Reproducibility of the circadian rhythms of serum cortisol and melatonin in healthy subjects: a study of three different 24-h cycles over six weeks

The association between the circadian misalignment of serum cortisol acrophase and sleep end time with chemotherapy-induced peripheral neuropathy

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of chemotherapy. The objective of this prospective observational study was to examine the association between circadian misalignment (CM), as measured by phase angle difference (PAD) of biological and behavioral rhythms and CIPN. The PAD of cortisol acrophase and actigraphy-based sleep end time in breast cancer patients was measured and categorized into low PAD (n = 11) and high PAD (n = 12) groups based on median value. CIPN was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-CIPN20 (CIPN20). The assessment of CM revealed that the sleep end time of the low PAD group was more delayed in relation to cortisol acrophase compared to the high PAD group. The low PAD group demonstrated significantly higher CIPN20 global and sensory scale scores compared to the high-PAD group at one month post-chemotherapy, with an estimated group difference of 17.63 ± 4.75 and 27.07 ± 6.70 (p = 0.001 and p < 0.001, respectively). The present findings indicate that the low PAD group, which exhibited a relatively delayed behavioral rhythm with respect to its biological rhythm, displayed an increased susceptibility to CIPN. Further large-sample research is necessary to attain a comprehensive understanding of the mechanisms through which CM affects CIPN.

Burning mouth syndrome - known and unknown

The aim of this literature review was to provide a brief perspective over the scientific research of the condition known as burning mouth syndrome. Information from review articles, original studies, and dissertations was gathered using keywords describing etiological factors, clinical, laboratory findings and treatment protocols. We compiled information on potential etiological factors, symptoms, and potential treatments from the fifty-three included studies on dental and general health issues in patients complaining of burning sensations in their mouths. Despite the numerous attempts by dental and medical professionals to diagnose and treat mouth burning, the etiology and pathogenesis of this disorder remain rather unclear. In most cases, it is concluded that further research is needed with the inclusion of more patients, administering a long-term therapy, and monitoring the results.

Diurnal variation of cerebral blood flow in healthy humans under normal entrained conditions

The presence of a circadian cycle of cerebral blood flow may have implications for the occurrence of daily variations in cerebrovascular events in humans, but how cerebral blood flow varies throughout the day and its mechanism are still unclear. The study aimed to explore the diurnal variation of cerebral blood flow in healthy humans and its possible mechanisms. Arterial spin labelling images were collected at six time-points (09:00 hours, 13:00 hours, 17:00 hours, 21:00 hours, 01:00 hours, 05:00 hours) from 18 healthy participants (22-39 years old; eight females) to analyse diurnal variations in cerebral blood flow. Resting heart rate and blood pressure at six time-points and blood indicators (20-hydroxyeicosatetraenoic acid, epoxyeicosatrienoic acids, prostaglandin E2, noradrenaline and nitric oxide) related to cerebral vascular tone at two time-points (09:00 hours and 21:00 hours) were collected to analyse possible influences on diurnal variations in cerebral blood flow. From 21:00 hours to 05:00 hours, parietal cortical relative cerebral blood flow tended to increase, while frontal cortical and cerebellar relative cerebral blood flow tended to decrease. There was a time-dependent negative correlation between parietal cortical relative cerebral blood flow and resting heart rate, whereas there was a time-dependent positive correlation between cerebellar relative cerebral blood flow and resting heart rate. The change of parietal cortical relative cerebral blood flow was positively correlated with the change of nitric oxide. There was also a time-dependent positive correlation between mean arterial pressure and mean whole-brain cerebral blood flow. The findings indicated that parietal cortical relative cerebral blood flow and frontal cortical/cerebellar relative cerebral blood flow showed roughly opposite trends throughout the day. The diurnal variations in relative cerebral blood flow were regional-specific. Diurnal variation of nitric oxide and neurogenic regulation may be potential mechanisms for diurnal variation in regional relative cerebral blood flow.

Adrenal insufficiency - causes and laboratory diagnosis

Adrenal insufficiency (AI) manifests as a clinical syndrome arising from either the direct impairment of adrenal glands, leading to primary AI characterized by deficiencies in glucocorticoids and mineralocorticoids, or adrenal cortex atrophy due to diminished adrenocorticotropic hormone (ACTH) stimulation, a consequence of hypothalamic and/or pituitary damage, resulting in secondary AI. The diagnosis of AI is based on clinical assessment and biochemical tests, including basal hormone level measurements and stimulation tests. In evaluating the results of laboratory tests, it is necessary to consider factors that may influence both pre-analytical and analytical phases, as well as the chosen methodology. Correct diagnosis of adrenal insufficiency and timely initiation of suitable replacement therapy are paramount. These steps are crucial not only for managing the condition but also to avert potentially life-threatening adrenal crises.

Blunted Melatonin Circadian Rhythm in Parkinson's Disease: Express Bewilderment

Melatonin (MTN) is a neuro-hormone released from the pineal gland. MTN secretion is regulated by different neuronal circuits, including the retinohypothalamic tract and suprachiasmatic nucleus (SCN), which are affected by light. MTN is neuroprotective in various neurodegenerative diseases, including Parkinson's disease (PD). MTN circulating level is highly blunted in PD. However, the underlying causes were not fully clarified. Thus, the present review aims to discuss the potential causes of blunted MTN levels in PD. Distortion of MTN circadian rhythmicity in PD patients causies extreme daytime sleepiness. The underlying mechanism for blunted MTN response may be due to reduction for light exposure, impairment of retinal light transmission, degeneration of circadian pacemaker and dysautonomia. In conclusion, degeneration of SCN and associated neurodegeneration together with neuroinflammation and activation of NF-κB and NLRP3 inflammasome, induce dysregulation of MTN secretion. Therefore, low serum MTN level reflects PD severity and could be potential biomarkers. Preclinical and clinical studies are suggested to clarify the underlying causes of low MTN in PD.

Circadian rhythm analysis using wearable-based accelerometry as a digital biomarker of aging and healthspan

Recognizing the pivotal role of circadian rhythm in the human aging process and its scalability through wearables, we introduce CosinorAge, a digital biomarker of aging developed from wearable-derived circadian rhythmicity from 80,000 midlife and older adults in the UK and US. A one-year increase in CosinorAge corresponded to 8-12% higher all-cause and cause-specific mortality risks and 3-14% increased prospective incidences of age-related diseases. CosinorAge also captured a non-linear decline in resilience and physical functioning, evidenced by an 8-33% reduction in self-rated health and a 3-23% decline in health-related quality of life score, adjusting for covariates and multiple testing. The associations were robust in sensitivity analyses and external validation using an independent cohort from a disparate geographical region using a different wearable device. Moreover, we illustrated a heterogeneous impact of circadian parameters associated with biological aging, with young (<45 years) and fast agers experiencing a substantially delayed acrophase with a 25-minute difference in peak timing compared to slow agers, diminishing to a 7-minute difference in older adults (>65 years). We demonstrated a significant enhancement in the predictive performance when integrating circadian rhythmicity in the estimation of biological aging over physical activity. Our findings underscore CosinorAge's potential as a scalable, economic, and digital solution for promoting healthy longevity, elucidating the critical and multifaceted circadian rhythmicity in aging processes. Consequently, our research contributes to advancing preventive measures in digital medicine.

