1
|
Garrivet J, d’Ortho MP, Frija-Masson J, Maruani J, Romier A, Stern E, Lejoyeux M, Bourgin P, Geoffroy PA. Images: "Too much heat for my non-24-hour sleep-wake disorder!" A case report. J Clin Sleep Med 2024; 20:329-333. [PMID: 38305229 PMCID: PMC10835780 DOI: 10.5664/jcsm.10858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 10/04/2023] [Accepted: 10/06/2023] [Indexed: 02/03/2024]
Abstract
The non-24-hour sleep-wake disorder (N24SWD) is a rare condition, sometimes associated with blindness or with suprachiasmatic nuclei lesions, resulting in a free-running rhythm or hypernycthemeral syndrome. Synchronizers, such as light, when light perception remains, melatonin, food intakes, physical activity, social interactions, and temperature, play a key role in the treatment of N24SWD. In this report, we describe a case illustrating the impact of outdoor temperature in a 34-year-old man with N24SWD effectively treated through a combination of chronotherapy interventions. During 3 consecutive heat waves, he experienced a recurrence of his natural 25.5-hour free-running rhythm, with a consistent bedtime phase delay caused by temperature, resulting in the discontinuation of chronotherapy. After these heat waves, he was able again to resynchronize his rhythms with the combination of chronotherapeutics. This case report highlights that patients with N24SWD may be particularly at risk of relapse during heat waves, with direct implications for monitoring and reinforcing chronotherapies. CITATION Garrivet J, d'Ortho M-P, Frija-Masson J, et al. "Too much heat for my non-24-hour sleep-wake disorder!" A case report. J Clin Sleep Med. 2024;20(2):329-333.
Collapse
Affiliation(s)
- Julie Garrivet
- Département de Psychiatrie et d’Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat—Claude Bernard, Paris, France
- Département de Physiologie-Explorations Fonctionnelles—Centre du Sommeil, AP-HP, Hôpital Bichat—Claude Bernard, Paris, France
| | - Marie-Pia d’Ortho
- Département de Physiologie-Explorations Fonctionnelles—Centre du Sommeil, AP-HP, Hôpital Bichat—Claude Bernard, Paris, France
- Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris, France
| | - Justine Frija-Masson
- Département de Physiologie-Explorations Fonctionnelles—Centre du Sommeil, AP-HP, Hôpital Bichat—Claude Bernard, Paris, France
- Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris, France
| | - Julia Maruani
- Département de Psychiatrie et d’Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat—Claude Bernard, Paris, France
- Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris, France
- GHU Paris—Psychiatry and Neurosciences, Paris, France
| | - Alix Romier
- Département de Psychiatrie et d’Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat—Claude Bernard, Paris, France
- Département de Physiologie-Explorations Fonctionnelles—Centre du Sommeil, AP-HP, Hôpital Bichat—Claude Bernard, Paris, France
- Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris, France
| | - Emilie Stern
- GHU Paris—Psychiatry and Neurosciences, Paris, France
| | - Michel Lejoyeux
- Département de Psychiatrie et d’Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat—Claude Bernard, Paris, France
- Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris, France
- GHU Paris—Psychiatry and Neurosciences, Paris, France
| | - Patrice Bourgin
- Sleep Disorders Center—CIRCOM (International Research Center for ChronoSomnology), CHRU Strasbourg—Hôpital Civil, Strasbourg, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
| | - Pierre A. Geoffroy
- Département de Psychiatrie et d’Addictologie, AP-HP, GHU Paris Nord, DMU Neurosciences, Hôpital Bichat—Claude Bernard, Paris, France
- Université Paris Cité, NeuroDiderot, Inserm, FHU I2-D2, Paris, France
- GHU Paris—Psychiatry and Neurosciences, Paris, France
- CNRS UPR 3212, Institute for Cellular and Integrative Neurosciences, Strasbourg, France
| |
Collapse
|
2
|
Abstract
Because the endogenous circadian pacemaker is a very strong determinant of alertness/sleep propensity across the 24 h period, its mistiming may contribute to symptoms of insomnia (e.g., difficulties initiating sleep and maintaining sleep) and to the development of insomnia disorder. Despite the separation of insomnia and circadian rhythm disorders in diagnostic nosology implying independent pathophysiology, there is considerable evidence of co-morbidity and interaction between them. Sleep onset insomnia is associated with later timed circadian rhythms and can be treated with morning bright light to shift rhythms to an earlier timing. It is also possible that the causal link may go in both directions and that having a delayed circadian rhythm can result in enough experiences of delayed sleep onset to lead to some conditioned insomnia or insomnia disorder further exacerbating a delayed circadian rhythm. Early morning awakening insomnia is associated with an advanced circadian phase (early timing) and can be treated with evening bright light resulting in a delay of rhythms and an improved ability to sleep later in the morning and to obtain more sleep. There is some evidence suggesting that sleep maintenance insomnia is associated with a blunted amplitude of circadian rhythm that may be treated with increased regularity of sleep and light exposure timing. However, this is an insomnia phenotype that requires considerably more circadian research as well as further insomnia clinical research with the other insomnia phenotypes incorporating circadian timing measures and treatments.
