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Chabal SA, Markwald RR, Chinoy ED. Life onboard a submarine: Sleep, fatigue, and lifestyle behaviors of sailors on a circadian-aligned watchstanding schedule. APPLIED ERGONOMICS 2024; 119:104321. [PMID: 38820921 DOI: 10.1016/j.apergo.2024.104321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 03/11/2024] [Accepted: 05/22/2024] [Indexed: 06/02/2024]
Abstract
This study characterizes, for the first time, the lives of U.S. Navy submariners engaged in normal, sea-based operations while following a circadian-aligned 24-h watchstanding schedule. Fifty-eight submarine crewmembers provided objective (actigraphy) and subjective (questionnaires) sleep data, and information about mood and lifestyle behaviors during 30 days underway. Projected performance scores and estimated circadian phase times were also calculated from actigraphy-based sleep/wake data. Submariners' objective (6.62 ± 0.94 h; mean ± SD) and subjective (5.90 ± 1.38 h) daily sleep quantities while underway were largely comparable to the sleep reportedly received by Sailors across other Navy platforms and watchstanding schedules. Additionally, submariners' actigraphy-predicted circadian phases shifted progressively toward better alignment with watchstanding schedules across time. Nevertheless, subjective sleep quality was low, submariners engaged in unfavorable lifestyle behaviors (lack of regular meals and exercise), and participants reported decreased mood at the completion of their underway time. Recommendations for countermeasure development are provided.
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Affiliation(s)
- Sarah A Chabal
- Naval Submarine Medical Research Laboratory, Groton, CT, USA; Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA; Leidos, Inc., Reston, VA, USA.
| | - Rachel R Markwald
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
| | - Evan D Chinoy
- Sleep, Tactical Efficiency, and Endurance Laboratory, Warfighter Performance Department, Naval Health Research Center, San Diego, CA, USA
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Wescott DL, Hasler BP, Franzen PL, Taylor ML, Klevens AM, Gamlin P, Siegle GJ, Roecklein KA. Circadian photoentrainment varies by season and depressed state: associations between light sensitivity and sleep and circadian timing. Sleep 2024; 47:zsae066. [PMID: 38530635 PMCID: PMC11168757 DOI: 10.1093/sleep/zsae066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 02/08/2024] [Indexed: 03/28/2024] Open
Abstract
STUDY OBJECTIVES Altered light sensitivity may be an underlying vulnerability for disrupted circadian photoentrainment. The photic information necessary for circadian photoentrainment is sent to the circadian clock from melanopsin-containing intrinsically photosensitive retinal ganglion cells (ipRGCs). The current study tested whether the responsivity of ipRGCs measured using the post-illumination pupil response (PIPR) was associated with circadian phase, sleep timing, and circadian alignment, and if these relationships varied by season or depression severity. METHODS Adult participants (N = 323, agem = 40.5, agesd = 13.5) with varying depression severity were recruited during the summer (n = 154) and winter (n = 169) months. Light sensitivity was measured using the PIPR. Circadian phase was assessed using Dim Light Melatonin Onset (DLMO) on Friday evenings. Midsleep was measured using actigraphy. Circadian alignment was calculated as the DLMO-midsleep phase angle. Multilevel regression models covaried for age, gender, and time since wake of PIPR assessment. RESULTS Greater light sensitivity was associated with later circadian phase in summer but not in winter (β = 0.23; p = 0.03). Greater light sensitivity was associated with shorter DLMO-midsleep phase angles (β = 0.20; p = 0.03) in minimal depression but not in moderate depression (SIGHSAD < 6.6; Johnson-Neyman region of significance). CONCLUSIONS Light sensitivity measured by the PIPR was associated with circadian phase during the summer but not in winter, suggesting ipRGC functioning in humans may affect circadian entrainment when external zeitgebers are robust. Light sensitivity was associated with circadian alignment only in participants with minimal depression, suggesting circadian photoentrainment, a possible driver of mood, may be decreased in depression year-round, similar to decreased photoentrainment in winter.
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Affiliation(s)
| | - Brant P Hasler
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Peter L Franzen
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Maddison L Taylor
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alison M Klevens
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Paul Gamlin
- Department of Ophthalmology and Visual Sciences, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Greg J Siegle
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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3
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Lok R, Qian J, Chellappa SL. Sex differences in sleep, circadian rhythms, and metabolism: Implications for precision medicine. Sleep Med Rev 2024; 75:101926. [PMID: 38564856 DOI: 10.1016/j.smrv.2024.101926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 02/16/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024]
Abstract
The number of individuals experiencing sleep loss has exponentially risen over the past decades. Extrapolation of laboratory findings to the real world suggests that females are more affected by extended wakefulness and circadian misalignment than males are. Therefore, long-term effects such as sleep and metabolic disorders are likely to be more prevalent in females than in males. Despite emerging evidence for sex differences in key aspects of sleep-wake and circadian regulation, much remains unknown, as females are often underrepresented in sleep and circadian research. This narrative review aims at highlighting 1) how sex differences systematically impinge on the sleep-wake and circadian regulation in humans, 2) how sex differences in sleep and circadian factors modulate metabolic control, and 3) the relevance of these differences for precision medicine. Ultimately, the findings justify factoring in sex differences when optimizing individually targeted sleep and circadian interventions in humans.
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Affiliation(s)
- Renske Lok
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA.
| | - Jingyi Qian
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Females's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Sarah L Chellappa
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, United Kingdom.
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Touitou Y, Cermakian N, Touitou C. The environment and the internal clocks: The study of their relationships from prehistoric to modern times. Chronobiol Int 2024; 41:859-887. [PMID: 38757600 DOI: 10.1080/07420528.2024.2353857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 05/03/2024] [Indexed: 05/18/2024]
Abstract
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.
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Affiliation(s)
- Yvan Touitou
- Unité de Chronobiologie, Fondation A. de Rothschild, Paris, France
| | - Nicolas Cermakian
- Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
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Karel P, Schilperoord M, Reichman LJA, Krabbe JG. The dark side of apnea: altered 24-hour melatonin secretion in obstructive sleep apnea (OSAS) is disease severity dependent. Sleep Breath 2024:10.1007/s11325-024-03066-5. [PMID: 38801480 DOI: 10.1007/s11325-024-03066-5] [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: 02/21/2024] [Revised: 05/13/2024] [Accepted: 05/20/2024] [Indexed: 05/29/2024]
Abstract
PURPOSE Melatonin aids in the synchronization of the circadian rhythm to the external environment. Few studies have tried to elucidate the relationship between melatonin and obstructive sleep apnea syndrome (OSAS). These often include few patients, do not differentiate between OSAS severity and/or do not analyse a 24-h melatonin profile. This study set out to investigate disease severity dependent differences in 24-h salivary melatonin secretion of OSAS patients compared to a reference population in a retrospective design. METHODS 24-h salivary melatonin profiles of 169 OSAS patients were analysed (55 light, 66 moderate, 48 severe) as well as 91 reference patients. Several aspects of the melatonin curve were analysed and stratified according to OSAS severity. Parameters included: dim light melatonin onset (DLMO), time of returning below DLMO (DLMOoff), peak melatonin concentration and time, and total melatonin exposure. RESULTS Significant effects were corrected for confounding by age and sex using linear regression. Our analysis shows that, compared to reference and in a disease dependent manner, OSAS patients have a significantly lower 24-h melatonin curve, lower melatonin peak concentration, lower total melatonin exposure and a smaller proportion of patients reach DLMO. The differences in peak melatonin production and total melatonin exposure were resistant to confounding by age and/or sex. CONCLUSION This study describes clear OSAS severity dependent abnormalities in melatonin production in OSAS patients, independent of sex and/or age. Future research should indicate whether oral melatonin supplementation has beneficial effects in OSAS patients with attenuated endogenous melatonin production.
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Affiliation(s)
- Peter Karel
- Department of Clinical Chemistry and Laboratory Medicine, Ziekenhuisgroep Twente, Almelo, The Netherlands
- Department of Clinical Chemistry and Laboratory Medicine, Unilabs Oost, Enschede, The Netherlands
| | | | | | - Johannes G Krabbe
- Department of Clinical Chemistry and Laboratory Medicine, Ziekenhuisgroep Twente, Almelo, The Netherlands.
- Department of Clinical Chemistry and Laboratory Medicine, Unilabs Oost, Enschede, The Netherlands.
- Department of Clinical Chemistry and Laboratory Medicine, Medisch Spectrum Twente, Enschede, The Netherlands.
- Faculty of Science and Technology, University of Twente, Enschede, The Netherlands.
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Tracy EL, Chin BN, Lehrer HM, Hasler BP, Thomas MC, Smagula S, Kimutis S, Hall MH, Buysse DJ. Behavioral-Social Rhythms and Cardiovascular Disease Risk in Retired Night Shift Workers and Retired Day Workers. Psychosom Med 2024; 86:227-233. [PMID: 38573015 PMCID: PMC11081820 DOI: 10.1097/psy.0000000000001287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE Stability in the timing of key daily routine behaviors such as working/doing housework, sleeping, eating, and engaging in social interactions (i.e., behavioral-social rhythms) contributes to health. This study examined whether behavioral-social rhythms were associated with cardiovascular disease (CVD) risk factors in retired night shift workers and retired day workers and explored whether past night shift work exposure moderated this association. METHODS A total of 154 retired older adults participated in this study. Multiple logistic regression models were used to examine associations between behavioral-social rhythms and CVD risk factors. Independent variables included Social Rhythm Metric (SRM)-5 score and actigraphy rest-activity rhythm intradaily variability (IV) and interdaily stability (IS). Dependent variables were metabolic syndrome prevalence and its five individual components. RESULTS More regular behavioral-social rhythms were associated with lower odds of prevalent metabolic syndrome (SRM: odds ratio [OR] = 0.57, 95% confidence interval [CI] = 0.35-0.88; IV: OR = 4.00, 95% CI = 1.86-8.58; IS: OR = 0.42, 95% CI = 0.24-0.73) and two of its individual components: body mass index (SRM: OR = 0.56, 95% CI = 0.37-0.85; IV: OR = 2.84, 95% CI = 1.59-5.07; IS: OR = 0.42, 95% CI = 0.26-0.68) and high-density lipoprotein cholesterol (SRM: OR = 0.49, 95% CI = 0.30-0.80; IV: OR = 2.49, 95% CI = 1.25-4.96; IS: OR = 0.35, 95% CI = 0.19-0.66). Past shift work history did not moderate the association between behavioral-social rhythms and metabolic syndrome. CONCLUSIONS Behavioral-social rhythms were related to CVD risk factors in retired adults regardless of prior night shift work exposure. Older retired workers may benefit from education and interventions aiming to increase behavioral-social rhythm regularity.
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Affiliation(s)
- Eunjin Lee Tracy
- From the Department of Human Development and Family Science (Tracy), University of Missouri, Columbia, Missouri; Department of Psychology (Chin), Trinity College, Hartford, Connecticut; Department of Psychiatry (Lehrer, Hasler, Smagula, Kimutis, Hall, Buysse), University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; and VISN 4 Mental Illness Research (Thomas), Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania
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Ogasawara J, Matsumoto N, Takeuchi Y, Yamashiro K, Yasui M, Ikegaya Y. Lengthened circadian rhythms in mice with self-controlled ambient light intensity. Sci Rep 2024; 14:7778. [PMID: 38565587 PMCID: PMC10987682 DOI: 10.1038/s41598-024-58415-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 03/28/2024] [Indexed: 04/04/2024] Open
Abstract
Laboratory animals are typically maintained under 12-h light and 12-h dark (12:12 LD) conditions with a daytime light intensity of ~ 200 lx. In this study, we designed an apparatus that allowed mice to self-select the room light intensity by nose poking. We measured the behavioral rhythms of the mice under this self-controlled light regimen. The mice quickly learned the relationship between their nose pokes and the resulting changes in the light intensity. Under these conditions, the mice exhibited free-running circadian behavior with a period of 24.5 ± 0.4 h. This circadian period was ~ 1 h longer than that of the same strain of mice when they were kept in constant darkness (DD) after 12:12 LD entrainment, and the lengthened period lasted for at least 30 days. The rhythm of the light intensity controlled by the mice also exhibited a similar period, but the phase of the illuminance rhythm preceded the phase of the locomotor activity rhythm. Mice that did not have access to the light controller were also entrained to the illuminance cycle produced by the mice that did have access to the light controller, but with a slightly delayed phase. The rhythm was likely controlled by the canonical circadian clock because mice with tau mutations in the circadian clock gene CSNK1E exhibited short periods of circadian rhythm under the same conditions. These results indicate that the free-running period of mice in the wild may differ from what they exhibit if they are attuned by forced light cycles in laboratories because mice in their natural habitats can self-control their exposure to ambient light, similar to our experimental conditions.
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Affiliation(s)
- Jun Ogasawara
- Department of Pharmacology, School of Medicine, Keio University, Tokyo, 160-8582, Japan
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Nobuyoshi Matsumoto
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
- Institute for AI and Beyond, The University of Tokyo, Tokyo, 113-0033, Japan
| | - Yuki Takeuchi
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Kotaro Yamashiro
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan
| | - Masato Yasui
- Department of Pharmacology, School of Medicine, Keio University, Tokyo, 160-8582, Japan
| | - Yuji Ikegaya
- Laboratory of Chemical Pharmacology, Graduate School of Pharmaceutical Sciences, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
- Institute for AI and Beyond, The University of Tokyo, Tokyo, 113-0033, Japan.
