanosine (8-oxodG), two important nucleic-acid damage markers, were accurately determined based on a robust self-established LC‒MS/MS method. The Mann-Whitney U or Kruskal-Wallis test was used for comparisons, and Pearson's or Spearman's correlation analysis was used to calculate the correlation coefficients. RESULTS The levels of serum 8-oxodG, estimated glomerular filtration rate-corrected serum 8-oxodG, and the serum-to-urine 8-oxodG ratio significantly increased during the nightshift period. These levels were significantly higher than pre-nightshift work level even after 1 month of discontinuation, but no such significant change was found for 8-oxoG. Moreover, 8-oxoG and 8-oxodG levels were significantly positively associated with many routine biomarkers, such as total bilirubin and urea levels, and significantly negatively associated with serum lipids, such as total cholesterol levels. CONCLUSION The results of our cohort study suggested that working night shifts may increase oxidative DNA damage even after a month of discontinuing nightshift work. Further studies with large-scale cohorts, different nightshift modes, and longer follow-up times are needed to clarify the short- and long-term effects of night shifts on DNA damage and find effective solutions to combat the negative effects.
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Affiliation(s)
- Yutong Zou
- Department of Laboratory Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, PR China
| | - Xiaoli Ma
- Department of Laboratory Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, PR China
- Medical Science Research Center (MRC), Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Qian Chen
- Department of Laboratory Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, PR China
| | - Ermu Xu
- Department of Laboratory Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, PR China
| | - Jialei Yu
- Department of Laboratory Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, PR China
| | - Yueming Tang
- Department of Laboratory Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, PR China
| | - Danchen Wang
- Department of Laboratory Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, PR China
| | - Songlin Yu
- Department of Laboratory Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, PR China.
| | - Ling Qiu
- Department of Laboratory Medicine, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, PR China.
- State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No. 1 Shuaifu Yuan, Dongcheng District, Beijing, 100730, PR China.
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Nishimura Y, Ikeda H, Matsumoto S, Izawa S, Kawakami S, Tamaki M, Masuda S, Kubo T. Impaired self-monitoring ability on reaction times of psychomotor vigilance task of nurses after a night shift. Chronobiol Int 2023:1-9. [DOI: 10.1080/07420528.2023.2193270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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12
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Sun X, Yu W, Wang M, Hu J, Li Y. Association between rest-activity rhythm and cognitive function in the elderly: The U.S. National Health and Nutrition Examination Survey, 2011-2014. Front Endocrinol (Lausanne) 2023; 14:1135085. [PMID: 36967786 PMCID: PMC10034093 DOI: 10.3389/fendo.2023.1135085] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 01/30/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Circadian rhythm plays an essential role in various physiological and pathological processes related to cognitive function. The rest-activity rhythm (RAR) is one of the most prominent outputs of the circadian system. However, little is known about the relationships between RAR and different domains of cognitive function in older adults. The purpose of this study was to examine the relationships between RAR and various fields of cognitive function in older Americans. METHODS This study included a total of 2090 older adults ≥ 60 years old from the National Health and Nutrition Examination Survey (NHANES) in 2011-2014. RAR parameters were derived from accelerometer recordings. Cognitive function was assessed using the word learning subtest developed by the Consortium to Establish a Registry for Alzheimer's disease (CERAD W-L), the Animal Fluency Test (AFT) and the Digital Symbol Substitution Test (DSST). Linear regression was used to determine the relationships between RAR parameters (IS, IV, RA, L5, M10) and cognitive function scores (CERAD W-L, AFT, DSST). RESULTS After adjusting for potential confounders, lower IS and M10 were associated with lower CERAD W-L scores (P=0.033 and P=0.002, respectively). Weaker RA and higher L5 were associated with lower AFT scores (P<0.001 and P=0.001, respectively). And lower IS, RA, and higher L5 were associated with lower DSST scores (P=0.019, P<0.001 and P<0.001, respectively). In addition, the results of sensitivity analysis were similar to those of our main analyses. The main correlation results between the RAR indicators and cognitive function were robust. CONCLUSIONS This study suggested that the weakened and/or disrupted RAR was associated with cognitive decline in different domains in Americans over the age of 60.
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Affiliation(s)
- Xinyi Sun
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
- National Key Discipline, Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China
| | - Weiwei Yu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Mingsi Wang
- Department of Health Economics, College of Health Management of Harbin Medical University, Harbin, China
- *Correspondence: Yunong Li, ; Jun Hu, ; Mingsi Wang,
| | - Jun Hu
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
- *Correspondence: Yunong Li, ; Jun Hu, ; Mingsi Wang,
| | - Yunong Li
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
- *Correspondence: Yunong Li, ; Jun Hu, ; Mingsi Wang,
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13
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Xu Y, Su S, Li X, Mansuri A, McCall WV, Wang X. Blunted rest-activity circadian rhythm increases the risk of all-cause, cardiovascular disease and cancer mortality in US adults. Sci Rep 2022; 12:20665. [PMID: 36450759 PMCID: PMC9712599 DOI: 10.1038/s41598-022-24894-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022] Open
Abstract
To examine whether rest-activity circadian rhythm parameters can predict all-cause, cardiovascular disease and cancer mortality in a general adult population of the US. We further compared the mortality predictive performance of these parameters with that of traditional risk factors. This study included 7,252 adults from US National Health and Nutrition Examination Surveys (NHANES) 2011-2014, who had wrist accelerometer data obtained at baseline and follow-up status linked to the National Death Index records (2011-2019). During a median of 81 months (interquartile range, 69-94 months) of follow-up, 674 (9.3%) deaths occurred. There were inverse associations between relative amplitude (RA) and all-cause mortality, cardiovascular disease and cancer mortality with increased quartiles RA associated with lower mortality risk (all P < 0.05). The Hazard Ratios ranged from 0.61 to 0.79. Furthermore, RA outperformed all the tested traditional predictors of all-cause mortality with the exception of age. This study suggests that participants with blunted rest-activity circadian rhythms had a higher risk of all-cause, cardiovascular disease and cancer mortality. Future studies will be needed to test whether interventions that regulate rest-activity circadian activity rhythms will improve health outcomes.
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Affiliation(s)
- Yanyan Xu
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Building HS-1715, Augusta, GA, 30912, USA
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Shaoyong Su
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Building HS-1715, Augusta, GA, 30912, USA
| | - Xinyue Li
- School of Data Science, City University of Hong Kong, Hong Kong, China
| | - Asifhusen Mansuri
- Division of Pediatric Nephrology and Hypertension, Children's Hospital of Georgia, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - William V McCall
- Department of Psychiatry and Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Xiaoling Wang
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Building HS-1715, Augusta, GA, 30912, USA.
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA.
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14
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Rigsby RK, Peters EM. Resident-attending discrepancy rates for two consecutive versus nonconsecutive weeks of overnight shifts. Emerg Radiol 2022; 29:819-823. [PMID: 35616766 DOI: 10.1007/s10140-022-02056-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/06/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE Recent Accreditation Council for Graduate Medical Education policy changes no longer limit the number of consecutive night shifts allowed for trainees. Few studies have examined radiology resident overnight performance over time. This study aimed to compare significant resident-attending discrepancy rates for residents working 2 nonconsecutive versus consecutive weeks of overnight shifts. The authors hypothesized significantly increased week-two discrepancies in the consecutive group. METHODS For 2020, a retrospective analysis of significant overnight resident-attending discrepancy rates over a 24-week period using database searches was performed for residents self-selecting 2 nonconsecutive versus consecutive weeks. The nonconsecutive group typically had a 7-day mix of days off and day shifts between their night shift weeks. Paired and unpaired t tests were performed with p < 0.05 considered significant. RESULTS For the 24 sets of 2 weeks covered by two residents at a time, eight were nonconsecutive and 16 were consecutive. The nonconsecutive group had 75.0% R4 coverage compared to 37.5% for the consecutive group. There were no significant study volume differences between the groups. A total of 27,906 studies (35.3% cross-sectional [CT and MR], 54.9% radiograph plus fluoroscopy, 9.8% US) were performed with 223 discrepancies (0.80%). Overall discrepancies for the nonconsecutive versus consecutive groups were 39/4505 (0.87%) versus 59/9462 (0.62%; p = 0.32) for week one and 46/4732 (1.0%) versus 79/9207 (0.86%; p = 0.60) for week two with no significant differences between the groups by modality. CONCLUSION Residents self-selecting 2 consecutive weeks of overnight shifts do not have increased resident-attending discrepancy rates compared to 2 nonconsecutive weeks.
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Affiliation(s)
- Ryan K Rigsby
- Department of Radiology, Loma Linda University Health, 11234 Anderson St, Loma Linda, CA, 92354, USA
| | - Eric M Peters
- Department of Radiology, Loma Linda University Health, 11234 Anderson St, Loma Linda, CA, 92354, USA.
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15
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16
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Lee R, McGee A, Fernandez FX. Systematic review of drugs that modify the circadian system's phase-shifting responses to light exposure. Neuropsychopharmacology 2022; 47:866-879. [PMID: 34961774 PMCID: PMC8882192 DOI: 10.1038/s41386-021-01251-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 11/08/2021] [Accepted: 11/30/2021] [Indexed: 11/09/2022]
Abstract
We searched PubMed for primary research quantifying drug modification of light-induced circadian phase-shifting in rodents. This search, conducted for work published between 1960 and 2018, yielded a total of 146 papers reporting results from 901 studies. Relevant articles were those with any extractable data on phase resetting in wildtype (non-trait selected) rodents administered a drug, alongside a vehicle/control group, near or at the time of exposure. Most circadian pharmacology experiments were done using drugs thought to act directly on either the brain's central pacemaker, the suprachiasmatic nucleus (SCN), the SCN's primary relay, the retinohypothalamic tract, secondary pathways originating from the medial/dorsal raphe nuclei and intergeniculate leaflet, or the brain's sleep-arousal centers. While the neurotransmitter systems underlying these circuits were of particular interest, including those involving glutamate, gamma-aminobutyric acid, serotonin, and acetylcholine, other signaling modalities have also been assessed, including agonists and antagonists of receptors linked to dopamine, histamine, endocannabinoids, adenosine, opioids, and second-messenger pathways downstream of glutamate receptor activation. In an effort to identify drugs that unduly influence circadian responses to light, we quantified the net effects of each drug class by ratioing the size of the phase-shift observed after administration to that observed with vehicle in a given experiment. This allowed us to organize data across the literature, compare the relative efficacy of one mechanism versus another, and clarify which drugs might best suppress or potentiate phase resetting. Aggregation of the available data in this manner suggested that several candidates might be clinically relevant as auxiliary treatments to suppress ectopic light responses during shiftwork or amplify the circadian effects of timed bright light therapy. Future empirical research will be necessary to validate these possibilities.