Collapse
Affiliation(s)
- Leon C Lack
- Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Gorica Micic
- Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Nicole Lovato
- Adelaide Institute for Sleep Health, Flinders University, Adelaide, South Australia, Australia
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| |
Collapse
|
3
|
He SK, Wang JH, Li T, Yin S, Cui JW, Xiao YF, Tang Y, Wang J, Bai YJ. Sleep and circadian rhythm disturbance in kidney stone disease: a narrative review. Front Endocrinol (Lausanne) 2023; 14:1293685. [PMID: 38089624 PMCID: PMC10711275 DOI: 10.3389/fendo.2023.1293685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
The circadian rhythm generated by circadian clock genes functions as an internal timing system. Since the circadian rhythm controls abundant physiological processes, the circadian rhythm evolved in organisms is salient for adaptation to environmental change. A disturbed circadian rhythm is a trigger for numerous pathological events. Recently, accumulated data have indicated that kidney stone disease (KSD) is related to circadian rhythm disturbance. However, the mechanism between them has not been fully elucidated. In this narrative review, we summarized existing evidence to illustrate the possible association between circadian rhythm disturbance and KSD based on the epidemiological studies and risk factors that are linked to circadian rhythm disturbance and discuss some chronotherapies for KSD. In summary, KSD is associated with systemic disorders. Metabolic syndrome, inflammatory bowel disease, and microbiome dysbiosis are the major risk factors supported by sufficient data to cause KSD in patients with circadian rhythm disturbance, while others including hypertension, vitamin D deficiency, parathyroid gland dysfunction, and renal tubular damage/dysfunction need further investigation. Then, some chronotherapies for KSD were confirmed to be effective, but the molecular mechanism is still unclear.
Collapse
Affiliation(s)
- Si-Ke He
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jia-Hao Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Li
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Shan Yin
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jian-Wei Cui
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yun-Fei Xiao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yin Tang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jia Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yun-Jin Bai
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
4
|
Kokash A, Vendrame M. Images: Irregular sleep-wake rhythm disorder in transgender individuals. J Clin Sleep Med 2023; 19:1981-1984. [PMID: 37485693 PMCID: PMC10620650 DOI: 10.5664/jcsm.10700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 06/11/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023]
Abstract
Growing evidence suggests that transgender individuals face a significant health disparity and are particularly vulnerable to sleep disorders. We present two patients who developed irregular sleep-wake rhythm disorder after gender reassignment and hormone replacement therapy. The growing interest in transgender health warrants further evaluation of the effects and frequency of all sleep disorders in this population. Efforts to address sleep disorders should consider assessing sleep disturbance in terms of sleep/wake patterns and schedules. CITATION Kokash A, Vendrame M. Images: irregular sleep-wake rhythm disorder in transgender individuals. J Clin Sleep Med. 2023;19(11):1981-1984.
Collapse
Affiliation(s)
- Atef Kokash
- Lehigh Valley Fleming Neuroscience Institute, Lehigh Valley Health Network, Allentown, Pennsylvania
| | - Martina Vendrame
- Lehigh Valley Fleming Neuroscience Institute, Lehigh Valley Health Network, Allentown, Pennsylvania
| |
Collapse
|
5
|
van Andel E, Bijlenga D, Vogel SWN, Beekman ATF, Kooij JJS. Attention-Deficit/Hyperactivity Disorder and Delayed Sleep Phase Syndrome in Adults: A Randomized Clinical Trial on the Effects of Chronotherapy on Sleep. J Biol Rhythms 2022; 37:673-689. [PMID: 36181304 DOI: 10.1177/07487304221124659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Delayed sleep phase syndrome (DSPS) is the most common sleep disturbance in adults with attention-deficit/hyperactivity disorder (ADHD). We previously showed that chronotherapy with melatonin effectively advanced the dim-light melatonin onset (DLMO), a biomarker for the internal circadian rhythm, by 1.5 h and reduced ADHD symptoms by 14%. Melatonin combined with bright light therapy (BLT) advanced the DLMO by 2 h, but did not affect ADHD symptoms. This article explores whether sleep times advanced along with DLMO, leading to longer sleep duration and better sleep in general, which might explain the working mechanism behind the reduction in ADHD symptoms after treatment with melatonin. This article presents exploratory secondary analysis on objective and self-reported sleep characteristics from a three-armed double-blind randomized placebo-controlled clinical trial (RCT), which included 49 adults (18-55 years) with ADHD and DSPS. Participants were randomized to receive sleep education and 3 weeks of (1) 0.5 mg/day placebo, (2) 0.5 mg/day melatonin, or (3) 0.5 mg/day melatonin plus 30 min of bright light therapy (BLT) between 0700 and 0800 h. Sleep was assessed at baseline, directly after treatment, and 2 weeks after the end of treatment. Objective measures were obtained by actigraphy, self-reported measures by various sleep questionnaires and a sleep diary. Melatonin with or without BLT did not advance sleep times, improve sleep in general, or strengthen wake-activity rhythms. So even though the DLMO had advanced, sleep timing did not follow. Adding extensive behavioral coaching to chronotherapy is necessary for advancing sleep times along with DLMO and to further alleviate ADHD symptoms.