- Center for Information and Neural Networks, National Institute of Information and Communications Technology, Suita City, Osaka, 565-0871, Japan.
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Usmani IM, Dijk DJ, Skeldon AC. Mathematical Analysis of Light-sensitivity Related Challenges in Assessment of the Intrinsic Period of the Human Circadian Pacemaker. J Biol Rhythms 2024; 39:166-182. [PMID: 38317600 PMCID: PMC10996302 DOI: 10.1177/07487304231215844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Accurate assessment of the intrinsic period of the human circadian pacemaker is essential for a quantitative understanding of how our circadian rhythms are synchronized to exposure to natural and man-made light-dark (LD) cycles. The gold standard method for assessing intrinsic period in humans is forced desynchrony (FD) which assumes that the confounding effect of lights-on assessment of intrinsic period is removed by scheduling sleep-wake and associated dim LD cycles to periods outside the range of entrainment of the circadian pacemaker. However, the observation that the mean period of free-running blind people is longer than the mean period of sighted people assessed by FD (24.50 ± 0.17 h vs 24.15 ± 0.20 h, p < 0.001) appears inconsistent with this assertion. Here, we present a mathematical analysis using a simple parametric model of the circadian pacemaker with a sinusoidal velocity response curve (VRC) describing the effect of light on the speed of the oscillator. The analysis shows that the shorter period in FD may be explained by exquisite sensitivity of the human circadian pacemaker to low light intensities and a VRC with a larger advance region than delay region. The main implication of this analysis, which generates new and testable predictions, is that current quantitative models for predicting how light exposure affects entrainment of the human circadian system may not accurately capture the effect of dim light. The mathematical analysis generates new predictions which can be tested in laboratory experiments. These findings have implications for managing healthy entrainment of human circadian clocks in societies with abundant access to light sources with powerful biological effects.
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Affiliation(s)
- Imran M. Usmani
- Department of Mathematics, University of Surrey, Guildford, UK
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK
- UK Dementia Research Institute Care Research & Technology Centre, Imperial College London and the University of Surrey, Guildford, UK
| | - Anne C. Skeldon
- Department of Mathematics, University of Surrey, Guildford, UK
- UK Dementia Research Institute Care Research & Technology Centre, Imperial College London and the University of Surrey, Guildford, UK
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VoPham T, Ton M, Weaver MD. Spatiotemporal light exposure modeling for environmental circadian misalignment and solar jetlag. Environ Epidemiol 2024; 8:e301. [PMID: 38617425 PMCID: PMC11008630 DOI: 10.1097/ee9.0000000000000301] [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: 11/02/2023] [Accepted: 02/12/2024] [Indexed: 04/16/2024] Open
Abstract
Background Light exposure is the most powerful resetting signal for circadian rhythms. The objective of this study was to develop and validate a high-resolution geospatial light exposure model that measures environmental circadian misalignment (or solar jetlag) as the mismatch between the social clock and sun clock, which occurs from geographic variation in light exposure leading to delayed circadian phase from relatively less morning light exposure and greater evening light exposure with increasing westward position within a time zone. Methods The light exposure model (30 m2 spatial resolution) incorporated geospatial data across the United States on time zones, elevation (using Google Earth Engine), sunrise time, and sunset time to estimate solar jetlag scores (higher values indicate higher environmental circadian misalignment). The validation study compared the light exposure model in 2022, which was linked with geocoded residential addresses of n = 20 participants in Boston, MA (eastern time zone position) and Seattle, WA (western time zone position) using a geographic information system, with illuminance values captured from wearable LYS light sensors and with sun times from the Solar Calculator. Results Western versus eastern positions within a time zone were associated with higher solar jetlag scores from the light exposure model (P < 0.01) and relatively larger differences in sunset time measured using light sensors (social clock) and the Solar Calculator (sun clock) (P = 0.04). Conclusion We developed and validated a geospatial light exposure model, enabling high spatiotemporal resolution and comprehensive characterization of geographic variation in light exposure potentially impacting circadian phase in epidemiologic studies.
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Affiliation(s)
- Trang VoPham
- Epidemiology Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington
- Department of Epidemiology, University of Washington, Seattle, Washington
| | - Mimi Ton
- Department of Epidemiology, University of Washington, Seattle, Washington
- Cancer Prevention Program, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Matthew D. Weaver
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
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Eto T, Kitamura S, Shikano A, Tanabe K, Higuchi S, Noi S. Estimating dim light melatonin onset time in children using delta changes in melatonin. Sleep Biol Rhythms 2024; 22:239-246. [PMID: 38524157 PMCID: PMC10959870 DOI: 10.1007/s41105-023-00493-x] [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: 05/28/2023] [Accepted: 09/19/2023] [Indexed: 03/26/2024]
Abstract
We aimed to establish a method for estimating dim light melatonin onset (DLMO) using mathematical slopes calculated from melatonin concentrations at three sampling points before and after sleep in children. The saliva of 30 children (mean age ± SD: 10.2 ± 1.3 years old) was collected under dim-light conditions up to six times every hour starting at 17:30 (t17), namely, 18:30 (t18), 19:30 (t19), 20:30 (t20), 21:30 (t21), 22:30 (t22), and 23:30 (t23), in the evening, and at 6:00 (t30) the following morning. We calculated SLOPE on (mathematical slope between melatonin concentrations at t18 and t20, t21 or t22), SLOPE off (the slope between t20, t21 or t22, and t30), and Δ S L O P E , which is generated by subtracting SLOPE on from SLOPE off . DLMO was estimated by multiple regression analysis with the leave-one-out cross-validation (LOOCV) method using SLOPE on and SLOPE off , and Δ S L O P E . The intraclass correlation coefficient (ICC) between the estimated and measured DLMOs was used as the index of estimation accuracy. DLMOs estimated using multiple regression equations with SLOPE on and SLOPE off yielded significant ICCs for the measured DLMOs, with the largest ICC at t20 (ICC = 0.634). Additionally, the ICC between the estimated and measured DLMOs using the equation with Δ S L O P E was significant, with a larger ICC at t20 (ICC = 0.726) than that of the equation with SLOPE on and SLOPE off . Our results showed that DLMO could be estimated with a certain level of accuracy from salivary melatonin levels at three time points before and after sleep in children. Supplementary Information The online version contains supplementary material available at 10.1007/s41105-023-00493-x.
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Affiliation(s)
- Taisuke Eto
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553 Japan
- Department of Human Life Design and Science, Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minami-Ku, Fukuoka, 815-8540 Japan
- Research Fellow of the Japan Society for the Promotion of Science, Kodaira, Japan
| | - Shingo Kitamura
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawa-Higashi, Kodaira, Tokyo 187-8553 Japan
| | - Akiko Shikano
- Research Institute for Children’s Physical Health, Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-Ku, Tokyo 158-8508 Japan
| | - Kosuke Tanabe
- Department of Business Administration, Faculty of Humanities and Social Sciences, Teikyo Heisei University, 4-21-2 Nakano, Nakano-Ku, Tokyo 164-8530 Japan
| | - Shigekazu Higuchi
- Department of Human Life Design and Science, Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minami-Ku, Fukuoka, 815-8540 Japan
| | - Shingo Noi
- Research Institute for Children’s Physical Health, Nippon Sport Science University, 7-1-1 Fukasawa, Setagaya-Ku, Tokyo 158-8508 Japan
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Mascaro L, Leota J, Hoffman D, Rajaratnam SMW, Drummond SPA, Facer-Childs ER. Disruptions to sleep and circadian rhythms are associated with poorer athlete mental health in female, but not male, elite Australian Rules footballers. J Sleep Res 2024:e14186. [PMID: 38471498 DOI: 10.1111/jsr.14186] [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: 10/16/2023] [Revised: 12/26/2023] [Accepted: 02/16/2024] [Indexed: 03/14/2024]
Abstract
Elite athletes are vulnerable to sleep and circadian disruption and associated mental health symptoms. This study aimed to investigate sex differences in sleep, circadian rhythms, and mental health, as well as the moderating role of sex in the prediction of mental health, among male professional and female semi-professional elite athletes. Participants were 87 elite Australian Rules football (ARF) athletes (43% female; mean [standard deviation] age 24.0 [4.1] years). Participants completed baseline questionnaires, 2 weeks of sleep/wake monitoring via actigraphy, and a circadian phase assessment (dim-light melatonin onset [DLMO]). Cross-sectional data were collected in training-only Australian Football League (AFL) Men's and Women's pre-season periods, with 53 providing data in two pre-seasons. Female athletes, relative to males, reported poorer mental health (a higher athlete psychological strain score), had a later mid-sleep time (by 28 min), reported a greater preference towards eveningness, and displayed a later circadian phase (by 33 min). For female athletes, lower sleep efficiency and lower sleep regularity were associated with poorer mental health. For female athletes, there were U-shaped relationships between both morningness-eveningness and phase angle (interval between sleep onset and DLMO time) and mental health. No significant relationships were found for male athletes. In summary, elite female ARF athletes reported poorer mental health, relative to males, especially when experiencing sleep or circadian disruption. Lifestyle factors associated with sex differences in ARF professionalism (scheduling, finances, supports) may contribute to these findings. Programmes to improve sleep, circadian alignment, and mental health among female semi-professional elite athletes should be strongly considered.
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Affiliation(s)
- Luis Mascaro
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Josh Leota
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Daniel Hoffman
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Shantha M W Rajaratnam
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Sean P A Drummond
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
| | - Elise R Facer-Childs
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
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Agostini A, Centofanti S. Normal Sleep in Children and Adolescence. Psychiatr Clin North Am 2024; 47:1-14. [PMID: 38302199 DOI: 10.1016/j.psc.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
Adequate sleep is essential for healthy development in childhood and adolescence. Healthy sleep contributes to good physical health, immune function, mental health, and academic performance. The regulation and architecture of sleep change greatly across childhood and adolescence, and the ability to obtain sufficient sleep is impacted by a range of factors that change with maturation. This article describes normal sleep across childhood and adolescence and discusses some of the most common barriers to adequate sleep, including early school start times, technology use, and changes to circadian rhythms, and sleep homeostasis across puberty.
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Affiliation(s)
- Alex Agostini
- Sleep and Chronobiology Laboratory, University of South Australia, Adelaide, Australia.
| | - Stephanie Centofanti
- UniSA Online, University of South Australia, University of South Australia Online, L4, Catherine Helen Spence Building, City West Campus, Adelaide, South Australia 5000, Australia
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13
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Feigl B, Lewis SJG, Rawashdeh O. Targeting sleep and the circadian system as a novel treatment strategy for Parkinson's disease. J Neurol 2024; 271:1483-1491. [PMID: 37943299 PMCID: PMC10896880 DOI: 10.1007/s00415-023-12073-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/12/2023] [Accepted: 10/18/2023] [Indexed: 11/10/2023]
Abstract
There is a growing appreciation of the wide range of sleep-wake disturbances that occur frequently in Parkinson's disease. These are known to be associated with a range of motor and non-motor symptoms and significantly impact not only on the quality of life of the patient, but also on their bed partner. The underlying causes for fragmented sleep and daytime somnolence are no doubt multifactorial but there is clear evidence for circadian disruption in Parkinson's disease. This appears to be occurring not only as a result of the neuropathological changes that occur across a distributed neural network, but even down to the cellular level. Such observations indicate that circadian changes may in fact be a driver of neurodegeneration, as well as a cause for some of the sleep-wake symptoms observed in Parkinson's disease. Thus, efforts are now required to evaluate approaches including the prescription of precision medicine to modulate photoreceptor activation ratios that reflect daylight inputs to the circadian pacemaker, the use of small molecules to target clock genes, the manipulation of orexin pathways that could help restore the circadian system, to offer novel symptomatic and novel disease modifying strategies.
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Affiliation(s)
- Beatrix Feigl
- Centre for Vision and Eye Research, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia
- School of Biomedical Sciences, Queensland University of Technology (QUT), Brisbane, QLD, 4059, Australia
- Queensland Eye Institute, South Brisbane, QLD, 4101, Australia
| | - Simon J G Lewis
- Parkinson's Disease Research Clinic, Brain and Mind Centre, School of Medical Sciences, University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Oliver Rawashdeh
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, 4072, Australia
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14
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Abhilash L, Shafer OT. A two-process model of Drosophila sleep reveals an inter-dependence between circadian clock speed and the rate of sleep pressure decay. Sleep 2024; 47:zsad277. [PMID: 37930351 DOI: 10.1093/sleep/zsad277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 10/18/2023] [Indexed: 11/07/2023] Open
Abstract
Sleep is controlled by two processes-a circadian clock that regulates its timing and a homeostat that regulates the drive to sleep. Drosophila has been an insightful model for understanding both processes. For four decades, Borbély and Daan's two-process model has provided a powerful framework for understanding sleep regulation. However, the field of fly sleep has not employed such a model as a framework for the investigation of sleep. To this end, we have adapted the two-process model to the fly and established its utility by showing that it can provide empirically testable predictions regarding the circadian and homeostatic control of fly sleep. We show that the ultradian rhythms previously reported for loss-of-function clock mutants in the fly are robustly detectable and a predictable consequence of a functional sleep homeostat in the absence of a functioning circadian system. We find that a model in which the circadian clock speed and homeostatic rates act without influencing each other provides imprecise predictions regarding how clock speed influences the strength of sleep rhythms and the amount of daily sleep. We also find that quantitatively good fits between empirical values and model predictions were achieved only when clock speeds were positively correlated with rates of decay of sleep pressure. Our results indicate that longer sleep bouts better reflect the homeostatic process than the current definition of sleep as any inactivity lasting 5 minutes or more. This two-process model represents a powerful framework for work on the molecular and physiological regulation of fly sleep.