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Affiliation(s)
- Robert Lee
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Austin McGee
- Department of Psychology, University of Arizona, Tucson, AZ, USA
| | - Fabian-Xosé Fernandez
- Department of Psychology, University of Arizona, Tucson, AZ, USA.
- Department of Neurology, University of Arizona, Tucson, AZ, USA.
- BIO5 and McKnight Brain Research Institutes, Tucson, AZ, USA.
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17
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Working around the Clock: Is a Person’s Endogenous Circadian Timing for Optimal Neurobehavioral Functioning Inherently Task-Dependent? Clocks Sleep 2022; 4:23-36. [PMID: 35225951 PMCID: PMC8883919 DOI: 10.3390/clockssleep4010005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/17/2022] [Accepted: 02/03/2022] [Indexed: 11/17/2022] Open
Abstract
Neurobehavioral task performance is modulated by the circadian and homeostatic processes of sleep/wake regulation. Biomathematical modeling of the temporal dynamics of these processes and their interaction allows for prospective prediction of performance impairment in shift-workers and provides a basis for fatigue risk management in 24/7 operations. It has been reported, however, that the impact of the circadian rhythm—and in particular its timing—is inherently task-dependent, which would have profound implications for our understanding of the temporal dynamics of neurobehavioral functioning and the accuracy of biomathematical model predictions. We investigated this issue in a laboratory study designed to unambiguously dissociate the influences of the circadian and homeostatic processes on neurobehavioral performance, as measured during a constant routine protocol preceded by three days on either a simulated night shift or a simulated day shift schedule. Neurobehavioral functions were measured every 3 h using three functionally distinct assays: a digit symbol substitution test, a psychomotor vigilance test, and the Karolinska Sleepiness Scale. After dissociating the circadian and homeostatic influences and accounting for inter-individual variability, peak circadian performance occurred in the late biological afternoon (in the “wake maintenance zone”) for all three neurobehavioral assays. Our results are incongruent with the idea of inherent task-dependent differences in the endogenous circadian impact on performance. Rather, our results suggest that neurobehavioral functions are under top-down circadian control, consistent with the way they are accounted for in extant biomathematical models.
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18
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Proper KI, Jaarsma E, Robroek SJW, Schram JLD, Boshuizen H, Picavet HSJ, Verschuren WMM, van Oostrom SH. The mediating role of unhealthy behavior in the relationship between shift work and perceived health. BMC Public Health 2021; 21:1300. [PMID: 34215233 PMCID: PMC8254208 DOI: 10.1186/s12889-021-11350-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 06/21/2021] [Indexed: 11/19/2022] Open
Abstract
Background Little is known about the relationship between shift work and perceived health, including potential underlying mechanisms such as unhealthy behaviors. The aim of this study was to investigate whether unhealthy behaviors mediate the relationship between shift work and perceived mental and physical health, taking into account potential differences by level of education. Methods Data from 1633 workers participating in the Doetinchem Cohort Study during 1995–2016 were used. Being engaged in shift work was determined at 1 year preceding the assessment of health behaviors. Mental and physical health were assessed after 5 years of follow-up by the 5-item Mental Health Inventory and the physical functioning scale of the 36-item Short Form Health Survey. Smoking, physical inactivity, alcohol consumption, and overweight were considered as potential mediators and education was treated as moderator. Moderated mediation analyses using generalized estimated equations were performed. Results Shift work was not statistically significantly related to either mental or physical health. Despite this, statistically significant mediation effects of smoking (Beta − 0.09; 95% Confidence Interval − 0.20 - -0.01, respectively B -0.09; 95%CI -0.21 - -0.01) and physical inactivity (B 0.11; 95%CI 0.03–0.23, respectively B 0.08; 95%CI 0.01–0.18) were found in the relationship between shift work and mental or physical health. Direct and indirect effects outweighed each other in the relationship between shift work and mental health, since the direction of these effects was opposite. The relationship between shift work, unhealthy behavior, and health was not different by educational level. Conclusion Shift workers did not report lower mental or physical health than non-shift workers. Though mediation effects of unhealthy behavior were observed in the relationship between shift work and perceived health, these small effects had minor public health relevance.
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Affiliation(s)
- Karin I Proper
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.,Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam, The Netherlands
| | - Eva Jaarsma
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands
| | - Suzan J W Robroek
- Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Jolinda L D Schram
- Department of Public Health, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Hendriek Boshuizen
- Division of Human Nutrition, Wageningen University, Wageningen, the Netherlands
| | - H Susan J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Sandra H van Oostrom
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment, P.O. Box 1, 3720 BA, Bilthoven, the Netherlands.
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19
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Vlahoyiannis A, Karali E, Giannaki CD, Karioti A, Pappas A, Lavdas E, Karatzaferi C, Sakkas GK. The vicious circle between physical, psychological, and physiological characteristics of shift work in nurses: a multidimensional approach. Sleep Breath 2021; 26:149-156. [PMID: 33864583 DOI: 10.1007/s11325-021-02381-5] [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: 01/27/2021] [Revised: 03/24/2021] [Accepted: 04/11/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare physical, psychological, and physiological adaptations between rotating and morning shift health workers using objective and subjective approaches. METHODS Forty nurses [n = 20 morning shift (MS) group; n = 20 rotating shift (RS) group] were evaluated for anthropometry, body composition, and handgrip strength. Quality of life, depression, fatigue, daytime sleepiness, and sleep quality were assessed with SF-36, Zung Self-Rating Depression Scale (SDS), Fatigue Severity Scale (FSS), Epworth Sleepiness Scale (ESS), and Pittsburgh Sleep Quality Index (PSQI), respectively. Physical activity was assessed by the International Physical Activity Questionnaire (IPAQ) and triaxial accelerometers. Sleep-related data were monitored with sleep actigraphy. Salivary melatonin levels were analyzed before/after sleep, and blood lipid profiles were measured the following morning. RESULTS The RS group had higher mean BMI and total and abdominal fat and scored lower in the SF-36 (p < 0.01). All nurses showed reduced physical activity levels, which, in the RS group, were negatively correlated with FSS (p = 0.033) and SDS scores (p = 0.025). Poor sleep was revealed in 53% of nurses. The RS group had worse sleep quality by PSQI than the MS group (p = 0.045). PSQI scores were inversely related to SF-36 scores and positively correlated with FSS, BMI, waist circumference, and body fat (p < 0.05). CONCLUSION RS nurses showed increased body mass and total and abdominal fat along with decreased quality of life and sleep quality compared to MS counterparts. A strong relationship was found between physical, psychological, and physiological domains. Further studies should consider workplace interventions to prevent obesity, promote physical activity, and manage poor sleeping patterns in nurses.
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Affiliation(s)
| | - Eirini Karali
- Department of Physical Education and Sport Science, University of Thessaly, Karies, 42100, Trikala, Thessaly, Greece
| | | | - Aggeliki Karioti
- Department of Physical Education and Sport Science, University of Thessaly, Karies, 42100, Trikala, Thessaly, Greece
| | - Aggelos Pappas
- Department of Physical Education and Sport Science, University of Thessaly, Karies, 42100, Trikala, Thessaly, Greece
| | - Eleftherios Lavdas
- Department of Radiology and Radiotherapy, Technological Educational Institute of Athens, Athens, Greece
| | - Christina Karatzaferi
- Department of Physical Education and Sport Science, University of Thessaly, Karies, 42100, Trikala, Thessaly, Greece
| | - Giorgos K Sakkas
- Department of Physical Education and Sport Science, University of Thessaly, Karies, 42100, Trikala, Thessaly, Greece. .,School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK.
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20
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Ferreira FC, Costa RJD, Ruivo Marques D. The Bergen Shift Work Sleep Questionnaire (BSWSQ) – European Portuguese validation in a sample of shift workers from the paper industry. BIOL RHYTHM RES 2021. [DOI: 10.1080/09291016.2021.1913897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | - Daniel Ruivo Marques
- Department of Education and Psychology, University of Aveiro, Aveiro, Portugal
- University of Coimbra, Coimbra, Portugal
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21
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Alfonsi V, Scarpelli S, Gorgoni M, Pazzaglia M, Giannini AM, De Gennaro L. Sleep-Related Problems in Night Shift Nurses: Towards an Individualized Interventional Practice. Front Hum Neurosci 2021; 15:644570. [PMID: 33796014 PMCID: PMC8007770 DOI: 10.3389/fnhum.2021.644570] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/22/2021] [Indexed: 02/05/2023] Open
Abstract
Rotating shifts (mostly 8- or 12-h) are common among nurses to ensure continuity of care. This scheduling system encompasses several adverse health and performance consequences. One of the most injurious effects of night-time shift work is the deterioration of sleep patterns due to both circadian rhythm disruption and increased sleep homeostatic pressure. Sleep problems lead to secondary effects on other aspects of wellbeing and cognitive functioning, increasing the risk of errors and workplace accidents. A wide range of interventions has been proposed to improve the sleep quality of nurses and promote an increase in attention levels. In recent years, particular attention has been paid to individual and environmental factors mediating the subjective ability to cope with sleep deprivation during the night shift. Given the predictive role of these factors on the negative impact of a night shift, an individualized intervention could represent an effective countermeasure by ensuring suitable management of shift schedules. Therefore, the aims of this mini-review are to: (a) provide an updated overview of the literature on sleep problems in night shift nurses and their adverse consequences; and (b) critically analyze the psychosocial factors that mediate the negative impact of shift work with the ultimate goal of defining an effective countermeasure based on an individualized approach.