Collapse
Affiliation(s)
- Emma van Andel
- PsyQ, Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Denise Bijlenga
- PsyQ, Expertise Center Adult ADHD, The Hague, The Netherlands
- Sleep-Wake Center SEIN, Heemstede, The Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Suzan W N Vogel
- PsyQ, Expertise Center Adult ADHD, The Hague, The Netherlands
| | - Aartjan T F Beekman
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - J J Sandra Kooij
- PsyQ, Expertise Center Adult ADHD, The Hague, The Netherlands
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
6
|
Shimura A, Kanno T, Inoue T. Ultra-low-dose early night ramelteon administration for the treatment of delayed sleep-wake phase disorder: case reports with a pharmacological review. J Clin Sleep Med 2022; 18:2861-2865. [PMID: 35929592 PMCID: PMC9713914 DOI: 10.5664/jcsm.10188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/27/2022] [Accepted: 06/29/2022] [Indexed: 12/14/2022]
Abstract
Delayed sleep-wake phase disorder (DSWPD) is a common circadian sleep-wake phase disorders brings serious social impairment of the patients. Melatonin is the main medication option; however, it has not been approved in some countries, and over-the-counter melatonin is under poor quality control. The melatonin receptor agonist ramelteon might be a potential treatment option, but there are few reports regarding its use in DSWPD patients. Existing pharmacological and chronobiological studies suggest that an ultra-low dose of ramelteon in the early night is beneficial for DSWPD. Here, we present our clinical experience together with a pharmacological review and discussion. Twenty-three DSWPD patients, of whom 18 patients had a treatment history of a normal dose of ramelteon, were prescribed low-dose ramelteon (median: 0.571 mg, 1/14 of a tablet) to be taken in the early night (mean: 18:10). After the treatment, the mean sleep schedule was significantly advanced, and clinical symptoms were improved. CITATION Shimura A, Kanno T, Inoue T. Ultra-low-dose early night ramelteon administration for the treatment of delayed sleep-wake phase disorder: case reports with a pharmacological review. J Clin Sleep Med. 2022;18(12):2861-2865.
Collapse
Affiliation(s)
- Akiyoshi Shimura
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
- Department of Sleep and Psychiatry, Kanno Hospital, Saitama, Japan
- Neuropsychiatric Research Center, Tokyo, Japan
| | - Takashi Kanno
- Department of Sleep and Psychiatry, Kanno Hospital, Saitama, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, Tokyo, Japan
| |
Collapse
|
7
|
Emens JS, St Hilaire MA, Klerman EB, Brotman DJ, Lin AL, Lewy AJ, Czeisler CA. Behaviorally and environmentally induced non-24-hour sleep-wake rhythm disorder in sighted patients. J Clin Sleep Med 2022; 18:453-459. [PMID: 34402783 PMCID: PMC8805008 DOI: 10.5664/jcsm.9612] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 02/03/2023]
Abstract
STUDY OBJECTIVES To determine whether there was evidence of circadian or sleep-regulatory dysfunction in sighted individuals with non-24-hour sleep-wake rhythm disorder. METHODS Three sighted individuals with signs and/or symptoms of non-24-hour sleep-wake rhythm disorder were studied. Thirty-five- to 332-day laboratory and home-based assessments of sleep-wake and circadian timing, endogenous circadian period, photic input to the circadian pacemaker, and/or circadian and sleep-wake-dependent regulation of sleep were conducted. RESULTS No evidence of circadian dysfunction was found in these individuals. Instead, sleep-wake timing appeared to dissociate from the circadian timing system, and/or self-selected sleep-wake and associated light/dark timing shifted the circadian pacemaker later, rather than the circadian pacemaker determining sleep-wake timing. CONCLUSIONS These findings suggest that the etiology of this disorder may be light- and/or behaviorally induced in some sighted people, which has implications for the successful treatment of this disorder. CITATION Emens JS, St Hilaire MA, Klerman EB, et al. Behaviorally and environmentally induced non-24-hour sleep-wake rhythm disorder in sighted patients. J Clin Sleep Med. 2022;18(2):453-459.
Collapse
Affiliation(s)
- Jonathan S. Emens
- Veterans Affairs Portland Health Care System, Division of Mental Health and Clinical Neurosciences, Portland, Oregon
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
- Oregon Institute of Occupational Health Sciences, Portland, Oregon
| | - Melissa A. St Hilaire
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth B. Klerman
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
- Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
| | - Daniel J. Brotman
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Amber L. Lin
- School of Public Health, Oregon Health & Science University, Portland, Oregon
| | - Alfred J. Lewy
- Department of Psychiatry, Oregon Health & Science University, Portland, Oregon
| | - Charles A. Czeisler
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
8
|
Huang X, Chen X, Zhao S, Hou J, Huang L, Xu J, Wang W, He M, Shen O, Zhang J. Metabolomic Profiles of Shift Workers and Day Workers: A Cross-Sectional Study. Obesity (Silver Spring) 2021; 29:1074-1082. [PMID: 34029446 DOI: 10.1002/oby.23164] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The purpose of this study was to characterize the metabolomic profiles of shift workers and day workers and to discover the effect of shift work on workers' metabolic health. METHODS A total of 824 participants aged 25 to 55 years were recruited, and 485 (275 shift workers and 210 day workers) completed the study. The mean age of the shift workers was 37.32 (5.53) years old, and that of day workers was 36.50 (7.83) years old. Serum and salivary samples were collected for the detection of key biochemical indicators (melatonin, cholesterol, and low-density lipoprotein cholesterol) and for metabolome profile analyses. RESULTS Compared with female day workers, female shift workers had a higher BMI, waist circumference, and hip circumference. Correspondingly, we identified 76 significant metabolites (false discovery rate < 0.05) in shift workers, including L-tryptophan, acylcarnitines, and several fatty acids. Three pathways that presented significant differences were biosynthesis of unsaturated fatty acids, linoleic acid metabolism, and ubiquinone and other terpenoid-quinone biosynthesis. CONCLUSIONS Compared with day workers, shift workers were more prone to weight gain and central obesity and were at a higher risk for impaired lipid metabolism with disrupted circadian rhythms.