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Affiliation(s)
- Lakshman Abhilash
- The Advanced Science Research Center, The City University of New York, New York, NY, USA
| | - Orie Thomas Shafer
- The Advanced Science Research Center, The City University of New York, New York, NY, USA
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15
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Zitting KM, Isherwood CM, Yuan RK, Wang W, Vujovic N, Münch M, Cain SW, Williams JS, Buxton OM, Czeisler CA, Duffy JF. Eating during the biological night is associated with nausea. Sleep Health 2024; 10:S144-S148. [PMID: 37730474 PMCID: PMC10947563 DOI: 10.1016/j.sleh.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVES This study assessed whether there was a time-of-day effect on nausea reports in participants during studies employing circadian protocols. METHODS Visual-analog-scales of nausea ratings were recorded from 34 participants (18-70years; 18 women) during forced desynchrony studies, where meals were scheduled at different circadian phases. Subjective nausea reports from a further 81 participants (18-35years; 36 women) were recorded during constant routine studies, where they ate identical isocaloric hourly snacks for 36-40 hours. RESULTS Feelings of nausea varied by circadian phase in the forced desynchrony studies, peaking during the biological night. Nausea during the constant routine was reported by 27% of participants, commencing 2.9 ± 5.2 hours after the midpoint of usual sleep timing, but was never reported to start in the evening (4-9 PM). CONCLUSIONS Nausea occurred more often during the biological night and early morning hours. This timing is relevant to overnight and early morning shift workers and suggests that a strategy to counteract that is to pay careful attention to meal timing.
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Affiliation(s)
- Kirsi-Marja Zitting
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
| | - Cheryl M Isherwood
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Robin K Yuan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Wei Wang
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Nina Vujovic
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Miriam Münch
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Sean W Cain
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Jonathan S Williams
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Orfeu M Buxton
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Jeanne F Duffy
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
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16
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McHill AW, Thosar SS, Bowles NP, Butler MP, Ordaz-Johnson O, Emens JS, Purnell JQ, Gillingham M, Shea SA. Obesity alters the circadian profiles of energy metabolism and glucose regulation in humans. Obesity (Silver Spring) 2024; 32:315-323. [PMID: 37964700 PMCID: PMC10842330 DOI: 10.1002/oby.23940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 09/06/2023] [Accepted: 09/26/2023] [Indexed: 11/16/2023]
Abstract
OBJECTIVE Given the complex interaction among the circadian system, energy metabolism, and obesity, the authors tested whether having obesity impacts the circadian variation in energy and glucose metabolism in humans. METHODS Participants with BMI either in the healthy weight or obesity ranges were studied in a 5-day, in-laboratory protocol that equally distributed behaviors (i.e., sleep, eating, exercise) across 24 h. Energy metabolism was measured at rest and during a standardized exercise bout and blood was sampled before and after each identical study meal to assess glucose and insulin levels. RESULTS In those with a healthy weight, the circadian nadir of energy expenditure, during both rest and exercise, occurred when participants would normally be asleep. However, in those with obesity, this nadir appears to occur during the habitual wake period. Differences in glucose regulation also depended on the circadian phase, such that individuals with obesity appeared to have relatively greater glucose intolerance during the circadian day and produced less insulin during the circadian night. CONCLUSIONS Obesity is associated with altered circadian energy and glucose metabolism. Understanding and addressing these associations could lead to strategies that improve body weight and metabolic health in people with obesity.
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Affiliation(s)
- Andrew W. McHill
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, Portland OR
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR
| | - Saurabh S. Thosar
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, Portland OR
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR
- OHSU-PSU School of Public Health at Oregon Health & Science University, Portland, OR
- Knight Cardiovascular Institute, Department of Medicine, Oregon Health & Science University, Portland, OR
| | - Nicole P. Bowles
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR
| | - Matthew P. Butler
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR
- Department of Behavioral Neuroscience, Oregon Health & Science University, Portland, OR
| | - Omar Ordaz-Johnson
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR
| | - Jonathan S. Emens
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR
- VA Portland Health Care System, Portland, OR
| | - Jonathan Q. Purnell
- Knight Cardiovascular Institute, Department of Medicine, Oregon Health & Science University, Portland, OR
| | - Melanie Gillingham
- Department of Molecular and Medical Genetics, Oregon Health & Science University, Portland, OR
- Graduate Programs in Human Nutrition, Oregon Health & Science University, Portland, OR
| | - Steven A. Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR
- OHSU-PSU School of Public Health at Oregon Health & Science University, Portland, OR
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17
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Zhong Z, Tan X, An X, Li J, Cai J, Jiang Y, Taufique SKT, Li B, Shi Q, Zhao M, Wang Y, Luo Q, Wang H. Administration of blue light in the morning and no blue-ray light in the evening improves the circadian functions of non-24-hour shift workers. Chronobiol Int 2024; 41:267-282. [PMID: 38267234 DOI: 10.1080/07420528.2024.2305218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 01/07/2024] [Indexed: 01/26/2024]
Abstract
In modern 24-hour society, various round-the-clock services have entailed shift work, resulting in non-24-hour schedules. However, the extent of behavioral and physiological alterations by non-24-hour schedules remains unclear, and particularly, effective interventions to restore the circadian functions of non-24-hour shift workers are rarely explored. In this study, we investigate the effects of a simulated non-24-hour military shift work schedule on daily rhythms and sleep, and establish an intervention measure to restore the circadian functions of non-24-hour shift workers. The three stages of experiments were conducted. The stage-one experiment was to establish a comprehensive evaluation index of the circadian rhythms and sleep for all 60 participants by analyzing wristwatch-recorded physiological parameters and sleep. The stage-two experiment evaluated the effects of an intervention strategy on physiological rhythms and sleep. The stage-three experiment was to examine the participants' physiological and behavioral disturbances under the simulated non-24-hour military shift work schedule and their improvements by the optimal lighting apparatus. We found that wristwatch-recorded physiological parameters display robust rhythmicity, and the phases of systolic blood pressures and heart rates can be used as reliable estimators for the human body time. The simulated non-24-hour military shift work schedule significantly disrupts the daily rhythms of oxygen saturation levels, blood pressures, heart rates, and reduces sleep quality. Administration of blue light in the morning and no blue-ray light in the evening improves the amplitude and synchronization of daily rhythms of the non-24-hour participants. These findings demonstrate the harmful consequences of the non-24-hour shift work schedule and provide a non-invasive strategy to improve the well-being and work efficiency of the non-24-hour shift population.
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Affiliation(s)
- Zhaomin Zhong
- Center for Circadian Clocks, Soochow University, Suzhou, Jiangsu, China
- School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Xiaohui Tan
- Center for Circadian Clocks, Soochow University, Suzhou, Jiangsu, China
- School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Xingna An
- Center for Circadian Clocks, Soochow University, Suzhou, Jiangsu, China
- School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Jie Li
- Center for Circadian Clocks, Soochow University, Suzhou, Jiangsu, China
- School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Jing Cai
- Center for Circadian Clocks, Soochow University, Suzhou, Jiangsu, China
- School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Yunchun Jiang
- Center for Circadian Clocks, Soochow University, Suzhou, Jiangsu, China
- School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - S K Tahajjul Taufique
- Center for Circadian Clocks, Soochow University, Suzhou, Jiangsu, China
- School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Bo Li
- Center for Circadian Clocks, Soochow University, Suzhou, Jiangsu, China
- School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Quan Shi
- Center for Circadian Clocks, Soochow University, Suzhou, Jiangsu, China
- School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Meng Zhao
- Center for Circadian Clocks, Soochow University, Suzhou, Jiangsu, China
- School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Yali Wang
- Department of Neurology, Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Qun Luo
- Naval Medical Center, PLA Naval Medical University, Shanghai, China
| | - Han Wang
- Center for Circadian Clocks, Soochow University, Suzhou, Jiangsu, China
- School of Biology & Basic Medical Sciences, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
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18
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Yuan RK, Kim YA, Cain SW, Münch MY, Ronda JM, Wang W, Czeisler CA, Duffy JF. Circadian- and wake-dependent influences on face-name memory in healthy men and women over 3weeks of chronic sleep restriction. Sleep Health 2024; 10:S84-S88. [PMID: 37783575 PMCID: PMC10980596 DOI: 10.1016/j.sleh.2023.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 10/04/2023]
Abstract
OBJECTIVES Facial recognition is one of the key functions of the human brain, and linking a face to a name is critical in many social and occupational settings. This study assessed circadian- and wake-dependent effects on face-name recognition in healthy adults. METHODS Thirteen healthy adults (20-70years; 7 F) were studied in a 39-day inpatient protocol that included 3weeks of 28 hours forced desynchrony with sleep restriction (6.5:21.5 hours sleep:wake). Starting 3 hours after scheduled wake, 6 novel face-name pairs were presented every 4 waking hours; recognition was tested 2 hours later. Performance data were averaged across ∼4 hours circadian phase or time-awake bins. RESULTS Face-name recognition deteriorated with increased time awake (p < .0001) and exhibited significant circadian variation (p < .0001), with worst performance shortly after the core temperature nadir. There was a significant interaction between sex and circadian phase (p = .0177), with women performing significantly better than men at all circadian phases except 60° and 120°. Women exhibited a significantly higher amplitude than men during the third week of forced desynchrony (p < .01). CONCLUSIONS Like many other aspects of neurobehavioral performance, recalling face-name associations is impacted by both duration of time awake and circadian phase. These results have implications for face recognition testing in medical contexts, such as in testing for dementia, because performance may be impacted by sleep deficiency and the time of testing.
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Affiliation(s)
- Robin K Yuan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
| | | | - Sean W Cain
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Mirjam Y Münch
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Joseph M Ronda
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Wei Wang
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Jeanne F Duffy
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital and Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
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19
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Broussard JL, Knud-Hansen BC, Grady S, Knauer OA, Ronda JM, Aeschbach D, Czeisler CA, Wright KP. Influence of circadian phase and extended wakefulness on glucose levels during forced desynchrony. Sleep Health 2024; 10:S96-S102. [PMID: 37996284 PMCID: PMC11031343 DOI: 10.1016/j.sleh.2023.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 09/23/2023] [Accepted: 10/18/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES Circadian misalignment and sleep deprivation often occur in tandem, and both negatively impact glucose homeostasis and metabolic health. The present study employed a forced desynchrony protocol to examine the influence of extended wakefulness and circadian misalignment on hourly glucose levels. METHODS Nine healthy adults (4F/5M; 26 ± 4years) completed a 31-day in-laboratory protocol. After three 24 hour baseline days with 8 hours scheduled sleep opportunities, participants were scheduled to 14 consecutive 42.85 hour sleep-wake cycles, with 28.57 hours extended wakefulness and 14.28 hours sleep opportunities each cycle. Blood was sampled hourly across the forced desynchrony and over 600 plasma samples per participant were analyzed for glucose levels. RESULTS Both hours into the 42.85 hours forced desynchrony day and circadian phase modulated glucose levels (p < .0001). Glucose peaked after each meal during scheduled wakefulness and decreased during scheduled sleep/fasting. Glucose levels were, on average, lowest during the biological daytime and rose throughout the biological night, peaking in the biological morning. When analyzed separately for scheduled sleep vs. wakefulness, the peak timing of the circadian rhythm in glucose was later during sleep (p < .05). Glucose area under the curve levels increased rapidly from the beginning of the forced desynchrony protocol and were highest on the second forced desynchrony day (p < .01), returning towards forced desynchrony day 1 levels thereafter. CONCLUSIONS These findings have important implications for understanding factors contributing to altered glucose metabolism during sleep loss and circadian misalignment, and for potential physiological adaptation of metabolism in healthy adults, who are increasingly exposed to such conditions in our society.