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Affiliation(s)
- Valentina Alfonsi
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Maurizio Gorgoni
- Department of Psychology, Sapienza University of Rome, Rome, Italy
| | - Mariella Pazzaglia
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy
| | | | - Luigi De Gennaro
- Body and Action Lab, IRCCS Fondazione Santa Lucia, Rome, Italy.,Department of Psychology, Sapienza University of Rome, Rome, Italy
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22
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Harrison EM, Easterling AP, Yablonsky AM, Glickman GL. Sleep-Scheduling Strategies in Hospital Shiftworkers. Nat Sci Sleep 2021; 13:1593-1609. [PMID: 34584475 PMCID: PMC8464337 DOI: 10.2147/nss.s321960] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 08/24/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Shiftwork causes circadian disruption and results in impaired performance, sleep, and health. Often, individuals on non-standard shifts cannot modify work schedules. At-home sleep schedules are a potentially modifiable point of intervention, yet sleep-scheduling strategies remain relatively understudied. Specifically, the adoption of multiple strategies and the employment of strategies for not only night shifts, but also early starts on days, have yet to be formally examined to our knowledge. We studied how adoption of specific and/or multiple sleep-scheduling strategies for day and night shifts relates to measures of adaptation to shiftwork, self-reported on-shift sleepiness, and individual characteristics (eg, age, chronotype, education in circadian and sleep health). We hypothesized: 1) strategies would differ by shift type, 2) individuals would adopt multiple strategies, 3) strategies better aligned with circadian principles would relate to measures of adaptation, and 4) individual characteristics, such as having dependents, would relate to strategy selection. METHODS A retrospective, online questionnaire (including items from the Survey of Shiftworkers and items related to sleep-scheduling strategies) was administered to both permanent and rotating hospital staff in four wards working 12-h day and/or night shifts (n=89). Additionally, reasons for strategy selection were explored. RESULTS Level of adaptation varied by sleep-scheduling strategy, with the least adaptation for those utilizing the Incomplete Shifter strategies. For night shifts, Night Stay and Switch Sleeper-N strategies were related to lower mid-shift sleepiness. Many night workers reported using strategies that restricted sleep, and most reported using multiple strategies, both of which also related to lower adaptation. Domestic considerations were the most common rationale for strategy selection. Strategies varied by several individual characteristics, including chronotype, dependents, and level of sleep education. DISCUSSION Future work should investigate sleep strategies and circadian interventions to help mitigate the effects of circadian and sleep disruption in hospital staff.
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Affiliation(s)
- Elizabeth M Harrison
- Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
| | | | | | - Gena L Glickman
- Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA.,Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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23
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Harrison EM, Schmied EA, Easterling AP, Yablonsky AM, Glickman GL. A Hybrid Effectiveness-Implementation Study of a Multi-Component Lighting Intervention for Hospital Shift Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9141. [PMID: 33297521 PMCID: PMC7730086 DOI: 10.3390/ijerph17239141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/12/2020] [Accepted: 11/25/2020] [Indexed: 12/13/2022]
Abstract
Simple lighting solutions may mitigate the harmful effects of shiftwork. This hybrid effectiveness-implementation study evaluated a multi-component lighting intervention in hospital nurses that included 6500 K architectural lighting in the nurses' station plus optional behavioral components (a lightbox, blueblocker glasses, eyemasks) with instruction about appropriately timed usage. Selective improvements from baseline were observed in on-shift performance, sleep quality, and caffeine consumption in day workers (all p < 0.05); off-shift sleepiness scores improved for night workers (p < 0.05). Further, self-reported measures of quality of life improved for both groups (p < 0.05). Preliminary implementation data from interviews and questionnaires suggest perceived benefits and high acceptability of the intervention.
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Affiliation(s)
- Elizabeth M. Harrison
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA; (A.P.E.); (G.L.G.)
- Leidos, Inc., San Diego, CA 92121, USA
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA 92016, USA;
| | - Emily A. Schmied
- School of Public Health, San Diego State University, San Diego, CA 92182, USA;
| | - Alexandra P. Easterling
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA; (A.P.E.); (G.L.G.)
- Leidos, Inc., San Diego, CA 92121, USA
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA 92016, USA;
| | - Abigail M. Yablonsky
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA 92016, USA;
- Naval Medical Center, San Diego, CA 92134, USA
| | - Gena L. Glickman
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA; (A.P.E.); (G.L.G.)
- Departments of Psychiatry and Neuroscience, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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24
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Fernandez RC, Moore VM, Marino JL, Whitrow MJ, Davies MJ. Night Shift Among Women: Is It Associated With Difficulty Conceiving a First Birth? Front Public Health 2020; 8:595943. [PMID: 33335878 PMCID: PMC7736040 DOI: 10.3389/fpubh.2020.595943] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 09/30/2020] [Indexed: 11/13/2022] Open
Abstract
Background: Asynchrony in circadian processes alters many physiological systems, including female reproduction. Thus, there are possible reproductive consequences of night shift work for women including menstrual irregularity, endometriosis, and prolonged time to conception. This study examined whether women who worked night shift were more likely than those who did not to require fertility treatment to conceive a first birth, whether they had specific infertility diagnoses, and if such relationships were age-specific. Methods: In a retrospective data linkage study of 128,852 primiparous women, fertility treatment data were linked to the state perinatal registry for South Australia (1986-2002). Potential exposure to night shift work was assessed using a job-exposure matrix. First, the association between night shift work and fertility treatment was assessed among (1) all women, then (2) women in paid employment, using logistic regression. Interactions between age and shift work status were also examined. Secondly, among women who conceived with fertility treatment, we assessed associations between night shift work and type of infertility diagnosis. Potential confounders were considered in all analyses. Results: Among women ≤35 years, night shift workers were more likely to require fertility treatment (all: OR = 1.40, 95% CI 1.19-1.64; in paid employment: OR = 1.27, 95% CI 1.08-1.50). There were no associations among women >35 years. Ethnicity, socioeconomic status and smoking did not affect these results. Among women who underwent fertility treatment, night shift workers were more likely than day workers to have menstrual irregularity (OR = 1.42, 95% CI 1.05-1.91) or endometriosis (OR = 1.34, 95% CI 1.00-1.80). Conclusions: Night shift work may contribute to increased need for fertility treatment in younger women. This increased risk may reflect young women's vulnerability in terms of poor tolerance of night shift work, and/or lack of control and choice about shift schedule.
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Affiliation(s)
- Renae C Fernandez
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.,School of Public Health, The University of Adelaide, Adelaide, SA, Australia.,Lifecourse and Intergenerational Health Research Group, Robinson Research Institute, Adelaide, SA, Australia
| | - Vivienne M Moore
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia.,Lifecourse and Intergenerational Health Research Group, Robinson Research Institute, Adelaide, SA, Australia.,Fay Gale Centre for Research on Gender, Adelaide, SA, Australia
| | - Jennifer L Marino
- Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, VIC, Australia.,Royal Women's Hospital, Melbourne, VIC, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Melissa J Whitrow
- School of Public Health, The University of Adelaide, Adelaide, SA, Australia.,Lifecourse and Intergenerational Health Research Group, Robinson Research Institute, Adelaide, SA, Australia
| | - Michael J Davies
- Adelaide Medical School, The University of Adelaide, Adelaide, SA, Australia.,Lifecourse and Intergenerational Health Research Group, Robinson Research Institute, Adelaide, SA, Australia
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25
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Reiter AM, Sargent C, Roach GD. Finding DLMO: estimating dim light melatonin onset from sleep markers derived from questionnaires, diaries and actigraphy. Chronobiol Int 2020; 37:1412-1424. [DOI: 10.1080/07420528.2020.1809443] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Andrew M. Reiter
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Australia
| | - Charli Sargent
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Australia
| | - Gregory D. Roach
- Appleton Institute for Behavioural Science, Central Queensland University, Adelaide, Australia
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26
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Rangan S, Riedy SM, Bassett R, Klinck ZA, Hagerty P, Schek E, Zhang Y, Hursh SR, Van Dongen HP. Predictive and proactive fatigue risk management approaches in commercial aviation. Chronobiol Int 2020; 37:1479-1482. [DOI: 10.1080/07420528.2020.1803902] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
| | - Samantha M. Riedy
- Sleep and Performance Research Center, Washington State University, Spokane, Washington, USA
| | - Rob Bassett
- FedEx Express Corporation, Memphis, Tennessee, USA
- Air Line Pilot Association, Memphis, Tennessee, USA
| | | | - Patrick Hagerty
- FedEx Express Corporation, Memphis, Tennessee, USA
- Air Line Pilot Association, Memphis, Tennessee, USA
| | - Ethan Schek
- FedEx Express Corporation, Memphis, Tennessee, USA
| | - Ying Zhang
- FedEx Express Corporation, Memphis, Tennessee, USA
| | | | - Hans P.A. Van Dongen
- Sleep and Performance Research Center, Washington State University, Spokane, Washington, USA
- Elson S. Floyd College of Medicine, Washington State University, Spokane, Washington, USA
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27
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Cè E, Doria C, Roveda E, Montaruli A, Galasso L, Castelli L, Mulè A, Longo S, Coratella G, D'Aloia P, Banfi G, Esposito F. Reduced Neuromuscular Performance in Night Shift Orthopedic Nurses: New Insights From a Combined Electromyographic and Force Signals Approach. Front Physiol 2020; 11:693. [PMID: 32695018 PMCID: PMC7338557 DOI: 10.3389/fphys.2020.00693] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/27/2020] [Indexed: 12/20/2022] Open
Abstract
The effect of sleep–wake rhythm disruption on neuromuscular control and muscle fatigue has received little attention. Because nurse shift work is so varied, including overnight duty, rotating shift schedules, early awakening, and interrupted nocturnal sleep, it offers an interesting model to study this paradigm. It has been investigated so far using only subjective markers. A combined approach based on the simultaneous analysis of surface electromyographic (sEMG) and force signals can objectively detect possible deficits in neuromuscular control and muscle fatigue. With this study we investigated neuromuscular activation and muscle contraction capacity at submaximum and maximum level in nurses working two night-shift schedules and compared them to levels in nurses working entirely in day shifts. Sleep quality and activity levels were also assessed. The study sample was 71 nurses grouped by their shift work schedule: night shift for 5 days (NS5, n = 46), night shift for 10 days (NS10, n = 9), and only day/swing shift (DS, n = 16). Before and after the shift-work cycle, maximum voluntary contraction (MVC) force and muscle activation, neuromuscular control, and muscle fatigability were measured in the finger flexor muscles. Activity level and sleep quality during the shift-work cycle were recorded with a wrist actigraph. After the shift-work cycles, MVC force and muscle activation were decreased (−11 ± 3% and −33 ± 3%, p < 0.001) as was neuromuscular control (−36 ± 8%, p = 0.007), whereas muscle fatigability was increased (+ 19 ± 9%, p = 0.006) in the NS5 and the NS10 group. Sleep quality was lower in the NS5 and the NS10 group (−8 ± 1.8% and −15%3, respectively, p < 0.001), while the activity level for the three groups was similar. There was a clear reduction in neuromuscular control and an increase in muscle fatigue in the nurses working the night shift. These findings may inform of work schedule planning or recommendations for devising new recovery strategies to counteract neuromuscular alterations in night shift nurses.