Collapse
Affiliation(s)
- Xinru Huang
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Xiaoyi Chen
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Shiyu Zhao
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Jiaojiao Hou
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Li Huang
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Jie Xu
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Wei Wang
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Mengting He
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
| | - Ouxi Shen
- Department of Occupational Health, Suzhou Industrial Park Center for Disease Control and Prevention, Suzhou, Jiangsu, China
| | - Jie Zhang
- Department of Toxicology, School of Public Health, Medical College of Soochow University, Suzhou, Jiangsu, China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou, Jiangsu, China
| |
Collapse
|
9
|
Rizza S, Longo S, Piciucchi G, Romanello D, Mavilio M, Montagna M, Coppeta L, Martelli E, Magrini A, Federici M. Carotid intimal medial thickness in rotating night shift is related to IL1β/IL6 axis. Nutr Metab Cardiovasc Dis 2020; 30:1826-1832. [PMID: 32665209 DOI: 10.1016/j.numecd.2020.05.028] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/24/2020] [Accepted: 05/27/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Sleep disturbances may promote glucose abnormalities and inflammatory burden among shift workers. Therefore, precocious subclinical atherosclerotic process might develop in healthy shift workers even without known metabolic and cardiovascular risk factors. METHODS AND RESULTS We measured anthropometric parameters, glucose, lipids, inflammation and common carotid Intimal Medial Thickness (cIMT) in rotating-night shift workers (r-NSW, n = 88, age = 40.3 ± 7.8 y) in comparison with former-night shift workers (f-NSW, n = 35, age = 44.2 ± 6.4 y) and with day-only workers (DW, n = 64, age = 44.1 ± 8.9 y). R-NSW and f-NSW showed significantly higher cIMT and high sensitivity C-Reactive Protein (hs-CRP) respect to DW (p = 0.043 and p = 0.025, respectively). IL-1β levels were higher in r-NSW than in DW and f-NSW (p = 0.043) and significantly correlated with IL6 (r = 0.365, p < 0.001). In addition, r-NSW and f-NSW had higher HbA1c levels in comparison with DW (p = 0.047). Carotid-IMT was significantly related to night shift work (p = 0.023), with age (p < 0.001), with HOMA IR (p = 0.009), with insulin (p = 0.006) with HbA1c (p = 0.002), with LDL cholesterol (p < 0.001), with diastolic BP (p < 0.001), with WBC (p = 0.002) and with IL6 (p = 0.004). After performing a multivariate analysis night shift work remained statistically related to cIMT (B = 2.633, 95%CI = 0.489-4.776, p = 0.016). CONCLUSIONS Our result described a possible link bridging night shift work, inflammation and carotid Intimal Medial Thickness. Future studies are warranted to understand if carotid atherosclerosis process should be mainly driven by the IL1β/IL6 citokine axis connected to sleep disturbances.
Collapse
Affiliation(s)
- Stefano Rizza
- Department of Systems Medicine, University of Rome Tor Vergata, Italy.
| | - Susanna Longo
- Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Giacomo Piciucchi
- Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Daniele Romanello
- Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Maria Mavilio
- Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Martina Montagna
- Department of Systems Medicine, University of Rome Tor Vergata, Italy
| | - Luca Coppeta
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Eugenio Martelli
- Division of Vascular Surgery, Department of Medical, Surgical, and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Andrea Magrini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Massimo Federici
- Department of Systems Medicine, University of Rome Tor Vergata, Italy
| |
Collapse
|
10
|
Abstract
PURPOSE OF REVIEW To integrate evidence on the role of circadian rhythm in male reproduction. Several studies report on various aspects of the association between the circadian system and male reproductive function in animals and humans both in physiological condition as well as in the case of subfertility. RECENT FINDINGS Epidemiological data demonstrate diurnal and seasonal changes as well as the effect of sleep/wake cycles on the quality of semen. Rare and common genetic variation in circadian clock genes in humans and animal models support the role of circadian rhythms in male fertility in humans. SUMMARY Current data support the modest effect of the circadian clock on male reproductive potential; however, the evidence available is still fragmented and inconclusive. Additional well designed and sufficiently powered studies are needed to delineate the role of the circadian clock both in cause and potential interventional and preventive approaches in male subfertility.
Collapse
Affiliation(s)
- Ana Peterlin
- Faculty of Medicine, Institute of Histology and Embryology
| | - Tanja Kunej
- Department of Animal Science, Biotechnical Faculty, University of Ljubljana
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
11
|
Abstract
PURPOSE OF REVIEW In recent years, new studies have investigated the role and influence of sleep on female fertility and early pregnancy outcomes, providing a growing body of knowledge demonstrating how regulation by sleep of hormones are important to reproduction, and how disruptions in sleep, circadian rhythms, and genes regulating circadian rhythmicity can negatively impact fertility and early pregnancy outcomes. This review aims to summarize the most recent research on the relationship among circadian rhythms, fertility, and early pregnancy outcomes in women, and to explore possible fertility interventions. RECENT FINDINGS Recent studies have found altered levels of FSH, LH, and prolactin with sleep disturbance or circadian dysrhythmia. Disruption of circadian rhythms in the form of shift work, jet lag, and daylight savings time changes have been associated with poorer fertility and early pregnancy outcomes. Alterations in the expression of circadian rhythm-regulating circadian locomotor output cycles kaput (CLOCK) genes have been associated with decreased fertility and increased rates of miscarriage. SUMMARY Overall, undisrupted sleep and circadian rhythmicity appear to optimize fertility and early pregnancy outcomes and may play an important role in the success of fertility treatment.