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Affiliation(s)
- Josiane L Broussard
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA; Sleep and Metabolism Laboratory, Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA.
| | - Brent C Knud-Hansen
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA; Sleep and Metabolism Laboratory, Department of Health and Exercise Science, Colorado State University, Fort Collins, Colorado, USA
| | - Scott Grady
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Portland Diabetes and Endocrinology Center, PC, Portland, Oregon, USA
| | - Oliver A Knauer
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA
| | - Joseph M Ronda
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Daniel Aeschbach
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Department of Sleep and Human Factors Research, Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
| | - Kenneth P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado, USA; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
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20
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Aeschbach D, Cohen DA, Lockyer BJ, Chellappa SL, Klerman EB. Spontaneous attentional failures reflect multiplicative interactions of chronic sleep loss with acute sleep loss and circadian misalignment. Sleep Health 2024; 10:S89-S95. [PMID: 37689503 DOI: 10.1016/j.sleh.2023.07.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 09/11/2023]
Abstract
OBJECTIVES Acute and chronic sleep loss and circadian timing interact such that, depending on their combination, small or very large performance decrements are observed in tasks of attention. Here, we tested whether such nonlinear interactions extend to a physiological measure of spontaneous visual attentional failures, indicating a fundamental principle of sleep-wake regulation. METHODS Nine healthy volunteers completed an in-laboratory 3-week forced desynchrony protocol consisting of 12 consecutive 42.85-hour cycles with a sleep-wake ratio of 1:3.3. The protocol induced increasing chronic sleep loss, while extended wake (32.85 hours) and sleep episodes (10 hours) occurred at multiple circadian phases. Attentional failure rate was quantified from continuous electrooculograms (number of 30-second epochs with slow eye movements/h of wakefulness) as a function of time since scheduled wake (acute sleep loss), week of study (chronic sleep loss), and circadian (melatonin) phase. RESULTS During the first ∼8 hours awake, attentional failure rate was low, irrespective of the week. During the following wake hours, attentional failure rate increased steadily but at a faster rate in weeks 2 and 3 compared to week 1. The effects of acute and chronic sleep loss on attentional failure rate were magnified during the biological night compared to the biological day. CONCLUSIONS A single extended sleep episode can only temporarily reverse attentional impairment associated with chronic sleep loss. Multiplicative effects of acute and chronic sleep loss-further amplified during the biological night-substantiate the interaction of 2 homeostatic response mechanisms and caution against underestimating their disproportionate combined impact on performance, health, and safety.
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Affiliation(s)
- Daniel Aeschbach
- Department of Sleep and Human Factors Research, Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany; Institute of Experimental Epileptology and Cognition Research, University of Bonn Medical Center, Bonn, Germany; Division of Sleep and Circadian Disorders, Department of Medicine, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA.
| | - Daniel A Cohen
- Department of Neurology, Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - Brandon J Lockyer
- Division of Sleep and Circadian Disorders, Department of Medicine, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Sarah L Chellappa
- School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK
| | - Elizabeth B Klerman
- Division of Sleep and Circadian Disorders, Department of Medicine, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts, USA
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21
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Klerman EB, Wright KP, Duffy JF, Scheer FAJL, Chang AM, Czeisler CA, Rajaratnam SM. A perspective on the Festschrift of Charles A. Czeisler, PhD MD. Sleep Health 2024; 10:S4-S10. [PMID: 38331654 PMCID: PMC11031332 DOI: 10.1016/j.sleh.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Affiliation(s)
- Elizabeth B Klerman
- Department of Neurology, Massachusetts General Hospital, Boston, USA; Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA.
| | - Kenneth P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology., University of Colorado Boulder, USA
| | - Jeanne F Duffy
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Frank A J L Scheer
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Anne-Marie Chang
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania, USA
| | - Charles A Czeisler
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Shantha Mw Rajaratnam
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA; Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, Massachusetts, USA; School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Victoria, Australia
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22
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Kaiser S, Henrich L, Kiessling I, Loy B, Schallner N. Neuroprotection via Carbon Monoxide Depends on the Circadian Regulation of CD36-Mediated Microglial Erythrophagocytosis in Hemorrhagic Stroke. Int J Mol Sci 2024; 25:1680. [PMID: 38338958 PMCID: PMC10855856 DOI: 10.3390/ijms25031680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/19/2024] [Accepted: 01/27/2024] [Indexed: 02/12/2024] Open
Abstract
The molecular basis for circadian dependency in stroke due to subarachnoid hemorrhagic stroke (SAH) remains unclear. We reasoned that microglial erythrophagocytosis, crucial for SAH response, follows a circadian pattern involving carbon monoxide (CO) and CD36 surface expression. The microglial BV-2 cell line and primary microglia (PMG) under a clocked medium change were exposed to blood ± CO (250 ppm, 1 h) in vitro. Circadian dependency and the involvement of CD36 were analyzed in PMG isolated from control mice and CD36-/- mice and by RNA interference targeting Per-2. In vivo investigations, including phagocytosis, vasospasm, microglia activation and spatial memory, were conducted in an SAH model using control and CD36-/- mice at different zeitgeber times (ZT). In vitro, the surface expression of CD36 and its dependency on CO and phagocytosis occurred with changed circadian gene expression. CD36-/- PMG exhibited altered circadian gene expression, phagocytosis and impaired responsiveness to CO. In vivo, control mice with SAH demonstrated circadian dependency in microglia activation, erythrophagocytosis and CO-mediated protection at ZT2, in contrast to CD36-/- mice. Our study indicates that circadian rhythmicity modulates microglial activation and subsequent CD36-dependent phagocytosis. CO altered circadian-dependent neuroprotection and CD36 induction, determining the functional outcome in a hemorrhagic stroke model. This study emphasizes how circadian rhythmicity influences neuronal damage after neurovascular events.
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Affiliation(s)
- Sandra Kaiser
- Department of Anesthesiology & Critical Care Medicine, Medical Center, University of Freiburg, 79106 Freiburg, Germany (N.S.)
- Faculty of Medicine, University of Freiburg, 79110 Freiburg, Germany
| | - Luise Henrich
- Department of Anesthesiology & Critical Care Medicine, Medical Center, University of Freiburg, 79106 Freiburg, Germany (N.S.)
- Faculty of Medicine, University of Freiburg, 79110 Freiburg, Germany
| | - Iva Kiessling
- Department of Anesthesiology & Critical Care Medicine, Medical Center, University of Freiburg, 79106 Freiburg, Germany (N.S.)
- Faculty of Medicine, University of Freiburg, 79110 Freiburg, Germany
| | - Benedikt Loy
- Department of Anesthesiology & Critical Care Medicine, Medical Center, University of Freiburg, 79106 Freiburg, Germany (N.S.)
- Faculty of Medicine, University of Freiburg, 79110 Freiburg, Germany
| | - Nils Schallner
- Department of Anesthesiology & Critical Care Medicine, Medical Center, University of Freiburg, 79106 Freiburg, Germany (N.S.)
- Faculty of Medicine, University of Freiburg, 79110 Freiburg, Germany
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23
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Furrer M, Meier SA, Jan M, Franken P, Sundset MA, Brown SA, Wagner GC, Huber R. Reindeer in the Arctic reduce sleep need during rumination. Curr Biol 2024; 34:427-433.e5. [PMID: 38141616 DOI: 10.1016/j.cub.2023.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2023] [Revised: 11/24/2023] [Accepted: 12/06/2023] [Indexed: 12/25/2023]
Abstract
Timing and quantity of sleep depend on a circadian (∼24-h) rhythm and a specific sleep requirement.1 Sleep curtailment results in a homeostatic rebound of more and deeper sleep, the latter reflected in increased electroencephalographic (EEG) slow-wave activity (SWA) during non-rapid eye movement (NREM) sleep.2 Circadian rhythms are synchronized by the light-dark cycle but persist under constant conditions.3,4,5 Strikingly, arctic reindeer behavior is arrhythmic during the solstices.6 Moreover, the Arctic's extreme seasonal environmental changes cause large variations in overall activity and food intake.7 We hypothesized that the maintenance of optimal functioning under these extremely fluctuating conditions would require adaptations not only in daily activity patterns but also in the homeostatic regulation of sleep. We studied sleep using non-invasive EEG in four Eurasian tundra reindeer (Rangifer tarandus tarandus) in Tromsø, Norway (69°N) during the fall equinox and both solstices. As expected, sleep-wake rhythms paralleled daily activity distribution, and sleep deprivation resulted in a homeostatic rebound in all seasons. Yet, these sleep rebounds were smaller in summer and fall than in winter. Surprisingly, SWA decreased not only during NREM sleep but also during rumination. Quantitative modeling revealed that sleep pressure decayed at similar rates during the two behavioral states. Finally, reindeer spent less time in NREM sleep the more they ruminated. These results suggest that they can sleep during rumination. The ability to reduce sleep need during rumination-undisturbed phases for both sleep recovery and digestion-might allow for near-constant feeding in the arctic summer.
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Affiliation(s)
- Melanie Furrer
- Child Development Center and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland
| | - Sara A Meier
- Institute of Pharmacology and Toxicology, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Maxime Jan
- Center for Integrative Genomics, University of Lausanne, Génopode building, 1015 Lausanne, Switzerland; Bioinformatics Competence Center, University of Lausanne, Génopode building, 1015 Lausanne, Switzerland
| | - Paul Franken
- Center for Integrative Genomics, University of Lausanne, Génopode building, 1015 Lausanne, Switzerland
| | - Monica A Sundset
- Department of Arctic and Marine Biology, UiT The Arctic University of Norway, Framstredet 39, 9019 Tromsø, Norway
| | - Steven A Brown
- Institute of Pharmacology and Toxicology, University of Zurich, Winterthurerstrasse 190, 8057 Zurich, Switzerland
| | - Gabriela C Wagner
- Department of Arctic and Marine Biology, UiT The Arctic University of Norway, Framstredet 39, 9019 Tromsø, Norway; Division of Forest and Forest Resources, Norwegian Institute of Bioeconomy Research, Holtvegen 66, 9016 Tromsø, Norway.
| | - Reto Huber
- Child Development Center and Children's Research Center, University Children's Hospital Zurich, University of Zurich, Steinwiesstrasse 75, 8032 Zurich, Switzerland; Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital Zurich, University of Zurich, Lenggstrasse 31, 8032 Zurich, Switzerland.
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Nishida S, Kitamura W. An Influx of Non-Native Bird Species into the Natural Environment Owing to the Accidental Release of Pet Birds in Japan. Animals (Basel) 2024; 14:221. [PMID: 38254389 PMCID: PMC10812534 DOI: 10.3390/ani14020221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 01/06/2024] [Accepted: 01/08/2024] [Indexed: 01/24/2024] Open
Abstract
The escape of pet birds into the wild raises concerns about the introduction of invasive avian species. This study investigated the impact of escaped pet birds on the introduction of non-native species in Japan. Data sourced from four lost-and-found pet websites between January 2018 and December 2021 revealed 12,125 recorded escapes exhibiting both daily occurrences and seasonal fluctuations. Statistical modeling identified the monthly average temperature (positively correlated) and maximum electricity demand (negatively correlated) as influential factors. Text analysis revealed "window" and "open" as frequently cited reasons for escapes. Budgerigars (Melopsittacus undulatus) and Cockatiels (Nymphicus hollandicus) accounted for 76% of the total escape, suggesting a low perceived risk of establishment in nonnative environments. Interestingly, two globally established invasive species, the Rose-ringed Parakeet (Psittacula krameri) and Monk Parakeet (Myiopsitta monachus), were among the escaped birds. While the Rose-ringed Parakeet is locally naturalized in Tokyo and its adjacent prefectures, the Monk Parakeet failed to establish itself in Japan. Despite the limited number of escaped Monk Parakeets, ongoing efforts are crucial for preventing the potential re-establishment of species with such capabilities.
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Affiliation(s)
- Sumiko Nishida
- Environmental and Information Studies Division, Graduate School of Environmental and Information Studies, Tokyo City University, 3-3-1 Ushikubo-nishi, Tuzuki-ku, Yokohama 224-8551, Kanagawa, Japan
| | - Wataru Kitamura
- Department of Restoration Ecology and Built Environment, Faculty of Environmental Studies, Tokyo City University, 3-3-1 Ushikubo-nishi, Tuzuki-ku, Yokohama 224-8551, Kanagawa, Japan;
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25
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Lee DY, Jung I, Park SY, Yu JH, Seo JA, Kim KJ, Kim NH, Yoo HJ, Kim SG, Choi KM, Baik SH, Kim NH. Attention to Innate Circadian Rhythm and the Impact of Its Disruption on Diabetes. Diabetes Metab J 2024; 48:37-52. [PMID: 38173377 PMCID: PMC10850272 DOI: 10.4093/dmj.2023.0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/16/2023] [Indexed: 01/05/2024] Open
Abstract
Novel strategies are required to reduce the risk of developing diabetes and/or clinical outcomes and complications of diabetes. In this regard, the role of the circadian system may be a potential candidate for the prevention of diabetes. We reviewed evidence from animal, clinical, and epidemiological studies linking the circadian system to various aspects of the pathophysiology and clinical outcomes of diabetes. The circadian clock governs genetic, metabolic, hormonal, and behavioral signals in anticipation of cyclic 24-hour events through interactions between a "central clock" in the suprachiasmatic nucleus and "peripheral clocks" in the whole body. Currently, circadian rhythmicity in humans can be subjectively or objectively assessed by measuring melatonin and glucocorticoid levels, core body temperature, peripheral blood, oral mucosa, hair follicles, rest-activity cycles, sleep diaries, and circadian chronotypes. In this review, we summarized various circadian misalignments, such as altered light-dark, sleep-wake, rest-activity, fasting-feeding, shift work, evening chronotype, and social jetlag, as well as mutations in clock genes that could contribute to the development of diabetes and poor glycemic status in patients with diabetes. Targeting critical components of the circadian system could deliver potential candidates for the treatment and prevention of type 2 diabetes mellitus in the future.