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Affiliation(s)
- Emiliano Cè
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Christian Doria
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - Eliana Roveda
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Angela Montaruli
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Letizia Galasso
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - Lucia Castelli
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - Antonino Mulè
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - Stefano Longo
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - Giuseppe Coratella
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | | | | | - Fabio Esposito
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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28
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Lee SI, Kinoshita S, Noguchi A, Eto T, Ohashi M, Nishimura Y, Maeda K, Motomura Y, Awata Y, Higuchi S. Melatonin suppression during a simulated night shift in medium intensity light is increased by 10-minute breaks in dim light and decreased by 10-minute breaks in bright light. Chronobiol Int 2020; 37:897-909. [PMID: 32326827 DOI: 10.1080/07420528.2020.1752704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Exposure to light at night results in disruption of endogenous circadian rhythmicity and/or suppression of pineal melatonin, which can consequently lead to acute or chronic adverse health problems. In the present study, we investigated whether exposure to very dim light or very bright light for a short duration influences melatonin suppression, subjective sleepiness, and performance during exposure to constant moderately bright light. Twenty-four healthy male university students were divided into two experimental groups: Half of them (mean age: 20.0 ± 0.9 years) participated in an experiment for short-duration (10 min) light conditions of medium intensity light (430 lx, medium breaks) vs. very dim light (< 1 lx, dim breaks) and the other half (mean age: 21.3 ± 2.5 years) participated in an experiment for short-duration light conditions of medium intensity light (430 lx, medium breaks) vs. very bright light (4700 lx, bright breaks). Each simulated night shift consisting of 5 sets (each including 50-minute night work and 10-minute break) was performed from 01:00 to 06:00 h. The subjects were exposed to medium intensity light (550 lx) during the night work. Each 10-minute break was conducted every hour from 02:00 to 06:00 h. Salivary melatonin concentrations were measured, subjective sleepiness was assessed, the psychomotor vigilance task was performed at hourly intervals from 21:00 h until the end of the experiment. Compared to melatonin suppression between 04:00 and 06:00 h in the condition of medium breaks, the condition of dim breaks significantly promoted melatonin suppression and the condition of bright breaks significantly diminished melatonin suppression. However, there was no remarkable effect of either dim breaks or bright breaks on subjective sleepiness and performance of the psychomotor vigilance task. Our findings suggest that periodic exposure to light for short durations during exposure to a constant light environment affects the sensitivity of pineal melatonin to constant light depending on the difference between light intensities in the two light conditions (i.e., short light exposure vs. constant light exposure). Also, our findings indicate that exposure to light of various intensities at night could be a factor influencing the light-induced melatonin suppression in real night work settings.
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Affiliation(s)
- Sang-Il Lee
- Department of Human Science, Faculty of Design, Kyushu University , Fukuoka, Japan.,Division of Human Environmental Systems, Faculty of Engineering, Hokkaido University , Sapporo, Japan
| | - Saki Kinoshita
- Department of Kansei Science, Graduate School of Integrated Frontier Science, Kyushu University , Fukuoka, Japan
| | - Anna Noguchi
- Department of Kansei Science, Graduate School of Integrated Frontier Science, Kyushu University , Fukuoka, Japan
| | - Taisuke Eto
- Department of Kansei Science, Graduate School of Integrated Frontier Science, Kyushu University , Fukuoka, Japan
| | - Michihiro Ohashi
- Department of Kansei Science, Graduate School of Integrated Frontier Science, Kyushu University , Fukuoka, Japan
| | - Yuki Nishimura
- Department of Kansei Science, Graduate School of Integrated Frontier Science, Kyushu University , Fukuoka, Japan.,Occupational Stress and Health Management Research Group, National Institute of Occupational Safety and Health , Kawasaki, Japan
| | - Kaho Maeda
- Ground Facilities Department, Japan Aerospace Exploration Agency , Tsukuba, Japan
| | - Yuki Motomura
- Department of Human Science, Faculty of Design, Kyushu University , Fukuoka, Japan
| | - Yasuhiro Awata
- Ground Facilities Department, Japan Aerospace Exploration Agency , Tsukuba, Japan
| | - Shigekazu Higuchi
- Department of Human Science, Faculty of Design, Kyushu University , Fukuoka, Japan
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29
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Brøchner AC, Binderup LG, Schaffalitzky de Muckadell C, Mikkelsen S. Does the "Morning Morality Effect" Apply to Prehospital Anaesthesiologists? An Investigation into Diurnal Changes in Ethical Behaviour. Healthcare (Basel) 2020; 8:healthcare8020101. [PMID: 32316371 PMCID: PMC7349197 DOI: 10.3390/healthcare8020101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 04/14/2020] [Indexed: 12/02/2022] Open
Abstract
The “morning morality effect”—the alleged phenomenon that people are more likely to act in unethical ways in the afternoon when they are tired and have less self-control than in the morning—may well be expected to influence prehospital anaesthesiologist manning mobile emergency care units (MECUs). The working conditions of these units routinely entail fatigue, hunger, sleep deprivation and other physical or emotional conditions that might make prehospital units predisposed to exhibit the “morning morality effect”. We investigated whether this is in fact the case by looking at the distribution of patient transports to hospital with and without physician escort late at night at the end of the shift as a surrogate marker for changing thresholds in ethical behaviour. All missions over a period of 11 years in the MECU in Odense were reviewed. Physician-escorted transports to hospital were compared with non-physician-escorted transports during daytime, evening, and night-time (which correlates with time on the 24 h shifts). In total, 26,883 patients were transported to hospital following treatment by the MECU. Of these, 27.4% (26.9%–27.9%) were escorted to the hospital. The ratio of patient transports to hospital with and without physician escort during the three periods of the day did not differ (p = 1.00). We found no evidence of changes in admission patterns over the day. Thus, no evidence of the expected “morning morality effect” could be found in a prehospital physician-manned emergency care unit.
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Affiliation(s)
- Anne Craveiro Brøchner
- Department of Anaesthesiology and Intensive Care Medicine V, Mobile Emergency Care Unit, Odense University Hospital, 5000 Odense, Denmark;
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
- Department of Anaesthesiology, Kolding Hospital, a Part of Hospital Lillebaelt, 6000 Kolding, Denmark
| | - Lars Grassmé Binderup
- Philosophy, Department for the Study of Culture, University of Southern Denmark, 5230 Odense, Denmark; (L.G.B.); (C.S.d.M.)
| | | | - Søren Mikkelsen
- Department of Anaesthesiology and Intensive Care Medicine V, Mobile Emergency Care Unit, Odense University Hospital, 5000 Odense, Denmark;
- Department of Regional Health Research, University of Southern Denmark, 5000 Odense, Denmark
- Correspondence: ; Tel.: +45-30252225
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30
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Depner CM, Cheng PC, Devine JK, Khosla S, de Zambotti M, Robillard R, Vakulin A, Drummond SPA. Wearable technologies for developing sleep and circadian biomarkers: a summary of workshop discussions. Sleep 2020; 43:zsz254. [PMID: 31641776 PMCID: PMC7368340 DOI: 10.1093/sleep/zsz254] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 09/17/2019] [Indexed: 01/03/2023] Open
Abstract
The "International Biomarkers Workshop on Wearables in Sleep and Circadian Science" was held at the 2018 SLEEP Meeting of the Associated Professional Sleep Societies. The workshop brought together experts in consumer sleep technologies and medical devices, sleep and circadian physiology, clinical translational research, and clinical practice. The goals of the workshop were: (1) characterize the term "wearable" for use in sleep and circadian science and identify relevant sleep and circadian metrics for wearables to measure; (2) assess the current use of wearables in sleep and circadian science; (3) identify current barriers for applying wearables to sleep and circadian science; and (4) identify goals and opportunities for wearables to advance sleep and circadian science. For the purposes of biomarker development in the sleep and circadian fields, the workshop included the terms "wearables," "nearables," and "ingestibles." Given the state of the current science and technology, the limited validation of wearable devices against gold standard measurements is the primary factor limiting large-scale use of wearable technologies for sleep and circadian research. As such, the workshop committee proposed a set of best practices for validation studies and guidelines regarding how to choose a wearable device for research and clinical use. To complement validation studies, the workshop committee recommends the development of a public data repository for wearable data. Finally, sleep and circadian scientists must actively engage in the development and use of wearable devices to maintain the rigor of scientific findings and public health messages based on wearable technology.