Collapse
Affiliation(s)
- Jacqueline Mills
- Department of Obstetrics and Gynecology, Boston Medical Center, Boston, Massachusetts, USA
| | | |
Collapse
|
12
|
Simon SL, McWhirter L, Diniz Behn C, Bubar KM, Kaar JL, Pyle L, Rahat H, Garcia-Reyes Y, Carreau AM, Wright KP, Nadeau KJ, Cree-Green M. Morning Circadian Misalignment Is Associated With Insulin Resistance in Girls With Obesity and Polycystic Ovarian Syndrome. J Clin Endocrinol Metab 2019; 104:3525-3534. [PMID: 30888398 PMCID: PMC6610211 DOI: 10.1210/jc.2018-02385] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 03/13/2019] [Indexed: 02/08/2023]
Abstract
CONTEXT To our knowledge, circadian rhythms have not been examined in girls with polycystic ovarian syndrome (PCOS), despite the typical delayed circadian timing of adolescence, which is an emerging link between circadian health and insulin sensitivity (SI), and decreased SI in PCOS. OBJECTIVE To examine differences in the circadian melatonin rhythm between obese adolescent girls with PCOS and control subjects, and evaluate relationships between circadian variables and SI. DESIGN Cross-sectional study. PARTICIPANTS Obese adolescent girls with PCOS (n = 59) or without PCOS (n = 33). OUTCOME MEASURES Estimated sleep duration and timing from home actigraphy monitoring, in-laboratory hourly sampled dim-light, salivary-melatonin and fasting hormone analysis. RESULTS All participants obtained insufficient sleep. Girls with PCOS had later clock-hour of melatonin offset, later melatonin offset relative to sleep timing, and longer duration of melatonin secretion than control subjects. A later melatonin offset after wake time (i.e., morning wakefulness occurring during the biological night) was associated with higher serum free testosterone levels and worse SI regardless of group. Analyses remained significant after controlling for daytime sleepiness and sleep-disordered breathing. CONCLUSION Circadian misalignment in girls with PCOS is characterized by later melatonin offset relative to clock time and sleep timing. Morning circadian misalignment was associated with metabolic dysregulation in girls with PCOS and obesity. Clinical care of girls with PCOS and obesity would benefit from assessment of sleep and circadian health. Additional research is needed to understand mechanisms underlying the relationship between morning circadian misalignment and SI in this population.
Collapse
Affiliation(s)
- Stacey L Simon
- Division of Pulmonary Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, Colorado
| | - Laura McWhirter
- Division of Pulmonary Medicine, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, Colorado
| | - Cecilia Diniz Behn
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, Colorado
- Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, Colorado
| | - Kate M Bubar
- Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, Colorado
| | - Jill L Kaar
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, Colorado
| | - Laura Pyle
- Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, Colorado
| | - Haseeb Rahat
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, Colorado
| | - Yesenia Garcia-Reyes
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, Colorado
| | - Anne-Marie Carreau
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, Colorado
| | - Kenneth P Wright
- Sleep and Chronobiology Laboratory, Department of Integrative Physiology, University of Colorado Boulder, Boulder, Colorado
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Kristen J Nadeau
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, Colorado
- Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Melanie Cree-Green
- Division of Endocrinology, Department of Pediatrics, University of Colorado Anschutz Medical Campus and Children’s Hospital Colorado, Aurora, Colorado
- Center for Women’s Health Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| |
Collapse
|
13
|
Rudin-Brown CM, Harris S, Rosberg A. How shift scheduling practices contribute to fatigue amongst freight rail operating employees: Findings from Canadian accident investigations. Accid Anal Prev 2019; 126:64-69. [PMID: 29397875 DOI: 10.1016/j.aap.2018.01.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 01/08/2018] [Accepted: 01/19/2018] [Indexed: 06/07/2023]
Abstract
Canada's freight rail system moves 70% of the country's surface goods and almost half of all exports (RAC, 2016). These include dangerous goods. Anonymous survey of freight rail operating employees conducted by the Teamsters Canada Rail Conference (TCRC, 2014) revealed that many do not report getting enough sleep because of their work schedules, and that fatigue may be affecting their performance at work. Besides general impairments in attention and cognitive functioning, fatigue in railway operating employees slows reaction time to safety alarms and impairs conformance to train operating requirements. Shift scheduling practices can contribute to sleep-related fatigue by restricting sleep opportunities, requiring extended periods of wakefulness and by disrupting daily (circadian) rhythms. The primary goal of accident investigation is to identify causal and contributing factors so that similar occurrences can be prevented. A database search of Transportation Safety Board (TSB) rail investigation reports published in the 21-year period from 1995 to 2015 identified 18 that cited sleep-related fatigue of freight rail operating employees as a causal, contributing, or risk finding. This number represents about 20% of TSB rail investigations from the same period in which a human factors aspect of freight train activities was a primary cause. Exploration of accident themes suggests that management of fatigue and shift scheduling in the freight rail industry is a complex issue that is often not conducive to employee circadian rhythms and sleep requirements. It also suggests that current shift scheduling and fatigue management practices may be insufficient to mitigate the associated safety risk. Railway fatigue management systems that are based on the principles of modern sleep science are needed to improve scheduling practices and mitigate the ongoing safety risk.