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Affiliation(s)
- Da Young Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Inha Jung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - So Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji Hee Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Ji A Seo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyeong Jin Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Nam Hoon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Hye Jin Yoo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sin Gon Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Kyung Mook Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Sei Hyun Baik
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Nan Hee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- BK21 FOUR R&E Center for Learning Health Systems, Korea University, Seoul, Korea
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26
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Shafer BM, Kogan SA, McHill AW. Pressure Building Against the Clock: The Impact of Circadian Misalignment on Blood Pressure. Curr Hypertens Rep 2024; 26:31-42. [PMID: 37837518 PMCID: PMC10916535 DOI: 10.1007/s11906-023-01274-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE OF REVIEW Misalignment between the endogenous biological timing system and behavioral activities (i.e., sleep/wake, eating, activity) contributes to adverse cardiovascular health. In this review, we discuss the effects of recurring circadian misalignment on blood pressure regulation and the implications for hypertension development. Additionally, we highlight emerging therapeutic approaches designed to mitigate the negative cardiovascular consequences elicited by circadian disruption. RECENT FINDINGS Circadian misalignment elicited by work schedules that require individuals to be awake during the biological night (i.e., shift work) alters 24-h blood pressure rhythms. Mechanistically, circadian misalignment appears to alter blood pressure via changes in autonomic nervous system balance, variations to sodium retention, dysregulation of endothelial vasodilatory responsiveness, and activation of proinflammatory mechanisms. Recurring circadian misalignment produced by a mismatch in sleep timing on free days vs. work days (i.e., social jetlag) appears to have no direct effects on prevailing blood pressure levels in healthy adults; though, circadian disruptions resulting from social jetlag may increase the risk of hypertension through enhanced sympathetic activation and/or obesity. Furthermore, social jetlag assessment may be a useful metric in shift work populations where the magnitude of circadian misalignment may be greater than in the general population. Circadian misalignment promotes unfavorable changes to 24-h blood pressure rhythms, most notably in shift working populations. While light therapy, melatonin supplementation, and the timing of drug administration may improve cardiovascular outcomes, interventions designed to target the effects of circadian misalignment on blood pressure regulation are warranted.
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Affiliation(s)
- Brooke M Shafer
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Sophia A Kogan
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA
| | - Andrew W McHill
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, 3455 SW US Veterans Hospital Rd, Portland, OR, 97239, USA.
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA.
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27
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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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28
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Aggestrup AS, Svendsen SD, Præstegaard A, Løventoft P, Nørregaard L, Knorr U, Dam H, Frøkjær E, Danilenko K, Hageman I, Faurholt-Jepsen M, Kessing LV, Martiny K. Circadian Reinforcement Therapy in Combination With Electronic Self-Monitoring to Facilitate a Safe Postdischarge Period for Patients With Major Depression: Randomized Controlled Trial. JMIR Ment Health 2023; 10:e50072. [PMID: 37800194 DOI: 10.2196/50072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/10/2023] [Accepted: 10/03/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Patients with major depression exhibit circadian disturbance of sleep and mood, and when they are discharged from inpatient wards, this disturbance poses a risk of relapse. We developed a circadian reinforcement therapy (CRT) intervention to facilitate the transition from the inpatient ward to the home for these patients. CRT focuses on increasing the zeitgeber strength for the circadian clock through social contact, physical activity, diet, daylight exposure, and sleep timing. OBJECTIVE In this study, we aimed to prevent the worsening of depression after discharge by using CRT, supported by an electronic self-monitoring system, to advance and stabilize sleep and improve mood. The primary outcome, which was assessed by a blinded rater, was the change in the Hamilton Depression Rating Scale scores from baseline to the end point. METHODS Participants were contacted while in the inpatient ward and randomized 1:1 to the CRT or the treatment-as-usual (TAU) group. For 4 weeks, participants in both groups electronically self-monitored their daily mood, physical activity, sleep, and medication using the Monsenso Daybuilder (MDB) system. The MDB allowed investigators and participants to simultaneously view a graphical display of registrations. An investigator phoned all participants weekly to coinspect data entry. In the CRT group, participants were additionally phoned between the scheduled calls if specific predefined trigger points for mood and sleep were observed during the daily inspection. Participants in the CRT group were provided with specialized CRT psychoeducation sessions immediately after inclusion, focusing on increasing the zeitgeber input to the circadian system; a PowerPoint presentation was presented; paper-based informative materials and leaflets were reviewed with the participants; and the CRT principles were used during all telephone consultations. In the TAU group, phone calls focused on data entry in the MDB system. When discharged, all patients were treated at a specialized affective disorders service. RESULTS Overall, 103 participants were included. Participants in the CRT group had a significantly larger reduction in Hamilton Depression Scale score (P=.04) than those in the TAU group. The self-monitored MDB data showed significantly improved evening mood (P=.02) and sleep quality (P=.04), earlier sleep onset (P=.009), and longer sleep duration (P=.005) in the CRT group than in the TAU group. The day-to-day variability of the daily and evening mood, sleep offset, sleep onset, and sleep quality were significantly lower in the CRT group (all P<.001) than in the TAU group. The user evaluation was positive for the CRT method and the MDB system. CONCLUSIONS We found significantly lower depression levels and improved sleep quality in the CRT group than in the TAU group. We also found significantly lower day-to-day variability in daily sleep, mood parameters, and activity parameters in the CRT group than in the TAU group. The delivery of the CRT intervention should be further refined and tested. TRIAL REGISTRATION ClinicalTrials.gov NCT02679768; https://clinicaltrials.gov/study/NCT02679768. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.1186/s12888-019-2101-z.
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Affiliation(s)
- Anne Sofie Aggestrup
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Signe Dunker Svendsen
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anne Præstegaard
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Philip Løventoft
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Lasse Nørregaard
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Ulla Knorr
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Henrik Dam
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Erik Frøkjær
- Department of Computer Science, University of Copenhagen, Copenhagen, Denmark
| | | | - Ida Hageman
- Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Faurholt-Jepsen
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Lars Vedel Kessing
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
| | - Klaus Martiny
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Frederiksberg, Denmark
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29
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Lemke T, Hökby S, Wasserman D, Carli V, Hadlaczky G. Associations between sleep habits, quality, chronotype and depression in a large cross-sectional sample of Swedish adolescents. PLoS One 2023; 18:e0293580. [PMID: 37917651 PMCID: PMC10621812 DOI: 10.1371/journal.pone.0293580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 10/16/2023] [Indexed: 11/04/2023] Open
Abstract
OBJECTIVE To investigate behavioral sleep habits, self-perceived quality of sleep, and chronotype, and to examine their association with clinically relevant levels of depression in Swedish adolescents. METHOD Questionnaire data were obtained from a representative sample of Swedish adolescents (n = 8449; 50.8% girls; aged 12-16). Depression was defined as >13 BDI-II scores. Logistic regression modelling estimated the effects of sleep duration, sleep quality, and chronotype on depression, adjusted for socio-demographic factors. RESULTS On weekdays, approximately 46% of adolescents slept less than the recommended length of eight hours per night (depressed: 68%, non-depressed: 40%). On weekends, however, only 17% slept shorter than recommended. Short weekday sleep duration was more common among girls than boys (53% vs. 38%) and girls reported worse sleep quality. The regression model showed that depression was predicted by weekday sleep duration (OR = 0.773, p < .0001), sleep quality (OR = 0.327, p < .0001), and late chronotype (OR = 1.126, p = .0017), but not by weekend sleep duration. A 30-minute increase in weekday sleep duration was associated with about 10% lower odds of depression. CONCLUSIONS A substantial proportion of Swedish adolescents do not seem to meet the sleep recommendations of eight hours per night. Short sleep duration on weekdays, poor sleep quality, and late chronotype were associated with increased risk of depression. Interventions promoting longer weekday sleep duration (e.g., later school start times) seem relevant in this context, but further research is needed to investigate the directionality and underlying mechanisms of these associations.
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Affiliation(s)
- Theresa Lemke
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Sebastian Hökby
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
| | - Gergö Hadlaczky
- National Centre for Suicide Research and Prevention (NASP), Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden
- National Centre for Suicide Research and Prevention (NASP), Centre for Health Economics, Informatics and Health Services Research (CHIS), Stockholm Health Care Services, Stockholm, Sweden
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30
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Keihani A, Mayeli A, Ferrarelli F. Circadian Rhythm Changes in Healthy Aging and Mild Cognitive Impairment. Adv Biol (Weinh) 2023; 7:e2200237. [PMID: 36403250 PMCID: PMC10199146 DOI: 10.1002/adbi.202200237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/01/2022] [Indexed: 11/21/2022]
Abstract
Disruptions in circadian rhythms can occur in healthy aging; however, these changes are more severe and pervasive in individuals with age-related and neurodegenerative diseases, such as dementia. Circadian rhythm alterations are also present in preclinical stages of dementia, for example, in patients with mild cognitive impairments (MCI); thus, providing a unique window of opportunity for early intervention in neurodegenerative disorders. Nonetheless, there is a lack of studies examining the association between relevant changes in circadian rhythms and their relationship with cognitive dysfunctions in MCI individuals. In this review, circadian system alterations occurring in MCI patients are examined compared to healthy aging individuals while also considering their association with MCI neurocognitive alterations. The main findings are that abnormal circadian changes in rest-activity, core body temperature, melatonin, and cortisol rhythms appear in the MCI stage and that these circadian rhythm disruptions are associated with some of the neurocognitive deficits observed in MCI patients. In addition, preliminary evidence indicates that interventions aimed at restoring regular circadian rhythms may prevent or halt the progress of neurodegenerative diseases and mitigate their related cognitive impairments. Future longitudinal studies with repeated follow-up assessments are needed to establish the translational potential of these findings in clinical practice.
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Affiliation(s)
- Ahmadreza Keihani
- Department of Psychiatry, University of Pittsburgh, 3501 Forbes Ave, Pittsburgh, PA, 15213, USA
| | - Ahmad Mayeli
- Department of Psychiatry, University of Pittsburgh, 3501 Forbes Ave, Pittsburgh, PA, 15213, USA
| | - Fabio Ferrarelli
- Department of Psychiatry, University of Pittsburgh, 3501 Forbes Ave, Pittsburgh, PA, 15213, USA
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31
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Ohashi M, Eto T, Takasu T, Motomura Y, Higuchi S. Relationship between Circadian Phase Delay without Morning Light and Phase Advance by Bright Light Exposure the Following Morning. Clocks Sleep 2023; 5:615-626. [PMID: 37873842 PMCID: PMC10594521 DOI: 10.3390/clockssleep5040041] [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: 07/31/2023] [Revised: 10/17/2023] [Accepted: 10/20/2023] [Indexed: 10/25/2023] Open
Abstract
Humans have a circadian rhythm for which the period varies among individuals. In the present study, we investigated the amount of natural phase delay of circadian rhythms after spending a day under dim light (Day 1 to Day 2) and the amount of phase advance due to light exposure (8000 lx, 4100 K) the following morning (Day 2 to Day 3). The relationships of the phase shifts with the circadian phase, chronotype and sleep habits were also investigated. Dim light melatonin onset (DLMO) was investigated as a circadian phase marker on each day. In the 27 individuals used for the analysis, DLMO was delayed significantly (-0.24 ± 0.33 h, p < 0.01) from Day 1 to Day 2 and DLMO was advanced significantly (0.18 ± 0.36 h, p < 0.05) from Day 2 to Day 3. There was a significant correlation between phase shifts, with subjects who had a greater phase delay in the dim environment having a greater phase advance by light exposure (r = -0.43, p < 0.05). However, no significant correlations with circadian phase, chronotype or sleep habits were found. These phase shifts may reflect the stability of the phase, but do not account for an individual's chronotype-related indicators.
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Affiliation(s)
- Michihiro Ohashi
- Graduate School of Integrated Frontier Sciences, Kyushu University, Fukuoka 815-8540, Japan; (M.O.)
- Research Fellow of the Japan Society for the Promotion of Science, Fukuoka 815-8540, Japan
| | - Taisuke Eto
- Research Fellow of the Japan Society for the Promotion of Science, Fukuoka 815-8540, Japan
- Department of Human Life Design and Science, Faculty of Design, Kyushu University, Fukuoka 815-8540, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan
| | - Toaki Takasu
- Graduate School of Integrated Frontier Sciences, Kyushu University, Fukuoka 815-8540, Japan; (M.O.)
| | - Yuki Motomura
- Department of Human Life Design and Science, Faculty of Design, Kyushu University, Fukuoka 815-8540, Japan
| | - Shigekazu Higuchi
- Department of Human Life Design and Science, Faculty of Design, Kyushu University, Fukuoka 815-8540, Japan
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Reis DJ, Yen P, Tizenberg B, Gottipati A, Postolache SY, De Riggs D, Nance M, Dagdag A, Plater L, Federline A, Grassmeyer R, Dagdag A, Akram F, Ozorio Dutra SV, Gragnoli C, RachBeisel JA, Volkov J, Bahraini NH, Stiller JW, Brenner LA, Postolache TT. Longitude-based time zone partitions and rates of suicide. J Affect Disord 2023; 339:933-942. [PMID: 37481129 PMCID: PMC10870927 DOI: 10.1016/j.jad.2023.07.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 06/19/2023] [Accepted: 07/14/2023] [Indexed: 07/24/2023]
Abstract
BACKGROUND Increasing evidence suggests that conditions with decreased morning and increased evening light exposure, including shift work, daylight-saving time, and eveningness, are associated with elevated mortality and suicide risk. Given that the alignment between the astronomical, biological, and social time varies across a time zone, with later-shifted daylight exposure in the western partition, we hypothesized that western time zone partitions would have higher suicide rates than eastern partitions. METHODS United States (U.S.) county-level suicide and demographic data, from 2010 to 2018, were obtained from a Centers for Disease Control database. Using longitude and latitude, counties were sorted into the western, middle, or eastern partition of their respective time zones, as well as the northern and southern halves of the U.S. Linear regressions were used to estimate the associations between suicide rates and time zone partitions, adjusting for gender, race, ethnicity, age group, and unemployment rates. RESULTS Data were available for 2872 counties. Across the U.S., western partitions had statistically significantly higher rates of suicide compared to eastern partitions and averaged up to two additional yearly deaths per 100,000 people (p < .001). LIMITATIONS Ecological design and limited adjustment for socioeconomic factors. CONCLUSIONS To our knowledge, this is the first study of the relationship between longitude-based time zone partitions and suicide. The results were consistent with the hypothesized elevated suicide rates in the western partitions, and concordant with previous reports on cancer mortality and transportation fatalities. The next step is to retest the hypothesis with individual-level data, accounting for latitude, photoperiodic changes, daylight-saving time, geoclimatic variables, physical and mental health indicators, as well as socioeconomic adversity and protection.