The environment and the internal clocks: The study of their relationships from prehistoric to modern times

The origin of biological rhythms goes back to the very beginning of life. They are observed in the animal and plant world at all levels of organization, from cells to ecosystems. As early as the 18th century, plant scientists were the first to explain the relationship between flowering cycles and environmental cycles, emphasizing the importance of daily light-dark cycles and the seasons. Our temporal structure is controlled by external and internal rhythmic signals. Light is the main synchronizer of the circadian system, as daily exposure to light entrains our clock over 24 hours, the endogenous period of the circadian system being close to, but not exactly, 24 hours. In 1960, a seminal scientific meeting, the Cold Spring Harbor Symposium on Biological Rhythms, brought together all the biological rhythms scientists of the time, a number of whom are considered the founders of modern chronobiology. All aspects of biological rhythms were addressed, from the properties of circadian rhythms to their practical and ecological aspects. Birth of chronobiology dates from this period, with the definition of its vocabulary and specificities in metabolism, photoperiodism, animal physiology, etc. At around the same time, and right up to the present day, research has focused on melatonin, the circadian neurohormone of the pineal gland, with data on its pattern, metabolism, control by light and clinical applications. However, light has a double face, as it has positive effects as a circadian clock entraining agent, but also deleterious effects, as it can lead to chronodisruption when exposed chronically at night, which can increase the risk of cancer and other diseases. Finally, research over the past few decades has unraveled the anatomical location of circadian clocks and their cellular and molecular mechanisms. This recent research has in turn allowed us to explain how circadian rhythms control physiology and health.

Investigation of the effect of Ramadan fasting on serum levels of melatonin, cortisol, and serotonin: the case of Turkey

INTRODUCTION

The aim of this study is to examine the effects of Ramadan fasting on melatonin, cortisol, and serotonin levels.

METHODS

In this study, the blood of 19 healthy male individuals between the ages of 26 and 51, registered in Agri (Turkey) Family Health Center and fasting during Ramadan, was studied. The study was carried out in 2021-2022. The SPSS-22 package program was used in the analysis of the data. Wilcoxon analysis was used in the study.

RESULTS

It was determined that the pre-test-post-test melatonin and cortisol levels of the individuals were not statistically significant (p>0.05). It was determined that the pre-test-post-test serotonin difference of the individuals was statistically significant (p<0.05).

CONCLUSION

It has been determined that Ramadan fasting increases the serotonin level of individuals but does not change the levels of melatonin and cortisol. It was determined that the level of happiness of individuals increased after Ramadan fasting. Longitudinal studies on the effects of Ramadan fasting are recommended.

Circadian Rhythms Disrupted by Light at Night and Mistimed Food Intake Alter Hormonal Rhythms and Metabolism

Availability of artificial light and light-emitting devices have altered human temporal life, allowing 24-hour healthcare, commerce and production, and expanding social life around the clock. However, physiology and behavior that evolved in the context of 24 h solar days are frequently perturbed by exposure to artificial light at night. This is particularly salient in the context of circadian rhythms, the result of endogenous biological clocks with a rhythm of ~24 h. Circadian rhythms govern the temporal features of physiology and behavior, and are set to precisely 24 h primarily by exposure to light during the solar day, though other factors, such as the timing of meals, can also affect circadian rhythms. Circadian rhythms are significantly affected by night shift work because of exposure to nocturnal light, electronic devices, and shifts in the timing of meals. Night shift workers are at increased risk for metabolic disorder, as well as several types of cancer. Others who are exposed to artificial light at night or late mealtimes also show disrupted circadian rhythms and increased metabolic and cardiac disorders. It is imperative to understand how disrupted circadian rhythms alter metabolic function to develop strategies to mitigate their negative effects. In this review, we provide an introduction to circadian rhythms, physiological regulation of homeostasis by the suprachiasmatic nucleus (SCN), and SCN-mediated hormones that display circadian rhythms, including melatonin and glucocorticoids. Next, we discuss circadian-gated physiological processes including sleep and food intake, followed by types of disrupted circadian rhythms and how modern lighting disrupts molecular clock rhythms. Lastly, we identify how disruptions to hormones and metabolism can increase susceptibility to metabolic syndrome and risk for cardiovascular diseases, and discuss various strategies to mitigate the harmful consequences associated with disrupted circadian rhythms on human health.

Circadian disruption and cancer- and treatment-related symptoms

Cancer patients experience a number of co-occurring side- and late-effects due to cancer and its treatment including fatigue, sleep difficulties, depressive symptoms, and cognitive impairment. These symptoms can impair quality of life and may persist long after treatment completion. Furthermore, they may exacerbate each other's intensity and development over time. The co-occurrence and interdependent nature of these symptoms suggests a possible shared underlying mechanism. Thus far, hypothesized mechanisms that have been purported to underlie these symptoms include disruptions to the immune and endocrine systems. Recently circadian rhythm disruption has emerged as a related pathophysiological mechanism underlying cancer- and cancer-treatment related symptoms. Circadian rhythms are endogenous biobehavioral cycles lasting approximately 24 hours in humans and generated by the circadian master clock - the hypothalamic suprachiasmatic nucleus. The suprachiasmatic nucleus orchestrates rhythmicity in a wide range of bodily functions including hormone levels, body temperature, immune response, and rest-activity behaviors. In this review, we describe four common approaches to the measurement of circadian rhythms, highlight key research findings on the presence of circadian disruption in cancer patients, and provide a review of the literature on associations between circadian rhythm disruption and cancer- and treatment-related symptoms. Implications for future research and interventions will be discussed.

A Pilot Study Evaluating the Feasibility of Testing for an Acute Impact of Human Exposure to a Power-line Frequency Magnetic Field on Blood Cortisol and Thyroid-Stimulating Hormone

Numerous studies have been carried out on the potential effects of an extremely low frequency (ELF-0-300 Hz) magnetic field (MF) on human health. However, there is limited data on the effect of a high exposure level to ELF MFs for a prolonged period. Therefore, the objective of this pilot work was to demonstrate the feasibility of a study evaluating the stress hormone concentrations resulting from a 10-min exposure to a 60 Hz MF of several tens of thousands of µT. In this pilot study, human volunteers were thus exposed for the first time to a 60 Hz, 50 mT MF for a duration of 10 min. Stress hormone levels were measured before (once), during (twice) and after (once) this 10-min exposure period. The small sample size (n = 5) did not allow to conduct standard inferential statistical tests and no conclusion regarding the exposure effects can be drawn. However, this study demonstrates the feasibility of using a simple blood testing material in a protocol testing for the effect of a 10-min exposure to a high MF level in healthy human volunteers. © 2022 Bioelectromagnetics Society.