Collapse
Affiliation(s)
- Christina M Rudin-Brown
- Human Factors and Macro Analysis Group, Transportation Safety Board of Canada, 200 Promenade du Portage, 4th Floor, Gatineau, QC, K1A 1K8, Canada.
| | - Sarah Harris
- Human Factors and Macro Analysis Group, Transportation Safety Board of Canada, 200 Promenade du Portage, 4th Floor, Gatineau, QC, K1A 1K8, Canada.
| | - Ari Rosberg
- Human Factors and Macro Analysis Group, Transportation Safety Board of Canada, 200 Promenade du Portage, 4th Floor, Gatineau, QC, K1A 1K8, Canada.
| |
Collapse
|
14
|
Abstract
The impact of shift work on sleep and health has been examined in the past, but most studies utilized cross-sectional designs relying on between-subject differences. The purpose this study was to examine the within-subject differences in self-report measures of health and wellness among a group of nurses engaged in rotating shifts. Patient-Reported Outcomes Measurement Information System (PROMIS) measures, collected post-day and post-night shift, were used to assess health, sleep disturbances and sleep-related impairment, fatigue, emotional distress (anger), satisfaction with social roles outside of work, and applied cognitive abilities. Among the sample of 23 White, mostly female (91.3%) nurses, all PROMIS measures were worse indicting lower health and wellness after working night shifts compare to after working day shifts ( p values from .167 to < .001). During both time points of assessment, sleep-related impairment was highly correlated with greater emotional distress, greater fatigue, and worse memory and concentration. Study findings support prior studies that shift work can negatively impact health and wellness.
Collapse
Affiliation(s)
- Christopher C. Imes
- University of Pittsburgh School of Nursing, Department of Acute and Tertiary Care
| | - Eileen R. Chasens
- University of Pittsburgh School of Nursing, Department of Health & Community Systems
| |
Collapse
|
15
|
Abstract
Many processes in the human body - including brain function - are regulated over the 24-hour cycle, and there are strong associations between disrupted circadian rhythms (for example, sleep-wake cycles) and disorders of the CNS. Brain disorders such as autism, depression and Parkinson disease typically develop at certain stages of life, and circadian rhythms are important during each stage of life for the regulation of processes that may influence the development of these disorders. Here, we describe circadian disruptions observed in various brain disorders throughout the human lifespan and highlight emerging evidence suggesting these disruptions affect the brain. Currently, much of the evidence linking brain disorders and circadian dysfunction is correlational, and so whether and what kind of causal relationships might exist are unclear. We therefore identify remaining questions that may direct future research towards a better understanding of the links between circadian disruption and CNS disorders.
Collapse
Affiliation(s)
- Ryan W Logan
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA
| | - Colleen A McClung
- University of Pittsburgh School of Medicine, Department of Psychiatry, Pittsburgh, PA, USA.
| |
Collapse
|
16
|
Bradford H. Soaking Up the Warmth While Enduring a Little Heat in the Transition From Clinical Practice to Teaching. Nurs Womens Health 2018; 22:510-512. [PMID: 30509363 DOI: 10.1016/j.nwh.2018.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Indexed: 06/09/2023]
|
17
|
Booker LA, Magee M, Rajaratnam SMW, Sletten TL, Howard ME. Individual vulnerability to insomnia, excessive sleepiness and shift work disorder amongst healthcare shift workers. A systematic review. Sleep Med Rev 2018; 41:220-233. [PMID: 29680177 DOI: 10.1016/j.smrv.2018.03.005] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 03/16/2018] [Accepted: 03/21/2018] [Indexed: 12/21/2022]
Abstract
Shift workers often experience reduced sleep quality, duration and/or excessive sleepiness due to the imposed conflict between work and their circadian system. About 20-30% of shift workers experience prominent insomnia symptoms and excessive daytime sleepiness consistent with the circadian rhythm sleep disorder known as shift work disorder. Individual factors may influence this vulnerability to shift work disorder or sleep-related impairment associated with shift work. This paper was registered with Prospero and was conducted using recommended standards for systematic reviews and meta-analyses. Published literature that measured sleep-related impairment associated with shift work including reduced sleep quality and duration and increased daytime sleepiness amongst healthcare shift workers and explored characteristics associated with individual variability were reviewed. Fifty-eight studies were included. Older age, morning-type, circadian flexibility, being married or having children, increased caffeine intake, higher scores on neuroticism and lower on hardiness were related to a higher risk of sleep-related impairment in response to shift work, whereas physical activity was a protective factor. The review highlights the diverse range of measurement tools used to evaluate the impact of shift work on sleep. Use of standardised and validated tools would enable cross-study comparisons. Longitudinal studies are required to establish causal relationships between individual factors and the development of shift work disorder.