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Affiliation(s)
- Daniel J Reis
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Poyu Yen
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Boris Tizenberg
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Anurag Gottipati
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Sonia Y Postolache
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Demitria De Riggs
- VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center, Baltimore, MD, USA
| | - Morgan Nance
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alexandra Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lynn Plater
- VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center, Baltimore, MD, USA
| | - Amanda Federline
- VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center, Baltimore, MD, USA
| | - Riley Grassmeyer
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA
| | - Aline Dagdag
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Faisal Akram
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; Psychiatry Residency Training, Saint Elizabeth's Hospital, Department of Behavioral Health, Washington, DC, USA
| | | | - Claudia Gragnoli
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA; Division of Endocrinology, Department of Medicine, Creighton University School of Medicine, Omaha, NE, USA
| | - Jill A RachBeisel
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Janna Volkov
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; Psychiatry Residency Training, Saint Elizabeth's Hospital, Department of Behavioral Health, Washington, DC, USA
| | - Nazanin H Bahraini
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - John W Stiller
- Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; Saint Elizabeth's Hospital, Neurology Consultation Service, Washington, DC, USA; Maryland State Athletic Commission, Baltimore, MD, USA
| | - Lisa A Brenner
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Denver, CO, USA
| | - Teodor T Postolache
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Veteran Suicide Prevention, Aurora, CO, USA; Mood and Anxiety Program, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, USA; VISN 5 Capitol Health Care Network Mental Illness Research Education and Clinical Center, Baltimore, MD, USA; Military and Veteran Microbiome: Consortium for Research and Education (MVM-CoRE), Denver, CO, USA
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Stowe SR, LeBourgeois MK, Behn CD. Modeling the Effects of Napping and Non-napping Patterns of Light Exposure on the Human Circadian Oscillator. J Biol Rhythms 2023; 38:492-509. [PMID: 37427666 PMCID: PMC10524998 DOI: 10.1177/07487304231180953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
In early childhood, consolidation of sleep from a biphasic to a monophasic sleep-wake pattern, that is, the transition from sleeping during an afternoon nap and at night to sleeping only during the night, represents a major developmental milestone. Reduced napping behavior is associated with an advance in the timing of the circadian system; however, it is unknown if this advance represents a standard response of the circadian clock to altered patterns of light exposure or if it additionally reflects features of the developing circadian system. Using a mathematical model of the human circadian pacemaker, we investigated the impact of napping and non-napping patterns of light exposure on entrained circadian phases. Simulated light schedules were based on published data from 20 children (34.2 ± 2.0 months) with habitual napping or non-napping sleep patterns (15 nappers). We found the model predicted different circadian phases for napping and non-napping light patterns: both the decrease in afternoon light during the nap and the increase in evening light associated with napping toddlers' later bedtimes contributed to the observed circadian phase difference produced between napping and non-napping light schedules. We systematically quantified the effects on phase shifting of nap duration, timing, and light intensity, finding larger phase delays occurred for longer and earlier naps. In addition, we simulated phase response curves to a 1-h light pulse and 1-h dark pulse to predict phase and intensity dependence of these changes in light exposure. We found the light pulse produced larger shifts compared with the dark pulse, and we analyzed the model dynamics to identify the features contributing to this asymmetry. These findings suggest that napping status affects circadian timing due to altered patterns of light exposure, with the dynamics of the circadian clock and light processing mediating the effects of the dark pulse associated with a daytime nap.
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Affiliation(s)
- Shelby R. Stowe
- Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, Colorado
| | | | - Cecilia Diniz Behn
- Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, Colorado
- Division of Endocrinology, Department of Pediatrics, University of Colorado Denver Anschutz Medical Campus, Aurora, Colorado
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Lok R, Duran M, Zeitzer JM. Moving time zones in a flash with light therapy during sleep. Sci Rep 2023; 13:14458. [PMID: 37660233 PMCID: PMC10475014 DOI: 10.1038/s41598-023-41742-w] [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: 04/11/2023] [Accepted: 08/30/2023] [Indexed: 09/04/2023] Open
Abstract
In humans, exposure to continuous light is typically used to change the timing of the circadian clock. This study examines the efficiency of a sequence of light flashes ("flash therapy") applied during sleep to shift the clock. Healthy participants (n = 10) took part in two 36-h laboratory stays, receiving a placebo (goggles, no light) during one visit and the intervention (goggles, 2-ms flashes broad-spectrum light for 60 min, delivered every 15 s, starting 30 min after habitual sleep onset) during the other. Circadian phase shift was assessed with changes in salivary dim light melatonin onset (DLMO). Sleep, measured with polysomnography, was analyzed to assess changes in sleep architecture and spectral power. After 1 h of flashes, DLMO showed a substantial delay (1.13 ± 1.27 h) compared to placebo (12 ± 20 min). Two individuals exhibited very large shifts of 6.4 and 3.1 h. There were no substantive differences in sleep architecture, but some evidence for greater instability in sleep. 1 h of flash therapy during sleep evokes large changes in circadian timing, up to 6 h, and does so with only minimal, if any, impact on sleep. Flash therapy may offer a practical option to delay the circadian clock in shift workers and jet travelers.
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Affiliation(s)
- Renske Lok
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA
| | - Marisol Duran
- Palo Alto Veterans Institute for Research, Palo Alto, CA, 94304, USA
| | - Jamie M Zeitzer
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, 94305, USA.
- Mental Illness Research Education and Clinical Center, VA Palo Alto Health Care System, Palo Alto, CA, 94304, USA.
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Nobari H, Azarian S, Saedmocheshi S, Valdés-Badilla P, García Calvo T. Narrative review: The role of circadian rhythm on sports performance, hormonal regulation, immune system function, and injury prevention in athletes. Heliyon 2023; 9:e19636. [PMID: 37809566 PMCID: PMC10558889 DOI: 10.1016/j.heliyon.2023.e19636] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 08/21/2023] [Accepted: 08/29/2023] [Indexed: 10/10/2023] Open
Abstract
Objectives This study was a narrative review of the importance of circadian rhythm (CR), describes the underlying mechanisms of CR in sports performance, emphasizes the reciprocal link between CR, endocrine homeostasis and sex differences, and the unique role of the circadian clock in immune system function and coordination. Method As a narrative review study, a comprehensive search was conducted in PubMed, Scopus, and Web of Science (core collection) databases using the keywords "circadian rhythm", "sports performance", "hormonal regulation", "immune system", and "injury prevention". Inclusion criteria were studies published in English and peer-reviewed journals until July 2023. Studies that examined the role of CR in sports performance, hormonal status, immune system function, and injury prevention in athletes were selected for review. Results CR is followed by almost all physiological and biochemical activities in the human body. In humans, the superchiasmatic nucleus controls many daily biorhythms under solar time, including the sleep-wake cycle. A body of literature indicates that the peak performance of essential indicators of sports performance is primarily in the afternoon hours, and the evening of actions occurs roughly at the peak of core body temperature. Recent studies have demonstrated that the time of day that exercise is performed affects the achievement of good physical performance. This review also shows various biomarkers of cellular damage in weariness and the underlying mechanisms of diurnal fluctuations. According to the clock, CR can be synchronized with photonic and non-photonic stimuli (i.e., temperature, physical activity, and food intake), and feeding patterns and diet changes can affect CR and redox markers. It also emphasizes the reciprocal links between CR and endocrine homeostasis, the specific role of the circadian clock in coordinating immune system function, and the relationship between circadian clocks and sex differences. Conclusion The interaction between insufficient sleep and time of day on performance has been established in this study because it is crucial to balance training, recovery, and sleep duration to attain optimal sports performance.
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Affiliation(s)
- Hadi Nobari
- Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran
| | - Somayeh Azarian
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran
| | - Saber Saedmocheshi
- Department of Physical Education and Sport Sciences, Faculty of Humanities and Social Sciences, University of Kurdistan, Sanandaj, 66177-15175, Iran
| | - Pablo Valdés-Badilla
- Department of Physical Activity Sciences, Faculty of Education Sciences, Universidad Católica del Maule, Talca, 3530000, Chile
- Sports Coach Career, School of Education, Universidad Viña del Mar, Viña del Mar, 2520000, Chile
| | - Tomás García Calvo
- Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain
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Johnson KG, Malow BA. Implications of Sleep Health Policy: Daylight Saving and School Start Times. Continuum (Minneap Minn) 2023; 29:1253-1266. [PMID: 37590832 DOI: 10.1212/con.0000000000001331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
ABSTRACT Two proposed public policies, ending seasonal clock change with a transition to permanent Standard Time and moving middle school and high school start times later, are population-based initiatives to improve sleep health. Daylight Saving Time and early school start times are associated with reduced sleep duration and increased circadian misalignment, the effects of which impact not only long-term health outcomes including obesity, cerebrovascular and cardiovascular disease, and cancer, but also mental health, academics, workforce productivity, and safety outcomes. This article highlights studies that led to the endorsement of these public policies by multiple scientific and medical organizations. Neurologists should advocate at the state and federal levels and educate the population about the importance of sleep health.
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Wu A. Updates and confounding factors in delayed sleep-wake phase disorder. Sleep Biol Rhythms 2023; 21:279-287. [PMID: 37363638 PMCID: PMC9979143 DOI: 10.1007/s41105-023-00454-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 02/09/2023] [Indexed: 03/06/2023]
Abstract
Delayed sleep-wake phase disorder (DSWPD) is a circadian rhythm sleep disorder characterised by a delay in the main sleep period, with patients experiencing difficulty getting to sleep and waking up at socially appropriate times. This often causes insomnia and compromised sleep, results in impairment to daytime function and is associated with a range of comorbidities. Besides interventions aimed at ameliorating symptoms, there is good evidence supporting successful phase advancement with bright light therapy or melatonin administration. However, no treatment to date addresses the tendency to phase delay, which is a common factor amongst the various contributing causes of DSWPD. Circadian phase markers such as core body temperature and circulating melatonin typically correlate well with sleep timing in healthy patients, but numerous variations exist in DSWPD patients that can make these unpredictable for use in diagnostics. There is also increasing evidence that, on top of problems with the circadian cycle, sleep homeostatic processes actually differ in DSWPD patients compared to controls. This naturally has ramifications for management but also for the current approach to the pathogenesis itself in which DSWPD is considered a purely circadian disorder. This review collates what is known on the causes and treatments of DSWPD, addresses the pitfalls in diagnosis and discusses the implications of current data on modified sleep homeostasis, making clinical recommendations and directing future research.
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Affiliation(s)
- Alexandra Wu
- Division of Biosciences, University College London, Gower Street, London, WC1E 6BT UK
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Eto T, Higuchi S. Review on age-related differences in non-visual effects of light: melatonin suppression, circadian phase shift and pupillary light reflex in children to older adults. J Physiol Anthropol 2023; 42:11. [PMID: 37355647 DOI: 10.1186/s40101-023-00328-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 06/15/2023] [Indexed: 06/26/2023] Open
Abstract
Physiological effects of light exposure in humans are diverse. Among them, the circadian rhythm phase shift effect in order to maintain a 24-h cycle of the biological clock is referred to as non-visual effects of light collectively with melatonin suppression and pupillary light reflex. The non-visual effects of light may differ depending on age, and clarifying age-related differences in the non-visual effects of light is important for providing appropriate light environments for people of different ages. Therefore, in various research fields, including physiological anthropology, many studies on the effects of age on non-visual functions have been carried out in older people, children and adolescents by comparing the effects with young adults. However, whether the non-visual effects of light vary depending on age and, if so, what factors contribute to the differences have remained unclear. In this review, results of past and recent studies on age-related differences in the non-visual effects of light are presented and discussed in order to provide clues for answering the question of whether non-visual effects of light actually vary depending on age. Some studies, especially studies focusing on older people, have shown age-related differences in non-visual functions including differences in melatonin suppression, circadian phase shift and pupillary light reflex, while other studies have shown no differences. Studies showing age-related differences in the non-visual effects of light have suspected senile constriction and crystalline lens opacity as factors contributing to the differences, while studies showing no age-related differences have suspected the presence of a compensatory mechanism. Some studies in children and adolescents have shown that children's non-visual functions may be highly sensitive to light, but the studies comparing with other age groups seem to have been limited. In order to study age-related differences in non-visual effects in detail, comparative studies should be conducted using subjects having a wide range of ages and with as much control as possible for intensity, wavelength component, duration, circadian timing, illumination method of light exposure, and other factors (mydriasis or non-mydriasis, cataracts or not in the older adults, etc.).