Circadian rhythms and pancreas physiology: A review

Type 2 diabetes mellitus, obesity and metabolic syndrome are becoming more prevalent worldwide and will present an increasingly challenging burden on healthcare systems. These interlinked metabolic abnormalities predispose affected individuals to a plethora of complications and comorbidities. Furthermore, diabetes is estimated by the World Health Organization to have caused 1.5 million deaths in 2019, with this figure projected to rise in coming years. This highlights the need for further research into the management of metabolic diseases and their complications. Studies on circadian rhythms, referring to physiological and behavioral changes which repeat approximately every 24 hours, may provide important insight into managing metabolic disease. Epidemiological studies show that populations who are at risk of circadian disruption such as night shift workers and regular long-haul flyers are also at an elevated risk of metabolic abnormalities such as insulin resistance and obesity. Aberrant expression of circadian genes appears to contribute to the dysregulation of metabolic functions such as insulin secretion, glucose homeostasis and energy expenditure. The potential clinical implications of these findings have been highlighted in animal studies and pilot studies in humans giving rise to the development of circadian interventions strategies including chronotherapy (time-specific therapy), time-restricted feeding, and circadian molecule stabilizers/analogues. Research into these areas will provide insights into the future of circadian medicine in metabolic diseases. In this review, we discuss the physiology of metabolism and the role of circadian timing in regulating these metabolic functions. Also, we review the clinical aspects of circadian physiology and the impact that ongoing and future research may have on the management of metabolic disease.

Cortisol and shiftwork: A scoping review

The aim of this review was to explore the extent and nature of evidence exploring shiftwork and disruptions to cortisol. A systematic search was conducted across five databases: Medline, EMBASE, Psych INFO, Joanna Briggs Institute and PubMed between July-August 2020. Cortisol data were characterised into three main outcomes, 1) cortisol levels, 2) cortisol rhythm, and 3) cortisol awakening response (CAR) during shiftwork. Main findings demonstrate that shiftwork, especially night shift, significantly disrupts production of cortisol, the cortisol rhythm and CAR and, irregular shift schedules produce greater disruptions to cortisol than regular shift schedules. It was difficult to draw conclusions about the impact of shiftwork on movement of the cortisol rhythm and adaptation or recovery of the cortisol rhythm to and from night shift as the literature lacks consistency in definition of methods and variables. The present state of literature demonstrates cortisol levels, cortisol rhythm and the CAR are all disrupted by shiftwork, but there is a lack of consistency between studies on use of variables and most of the literature focuses on acute disruption rather than chronic effects. It will be important for future studies to investigate possible mechanisms that link shiftwork, disruptions to cortisol and chronic health conditions prevalent in shiftworkers.

Electric lighting, adolescent sleep and circadian outcomes, and recommendations for improving light health

Light is a potent circadian entraining agent. For many people, daily light exposure is fundamentally dysregulated with reduced light during the day and increased light into the late evening. This lighting schedule promotes chronic disruption to circadian physiology resulting in a myriad of impairments. Developmental changes in sleep-wake physiology suggest that such light exposure patterns may be particularly disruptive for adolescents and further compounded by lifestyle factors such as early school start times. This narrative review describes evidence that reduced light exposure during the school day delays the circadian clock, and longer exposure durations to light-emitting electronic devices in the evening suppress melatonin. While home lighting in the evening can suppress melatonin secretion and delay circadian phase, the patterning of light exposure across the day and evening can have moderating effects. Photic countermeasures may be flexibly and scalably implemented to support sleep-wake health; including manipulations of light intensity, spectra, duration and delivery modality across multiple contexts. An integrative approach addressing physiology, attitudes, and behaviors will support optimization of light-driven sleep-wake outcomes in adolescents.

Rules of thumb to obtain, isolate, and preserve porcine peripheral blood mononuclear cells

One of the most used biospecimens in immunology are peripheral blood mononuclear cells (PBMC). PBMC are particularly useful when evaluating immunity through responses of circulating B- and T-cells, during an infection, or after a vaccination. While several reviews and research papers have been published aiming to point out critical steps when sampling, isolating, and cryopreserving human PBMC -or even analyzing any parameter before sampling that could impair the immune assays' outcomes-, there are almost no publications in swine research dealing with these topics. As it has been demonstrated, several factors, such as stress, circadian rhythmicity, or the anticoagulant used have serious negative impact, not only on the separation performance of PBMC, but also on the ulterior immune assays. The present review aims to discuss studies carried out in humans that could shed some light for swine research. When possible, publications in pigs are also discussed. The main goal of the review is to encourage swine researchers to standardize protocols to obtain, manage and preserve porcine PBMC, as well as to minimize, or at least to consider, the bias that some parameters might induce in their studies before, during and after isolating PBMC.

Impact of time-of-day and chronotype on neuromuscular performance in semi-professional female volleyball players

This study aimed to determine if time-of-day could influence physical volleyball performance in females and to explore the relationship between chronotype and volleyball-specific performance. Fifteen young female athletes participated in a randomized counterbalanced trial, performing a neuromuscular test battery in the morning (9:00 h) and the evening (19:00 h) that consisted of volleyball standing spike, straight leg raise, dynamic balance, vertical jump, modified agility T-test and isometric handgrip tests. Chronotype was determined by the morningness-eveningness questionnaire. Compared to the morning, an increased performance was found in the standing spike (4.5%, p = .002, ES = 0.59), straight leg raise test (dominant-limb) (6.5%, p = .012, ES = 0.40), dynamic balance (non-dominant-limb) (5.0%, p = .010, ES = 0.57) and modified T-test (2.1%, p = .049, ES = 0.45) performance in the evening; while no statistical differences were reported in vertical jump tests or isometric handgrip strength. Moreover, no associations were found between chronotype and neuromuscular performance (r = -0.368-0.435, p = .052-0.439). Time-of-day affected spike ball velocity, flexibility in the dominant-limb, dynamic balance in the non-dominant-limb and agility tests. However, no association was reported among these improvements and the chronotype. Therefore, although the chronotype may not play critical role in volleyball-specific performance, evening training/matches schedules could benefit performance in semi-professional female volleyball players.

Assessment of cortisol secretory pattern in workers chronically exposed to ELF-EMF generated by high voltage transmission lines and substations

We investigated the effects of extremely-low frequency electromagnetic fields (ELF-EMFs; 50 Hz) on the secretion of cortisol in 14 men (mean age = 38.0 ± 0.9 years) working in extra-high voltage (EHV) substations. The workers dwelt in houses that were close to substations and high-voltage lines. Thus, they had long histories (1-20 years) of long-yerm exposure to ELF-EMFs. Magnetic field strength was recorded using Emdex dosimeters worn by the volunteers day and night for seven days; the one-week geometric mean ranged from 0.1 to 2.6 μT. Blood samples were taken hourly from 20:00 to 08:00 the next morning. Cortisol concentrations and patterns were compared to age-matched, unexposed control subjects whose exposure level was ten times lower. The comparison of the control group (n = 15) and the groups exposed to fields of 0.1-0.3 μT (n = 5) and > 0.3 μT (n = 9), respectively, revealed a significant effect of field intensity on the cortisol secretory pattern. This study strongly suggests that chronic exposure to ELF-EMFs alters the peak-time serum cortisol levels. Studies are required on the effect of this disruption in high-risk populations such as children, elderly people, and patients with cancer.