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Affiliation(s)
- Christopher M Depner
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO
| | - Philip C Cheng
- Sleep Disorders and Research Center, Division of Sleep Medicine, Henry Ford Health System, Detroit, MI
| | - Jaime K Devine
- Behavioral Biology Branch, Walter Reed Army Institute of Research, Silver Spring, MD
| | | | | | - Rébecca Robillard
- Sleep Research Unit, The Royal’s Institute for Mental Health Research, affiliated to the University of Ottawa, Ottawa, ON, Canada
| | - Andrew Vakulin
- Adelaide Institute for Sleep Health: Flinders Centre of Research Excellence, College of Medicine and Public Health, Flinders University, Bedford Park, SA, Australia
- NeuroSleep, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW, Australia
| | - Sean P A Drummond
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
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31
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Olson JA, Artenie DZ, Cyr M, Raz A, Lee V. Developing a light-based intervention to reduce fatigue and improve sleep in rapidly rotating shift workers. Chronobiol Int 2019; 37:573-591. [PMID: 31823658 DOI: 10.1080/07420528.2019.1698591] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Over a quarter of employees in North America and a fifth of those in the European Union do shift work. Working these schedules increases fatigue, sleepiness, and errors at work. In the long term, it may also increase the risk of cardiovascular disease, gastrointestinal problems, and cancer. Some of these consequences may be partly due to circadian misalignment, in which sleep and activity patterns no longer align with one's circadian rhythms. Previous research has found that controlling light exposure can improve circadian alignment in individuals who work permanent night shifts. However, light-based interventions are rarely tested with rapidly rotating shift schedules, which include more than one type of shift within the same week (e.g., day shifts followed by night shifts). Further, many of the available interventions are seldom used in the workplace and may be less feasible in healthcare environments. In hospitals, the health and safety of both workers and patients can be compromised by increases in fatigue. We thus developed a practical intervention based on circadian and sleep hygiene principles to reduce some of the negative consequences associated with shift work. We then tested this intervention in a feasibility study of 33 nurses working rapidly rotating shifts. The study took place over two separate periods: the control (observation) period and the intervention period. Each period included two to four consecutive night shifts as well as the two days before and after those shifts. Nurses completed daily self-report questionnaires during both periods. During the intervention period, the nurses additionally followed a fatigue reduction plan. The plan involved 40 min of bright light exposure from a portable light box before night shifts, light avoidance using sunglasses after those shifts, and suggestions regarding the ideal times to sleep and nap. Results showed that nurses complied with the large majority of these recommendations. During the intervention period, nurses reported less fatigue, fewer work errors, better and longer sleep, and a more positive mood. Moreover, nurses with a preference for evenings (i.e., later chronotypes) reported the strongest benefits. Though more controlled studies are needed to assess causal mechanisms and long-term effectiveness, these promising results suggest that light-based interventions are feasible and may be effective at reducing fatigue in rapidly rotating shift workers.
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Affiliation(s)
- Jay A Olson
- Department of Psychiatry, McGill University, Montreal, Canada
| | | | - Mariève Cyr
- Department of Psychiatry, McGill University, Montreal, Canada.,Faculty of Medicine, McGill University, Montreal, Canada
| | - Amir Raz
- Department of Psychiatry, McGill University, Montreal, Canada.,Institute for Interdisciplinary Behavioral and Brain Sciences, Chapman University, Irvine, USA
| | - Virginia Lee
- Department of Nursing, McGill University, Montreal, Canada.,Department of Nursing, McGill University Health Centre, Montreal, Canada
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32
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Walbeek TJ, Harrison EM, Soler RR, Gorman MR. Enhanced Circadian Entrainment in Mice and Its Utility under Human Shiftwork Schedules. Clocks Sleep 2019; 1:394-413. [PMID: 33089177 PMCID: PMC7445835 DOI: 10.3390/clockssleep1030032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/20/2019] [Indexed: 12/21/2022] Open
Abstract
The circadian system is generally considered to be incapable of adjusting to rapid changes in sleep/work demands. In shiftworkers this leads to chronic circadian disruption and sleep loss, which together predict underperformance at work and negative health consequences. Two distinct experimental protocols have been proposed to increase circadian flexibility in rodents using dim light at night: rhythm bifurcation and T-cycle (i.e., day length) entrainment. Successful translation of such protocols to human shiftworkers could facilitate alignment of internal time with external demands. To assess entrainment flexibility following bifurcation and exposure to T-cycles, mice in Study 1 were repeatedly phase-shifted. Mice from experimental conditions rapidly phase-shifted their activity, while control mice showed expected transient misalignment. In Study 2 and 3, mice followed a several weeks-long intervention designed to model a modified DuPont or Continental shiftwork schedule, respectively. For both schedules, bifurcation and nocturnal dim lighting reduced circadian misalignment. Together, these studies demonstrate proof of concept that mammalian circadian systems can be rendered sufficiently flexible to adapt to multiple, rapidly changing shiftwork schedules. Flexible adaptation to exotic light-dark cycles likely relies on entrainment mechanisms that are distinct from traditional entrainment.
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Affiliation(s)
- Thijs J. Walbeek
- Department of Psychology, University of California San Diego, La Jolla, CA 92093, USA
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA
- Correspondence: (T.J.W.); (M.R.G.); Tel.: +1-858-822-2466 (M.R.G.)
| | - Elizabeth M. Harrison
- Department of Psychology, University of California San Diego, La Jolla, CA 92093, USA
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA
| | - Robert R. Soler
- Department of Psychology, University of California San Diego, La Jolla, CA 92093, USA
| | - Michael R. Gorman
- Department of Psychology, University of California San Diego, La Jolla, CA 92093, USA
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA
- Correspondence: (T.J.W.); (M.R.G.); Tel.: +1-858-822-2466 (M.R.G.)
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33
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LOWDEN A, ÖZTÜRK G, REYNOLDS A, BJORVATN B. Working Time Society consensus statements: Evidence based interventions using light to improve circadian adaptation to working hours. INDUSTRIAL HEALTH 2019; 57:213-227. [PMID: 30700675 PMCID: PMC6449639 DOI: 10.2486/indhealth.sw-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
Interventions and strategies to improve health through the management of circadian (re) adaptation have been explored in the field, and in both human and animal laboratory manipulations of shiftwork. As part of an initiative by the Working Time Society (WTS) and International Committee on Occupational Health (ICOH), this review summarises the literature on the management of circadian (re) adaption using bright light treatment. Recommendations to maximise circadian adaptation are summarised for practitioners based on a variety of shiftwork schedules. In slowly rotating night shift schedules bright light appears most suitable when used in connection with the first three night shifts. These interventions are improved when combined with orange glasses (to block blue-green light exposure) for the commute home. Non-shifting strategies involve a lower dosage of light at night and promoting natural daylight exposure during the day (also recommended for day shifts) in acordance with the phase and amplitude response curves to light in humans.
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Affiliation(s)
- Arne LOWDEN
- Stress Research Institute, Stockholm University, Sweden
- *To whom correspondence should be addressed. E-mail:
| | - Gülcin ÖZTÜRK
- Stress Research Institute, Stockholm University, Sweden
| | | | - Bjørn BJORVATN
- Department of Global Public Health and Primary Care,
University of Bergen, Norway
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34
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Ganesan S, Magee M, Stone JE, Mulhall MD, Collins A, Howard ME, Lockley SW, Rajaratnam SMW, Sletten TL. The Impact of Shift Work on Sleep, Alertness and Performance in Healthcare Workers. Sci Rep 2019; 9:4635. [PMID: 30874565 PMCID: PMC6420632 DOI: 10.1038/s41598-019-40914-x] [Citation(s) in RCA: 141] [Impact Index Per Article: 28.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 02/19/2019] [Indexed: 01/19/2023] Open
Abstract
Shift work is associated with impaired alertness and performance due to sleep loss and circadian misalignment. This study examined sleep between shift types (day, evening, night), and alertness and performance during day and night shifts in 52 intensive care workers. Sleep and wake duration between shifts were evaluated using wrist actigraphs and diaries. Subjective sleepiness (Karolinska Sleepiness Scale, KSS) and Psychomotor Vigilance Test (PVT) performance were examined during day shift, and on the first and subsequent night shifts (3rd, 4th or 5th). Circadian phase was assessed using urinary 6-sulphatoxymelatonin rhythms. Sleep was most restricted between consecutive night shifts (5.74 ± 1.30 h), consecutive day shifts (5.83 ± 0.92 h) and between evening and day shifts (5.20 ± 0.90 h). KSS and PVT mean reaction times were higher at the end of the first and subsequent night shift compared to day shift, with KSS highest at the end of the first night. On nights, working during the circadian acrophase of the urinary melatonin rhythm led to poorer outcomes on the KSS and PVT. In rotating shift workers, early day shifts can be associated with similar sleep restriction to night shifts, particularly when scheduled immediately following an evening shift. Alertness and performance remain most impaired during night shifts given the lack of circadian adaptation to night work. Although healthcare workers perceive themselves to be less alert on the first night shift compared to subsequent night shifts, objective performance is equally impaired on subsequent nights.
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Affiliation(s)
- Saranea Ganesan
- Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.,Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Michelle Magee
- Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.,Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Julia E Stone
- Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.,Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Megan D Mulhall
- Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.,Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | - Allison Collins
- Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Mark E Howard
- Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.,Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
| | - Steven W Lockley
- Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.,Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Shantha M W Rajaratnam
- Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.,Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.,Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Tracey L Sletten
- Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia. .,Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.
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35
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Yau A, Haque M. Shiftwork Association with Cardiovascular Diseases and Cancers Among Healthcare Workers: A Literature Review. Medeni Med J 2019; 34:387-395. [PMID: 32821466 PMCID: PMC7433719 DOI: 10.5222/mmj.2019.54775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 09/13/2019] [Indexed: 02/06/2023] Open
Abstract
The round-the-clock demands of healthcare services, coupled with the shortage of healthcare providers in many parts of the world, have made shiftwork widespread among healthcare workers. Understanding how to mitigate unfavourable effects of shiftwork on well-being is essential to improve health promotion, to prevent disease prevention, and to increase quality of life. This comprehensive review aims to present evidence linking shiftwork with cardiovascular diseases and cancers among healthcare workers. Several studies have demonstrated evidence indicating the relationship between long-term exposure to shiftwork tempo and a higher risk of cardiovascular diseases. Health workers are increasingly witnesing unfavourable effects of shiftwork on their health state. Shiftwork disturbs circadian rhythm and cardiopulmonary processes, leading to adverse health outcomes. Increasing prevalence of shiftwork in healthcare industries due to population expansion and public health threat of cancers call for investigation towards a better understanding of the underlying mechanism of shiftwork-induced diseases. The shift work period has been considered in different studies using various criteria, resulting in inconsistent definition of measurement criteria leading to misclassification of the study population. There is a need for a more considerable and holistic effort towards standardization of shiftwork definition and conduct an assessment to establish a more conveniently appliacable framework for intervention strategies.