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Affiliation(s)
- Taisuke Eto
- Research Fellow of the Japan Society for the Promotion of Science, Kodaira, Japan
- Department of Sleep-Wake Disorders, National Center of Neurology and Psychiatry, National Institute of Mental Health, Kodaira, Japan
| | - Shigekazu Higuchi
- Department of Human Life Design and Science, Faculty of Design, Kyushu University, Fukuoka, Japan.
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Salles C, Moraes Almondes K, Araújo M, Marques I, Haine Gonzaga L, Meira-e-Cruz M, Aguiar C, Costa Dias C. Sleep Quality and Social Jetlag in Young Adults During the Social Distancing Caused by COVID-19. Sleep Sci 2023; 16:216-226. [PMID: 37425972 PMCID: PMC10325845 DOI: 10.1055/s-0043-1770806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
Introduction: This study aimed to evaluate the sleep quality and the Social Jetlag frequency in young adults during social distancing because of COVID-19. Methods: This is a cross-sectional study with 308 students aged ≥18 years and with Internet access. Questionnaires used: Pittsburgh Sleep Quality Index - Brazil (PSQI-BR), Epworth Sleepiness Scale, and Munich Chronotype Questionnaire. Results: The mean age of the students was 21 ± 3 years (17 - 42y), with no statistically significant difference between genders. The PSQI-BR indicated that 257 (83.4%) had poor sleep quality. The mean of Social Jetlag for young adults was 02:00 ± 01:49h, and we observed that 16.6% (n = 51) had Social Jetlag. Compared to men in the good sleep quality group, women had higher means for sleep duration on study days and free days, mid-point of sleep on study days and free days and corrected mid-point of sleep on free days. However, when compared to men in the group of poor sleep quality, we observed higher means for women regarding sleep duration on study days, the mid-point of sleep on study days, and the corrected mid-point of sleep on free days. Conclusions: Thus, the high frequency of young adult students who had poor sleep quality associated with Social Jetlag (2 hours) in the present study may reflect a pattern of sleep irregularity, which may be associated with impairment of environmental synchronizers and stimulation of social synchronizers during the lockdown resulting from the COVID-19 pandemic.
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Affiliation(s)
- Cristina Salles
- Bahiana School of Medicine and Public Health, International Center on Clinical Sleep Medicine and Research, Medical Departament, Salvador, Bahia, Brazil
| | - Katie Moraes Almondes
- Bahiana School of Medicine and Public Health, International Center on Clinical Sleep Medicine and Research, Medical Departament, Salvador, Bahia, Brazil
- Department of Psychology and Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, AMBSONO Sleep Clinic, Natal, RN, Brazil
| | - Matheus Araújo
- Bahiana School of Medicine and Public Health, International Center on Clinical Sleep Medicine and Research, Medical Departament, Salvador, Bahia, Brazil
- Bahiana School of Medicine and Public Health, Medical Departament, Salvador, Bahia, Brazil
| | - Iohana Marques
- Bahiana School of Medicine and Public Health, International Center on Clinical Sleep Medicine and Research, Medical Departament, Salvador, Bahia, Brazil
- Bahiana School of Medicine and Public Health, Medical Departament, Salvador, Bahia, Brazil
| | - Lucas Haine Gonzaga
- Bahiana School of Medicine and Public Health, International Center on Clinical Sleep Medicine and Research, Medical Departament, Salvador, Bahia, Brazil
- Bahiana School of Medicine and Public Health, Medical Departament, Salvador, Bahia, Brazil
| | - Miguel Meira-e-Cruz
- Bahiana School of Medicine and Public Health, International Center on Clinical Sleep Medicine and Research, Medical Departament, Salvador, Bahia, Brazil
- Lisbon School of Medicine, Cardiovascular Center of the University of Lisbon, Medical Departament, Lisbon, Portugal, Sleep Unit, Lisbon, Portugal
| | - Carolina Aguiar
- Bahiana School of Medicine and Public Health, International Center on Clinical Sleep Medicine and Research, Medical Departament, Salvador, Bahia, Brazil
- Bahiana School of Medicine and Public Health, Medical Departament, Salvador, Bahia, Brazil
| | - Cristiane Costa Dias
- Bahiana School of Medicine and Public Health, International Center on Clinical Sleep Medicine and Research, Medical Departament, Salvador, Bahia, Brazil
- Bahiana School of Medicine and Public Health, Medical Departament, Salvador, Bahia, Brazil
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Futenma K, Takaesu Y, Komada Y, Shimura A, Okajima I, Matsui K, Tanioka K, Inoue Y. Delayed sleep-wake phase disorder and its related sleep behaviors in the young generation. Front Psychiatry 2023; 14:1174719. [PMID: 37275982 PMCID: PMC10235460 DOI: 10.3389/fpsyt.2023.1174719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 05/08/2023] [Indexed: 06/07/2023] Open
Abstract
Delayed sleep-wake phase disorder (DSWPD) is a sleep disorder in which the habitual sleep-wake timing is delayed, resulting in difficulty in falling asleep and waking up at the desired time. Patients with DSWPD frequently experience fatigue, impaired concentration, sleep deprivation during weekdays, and problems of absenteeism, which may be further complicated by depressive symptoms. DSWPD is typically prevalent during adolescence and young adulthood. Although there are no studies comparing internationally, the prevalence of DSWPD is estimated to be approximately 3% with little racial differences between Caucasians and Asians. The presence of this disorder is associated with various physiological, genetic and psychological as well as behavioral factors. Furthermore, social factors are also involved in the mechanism of DSWPD. Recently, delayed sleep phase and prolonged sleep duration in the young generation have been reported during the period of COVID-19 pandemic-related behavioral restrictions. This phenomenon raises a concern about the risk of a mismatch between their sleep-wake phase and social life that may lead to the development of DSWPD after the removal of these restrictions. Although the typical feature of DSWPD is a delay in circadian rhythms, individuals with DSWPD without having misalignment of objectively measured circadian rhythm markers account for approximately 40% of the cases, wherein the psychological and behavioral characteristics of young people, such as truancy and academic or social troubles, are largely involved in the mechanism of this disorder. Recent studies have shown that DSWPD is frequently comorbid with psychiatric disorders, particularly mood and neurodevelopmental disorders, both of which have a bidirectional association with the pathophysiology of DSWPD. Additionally, patients with DSWPD have a strong tendency toward neuroticism and anxiety, which may result in the aggravation of insomnia symptoms. Therefore, future studies should address the effectiveness of cognitive-behavioral approaches in addition to chronobiological approaches in the treatment of DSWPD.
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Affiliation(s)
- Kunihiro Futenma
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Yoshikazu Takaesu
- Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
| | - Yoko Komada
- Institute for Liberal Arts, Tokyo Institute of Technology, Tokyo, Japan
| | - Akiyoshi Shimura
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| | - Isa Okajima
- Department of Psychological Counseling, Faculty of Humanities, Tokyo Kasei University, Tokyo, Japan
| | - Kentaro Matsui
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Clinical Laboratory, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Sleep-Wake Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Kosuke Tanioka
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
| | - Yuichi Inoue
- Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan
- Department of Somnology, Tokyo Medical University, Tokyo, Japan
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Ali FZ, Parsey RV, Lin S, Schwartz J, DeLorenzo C. Circadian rhythm biomarker from wearable device data is related to concurrent antidepressant treatment response. NPJ Digit Med 2023; 6:81. [PMID: 37120493 PMCID: PMC10148831 DOI: 10.1038/s41746-023-00827-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/11/2023] [Indexed: 05/01/2023] Open
Abstract
Major depressive disorder (MDD) is associated with circadian rhythm disruption. Yet, no circadian rhythm biomarkers have been clinically validated for assessing antidepressant response. In this study, 40 participants with MDD provided actigraphy data using wearable devices for one week after initiating antidepressant treatment in a randomized, double-blind, placebo-controlled trial. Their depression severity was calculated pretreatment, after one week and eight weeks of treatment. This study assesses the relationship between parametric and nonparametric measures of circadian rhythm and change in depression. Results show significant association between a lower circadian quotient (reflecting less robust rhythmicity) and improvement in depression from baseline following first week of treatment (estimate = 0.11, F = 7.01, P = 0.01). There is insufficient evidence of an association between circadian rhythm measures acquired during the first week of treatment and outcomes after eight weeks of treatment. Despite this lack of association with future treatment outcome, this scalable, cost-effective biomarker may be useful for timely mental health care through remote monitoring of real-time changes in current depression.
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Affiliation(s)
- Farzana Z Ali
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA.
| | - Ramin V Parsey
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Radiology, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Shan Lin
- Department of Electrical and Computer Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Joseph Schwartz
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
| | - Christine DeLorenzo
- Department of Biomedical Engineering, Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Renaissance School of Medicine at Stony Brook University, 100 Nicolls Road, Stony Brook, NY, 11794, USA
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
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D'cunha K, Park Y, Protani MM, Reeves MM. Circadian rhythm disrupting behaviours and cancer outcomes in breast cancer survivors: a systematic review. Breast Cancer Res Treat 2023; 198:413-421. [PMID: 36422754 PMCID: PMC10036454 DOI: 10.1007/s10549-022-06792-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 10/30/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE Circadian rhythm disruptors (e.g., night-shift work) are risk factors for breast cancer, however studies on their association with prognosis is limited. A small but growing body of research suggests that altered sleep patterns and eating behaviours are potential mechanistic links between circadian rhythm disruptors and breast cancer. We therefore systematically summarised literature examining the influence of circadian rhythm disrupting behaviours on cancer outcomes in women with breast cancer. METHODS A systematic search of five databases from inception to January 2021 was conducted. Original research published in English, assessing the relationship between post-diagnosis sleep patters and eating behaviours, and breast cancer outcomes were considered. Risk of bias was assessed using the Newcastle-Ottawa Assessment Scale for Cohort Studies. RESULTS Eight studies published original evidence addressing sleep duration and/or quality (k = 7) and, eating time and frequency (k = 1). Longer sleep duration (≥ 9 h versus [referent range] 6-8 h) was consistently associated with increased risk of all outcomes of interest (HR range: 1.37-2.33). There was limited evidence to suggest that measures of better sleep quality are associated with lower risk of all-cause mortality (HR range: 0.29-0.97). Shorter nightly fasting duration (< 13 h versus ≥ 13 h) was associated with higher risk of all breast cancer outcomes (HR range: 1.21-1.36). CONCLUSION Our review suggests that circadian rhythm disrupting behaviours may influence cancer outcomes in women with breast cancer. While causality remains unclear, to further understand these associations future research directions have been identified. Additional well-designed studies, examining other exposures (e.g., light exposure, temporal eating patterns), biomarkers, and patient-reported outcomes, in diverse populations (e.g., breast cancer subtype-specific, socio-demographic diversity) are warranted.
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Affiliation(s)
- Kelly D'cunha
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
| | - Yikyung Park
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO, USA
| | - Melinda M Protani
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Marina M Reeves
- School of Public Health, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
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Campbell I, Sharifpour R, Vandewalle G. Light as a Modulator of Non-Image-Forming Brain Functions—Positive and Negative Impacts of Increasing Light Availability. Clocks Sleep 2023; 5:116-140. [PMID: 36975552 PMCID: PMC10047820 DOI: 10.3390/clockssleep5010012] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 02/17/2023] [Accepted: 03/13/2023] [Indexed: 03/19/2023] Open
Abstract
Light use is rising steeply, mainly because of the advent of light-emitting diode (LED) devices. LEDs are frequently blue-enriched light sources and may have different impacts on the non-image forming (NIF) system, which is maximally sensitive to blue-wavelength light. Most importantly, the timing of LED device use is widespread, leading to novel light exposure patterns on the NIF system. The goal of this narrative review is to discuss the multiple aspects that we think should be accounted for when attempting to predict how this situation will affect the NIF impact of light on brain functions. We first cover both the image-forming and NIF pathways of the brain. We then detail our current understanding of the impact of light on human cognition, sleep, alertness, and mood. Finally, we discuss questions concerning the adoption of LED lighting and screens, which offer new opportunities to improve well-being, but also raise concerns about increasing light exposure, which may be detrimental to health, particularly in the evening.
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Banasiak M, Wilkerson A, Safranek S. Evaluating Occupant Light Exposure and Usage Patterns in an Inpatient Behavioral Health Unit. HERD-HEALTH ENVIRONMENTS RESEARCH & DESIGN JOURNAL 2023; 16:89-108. [PMID: 36855952 PMCID: PMC10133784 DOI: 10.1177/19375867221150226] [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: 03/02/2023]
Abstract
OBJECTIVE To (1) evaluate the use case for tunable lighting in inpatient behavioral health, (2) describe differences in staff lighting exposures between static and tunable lighting conditions using wearable sensors, and (3) document occupant lighting control usage patterns. BACKGROUND Tunable lighting fixtures can vary the amount of light and spectral content, so have been offered as a way to address light and health considerations. Before we can understand potential health benefits of tunable lighting, it is helpful to understand how occupant exposures under tunable lighting differ from those under more traditional lighting systems. METHODS Tunable lighting benefits and challenges for inpatient behavioral health were carefully detailed during design. Light exposure measurements were recorded at an old site with static fluorescent lighting and a new site with tunable light-emitting diode (LED) lighting. Behavioral health inpatient unit staff participants voluntarily wore a light measurement device to estimate light exposure. At the new site, controls usage data were recorded each time a button was pressed on a lighting control station. RESULTS While general observations can be made about the data between sites, there is notable variation at both sites depending on the day and hour. Button press data revealed that occupants used the full capability of the tunable lighting system to support different activities and needs. CONCLUSION Understanding the relationship between occupant well-being and light requires a holistic research approach including thoughtful design accounting for real-world constraints, detailed measurement of light exposure, and understanding how occupants interact and make use of new technology.