Cell-associated HIV RNA has a Circadian Cycle in Males Living with HIV on Antiretroviral Therapy

BACKGROUND

Circadian transcription factors that regulate cell-autonomous circadian clocks can also increase HIV transcription in vitro. We aimed to determine if circadian variation in HIV transcription exists in people living with HIV (PLHIV) on antiretroviral therapy (ART).

METHODS

We performed a prospective observational study of male PLHIV on ART, sampling blood every four hours for 24 hours. Using qPCR, we quantified expression of circadian associated genes, HIV DNA and cell-associated unspliced (CA-US) RNA in peripheral blood CD4+ T-cells. Plasma sex hormones were quantified alongside plasma and salivary cortisol. The primary outcome was to identify temporal variations in CA-US HIV RNA using a linear mixed effect regression framework and maximum likelihood estimation.

RESULTS

Salivary and plasma cortisol, and circadian genes including Clock, Bmal1, and Per3 varied with a circadian rhythm. CA-US HIV RNA and the ratio of CA-US HIV RNA-to-DNA in CD4+ T-cells also demonstrated circadian variations, with no variation in HIV DNA. Circulating oestradiol was highly predictive of CA-US HIV RNA variation in vivo.

CONCLUSION

CA-US HIV RNA in PLHIV on ART varies temporally with a circadian rhythm. These findings have implications for the design of clinical trials and biomarkers to assess HIV cure interventions.

Effects of Intermittent Fasting on the Circulating Levels and Circadian Rhythms of Hormones

Intermittent fasting has become an increasingly popular strategy in losing weight and associated reduction in obesity-related medical complications. Overwhelming studies support metabolic improvements from intermittent fasting in blood glucose levels, cardiac and brain function, and other health benefits, in addition to weight loss. However, concerns have also been raised on side effects including muscle loss, ketosis, and electrolyte imbalance. Of particular concern, the effect of intermittent fasting on hormonal circadian rhythms has received little attention. Given the known importance of circadian hormonal changes to normal physiology, potential detrimental effects by dysregulation of hormonal changes deserve careful discussions. In this review, we describe the changes in circadian rhythms of hormones caused by intermittent fasting. We covered major hormones commonly pathophysiologically involved in clinical endocrinology, including insulin, thyroid hormones, and glucocorticoids. Given that intermittent fasting could alter both the level and frequency of hormone secretion, decisions on practicing intermittent fasting should take more considerations on potential detrimental consequences versus beneficial effects pertaining to individual health conditions.

Melatonin's neuroprotective role in mitochondria and its potential as a biomarker in aging, cognition and psychiatric disorders

Melatonin is an ancient molecule that is evident in high concentrations in various tissues throughout the body. It can be separated into two pools; one of which is synthesized by the pineal and can be found in blood, and the second by various tissues and is present in these tissues. Pineal melatonin levels display a circadian rhythm while tissue melatonin does not. For decades now, melatonin has been implicated in promoting and maintaining sleep. More recently, evidence indicates that it also plays an important role in neuroprotection. The beginning of our review will summarize this literature. As an amphiphilic, pleiotropic indoleamine, melatonin has both direct actions and receptor-mediated effects. For example, melatonin has established effects as an antioxidant and free radical scavenger both in vitro and in animal models. This is also evident in melatonin's prominent role in mitochondria, which is reviewed in the next section. Melatonin is synthesized in, taken up by, and concentrated in mitochondria, the powerhouse of the cell. Mitochondria are also the major source of reactive oxygen species as a byproduct of mitochondrial oxidative metabolism. The final section of our review summarizes melatonin's potential role in aging and psychiatric disorders. Pineal and tissue melatonin levels both decline with age. Pineal melatonin declines in individuals suffering from psychiatric disorders. Melatonin's ability to act as a neuroprotectant opens new avenues of exploration for the molecule as it may be a potential treatment for cases with neurodegenerative disease.

Intraindividual Variability and Temporal Stability of Mid-Sleep on Free and Workdays

People differ in their sleep timings that are often referred to as a chronotype and can be operationalized as mid-sleep (midpoint between sleep onset and wake-up). The aims of the present studies were to examine intraindividual variability and longer-term temporal stability of mid-sleep on free and workdays, while also considering the effect of age. We used data from a 2-week experience sampling study of British university students (Study 1) and from a panel study of Estonian adults who filled in the Munich Chronotype Questionnaire twice up to 5 years apart (Study 2). Results of Study 1 showed that roughly 50% of the variance in daily mid-sleep scores across the 14-day period was attributed to intraindividual variability as indicated by the intraclass correlation coefficient. However, when the effect of free versus workdays was considered, the intraindividual variability in daily mid-sleep across 2 weeks was 0.71 the size of the interindividual variability. In Study 2, mid-sleep on free and workdays showed good levels of temporal stability-the retest correlations of mid-sleep on free and workdays were 0.66 and 0.58 when measured twice over a period of 0-1 to 5 years. The retest stability of mid-sleep scores on both free and workdays sharply increased from young adulthood and reached their peak when participants were in late 40 to early 50 years of age, indicating that age influences the stability of mid-sleep. Future long-term longitudinal studies are necessary to explore how age-related life circumstances and other possible factors may influence the intraindividual variability and temporal stability of mid-sleep.

The role of melatonin in sarcopenia: Advances and application prospects

Sarcopenia is an age-related disease that has gradually become a serious health problem for elderly individuals. It not only greatly increases the risk of falls, weakness, and disability but also reduces the ability of patients to take care of themselves. Sarcopenia can directly affect the quality of life and disease prognosis of elderly individuals. However, drug interventions for this disease are lacking. Melatonin is a biological hormone produced by the body that has good free radical scavenging effects, antioxidant effects and other effects. It was originally used as a sleep aid and is now being used for an increasing number of new indications. Its effect on sarcopenia has also begun to attract attention. It is currently known that it can protect the mitochondria of skeletal muscle cells, maintain the number of muscle fibres, partially reverse the pathological changes of ageing muscle tissue, and increase muscle strength in patients with sarcopenia. A large number of microRNAs are expressed during cell ageing, that in turn provides a biological background to age-related diseases, like sarcopenia. Increasing studies have found an interaction between melatonin and miRNAs, suggesting that melatonin can be used in the treatment of sarcopenia. The increased expression of inflammation-associated miRNA-483 in elderly patients may be the basis for the age-dependent decrease in melatonin secretion，that may play a role in the morbidity of sarcopenia. Melatonin is closely related to sarcopenia. It has a wide range of effects on sarcopenia and has good application prospects for the prevention and treatment of sarcopenia.

Long-term continuous positive airway pressure treatment ameliorates biological clock disruptions in obstructive sleep apnea

BACKGROUND

Obstructive Sleep Apnea (OSA) is a highly prevalent and underdiagnosed sleep disorder. Recent studies suggest that OSA might disrupt the biological clock, potentially causing or worsening OSA-associated comorbidities. However, the effect of OSA treatment on clock disruption is not fully understood.