Collapse
Affiliation(s)
- Lauren A Booker
- Institute for Breathing and Sleep, Austin Health, Austin Hospital, Heidelberg, Victoria, Australia; School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.
| | - Michelle Magee
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Shantha M W Rajaratnam
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Tracey L Sletten
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
| | - Mark E Howard
- Institute for Breathing and Sleep, Austin Health, Austin Hospital, Heidelberg, Victoria, Australia; School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia; Department of Medicine, University of Melbourne, Parkville, Victoria, Australia
| |
Collapse
|
18
|
Lemke MK, Apostolopoulos Y, Hege A, Newnam S, Sönmez S. Can subjective sleep problems detect latent sleep disorders among commercial drivers? Accid Anal Prev 2018; 115:62-72. [PMID: 29549772 DOI: 10.1016/j.aap.2018.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 01/31/2018] [Accepted: 03/06/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Long-haul truck drivers experience poor sleep health and heightened accident rates, and undiagnosed sleep disorders contribute to these negative outcomes. Subjective sleep disorder screening tools may aid in detecting drivers' sleep disorders. This study sought to evaluate the value of subjective screening methods for detecting latent sleep disorders and identifying truck drivers at-risk for poor sleep health and safety-relevant performance. MATERIALS AND METHODS Using cross-sectional data from 260 long-haul truck drivers, we: 1) used factor analysis to identify possible latent sleep disorders; 2) explored the construct validity of extracted sleep disorder factors by determining their associations with established sleep disorder risk factors and symptoms; and 3) explored the predictive validity of resulting sleep disorder factors by determining their associations with sleep health and safety-relevant performance. RESULTS Five latent sleep disorder factors were extracted: 1) circadian rhythm sleep disorders; 2) sleep-related breathing disorders; 3) parasomnias; 4) insomnias; 5) and sleep-related movement disorders. Patterns of associations between these factors generally corresponded with known risk factors and symptoms. One or more of the extracted latent sleep disorder factors were significantly associated with all the sleep health and safety outcomes. DISCUSSION Using subjective sleep problems to detect latent sleep disorders among long-haul truck drivers may be a timely and effective way to screen this highly mobile occupational segment. This approach should constitute one component of comprehensive efforts to diagnose and treat sleep disorders among commercial transport operators.
Collapse
Affiliation(s)
- Michael K Lemke
- Complexity & Computational Population Health Group, Department of Kinesiology and Health Science, Stephen F. Austin State University, P.O. Box 13015, Nacogdoches, TX, 75962, USA.
| | - Yorghos Apostolopoulos
- Complexity & Computational Population Health Group, Department of Health & Kinesiology, Texas A&M University, 4243 TAMU, College Station, TX, 77843-4243, USA.
| | - Adam Hege
- Department of Health & Exercise Science, Appalachian State University, 111 Rivers Street, Boone, NC, 28608, USA.
| | - Sharon Newnam
- Accident Research Centre, Monash University, 21 Alliance Lane, Clayton, VIC, 3800, Australia.
| | - Sevil Sönmez
- Rosen College of Hospitality Management, University of Central Florida, 9907 Universal Blvd., Orlando, FL, 32819, USA.
| |
Collapse
|
19
|
Wallace DD, Boynton MH, Lytle LA. Multilevel analysis exploring the links between stress, depression, and sleep problems among two-year college students. J Am Coll Health 2017; 65:187-196. [PMID: 27937737 PMCID: PMC5373919 DOI: 10.1080/07448481.2016.1269111] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVE This study explored the association of stress and depression with a multidimensional sleep problems construct in a sample of 2-year college students. PARTICIPANTS The sample consisted of 440 students enrolled in 2-year study from Fall 2011 to Fall 2013. METHODS Participants in an obesity prevention study completed surveys assessing sleep, stress, and depression at baseline, 4, 12, and 24 months. Multilevel models predicting sleep problems were conducted to distinguish episodic from chronic reports of stress and depression. RESULTS Participants were primarily women (68%), white (73%), young adults (M age = 22.8), with an average of 8.4 hours of sleep per night. Neither stress nor depression was predictive of sleep quantity; however, they were predictive of sleep quality. CONCLUSIONS Results show that sleep quality rather than sleep quantity may be the greater health concern for young adults, suggesting that intervention programs targeting depression, stress management, and healthy sleep patterns are warranted.
Collapse
Affiliation(s)
- Deshira D Wallace
- a Department of Health Behavior , School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Marcella H Boynton
- a Department of Health Behavior , School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
- b Lineberger Comprehensive Cancer Center , University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| | - Leslie A Lytle
- a Department of Health Behavior , School of Global Public Health, University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
| |
Collapse
|
20
|
Takaesu Y, Inoue Y, Murakoshi A, Komada Y, Otsuka A, Futenma K, Inoue T. Prevalence of Circadian Rhythm Sleep-Wake Disorders and Associated Factors in Euthymic Patients with Bipolar Disorder. PLoS One 2016; 11:e0159578. [PMID: 27442503 PMCID: PMC4956158 DOI: 10.1371/journal.pone.0159578] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 07/04/2016] [Indexed: 11/26/2022] Open
Abstract
Recent studies have suggested that there are certain pathophysiological relationships between bipolar disorder (BD) and circadian rhythm dysfunction. However, apparently no studies have clarified the prevalence of circadian rhythm sleep-wake disorders (CRSWD) in patients with BD. This study was set out to investigate the prevalence of CRSWD and associated factors in patients with BD. One hundred four euthymic BD outpatients participated in this study. The subjects were asked to answer questionnaires including demographic variables, clinical course of BD, and family history of psychiatric disorders and suicide. Severity of BD was assessed by the Montgomery-Åsberg Depression Rating Scale and Young Mania Rating Scale. CRSWD was diagnosed by clinical interview, together with sleep logs, according to the International Classification of Sleep Disorders, third edition (ICSD-3). Thirty-five subjects (32.4%) met the criteria for CRSWD. The age at the time of investigation and that at the onset of BD were both lower in the CRSWD group than in the non-CRSWD group. The rates of family history of psychiatric disorders and suicide in the CRSWD group were higher than those in the non-CRSWD group. Multiple logistic regression analysis revealed that the presence of CRSWD was significantly associated with younger onset age of BD and family history of suicide. The prevalence of CRSWD could be quite high in BD patients. Younger onset age of BD and family history of suicide were associated with presence of CRSWD in BD patients.