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Affiliation(s)
- Adamu Yau
- Naresuan University, Faculty of Pharmaceutical Sciences, Phitsanulok, Thailand Texas A&M University, School of Public Health, Health Science Center, Department of Epidemiology and Biostatistics, Texas, USA.,Bayero University, Faculty of Pharmaceutical Sciences, Department of Pharmacology and Therapeutics, Kano, Nigeria
| | - Mainul Haque
- Universiti Pertahanan Nasional Malaysia, Faculty of Medicine and Defence Health, Department of Pharmacology, Kem Perdana Sungai Besi, 57000 Kuala Lumpur, Malaysia
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36
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Uhm JY, Kim HR, Kang GH, Choi YG, Park TH, Kim SY, Chang SS, Choo WO. The association between shift work and chronic kidney disease in manual labor workers using data from the Korea National Health and Nutrition Examination Survey (KNHANES 2011-2014). Ann Occup Environ Med 2018; 30:69. [PMID: 30564370 PMCID: PMC6295007 DOI: 10.1186/s40557-018-0279-z] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/30/2018] [Indexed: 12/12/2022] Open
Abstract
Objective Kidneys are organs having a biological clock, and it is well known that the disruption of the circadian rhythm increases the risk of chronic kidney disease (CKD), including the decline of renal and proteinuria. Because shift work causes circadian disruption, it can directly or indirectly affect the incidence of chronic kidney disease. Therefore, the purpose of this study was to investigate the association between shift work and chronic kidney disease using a Korean representative survey dataset. Methods This study was comprised of 3504 manual labor workers over 20 years of age from data from the fifth and sixth Korea National Health and Nutrition Examination Survey (2011–2014). The work schedules were classified into two types: day work and shift work. The estimated glomerular filtration rate, which is the ideal marker of renal function, was estimated according to the Chronic Kidney Disease Epidemiology Collaboration creatinine equation, and chronic kidney disease was defined as urinary albumin to a creatinine ratio equal to or high than 30 mg/g and/or estimated glomerular filtration rate lower than 60 mL/min/1.73 m2. The cross-tabulation analysis and multivariate logistic regression analysis were performed to confirm the association between shift work and chronic kidney disease stratified by gender. Results The risk of CKD showed a significant increase (odds ratio = 2.04, 95% confidence interval = 1.22, 3.41) in the female worker group. The same results were obtained after all confounding variables were adjusted (odds ratio = 2.34, 95% confidence interval = 1.35, 4.07). However, the results of the male worker group were not significant. Conclusions In this study using nationally representative surveys, we found that the risk of CKD was higher female workers and shift work. Future prospective cohort studies will be needed to clarify the causal relationship between shift work and CKD.
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Affiliation(s)
- Jun Young Uhm
- 1Department of Occupational & Environmental Medicine, Eulji University Hospital, Daejeon, Republic of Korea 35233
| | - Hyoung-Ryoul Kim
- 2Department of Occupational and Environmental Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137701 Republic of Korea
| | - Gu Hyeok Kang
- 1Department of Occupational & Environmental Medicine, Eulji University Hospital, Daejeon, Republic of Korea 35233
| | - Young Gon Choi
- 1Department of Occupational & Environmental Medicine, Eulji University Hospital, Daejeon, Republic of Korea 35233
| | - Tae Hwi Park
- 1Department of Occupational & Environmental Medicine, Eulji University Hospital, Daejeon, Republic of Korea 35233
| | - Soo Young Kim
- 1Department of Occupational & Environmental Medicine, Eulji University Hospital, Daejeon, Republic of Korea 35233
| | - Seong Sil Chang
- 1Department of Occupational & Environmental Medicine, Eulji University Hospital, Daejeon, Republic of Korea 35233
| | - Won Oh Choo
- 1Department of Occupational & Environmental Medicine, Eulji University Hospital, Daejeon, Republic of Korea 35233
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HITTLE BM, GILLESPIE GL. Identifying shift worker chronotype: implications for health. INDUSTRIAL HEALTH 2018; 56:512-523. [PMID: 29973467 PMCID: PMC6258747 DOI: 10.2486/indhealth.2018-0018] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 06/25/2018] [Indexed: 06/08/2023]
Abstract
Shift workers are at risk for developing serious health issues due to short sleep. One cause of short sleep is circadian misalignment: sleep time is not synchronized with the body's natural circadian rhythms. Although circadian rhythms are strongly driven by the light/dark cycle, humans have individualized sleep time preferences (chronotypes) based on genetics, development, and external influences. Evening chronotype individuals fall asleep later than average and have a higher risk for developing various noncommunicable diseases. What is unclear is the association between chronotype, shift work, and risks for acquiring chronic conditions. This review is focused on shift worker chronotype and associations with obesity. Because of the paucity of research, other health issues connected with circadian misalignment were included, allowing for a total of 21 research studies. Evidence from this review supports chronotype and certain health issues are associated with shift work, even after adjusting for short sleep duration. In addition, there is evidence to support future research on how shift worker chronotype matched with shift timing impacts worker health. Through better understanding of this interface, occupational health providers can provide more comprehensive worker education on the risks associated with shift work and sleep disturbances.
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Thosar SS, Butler MP, Shea SA. Role of the circadian system in cardiovascular disease. J Clin Invest 2018; 128:2157-2167. [PMID: 29856365 DOI: 10.1172/jci80590] [Citation(s) in RCA: 223] [Impact Index Per Article: 37.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
All species organize behaviors to optimally match daily changes in the environment, leading to pronounced activity/rest cycles that track the light/dark cycle. Endogenous, approximately 24-hour circadian rhythms in the brain, autonomic nervous system, heart, and vasculature prepare the cardiovascular system for optimal function during these anticipated behavioral cycles. Cardiovascular circadian rhythms, however, may be a double-edged sword. The normal amplified responses in the morning may aid the transition from sleep to activity, but such exaggerated responses are potentially perilous in individuals susceptible to adverse cardiovascular events. Indeed, the occurrence of stroke, myocardial infarction, and sudden cardiac death all have daily patterns, striking most frequently in the morning. Furthermore, chronic disruptions of the circadian clock, as with night-shift work, contribute to increased cardiovascular risk. Here we highlight the importance of the circadian system to normal cardiovascular function and to cardiovascular disease, and identify opportunities for optimizing timing of medications in cardiovascular disease.
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Khan S, Nabi G, Yao L, Siddique R, Sajjad W, Kumar S, Duan P, Hou H. Health risks associated with genetic alterations in internal clock system by external factors. Int J Biol Sci 2018; 14:791-798. [PMID: 29910689 PMCID: PMC6001675 DOI: 10.7150/ijbs.23744] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/28/2018] [Indexed: 12/20/2022] Open
Abstract
The circadian system maintains the main aspects of physiological and behavioral processes. Both circadian rhythm and sleep impact an organism's health through interaction with environmental factors. Variations in external factors influence the functionality of clock genes and disrupt 24-hour rhythmic cycle. The disrupted circadian rhythm and disregulated sleep affect an organism's health, thereby causing several disorders including cancer, depression and cardiac disorders. Considering the role of clock genes and environmental factors, extensive investigation is required focusing on pathways involved in development of life-threatening disorders. This review identifies the major risks and associated factors related with disruption in circadian system and sleep.
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Affiliation(s)
- Suliman Khan
- The Key Laboratory of Aquatic Biodiversity and Conservation of Chinese Academy of Sciences, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, Hubei, 430072, P.R China
- Henan Key Laboratory of Ecological Security for Water Source Region of Mid-line of South-to-North Diversion Project, Collaborative Innovation Center of Water Security for Water Source Region of Mid-line of South-to-North Diversion Project of Henan Province, Nanyang Normal University
- University of Chinese Academy of Sciences, Beijing 100049
| | - Ghulam Nabi
- The Key Laboratory of Aquatic Biodiversity and Conservation of Chinese Academy of Sciences, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, Hubei, 430072, P.R China
- University of Chinese Academy of Sciences, Beijing 100049
| | - Lunguang Yao
- Henan Key Laboratory of Ecological Security for Water Source Region of Mid-line of South-to-North Diversion Project, Collaborative Innovation Center of Water Security for Water Source Region of Mid-line of South-to-North Diversion Project of Henan Province, Nanyang Normal University
| | - Rabeea Siddique
- Advanced Biomaterials and Tissue Engineering Center and Department of Biomedical Engineering, Huazhong University of Science and Technology, Wuhan 430074, China
| | - Wasim Sajjad
- University of Chinese Academy of Sciences, Beijing 100049
- Key Laboratory of Petroleum Resources, Gansu Province / Key Laboratory of Petroleum Resources Research, Institute of Geology and geophysics, Chinese Academy of Sciences, Lanzhou, 730000, China
| | - Sunjeet Kumar
- The Key Laboratory of Aquatic Biodiversity and Conservation of Chinese Academy of Sciences, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, Hubei, 430072, P.R China
| | - Pengfei Duan
- Henan Key Laboratory of Ecological Security for Water Source Region of Mid-line of South-to-North Diversion Project, Collaborative Innovation Center of Water Security for Water Source Region of Mid-line of South-to-North Diversion Project of Henan Province, Nanyang Normal University
| | - Hongwei Hou
- The Key Laboratory of Aquatic Biodiversity and Conservation of Chinese Academy of Sciences, Institute of Hydrobiology, Chinese Academy of Sciences, Wuhan, Hubei, 430072, P.R China
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Hanna TN, Zygmont ME, Peterson R, Theriot D, Shekhani H, Johnson JO, Krupinski EA. The Effects of Fatigue From Overnight Shifts on Radiology Search Patterns and Diagnostic Performance. J Am Coll Radiol 2018; 15:1709-1716. [PMID: 29366599 DOI: 10.1016/j.jacr.2017.12.019] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 12/02/2017] [Accepted: 12/12/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to assess the effect of overnight shifts (ONS) on radiologist fatigue, visual search pattern, and diagnostic performance. METHODS This experimental study was approved by the institutional review board. Twelve radiologists (five faculty members and seven residents) each completed two sessions: one during a normal workday ("not fatigued") and another in the morning after an ONS ("fatigued"). Each radiologist completed the Swedish Occupational Fatigue Inventory. During each session, radiologists viewed 20 bone radiographs consisting of normal and abnormal findings. Viewing time, diagnostic confidence, and eye-tracking data were recorded. RESULTS Swedish Occupational Fatigue Inventory results demonstrated worsening in all five variables (lack of energy, physical exertion, physical discomfort, lack of motivation, and sleepiness) after ONS (P < .01). Overall, participants demonstrated worse diagnostic performance in the fatigued versus not fatigued state (P < .05). Total viewing time per case was longer when fatigued (35.9 ± 25.8 seconds) than not fatigued (24.8 ± 16.3 seconds) (P < .0001). Total viewing time per case was longer for residents (P < .05). Mean total fixations generated during the search increased by 60% during fatigued sessions (P < .0001). Mean time to first fixate on the fracture increased by 34% during fatigued sessions (P < .0001) and was longer for residents (P < .01). Dwell times associated with true- and false-positive decisions increased, whereas those with false negatives decreased. CONCLUSIONS After ONS, radiologists were more fatigued with worse diagnostic performance, a 45% increase in view time per case, a 60% increase in total gaze fixations, and a 34% increase in time to fixate on the fracture. The effects of fatigue were more pronounced in residents.