METHODS

The impact of OSA and short- (four months) and long-term (two years) OSA treatment, with Continuous Positive Airway Pressure (CPAP), on the biological clock was investigated at four time points within 24 h, in OSA patients relative to controls subjects (no OSA) of the same sex and age group, in a case-control study. Plasma melatonin and cortisol, body temperature and the expression levels and rhythmicity of eleven clock genes in peripheral blood mononuclear cells (PBMCs) were assessed. Additional computational tools were used for a detailed data analysis.

FINDINGS

OSA impacts on clock outputs and on the expression of several clock genes in PBMCs. Neither short- nor long-term treatment fully reverted OSA-induced alterations in the expression of clock genes. However, long-term treatment was able to re-establish levels of plasma melatonin and cortisol and body temperature. Machine learning methods could discriminate controls from untreated OSA patients. Following long-term treatment, the distinction between controls and patients disappeared, suggesting a closer similarity of the phenotypes.

INTERPRETATION

OSA alters biological clock-related characteristics that differentially respond to short- and long-term CPAP treatment. Long-term CPAP was more efficient in counteracting OSA impact on the clock, but the obtained results suggest that it is not fully effective. A better understanding of the impact of OSA and OSA treatment on the clock may open new avenues to OSA diagnosis, monitoring and treatment.

Association Between Mobile Phone Radiation Exposure and the Secretion of Melatonin and Cortisol, Two Markers of the Circadian System: A Review

The extremely important use of mobile phones in the world, at all ages of life, including children and adolescents, leads to significant exposure of these populations to electromagnetic waves of radiofrequency. The question, therefore, arises as to whether exposure to these radiofrequencies (RFs) could lead to deleterious effects on the body's biological systems and health. In the current article, we review the effects, in laboratory animals and humans, of exposure to RF on two hormones considered as endocrine markers: melatonin, a neurohormone produced by the pineal gland and cortisol, a glucocorticosteroid synthesized by the adrenal glands. These two hormones are also considered as markers of the circadian system. The literature search was performed using PubMed, Medline, Web of Sciences (ISI Web of Knowledge), Google Scholar, and EMF Portal. From this review on RF effects on cortisol and melatonin, it appears that scientific papers in the literature are conflicting, showing effects, no effects, or inconclusive data. This implies the need for additional research on higher numbers of subjects and with protocols perfectly controlled with follow-up studies to better determine whether the chronic effect of RF on the biological functioning and health of users exists (or not). Bioelectromagnetics. 2021;42:5-17. © 2020 Bioelectromagnetics Society.

Effects and mechanisms of action of light-emitting diodes on the human retina and internal clock

White light-emitting diodes (LEDs) will likely become the most used lighting devices worldwide in the future because of their very low prices over the course of their long lifespans which can be up to several tens of thousands of hours. The expansion of LED use in both urban and domestic lighting has prompted questions regarding their possible health effects, because the light that they provide is potentially high in the harmful blue band (400-500 nm) of the visible light spectrum. Research on the potential effects of LEDs and their blue band on human health has followed three main directions: 1) examining their retinal phototoxicity; 2) examining disruption of the internal clock, i.e., an out-of-sync clock, in shift workers and night workers, including the accompanying health issues, most concerningly an increased relative risk of cancer; and 3) examining risky, inappropriate late-night use of smartphones and consoles among children and adolescents. Here, we document the recognized or potential health issues associated with LED lighting together with their underlying mechanisms of action. There is so far no evidence that LED lighting is deleterious to human retina under normal use. However, exposure to artificial light at night is a new source of pollution because it affects the circadian clock. Blue-rich light, including cold white LEDs, should be considered a new endocrine disruptor, because it affects estrogen secretion and has unhealthful consequences in women, as demonstrated to occur via a complex mechanism.

Association between circadian disruption and diseases: A narrative review

Circadian rhythms play an important role in a wide range of human physiology and pathology. Individuals increasingly experience situations such as night-shift work schedules, likely leading to circadian disruption. Recent studies have also demonstrated that patients with other diseases often show symptoms of circadian disruption as manifested by the sleep-wake cycle and other biological rhythms. Circadian disruption often results in changes to the phase, period, and amplitude of the sleep-wake cycle, melatonin rhythm, and core body temperature. Several cardiometabolic, psychiatric, and neurodegenerative diseases are closely related to circadian disruption. Several interventions are also available, including phototherapy, exogenous melatonin, and exercise. The cumulative findings suggest that circadian disruption can increase risk for some cardiometabolic diseases. Circadian disruption also acts as a concomitant symptom of several psychiatric and neurodegenerative diseases. More attention should be paid to evaluating the impact of circadian disruption on these related diseases, as well as the benefits of the mitigation interventions for both circadian disruption and related diseases.

Sleep in Myopic and Non-Myopic Children

Purpose

To examine differences in sleep between myopic and non-myopic children.

Methods

Objective measurements of sleep, light exposure, and physical activity were collected from 91 children, aged 10 to 15 years, for two 14-day periods approximately 6 months apart. Sleep parameters were analyzed with respect to refractive error, season, day of the week, age, and sex.

Results

Myopic children exhibited differences in sleep duration by day of the week (P < 0.001) and season (P = 0.007). Additionally, myopic children exhibited shorter sleep latency than non-myopic children (P = 0.04). For all children, wake time was later (P < 0.001) and sleep duration was longer (P = 0.03) during the cooler season compared with the warmer season. On weekends, children went to bed later (P < 0.001), woke up later (P < 0.001), and had increased sleep duration (P < 0.001) than on weekdays. Younger children exhibited earlier bedtime (P = 0.005) and wake time (P = 0.01) than older children. Time spent outdoors was positively associated with sleep duration (P = 0.03), and daily physical activity was negatively associated with wake time (P < 0.001).

Conclusions

Myopic children tended to have more variable sleep duration and shorter latency than non-myopic children. Sleep patterns were influenced by season, day of the week, age, time outdoors, and activity.

Translational Relevance

Myopic children tended to have more variable sleep duration and shorter latency than non-myopic children, which may reflect previously reported differences in environmental and behavioral factors between refractive error groups.