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Affiliation(s)
| | | | - Sarah Safranek
- Pacific Northwest National Laboratory, Portland, OR, USA
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45
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Moreno JP, Hannay KM, Goetz AR, Walch O, Cheng P. Validation of the Entrainment Signal Regularity Index and associations with children's changes in BMI. Obesity (Silver Spring) 2023; 31:642-651. [PMID: 36628610 PMCID: PMC9975028 DOI: 10.1002/oby.23641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 10/12/2022] [Accepted: 10/30/2022] [Indexed: 01/12/2023]
Abstract
OBJECTIVE This study examined the validity of a novel metric of circadian health, the Entrainment Signal Regularity Index (ESRI), and its relationship to changes in BMI during the school year and summer. METHODS In a longitudinal observational data set, this study examined the relationship between ESRI score and children's (n = 119, 5- to 8-year-olds) sleep and physical activity levels during the school year and summer, differences in ESRI score during the school year and summer, and the association of ESRI score during the school year and summer with changes in BMI across those time periods. RESULTS The ESRI score was higher during the school year (0.70 ± 0.10) compared with summer (0.63 ± 0.11); t(111) = 5.484, p < 0.001. Whereas the ESRI score at the beginning of the school year did not significantly predict BMI change during the school year (β = 0.05 ± 0.09 SE, p = 0.57), having a higher ESRI score during summer predicted smaller increases in BMI during summer (β = -0.22 ± 0.10 SE, p = 0.03). CONCLUSIONS Overall, children demonstrated higher entrainment regularity during the school year compared with the summer. During summer, having a higher entrainment signal was associated with smaller changes in summertime BMI. This effect was independent of the effects of children's sleep midpoint, sleep regularity, and physical activity on children's BMI.
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Affiliation(s)
- Jennette P. Moreno
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Kevin M. Hannay
- Department of Mathematics, University of Michigan, Ann Arbor, MI, USA
- Arcascope; Chantilly, VA, USA
| | - Amy R. Goetz
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Olivia Walch
- Arcascope; Chantilly, VA, USA
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Philip Cheng
- Sleep Disorders and Research Center, Henry Ford Health, Detroit, MI, USA
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Kamyab P, Kouchaki H, Motamed M, Boroujeni ST, Akbari H, Tabrizi R. Sleep disturbance and gastrointestinal cancer risk: a literature review. J Investig Med 2023; 71:163-172. [PMID: 36645049 DOI: 10.1177/10815589221140595] [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: 01/15/2023]
Abstract
Sleep, accounting for roughly one-third of a person's life, plays an important role in human health. Despite the close association between sleep patterns and medical diseases proven by several studies, it has been neglected in recent years. Presently, all societies are facing the most challenging health-threatening disease, cancer. Among all cancer types, gastrointestinal (GI) cancers, especially colorectal type, seem to be one of the most relevant to an individual's lifestyle; thus, they can be prevented by modifying behaviors most of the time. Previous studies have shown that disruption of the 24-h sleep-wake cycle increases the chance of colorectal cancer, which can be due to exposure to artificial light at night and some complex genetic and hormone-mediated mechanisms. There has also been some evidence showing the possible associations between other aspects of sleep such as sleep duration or some sleep disorders and GI cancer risk. This review brings some information together and presents a detailed discussion of the possible role of sleep patterns in GI malignancy initiation.
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Affiliation(s)
- Parnia Kamyab
- Universal Scientific Education and Research Network, Fasa University of Medical Sciences, Fasa, Iran
| | - Hosein Kouchaki
- Universal Scientific Education and Research Network, Fasa University of Medical Sciences, Fasa, Iran
| | - Mahsa Motamed
- Department of Psychiatry, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Hamed Akbari
- Department of Biochemistry, School of Medicine, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Tabrizi
- Noncommunicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.,Clinical Research Development Unit, Valiasr Hospital, Fasa University of Medical Sciences, Fasa, Iran.,USERN Office, Fasa University of Medical Sciences, Fasa, Iran
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Abstract
SUMMARY Circadian sleep-wake disorders are common. Because they represent conflict between the timing of the patient's endogenous rhythms and desired timing of sleep, the presenting complaints may include both difficulty of sleep initiation or maintenance and undesired or unplanned daytime or early evening sleepiness. Therefore, circadian disorders may be misdiagnosed as either a primary insomnia or a hypersomnia disorder, depending on which complaint is more troublesome for the patient. Objective information about sleep and wake patterns over long periods is crucial for accurate diagnosis. Actigraphy provides long-term information about the rest/activity pattern about an individual. However, caution should be applied in interpretation of the results because the information provided only includes information of movements, and activity is only an indirect circadian phase marker. Timing of light and melatonin therapy is critical for successful treatment of circadian rhythm disorders. Therefore, results of actigraphy are useful and should be used in conjunction with additional measurements, including 24 hours sleep-wake history, sleep log, and melatonin measurements.
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Affiliation(s)
- Alessandra Giordano
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Harvard Medical School, Boston Massachusetts, U.S.A
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48
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Falck RS, Davis JC, Khan KM, Handy TC, Liu-Ambrose T. A Wrinkle in Measuring Time Use for Cognitive Health: How should We Measure Physical Activity, Sedentary Behaviour and Sleep? Am J Lifestyle Med 2023; 17:258-275. [PMID: 36896037 PMCID: PMC9989499 DOI: 10.1177/15598276211031495] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
One new case of dementia is detected every 4 seconds and no effective drug therapy exists. Effective behavioural strategies to promote healthy cognitive ageing are thus essential. Three behaviours related to cognitive health which we all engage in daily are physical activity, sedentary behaviour and sleep. These time-use activity behaviours are linked to cognitive health in a complex and dynamic relationship not yet fully elucidated. Understanding how each of these behaviours is related to each other and cognitive health will help determine the most practical and effective lifestyle strategies for promoting healthy cognitive ageing. In this review, we discuss methods and analytical approaches to best investigate how these time-use activity behaviours are related to cognitive health. We highlight four key recommendations for examining these relationships such that researchers should include measures which (1) are psychometrically appropriate; (2) can specifically answer the research question; (3) include objective and subjective estimates of the behaviour and (4) choose an analytical method for modelling the relationships of time-use activity behaviours with cognitive health which is appropriate for their research question.
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Affiliation(s)
- Ryan S. Falck
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada(RSF, TLA); Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada(RSF, TLA); Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada(RSF, KMK, TLA); Faculty of Management, University of British Columbia–Okanagan, Kelowna, BC, Canada(JCD); Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada(KMK); Attentional Neuroscience Laboratory, Department of Psychology, Faculty of Arts, University of British Columbia, Vancouver, BC, Canada(TCH)
| | - Jennifer C. Davis
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada(RSF, TLA); Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada(RSF, TLA); Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada(RSF, KMK, TLA); Faculty of Management, University of British Columbia–Okanagan, Kelowna, BC, Canada(JCD); Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada(KMK); Attentional Neuroscience Laboratory, Department of Psychology, Faculty of Arts, University of British Columbia, Vancouver, BC, Canada(TCH)
| | - Karim M. Khan
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada(RSF, TLA); Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada(RSF, TLA); Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada(RSF, KMK, TLA); Faculty of Management, University of British Columbia–Okanagan, Kelowna, BC, Canada(JCD); Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada(KMK); Attentional Neuroscience Laboratory, Department of Psychology, Faculty of Arts, University of British Columbia, Vancouver, BC, Canada(TCH)
| | - Todd C. Handy
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada(RSF, TLA); Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada(RSF, TLA); Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada(RSF, KMK, TLA); Faculty of Management, University of British Columbia–Okanagan, Kelowna, BC, Canada(JCD); Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada(KMK); Attentional Neuroscience Laboratory, Department of Psychology, Faculty of Arts, University of British Columbia, Vancouver, BC, Canada(TCH)
| | - Teresa Liu-Ambrose
- Aging, Mobility and Cognitive Neuroscience Laboratory, Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada(RSF, TLA); Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, BC, Canada(RSF, TLA); Center for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada(RSF, KMK, TLA); Faculty of Management, University of British Columbia–Okanagan, Kelowna, BC, Canada(JCD); Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada(KMK); Attentional Neuroscience Laboratory, Department of Psychology, Faculty of Arts, University of British Columbia, Vancouver, BC, Canada(TCH)
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49
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Zhang R, Volkow ND. Seasonality of brain function: role in psychiatric disorders. Transl Psychiatry 2023; 13:65. [PMID: 36813773 PMCID: PMC9947162 DOI: 10.1038/s41398-023-02365-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/24/2023] Open
Abstract
Seasonality patterns are reported in various psychiatric disorders. The current paper summarizes findings on brain adaptations associated with seasonal changes, factors that contribute to individual differences and their implications for psychiatric disorders. Changes in circadian rhythms are likely to prominently mediate these seasonal effects since light strongly entrains the internal clock modifying brain function. Inability of circadian rhythms to accommodate to seasonal changes might increase the risk for mood and behavior problems as well as worse clinical outcomes in psychiatric disorders. Understanding the mechanisms that account for inter-individual variations in seasonality is relevant to the development of individualized prevention and treatment for psychiatric disorders. Despite promising findings, seasonal effects are still understudied and only controlled as a covariate in most brain research. Rigorous neuroimaging studies with thoughtful experimental designs, powered sample sizes and high temporal resolution alongside deep characterization of the environment are needed to better understand the seasonal adaptions of the human brain as a function of age, sex, and geographic latitude and to investigate the mechanisms underlying the alterations in seasonal adaptation in psychiatric disorders.
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Affiliation(s)
- Rui Zhang
- Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD, 20892-1013, USA.
| | - Nora D. Volkow
- grid.94365.3d0000 0001 2297 5165Laboratory of Neuroimaging, National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, MD 20892-1013 USA
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50
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Alonso-Alonso ML, Sampedro-Viana A, Rodríguez-Yáñez M, López-Dequidt I, Pumar JM, Mosqueira AJ, Fernández-Rodicio S, Bazarra-Barreiros M, Sobrino T, Campos F, Castillo J, Hervella P, Iglesias-Rey R. Influence of Temperature Chronobiology on Stroke Outcome. Int J Mol Sci 2023; 24:ijms24043746. [PMID: 36835156 PMCID: PMC9967262 DOI: 10.3390/ijms24043746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/03/2023] [Accepted: 02/09/2023] [Indexed: 02/16/2023] Open
Abstract
The circadian system regulates numerous physiological variables, including body temperature. Additionally, a circadian patter has been described in stroke onset. Considering this, we hypothesised that the chronobiology of temperature may have an impact on stroke onset and functional outcomes. We also studied the variation of blood biomarkers according to stroke onset time. This is a retrospective observational study. Of the patients included, 2763 had a stroke between midnight and 8:00 h; 1571 between 8:00-14:00 h; and 655 between 14:00 h and midnight. Axillary temperature was measured at admission. At this time, blood samples were collected for biomarker analysis (TNF-α, IL-1β, IL-6, IL-10, and glutamate). Temperature was higher in patients admitted from 8:00 h to midnight (p < 0.0001). However, the percentage of poor outcome at 3 months was highest in patients from midnight to 8:00 h (57.7%, p < 0.001). The association between temperature and mortality was highest during night time (OR: 2.79; CI 95%: 2.36-3.28; p < 0.001). These patients exhibited high glutamate (220.2 ± 140.2 µM), IL-6 (32.8 ± 14.3 pg/mL) and low IL-10 (9.7 ± 14.3 pg/mL) levels. Therefore, temperature chronobiology could have a significant impact on stroke onset and functional outcome. Superficial body hyperthermia during sleep seems to be more dangerous than during wakefulness. Further studies will be necessary to confirm our data.
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Affiliation(s)
- Maria Luz Alonso-Alonso
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Ana Sampedro-Viana
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Manuel Rodríguez-Yáñez
- Stroke Unit, Department of Neurology, Hospital Clínico Universitario, 15706 Santiago de Compostela, Spain
| | - Iria López-Dequidt
- Stroke Unit, Department of Neurology, Hospital Clínico Universitario, 15706 Santiago de Compostela, Spain
| | - José M. Pumar
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Department of Neuroradiology, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Antonio J. Mosqueira
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Department of Neuroradiology, Hospital Clínico Universitario, Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Sabela Fernández-Rodicio
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Marcos Bazarra-Barreiros
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Tomás Sobrino
- NeuroAging Group (NEURAL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Francisco Campos
- Translational Stroke Laboratory (TREAT), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - José Castillo
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Pablo Hervella
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
| | - Ramón Iglesias-Rey
- Neuroimaging and Biotechnology Laboratory (NOBEL), Clinical Neurosciences Research Laboratory (LINC), Health Research Institute of Santiago de Compostela (IDIS), 15706 Santiago de Compostela, Spain
- Correspondence:
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