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Affiliation(s)
- Tarek N Hanna
- Division of Emergency and Trauma Imaging, Department of Radiology and Imaging Sciences, Emory University, Emory University Midtown Hospital, Atlanta, Georgia.
| | - Matthew E Zygmont
- Division of Emergency and Trauma Imaging, Department of Radiology and Imaging Sciences, Emory University, Emory University Midtown Hospital, Atlanta, Georgia
| | - Ryan Peterson
- Division of Emergency and Trauma Imaging, Department of Radiology and Imaging Sciences, Emory University, Emory University Midtown Hospital, Atlanta, Georgia
| | - David Theriot
- Division of Emergency and Trauma Imaging, Department of Radiology and Imaging Sciences, Emory University, Emory University Midtown Hospital, Atlanta, Georgia
| | - Haris Shekhani
- Division of Emergency and Trauma Imaging, Department of Radiology and Imaging Sciences, Emory University, Emory University Midtown Hospital, Atlanta, Georgia
| | - Jamlik-Omari Johnson
- Division of Emergency and Trauma Imaging, Department of Radiology and Imaging Sciences, Emory University, Emory University Midtown Hospital, Atlanta, Georgia
| | - Elizabeth A Krupinski
- Division of Emergency and Trauma Imaging, Department of Radiology and Imaging Sciences, Emory University, Emory University Midtown Hospital, Atlanta, Georgia
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Shiftwork-Mediated Disruptions of Circadian Rhythms and Sleep Homeostasis Cause Serious Health Problems. Int J Genomics 2018; 2018:8576890. [PMID: 29607311 PMCID: PMC5828540 DOI: 10.1155/2018/8576890] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 12/12/2017] [Indexed: 12/12/2022] Open
Abstract
Shiftwork became common during the last few decades with the growing demands of human life. Despite the social inactivity and irregularity in habits, working in continuous irregular shifts causes serious health issues including sleep disorders, psychiatric disorders, cancer, and metabolic disorders. These health problems arise due to the disruption in circadian clock system, which is associated with alterations in genetic expressions. Alteration in clock controlling genes further affects genes linked with disorders including major depression disorder, bipolar disorder, phase delay and phase advance sleep syndromes, breast cancer, and colon cancer. A diverse research work is needed focusing on broad spectrum changes caused by jet lag in brain and neuronal system. This review is an attempt to motivate the researchers to conduct advanced studies in this area to identify the risk factors and mechanisms. Its goal is extended to make the shift workers aware about the risks associated with shiftwork.
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Kantermann T, Eastman CI. Circadian phase, circadian period and chronotype are reproducible over months. Chronobiol Int 2017; 35:280-288. [PMID: 29148844 DOI: 10.1080/07420528.2017.1400979] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The timing of the circadian clock, circadian period and chronotype varies among individuals. To date, not much is known about how these parameters vary over time in an individual. We performed an analysis of the following five common circadian clock and chronotype measures: 1) the dim light melatonin onset (DLMO, a measure of circadian phase), 2) phase angle of entrainment (the phase the circadian clock assumes within the 24-h day, measured here as the interval between DLMO and bedtime/dark onset), 3) free-running circadian period (tau) from an ultradian forced desynchrony protocol (tau influences circadian phase and phase angle of entrainment), 4) mid-sleep on work-free days (MSF from the Munich ChronoType Questionnaire; MCTQ) and 5) the score from the Morningness-Eveningness Questionnaire (MEQ). The first three are objective physiological measures, and the last two are measures of chronotype obtained from questionnaires. These data were collected from 18 individuals (10 men, eight women, ages 21-44 years) who participated in two studies with identical protocols for the first 10 days. We show how much these circadian rhythm and chronotype measures changed from the first to the second study. The time between the two studies ranged from 9 months to almost 3 years, depending on the individual. Since the full experiment required living in the laboratory for 14 days, participants were unemployed, had part-time jobs or were freelance workers with flexible hours. Thus, they did not have many constraints on their sleep schedules before the studies. The DLMO was measured on the first night in the lab, after free-sleeping at home and also after sleeping in the lab on fixed 8-h sleep schedules (loosely tailored to their sleep times before entering the laboratory) for four nights. Graphs with lines of unity (when the value from the first study is identical to the value from the second study) showed how much each variable changed from the first to the second study. The DLMO did not change more than 2 h from the first to the second study, except for two participants whose sleep schedules changed the most between studies, a change in sleep times of 3 h. Phase angle did not change by more than 2 h regardless of changes in the sleep schedule. Circadian period did not change more than 0.2 h, except for one participant. MSF did not change more than 1 h, except for two participants. MEQ did not change more than 10 points and the categories (e.g. M-type) did not change. Pearson's correlations for the DLMO between the first and second studies increased after participants slept in the lab on their individually timed fixed 8-h sleep schedules for four nights. A longer time between the two studies did not increase the difference between any of the variables from the first to the second study. This analysis shows that the circadian clock and chronotype measures were fairly reproducible, even after many months between the two studies.
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Affiliation(s)
- Thomas Kantermann
- a SynOpus , Alte Hattinger Strasse, Bochum , DE.,b FOM University of Applied Sciences , Leimkugelstraße, Essen , Germany
| | - Charmane I Eastman
- c Biological Rhythms Research Lab , Rush University Medical Center , Chicago , IL 60612 , USA
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Paech GM, Crowley SJ, Eastman CI. Sleep and cognitive performance of African-Americans and European-Americans before and during circadian misalignment produced by an abrupt 9-h delay in the sleep/wake schedule. PLoS One 2017; 12:e0186843. [PMID: 29073187 PMCID: PMC5658102 DOI: 10.1371/journal.pone.0186843] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/09/2017] [Indexed: 01/12/2023] Open
Abstract
We conducted two studies of circadian misalignment in non-Hispanic African and European-Americans. In the first, the sleep/wake (light/dark) schedule was advanced 9 h, similar to flying east, and in the second these schedules were delayed 9 h, similar to flying west or sleeping during the day after night work. We confirmed that the free-running circadian period is shorter in African-Americans compared to European-Americans, and found differences in the magnitude and direction of circadian rhythm phase shifts which were related to the circadian period. The sleep and cognitive performance data from the first study (published in this journal) documented the impairment in both ancestry groups due to this extreme circadian misalignment. African-Americans slept less and performed slightly worse during advanced/misaligned days than European-Americans. The current analysis is of sleep and cognitive performance from the second study. Participants were 23 African-Americans and 22 European-Americans (aged 18-44 years). Following four baseline days (8 h time in bed, based on habitual sleep), the sleep/wake schedule was delayed by 9 h for three days. Sleep was monitored using actigraphy. During the last two baseline/aligned days and the first two delayed/misaligned days, beginning 2 h after waking, cognitive performance was assessed every 3 h using the Automated Neuropsychological Assessment Metrics (ANAM) battery. Mixed model ANOVAs assessed the effects of ancestry (African-American or European-American) and condition (baseline/aligned or delayed/misaligned) on sleep and performance. There was decreased sleep and impaired cognitive performance in both ancestry groups during the two delayed/misaligned days relative to baseline/aligned days. Sleep and cognitive performance did not differ between African-Americans and European-Americans during either baseline/aligned or delayed/misaligned days. While our previous work showed that an advance in the sleep/wake schedule impaired the sleep of African-Americans more than European-Americans, delaying the sleep/wake schedule impaired the sleep and cognitive performance of African-Americans and European-Americans equally.
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Affiliation(s)
- Gemma M. Paech
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Stephanie J. Crowley
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Charmane I. Eastman
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
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Paech GM, Crowley SJ, Fogg LF, Eastman CI. Advancing the sleep/wake schedule impacts the sleep of African-Americans more than European-Americans. PLoS One 2017; 12:e0186887. [PMID: 29059251 PMCID: PMC5653363 DOI: 10.1371/journal.pone.0186887] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 10/09/2017] [Indexed: 12/16/2022] Open
Abstract
There are differences in sleep duration between Blacks/African-Americans and Whites/European-Americans. Recently, we found differences between these ancestry groups in the circadian system, such as circadian period and the magnitude of phase shifts. Here we document the role of ancestry on sleep and cognitive performance before and after a 9-h advance in the sleep/wake schedule similar to flying east or having a large advance in sleep times due to shiftwork, both of which produce extreme circadian misalignment. Non-Hispanic African and European-Americans (N = 20 and 17 respectively, aged 21-43 years) were scheduled to four baseline days each with 8 h time in bed based on their habitual sleep schedule. This sleep/wake schedule was then advanced 9 h earlier for three days. Sleep was monitored using actigraphy. During the last two baseline/aligned days and the first two advanced/misaligned days, beginning 2 h after waking, cognitive performance was measured every 3 h using the Automated Neuropsychological Assessment Metrics (ANAM) test battery. Mixed model ANOVAs assessed the effects of ancestry (African-American or European-American) and condition (baseline/aligned or advanced/misaligned) on sleep and cognitive performance. There was decreased sleep and impaired performance in both ancestry groups during the advanced/misaligned days compared to the baseline/aligned days. In addition, African-Americans obtained less sleep than European-Americans, especially on the first two days of circadian misalignment. Cognitive performance did not differ between African-Americans and European-Americans during baseline days. During the two advanced/misaligned days, however, African-Americans tended to perform slightly worse compared to European-Americans, particularly at times corresponding to the end of the baseline sleep episodes. Advancing the sleep/wake schedule, creating extreme circadian misalignment, had a greater impact on the sleep of African-Americans than European-Americans. Ancestry differences in sleep appear to be exacerbated when the sleep/wake schedule is advanced, which may have implications for individuals undertaking shiftwork and transmeridian travel.