Comparison of Cortisol level by Shift Cycle in Korean Firefighters

(1) Study Objectives: By investigating the change of cortisol levels during shift cycles among professional firefighters in Korea, this study aims to evaluate the difference between individuals' stress response and the recovery of their circadian rhythm after working night shifts. (2) Methods: A total of 325 shift firefighters, who were working in 3, 6, 9, or 21 day cycles, participated in the study. Their urinary and serum cortisol levels were measured during the day (09-18), during the night (18-09), and every 24 h (09-09) per shift cycle, and adjustments were made for confounding factors. (3) Results: Serum cortisol levels were significantly increased after working during the night or for 24 h compared with that of working throughout the day. However, whether working night or 24 h shifts, the serum cortisol levels were undoubtedly different based on the 3, 6, 9, or 21 day cycles. In all shift cycles, the urinary cortisol level decreased during the night or throughout the 24 h shifts compared with sleeping during this time, but this was considered to be significantly applicable only to those working in 21 day cycles. Additionally, in serial measurements, the recovery of urinary cortisol secretion after a night or 24 h shift was successful for individuals working in 9 day cycles, but the recovery was delayed for those working in 6 or 21 day cycles. (4) Conclusions: After analyzing the urine cortisol levels, the study indicates that only subjects working in 9 day cycles fully recovered their circadian rhythm while those working in 6 day or 21 day cycles did not completely recover. Therefore, it is important to recognize how stressful night shifts can be, and it is crucial to enhance firefighters' current shift cycles in order to allow sufficient recovery of their circadian rhythm as well as the prevention of disrupting their circadian rhythm after working at night. Further research is necessary to take into account the amount of work load, the challenges of being sleep deprived, and the individual's capacity to overcome sleepiness.

Effect of whole-body vibration exposures on physiological stresses: Mining heavy equipment applications

The aim of this study was to employ validated biological markers to quantify the physiologic consequences of exposure to whole-body vibration (WBV) and evaluate the relative impact of mining vehicle operator vibration exposure on physiological responses as compared to vertical-axial dominant WBV. In a laboratory-based study with a repeated-measures design, we played actual field-measured floor vibration profiles into a 6-degree-of-freedom motion platform to create different realistic WBV exposures: 1) vertical-dominant vibration collected from long-haul trucks, 2) multi-axial vibration collected from mining heavy equipment vehicles, and 3) no vibration (control condition). Circulating biomarkers of interest were cortisol and catecholamines (epinephrine and norepinephrine) to assess physiological stress, interleukin-6 (IL-6) and tumor necrosis factor-α (TNFα) to test for inflammation, thiobarbituric acid reactive substances (TBARS) to measure oxidative stress, and myoglobin and plasma creatine kinase to assess muscle damage. We collected blood samples at pre-exposure (0 h), during-exposure (2 and 4 h), and 2 h into recovery after the WBV exposure (6 h) in all four exposure conditions. The results showed that a single, 4-h acute exposure to WBV may not be sufficient to induce skeletal muscle damage, inflammation or physiologic stress measurable in the blood. No significant differences were observed between conditions for any of the biomarkers that could be attributed to the exposure contrast between vertical-dominant and multi-axial WBV exposures. These findings further indicate known complications of WBV exposure likely arise secondary to chronic, repeated exposures that give rise to subclinical stresses that were not captured here.

Fluoride and Pineal Gland

The pineal gland is an endocrine gland whose main function is the biosynthesis and secretion of melatonin, a hormone responsible for regulating circadian rhythms, e.g., the sleep/wake cycle. Due to its exceptionally high vascularization and its location outside the blood–brain barrier, the pineal gland may accumulate significant amounts of calcium and fluoride, making it the most fluoride-saturated organ of the human body. Both the calcification and accumulation of fluoride may result in melatonin deficiency.

Diurnal variation of salivary cortisol in captive African elephants (Loxodonta africana) under routine management conditions and in relation to a translocation event

The present study assessed the diurnal variation in salivary cortisol in captive African elephants during routine management (baseline) and in relation to a potential stressor (translocation) to evaluate to what extent acute stress may affect diurnal cortisol patterns. Under baseline conditions, we collected morning and afternoon saliva samples of 10 animals (three zoos) on different days in two study periods (n = 3-10 per animal, daytime and period). Under stress conditions, we sampled the transported cow (newcomer) and the two cows of the destination zoo before and after the transport in the morning and afternoon (n = 3-9 per animal, daytime and transport phase), as well as after the first introduction of the newcomer to the bull (n = 1 per animal). Cortisol was measured in unextracted samples by enzyme immunoassay. Under baseline conditions, we observed the expected diurnal variation with higher cortisol levels in the morning than in the afternoon. Under stress conditions, neither a significant difference between pre- and posttransport, nor between morning and afternoon levels was found. The percentage difference between morning and afternoon cortisol after the transport, however, was remarkably lower than before the transport in the newcomer potentially indicating a stress response to familiarization. Saliva samples taken immediately after the introduction of the newcomer to the bull revealed a marked cortisol increase. Our findings indicate that stressors may disturb the diurnal cortisol rhythm. Furthermore, provided that samples can be collected promptly, salivary cortisol is a useful minimally invasive measure of physiological stress in the African elephant.

Continuous Free Cortisol Profiles-Circadian Rhythms in Healthy Men

CONTEXT

The pituitary-adrenal axis had historically been considered a representative model for circadian rhythms. A recently developed portable collection device has provided the opportunity to evaluate free cortisol profiles using the microdialysis approach in individuals free to conduct their day-to-day activities in their own surroundings.

METHODS

Two separate experiments were conducted in healthy male volunteers. The total and subcutaneous (SC) free cortisol levels were measured at 10-minute intervals for a 24-hour period in one experiment, and the SC free cortisol levels were measured at 20-minute interval for 72 consecutive hours in free-living individuals in the second experiment.

RESULTS

The characteristic circadian rhythm was evident in both serum total and SC free cortisol, with the lowest levels achieved and maintained in the hours surrounding sleep onset and the peak levels occurring in every individual around waking. In all free-living individuals, the circadian rhythm was consistent across the 72-hour period, despite a wide range of activities. All the participants also showed increased cortisol after the consumption of lunch. The lowest levels during all 24-hour periods were observed during the hours after lights off, at the onset of sleep.

CONCLUSIONS

To the best of our knowledge, the present study is the first to report up to three consecutive 24-hour measurements of SC free cortisol in healthy individuals. We believe our study is a landmark study that paves the way for ambulatory monitoring of free cortisol profiles continuously for a period of 72 hours in free-living individuals performing their day-to-day activities whether healthy or with diseases involving the hypothalamic-pituitary-adrenal axis.

Clock Genes Expression in Peripheral Leukocytes and Plasma Melatonin Daily Rhythm in Horses

In mammals, behavioral and physiological processes display 24-hour rhythms that are regulated by the circadian system. In the present study, we investigated clock gene expression in peripheral leukocytes in horses. For this purpose, 10 Italian Saddle gelding horses (9-11 years old; 475 ± 28 Kg) were housed in individual boxes under natural photoperiod and natural environmental temperature. Blood samples were collected at 4-hour intervals over a 48-hour period. The day before the start of sampling, left jugular furrow of each horse was cannulated for the blood sample collection performed in heparinized tubes, for the assessment of melatonin concentration by means of radioimmunoassay and into PAX gene Blood RNA Tube for the assessment of clock genes by real-time RT-quantitative polymerase chain reaction (RTqPCR). Well-established melatonin showed a daily rhythm with nocturnal acrophase (day 1-21:30; day 2-21:40). All genes tested (Bmal1, Cry 1, Per 1, Per 2, and Per 3) except Clock showed daily rhythmicity of their expression in peripheral blood. Oscillations of Bmal1 and Per 2 were correlated with the oscillation of melatonin, which anticipated the acrophase of Bmal1 (day 1-01:29; day 2-01:00) and Per 2 (day 1-01:00; day 2-00:32) of about 3 hours. Our results support the presence of a cyclic transcription of clock genes in peripheral leukocytes in horses.

Validated criteria for the interpretation of a single measurement of serum cortisol in the investigation of suspected adrenal insufficiency

OBJECTIVE

The diagnostic value of a single measurement of serum cortisol as a first step in the investigation of suspected adrenal insufficiency remains unclear. Previously proposed criteria have not been validated, and little is known regarding the performance of the test outwith morning samples in outpatients. We aimed to identify and validate criteria for morning and afternoon serum cortisol which could be used to determine which individuals require dynamic testing, in both outpatient and medical inpatient settings.

METHODS

We performed a retrospective analysis of 2768 patients attending endocrinology clinics and patients admitted to general medical units in two hospitals in Edinburgh, UK. In baseline samples from the short synacthen test, thresholds which identified a subnormal-stimulated serum cortisol (<430 nmol/L using the Abbott Architect assay) with 95% sensitivity were identified. Criteria drawn from data in patients attending outpatient clinics in one hospital were tested in additional outpatient and inpatient validation cohorts.

RESULTS

A morning (8 am-12 pm) serum cortisol of <275 nmol/L identified subnormal-stimulated cortisol with 96.2% sensitivity. For afternoon (12 pm-6 pm) samples, a cut-off of <250 nmol/L achieved 96.1% sensitivity. Sensitivity was maintained when the criteria were applied to outpatients in the validation cohort for both morning and afternoon samples. For inpatients, the test was sufficiently sensitive in morning samples only.

CONCLUSIONS

A single measurement of serum cortisol carries the potential to significantly reduce the need for dynamic testing in the investigation of adrenal insufficiency, whether this is taken in morning or afternoon outpatient clinics, or in morning samples from medical inpatients.

Differences in workday sleep fragmentation, rest-activity cycle, sleep quality, and activity level among nurses working different shifts

Schedule changes associated with rotating shifts can interfere with the circadian rhythms of nurses and thereby affect their sleep duration, sleep quality, work efficiency, and work performance. The objectives of this study was to investigate differences in workday sleep fragmentation, rest-activity cycle, sleep quality, and activity level among nurses working different shifts. After filling out a basic information questionnaire and completing the Pittsburgh Sleep Quality Index (PSQI) questionnaire, participants were asked to wear an actigraph and keep sleep records for seven consecutive days. Data pertaining to wake after sleep onset (WASO), 24-hour autocorrelation coefficient (r24), and daytime activity mean was collected in order to investigate workday sleep fragmentation, rest-activity cycle, and daytime activity level. We obtained complete questionnaires and data from 191 nurses. Day- and evening-shift nurses had more regular workday rest-activity cycles than did night-shift nurses (F = 51.26, p < .001). After controlling for r24 coefficients, we determined that nurses who experienced greater workday sleep fragmentation had higher PSQI scores (β = .18, p = .008). After controlling for WASO times, we determined that nurses who had more regular rest-activity cycles on workdays had lower PSQI scores (β = - .16, p = .036). After controlling for shift type and WASO times, we determined that nurses with higher PSQI scores displayed lower activity levels (β = - .21, p = .015) and those with higher r24 coefficients displayed higher activity levels (β = .18, p = .040) on workdays. We then examined the causal path relationships. Among the shifts, only the day-shift nurses had a higher r24 (β = -.59, p < .001) than did the night-shift nurses; WASO exerted a significant impact on PSQI scores (β = .20, p = .002); r24 had a significant and negative influence on PSQI scores (β = -.38, p < .001), and PSQI scores significantly and negatively influenced workday activity levels (β = -.20, p = .006). This study determined that day- and evening-shift nurses enjoyed more regular and consistent rest-activity cycles than did night-shift nurses; nurses with greater workday sleep fragmentation and/or more irregular rest-activity cycles experienced poorer sleep quality; and nurses suffering from poorer sleep quality displayed lower daytime activity levels on workdays.

Effect of mobile phone radiofrequency signal on the alpha rhythm of human waking EEG: A review

In response to the exponential increase in mobile phone use and the resulting increase in exposure to radiofrequency electromagnetic fields (RF-EMF), there have been several studies to investigate via electroencephalography (EEG) whether RF-EMF exposure affects brain activity. Data in the literature have shown that exposure to radiofrequency signals modifies the waking EEG with the main effect on the alpha band frequency (8-13 Hz). However, some studies have reported an increase in alpha band power, while others have shown a decrease, and other studies showed no effect on EEG power. Given that changes in the alpha amplitude are associated with attention and some cognitive aspects of human behavior, researchers deemed necessary to look whether alpha rhythm was modulated under RF-EMF exposure. The present review aims at comparing and discussing the main findings obtained so far regarding RF-EMF effects on alpha rhythm of human waking spontaneous EEG, focusing on differences in protocols between studies, which might explain the observed discrepancies and inconclusive results.

[What is the scientific evidence with regard to the effects of forests, trees on human health and well-being?]

In today's modern society, lifestyle-related diseases play an increasingly important role as the cause of bad health. Staying in and access to environments that contain natural elements such as forests, parks and gardens has been featured because of its potential to stimulating people's health and well-being. An independent research area has developed, which addresses issues that try to explain and document the health effects of access to and activities in nature. To bring together European researchers working with different aspects of the relation between nature and health, COST Action E39 "Forests, Trees, and Human Health and Wellbeing" was established in 2004 and terminated in November 2009. The main results of COST E39 was presented in the book "Forests, Trees and Human Health" published in 2011. This article focuses on three central research questions regarding the relationship between nature and health: (1) Nature's restorative and salutogenic effects on human beings, (2) Health effects of outdoor physical activities, and (3) Therapeutic interventions such as therapy gardens and forest bathing. Based on a systematic review of research carried out in the aftermath of the COST Action the following conclusions are made: (1) There is a remarkable amount of research publications showing a statistical correlation between access to nature and green areas and human physical activity and health. However, there are few studies that really prove a causal relationship, i.e. that access to green areas leads to increased physical activity and better health. (2) The existing research on outdoor activities in natural environments describes a number of positive associations and effects on health, and the evidence for some of these are convincing, albeit there must be reservations for the immediate applicability of the conclusions. (3) A lot of studies also show that nature-based therapeutic interventions work and provide clear positive effects, but there is serious criticism about the quality of the studies. Finally, the authors suggest more emphasis on research regarding the economic benefits of nature's health effects, more research on the effects of nature-based therapeutic interventions, and of broadening the theoretical basis. Furthermore, we foresee a better integration with health policies and practical implementation within urban planning and forest management.

Tiered Levels of Resting Cortisol in an Athletic Population. A Potential Role for Interpretation in Biopsychosocial Assessment?