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Affiliation(s)
- Gemma M. Paech
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Stephanie J. Crowley
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Louis F. Fogg
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Charmane I. Eastman
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
- * E-mail:
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Kaliyaperumal D, Elango Y, Alagesan M, Santhanakrishanan I. Effects of Sleep Deprivation on the Cognitive Performance of Nurses Working in Shift. J Clin Diagn Res 2017; 11:CC01-CC03. [PMID: 28969117 DOI: 10.7860/jcdr/2017/26029.10324] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 04/21/2017] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Sleep deprivation and altered circadian rhythm affects the cognitive performance of an individual. Quality of sleep is compromised in those who are frequently involved in extended working hours and shift work which is found to be more common among nurses. Cognitive impairment leads to fatigability, decline in attention and efficiency in their workplace which puts their health and patients' health at risk. AIM To find out the prevalence of sleep deprivation and its impact on cognition among shift working nurses. MATERIALS AND METHODS Sleep deprivation among 97 female and three male healthy nurses of age 20-50 years was assessed by Epworth sleepiness scale (ESS). Cognition was assessed by Montreal Cognitive Assessment (MoCA) questionnaire. Mobile applications were used to test their vigilance, reaction time, photographic memory and numerical cognition. The above said parameters were assessed during end of day shift and 3-4 days after start of night shift. RESULTS Poor sleep quality was observed among 69% of shift working nurses according to ESS scores. The cognitive performance was analysed using Wilcoxon signed rank test. The MoCA score was found to be lesser among 66% of nurses during night (25.72) than day (26.81). During the night, 32% made more mathematical errors. It was also found that, 71%, 83% and 68% of the nurses scored lesser during night in the Stroop's colour test, vigilance test and memory tests respectively. Thus, impairment in cognitive performance was statistically significant (p<0.001) among shift working nurses. CONCLUSION Cognitive performance was found to be impaired among shift working nurses, due to poor sleep quality and decreased alertness during wake state. Thus, shift work poses significant cognitive risks in work performance of nurses.
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Affiliation(s)
- Deepalakshmi Kaliyaperumal
- Associate Professor, Department of Physiology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Yaal Elango
- Undergraduate Student, Department of Physiology, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Murali Alagesan
- Professor, Department of General Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
| | - Iswarya Santhanakrishanan
- Assistant Professor, Community Medicine, PSG Institute of Medical Sciences and Research, Coimbatore, Tamil Nadu, India
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Wirth MD, Andrew ME, Burchfiel CM, Burch JB, Fekedulegn D, Hartley TA, Charles LE, Violanti JM. Association of shiftwork and immune cells among police officers from the Buffalo Cardio-Metabolic Occupational Police Stress study. Chronobiol Int 2017; 34:721-731. [PMID: 28488901 DOI: 10.1080/07420528.2017.1316732] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Shift workers suffer from a constellation of symptoms associated with disruption of circadian rhythms including sleep abnormalities, and abnormal hormone secretion (e.g. melatonin, cortisol). Recent, but limited, evidence suggests that shift workers have elevated levels of circulating white blood cells (WBCs) compared to their day working counterparts. Interestingly, recent reviews highlight the strong linkage between the immune system and circadian rhythms which includes, but is not limited to, circulating cell populations and functions. The elevated levels of these WBCs may be associated with the increased chronic disease risk observed among this group. The purpose of this analysis was to examine the cross-sectional association between long- and short-term (3, 5, 7, and 14 days) shiftwork (SW) and counts of WBCs among officers in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) cohort. Data collection for this analysis took place among 464 police officers working in Buffalo, New York, USA between 2004 and 2009. Precise SW histories were obtained using electronic payroll records. Officers were assigned a shift type based on the shift (i.e. day, evening, night) that they spent a majority (i.e. ≥50%) of their time from 1994 to the data collection date for long-term SW. The same process was applied to SW over 3, 5, 7, and 14 days prior to data collection. A fasted blood sample collected in the morning of a non-work day was used for characterization of WBCs (total), neutrophils, monocytes, lymphocytes, eosinophils, and basophils. Potential confounding factors included demographic characteristics (e.g. age, sex, race), occupational characteristics (e.g. rank), health behaviors (e.g. smoking, alcohol consumption, diet), anthropometrics, and other biomarkers (e.g. lipids, hemoglobin A1C, leptin). Generalized linear models were used to estimate least square means of the immune cells according to SW categorization for long- and short-term SW histories. Compared to the day shift group, those working long-term night shifts had greater absolute numbers of total WBCs, neutrophils, lymphocytes, and monocytes (all p < 0.05). Those working mainly on the night shift over 7-days had elevated counts of WBCs, lymphocytes, and monocytes (p < 0.05) compared to those mainly working day shifts. Results based on 3-, 5-, and 14-day SW were similar to the 7-day results. This study corroborates other studies with similar findings. However, this analysis provided insights into the effect of both long- and short-term SW on the number of circulating WBCs. SW may lead to disruption of circadian-influenced components of the immune system, which in term, may result in various chronic diseases. These findings, plus previous findings, may provide evidence that SW may lead to immune system dysregulation. Future research is needed to understand whether increases in immune cells among shift workers may be associated with the increased disease risk among this group.
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Affiliation(s)
- Michael D Wirth
- a Cancer Prevention and Control Program , University of South Carolina , Columbia , SC , USA.,b Department of Epidemiology and Biostatistics , University of South Carolina , Columbia , SC , USA.,c Connecting Health Innovations , Columbia , SC , USA
| | - Michael E Andrew
- d Biostatistics and Epidemiology Branch, Health Effects Laboratory Division , National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Morgantown , WV , USA
| | - Cecil M Burchfiel
- d Biostatistics and Epidemiology Branch, Health Effects Laboratory Division , National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Morgantown , WV , USA
| | - James B Burch
- a Cancer Prevention and Control Program , University of South Carolina , Columbia , SC , USA.,b Department of Epidemiology and Biostatistics , University of South Carolina , Columbia , SC , USA.,e WJB Dorn VA Medical Center , Columbia , SC , USA
| | - Desta Fekedulegn
- d Biostatistics and Epidemiology Branch, Health Effects Laboratory Division , National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Morgantown , WV , USA
| | - Tara A Hartley
- d Biostatistics and Epidemiology Branch, Health Effects Laboratory Division , National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Morgantown , WV , USA
| | - Luenda E Charles
- d Biostatistics and Epidemiology Branch, Health Effects Laboratory Division , National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention , Morgantown , WV , USA
| | - John M Violanti
- f Department of Epidemiology and Environmental Health, School of Public Health and Health Professions , University of Buffalo, The State University of New York , Buffalo , New York , USA
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Circadian rhythms of European and African-Americans after a large delay of sleep as in jet lag and night work. Sci Rep 2016; 6:36716. [PMID: 27819313 PMCID: PMC5098183 DOI: 10.1038/srep36716] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Accepted: 10/17/2016] [Indexed: 12/31/2022] Open
Abstract
Jet travel and night shift work produce large changes in when people sleep, work and eat; a challenge that was not encountered during most of our evolution. Successful adaptation would require the internal, master, circadian clock to make large phase shifts to reduce the circadian misalignment between circadian rhythms and the times for sleep, work and meals. We compared African-Americans and non-Hispanic European-Americans in how much their circadian clocks shifted after a 9 hour phase delay of the light/dark, sleep/wake and meal schedule, which has similarities to flying west or sleeping in the daytime after night shifts. We also measured their free-running circadian periods using a forced desynchrony protocol with a 5-h day. European-Americans had longer free-running periods and larger phase delays than African-Americans. Correlations (among all subjects, just African-Americans and just European-Americans) showed that longer circadian periods were associated with larger phase delays. Larger phase delays, facilitated by longer circadian periods, reduce jet lag after westward travel and make it easier to work night shifts and sleep during the daytime after night work. On the other hand, a shorter circadian period, which makes one more of a morning-type person, is better for most people given our early-bird dominated society.
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Murnane EL, Abdullah S, Matthews M, Kay M, Kientz JA, Choudhury T, Gay G, Cosley D. Mobile Manifestations of Alertness: Connecting Biological Rhythms with Patterns of Smartphone App Use. MOBILEHCI : PROCEEDINGS OF THE ... INTERNATIONAL CONFERENCE ON HUMAN COMPUTER INTERACTION WITH MOBILE DEVICES AND SERVICES. MOBILEHCI (CONFERENCE) 2016; 2016:465-477. [PMID: 30931436 DOI: 10.1145/2935334.2935383] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Our body clock causes considerable variations in our behavioral, mental, and physical processes, including alertness, throughout the day. While much research has studied technology usage patterns, the potential impact of underlying biological processes on these patterns is under-explored. Using data from 20 participants over 40 days, this paper presents the first study to connect patterns of mobile application usage with these contributing biological factors. Among other results, we find that usage patterns vary for individuals with different body clock types, that usage correlates with rhythms of alertness, that app use features such as duration and switching can distinguish periods of low and high alertness, and that app use reflects sleep interruptions as well as sleep duration. We conclude by discussing how our findings inform the design of biologically-friendly technology that can better support personal rhythms of performance.
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Affiliation(s)
| | | | | | - Matthew Kay
- Computer Science & Engineering, University of Washington
| | - Julie A Kientz
- Human Centered Design & Engineering, University of Washington
| | | | - Geri Gay
- Information Science, Cornell University
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Mukherjee S, Patel SR, Kales SN, Ayas NT, Strohl KP, Gozal D, Malhotra A. An Official American Thoracic Society Statement: The Importance of Healthy Sleep. Recommendations and Future Priorities. Am J Respir Crit Care Med 2015; 191:1450-8. [PMID: 26075423 DOI: 10.1164/rccm.201504-0767st] [Citation(s) in RCA: 148] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Despite substantial public interest, few recommendations on the promotion of good sleep health exist to educate health care providers and the general public on the importance of sleep for overall health. OBJECTIVES The aim of this American Thoracic Society (ATS) statement is to provide a review of the current scientific literature to assist health care providers, especially pulmonologists and sleep physicians, in making recommendations to patients and the general public about the importance of achieving good quality and adequate quantity of sleep. METHODS ATS members were invited, based on their expertise in sleep medicine, and their conclusions were based on both empirical evidence identified after comprehensive literature review and clinical experience. MAIN RESULTS We focus on sleep health in both children and adults, including the impact of occupation on sleep, the public health implications of drowsy driving, and the common sleep disorders of obstructive sleep apnea and insomnia. This ATS statement also delineates gaps in research and knowledge that should be addressed and lead to new focused research priorities to advance knowledge in sleep and sleep health. CONCLUSIONS Good quality and quantity of sleep are essential for good health and overall quality of life; therefore a strong recommendation was made for the implementation of public education programs on the importance of sleep health.
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