BACKGROUND

Cortisol is a steroid hormone that follows a distinct diurnal timeline; however, while healthy ranges exist, it not been determined whether or why individuals differ on baseline cortisol levels. The aim of this study was to test the anecdotal evidence of different levels of responders by classifying these levels in resting cortisol, and to correlate individual cortisol responses to psychological traits.

METHODS

Twenty-two male athletes (mean age 22.5 ± 4.34 years) provided two saliva samples at the same time each day over three days in week one of their pre-season to determine individual baseline salivary cortisol levels. Participants also completed self-report psychological traits measures for correlation to cortisol levels.

RESULTS

Three levels of cortisol in responders were clearly identified (F_2,19 = 69.00, p < 0.001). Pearson's correlation coefficient showed that there was no significant relationship between baseline cortisol levels and psychological traits (optimism, r = 0.23, p = 0.29; stress, r = 0.05 p = 0.82; decision making, r = 0.19 p = 0.38).

CONCLUSIONS

This novel study identified that within an overall healthy range, individual athletes will likely fall into either a low, average or high band of baseline cortisol. However individual responses did not correlate to self-report psychological traits. Caution is required if sports science staff wish to use cortisol to measure psychological stress.

Effects of red light on sleep inertia

Introduction: Sleep inertia, broadly defined as decrements in performance and lowering of alertness following waking, lasts for durations ranging between 1 min and 3 hrs. This study investigated whether, compared to a dim light condition (the control), exposure to long-wavelength (red) light delivered to closed eyelids during sleep (red light mask) and to eyes open upon waking (red light goggles) reduced sleep inertia. Methods: Thirty participants (18 females, 12 males; mean age=30.4 years [SD 13.7]) completed this crossover, within-subjects, counterbalanced design study. Self-reported measures of sleepiness and objective measures of auditory performance and cortisol levels were collected on 3 Friday nights over the course of 3 consecutive weeks. Results: Performance improved significantly during the 30-min data collection period in all experimental conditions. Subjective sleepiness also decreased significantly with time awake in all experimental conditions. As hypothesized, performance of some tasks was significantly better in the red light mask condition than in the dim light condition. Performance scores in the red light goggles condition improved significantly after a few minutes of wearing the light goggles. Discussion: The results show that saturated red light delivered through closed eyelids at levels that do not suppress melatonin can be used to mitigate sleep inertia upon waking.

Hypothalamic-pituitary-adrenal axis differentially responses to morning and evening psychological stress in healthy subjects

Aim

The hypothalamic‐pituitary‐adrenal (HPA) axis responds to changing environmental demands including psychological stressors. The aim of the present study was to assess whether the time of day effects on the acute response of HPA axis activity to acute psychological stress.

Method

We studied 27 healthy young subjects. The subjects were participated two experiments as follows. In the first experiment, subjects were instructed to keep their regular sleep schedule for 2 weeks which were measured by using a wrist‐worn activity monitor. Afterward, to evaluate a diurnal rhythm of salivary cortisol, eight saliva samples were collected during waking period every 2 hours from when the subjects woke up. In the second experiment, the subjects were randomly assigned to two groups. The Trier Social Stress Test (TSST) was performed either in the morning (n = 14) or in the evening (n = 13). We measured diurnal rhythm of salivary cortisol and stress response of salivary cortisol and heart rate by the TSST. Morning and evening tests were started at 2 hours and 10 hours after woke up, respectively.

Results

All subjects showed a normal diurnal rhythm of salivary cortisol concentration, with a peak in the morning immediately after awaking and a minimum in the evening. The salivary cortisol response after the TSST was significantly increased from the prestress level in the morning but not in the evening.

Conclusion

The HPA response to acute psychological stress was more pronounced in the morning than in the evening, correlating with the circadian regulation of cortisol synthesis.

The aim of the present study was to examine whether the HPA axis differentially responses to morning and evening psychological stressor in healthy subjects. Here, we could demonstrate that the HPA axis activity response to acute psychological stressor is higher in the morning than in the evening, relating with circadian rhythm of salivary cortisol concentration.

Sleep quality and the cortisol awakening response (CAR) among law enforcement officers: The moderating role of leisure time physical activity

OBJECTIVE

The goal of this study was to investigate the role of leisure time physical activity (LTPA) on the association between sleep quality and the cortisol awakening response (CAR) in people with an occupation that exposes them to high levels of stress.

METHODS

Participants were 275 police officers (age = 42 years ± 8.3, 27% women) enrolled in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study (conducted between 2004 and 2009). Officers provided four salivary cortisol samples (on awakening and 15, 30, and 45 min after awakening). Hours of leisure time physical activity were assessed using the Seven-Day Physical Activity Recall questionnaire. Sleep quality (good/poor) was evaluated using the Pittsburgh Sleep Quality Index (PSQI) scale. Analysis of covariance and repeated measures models were used to examine the association of sleep quality to the two aspects of CAR: cortisol levels (total area under the curve (AUCG), mean, and peak cortisol) and cortisol profiles (the overall pattern in cortisol level during the 45 min period following awakening, the increase in cortisol from baseline to average of post awakening values (mean increase), and area under the curve with respect to increase (AUCI)). Analyses were stratified by participant level of reported LTPA (sufficiently vs. insufficiently active, defined as ≥ 150 vs. < 150 min/week of moderate intensity activity, respectively). Since cortisol activity is known to be influenced by gender, we conducted additional analyses also stratified by gender.

RESULTS

Overall, results demonstrated that LTPA significantly moderated the association of sleep quality with CAR. Among participants who were sufficiently active, CAR did not differ by sleep quality. However, in those who were insufficiently active during their leisure time, poor sleep quality was associated with a significantly reduced level of total awakening cortisol secretion (AUCG (a.u.) = 777.4 ± 56 vs. 606.5 ± 45, p = 0.02; mean cortisol (nmol/l) = 16.7 ± 1.2 vs. 13.3 ± 0.9, p = 0.03; peak cortisol (nmol/l) = 24.0 ± 1.8 vs. 18.9 ± 1.5, p = 0.03 for good vs. poor sleep quality, respectively). The normal rise in cortisol after awakening was also significantly lower in inactive officers with poor sleep quality than in those with good sleep quality (mean increase (nmol/l) = 6.7 ± 1.5 vs. 2.3 ± 1.2, p = 0.03; AUCI (a.u.) = 249.3 ± 55 vs. 83.3 ± 44, p = 0.02 for those with good vs. poor sleep quality, respectively). While findings for male officers were consistent with the overall results, CAR did not differ by sleep quality in female officers regardless of LTPA level.

CONCLUSION

Findings of this study suggest that poor sleep quality is associated with diminished awakening cortisol levels and dysregulated cortisol patterns over time, but only among officers who were inactive or insufficiently active during their leisure time. In contrast, sleep quality was not associated with any measures of CAR in officers who reported sufficient activity, suggesting a potential protective effect of LTPA. In analyses stratified by gender, findings for male officers were similar to those in the pooled sample, although we found no evidence for a modifying effect of LTPA in women. Future longitudinal studies in a larger population are needed to confirm these findings and further elucidate the relationships between LTPA, sleep quality, and cortisol response.