Collapse
Affiliation(s)
- Yoshikazu Takaesu
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160–0023, Japan
- * E-mail:
| | - Yuichi Inoue
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160–0023, Japan
- Department of Somnology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160–0023, Japan
| | - Akiko Murakoshi
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160–0023, Japan
| | - Yoko Komada
- Department of Somnology, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160–0023, Japan
| | - Ayano Otsuka
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160–0023, Japan
| | - Kunihiro Futenma
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160–0023, Japan
| | - Takeshi Inoue
- Department of Psychiatry, Tokyo Medical University, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160–0023, Japan
| |
Collapse
|
21
|
Takahashi M, Matsudaira K, Shimazu A. Disabling low back pain associated with night shift duration: sleep problems as a potentiator. Am J Ind Med 2015; 58:1300-10. [PMID: 26122920 DOI: 10.1002/ajim.22493] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2015] [Indexed: 01/28/2023]
Abstract
BACKGROUND We investigated how night shift duration and sleep problems were jointly associated with disabling low back pain (LBP) among workers in different occupations. METHODS An online-survey was conducted regarding work schedules, disabling LBP, sleep problems, and other relevant factors in 5,008 workers who were randomly selected from a market research panel. Multiple logistic regression analyses determined the joint associations of night shift duration (0 [permanent day shift], <8, 8-9.9, 10-15.9, ≥16 hr) and sleep problems (no, yes) with disabling LBP adjusted for potential confounders. RESULTS A night shift ≥16 hr was associated with a significant increase in the likelihood of disabling LBP. The magnitude of this association was elevated when participants perceived sleep problems including both sleep duration and quality. CONCLUSION Associations between extended night shifts and disabling LBP became stronger in the presence of short or poor quality sleep.
Collapse
Affiliation(s)
- Masaya Takahashi
- National Institute of Occupational Safety and Health, Tama-ku, Kawasaki, Japan
| | - Ko Matsudaira
- Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, Faculty of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
- Clinical Research Center for Occupational Musculoskeletal Disorders, Kanto Rosai Hospital, Nakahara-ku, Kawasaki, Japan
| | - Akihito Shimazu
- Department of Mental Health, The University of Tokyo, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
22
|
Affiliation(s)
- Sohinee Bhattacharya
- University of Aberdeen, Dugald Baird Centre for Research on Women's Health, Aberdeen Maternity Hospital, Aberdeen, UK
| |
Collapse
|
23
|
Barger LK, Rajaratnam SM, Wang W, O'Brien CS, Sullivan JP, Qadri S, Lockley SW, Czeisler CA. Common sleep disorders increase risk of motor vehicle crashes and adverse health outcomes in firefighters. J Clin Sleep Med 2015; 11:233-40. [PMID: 25580602 PMCID: PMC4346644 DOI: 10.5664/jcsm.4534] [Citation(s) in RCA: 91] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 05/11/2014] [Indexed: 12/18/2022]
Abstract
STUDY OBJECTIVES Heart attacks and motor vehicle crashes are the leading causes of death in US firefighters. Given that sleep disorders are an independent risk factor for both of these, we examined the prevalence of common sleep disorders in a national sample of firefighters and their association with adverse health and safety outcomes. METHODS Firefighters (n = 6,933) from 66 US fire departments were assessed for common sleep disorders using validated screening tools, as available. Firefighters were also surveyed about health and safety, and documentation was collected for reported motor vehicle crashes. RESULTS A total of 37.2% of firefighters screened positive for any sleep disorder including obstructive sleep apnea (OSA), 28.4%; insomnia, 6.0%; shift work disorder, 9.1%; and restless legs syndrome, 3.4%. Compared with those who did not screen positive, firefighters who screened positive for a sleep disorder were more likely to report a motor vehicle crash (adjusted odds ratio 2.00, 95% CI 1.29-3.12, p = 0.0021) and were more likely to self-report falling asleep while driving (2.41, 2.06-2.82, p < 0.0001). Firefighters who screened positive for a sleep disorder were more likely to report having cardiovascular disease (2.37, 1.54-3.66, p < 0.0001), diabetes (1.91, 1.31-2.81, p = 0.0009), depression (3.10, 2.49-3.85, p < 0.0001), and anxiety (3.81, 2.87-5.05, p < 0.0001), and to report poorer health status (p < 0.0001) than those who did not screen positive. Adverse health and safety associations persisted when OSA and non-OSA sleep disorders were examined separately. CONCLUSIONS Sleep disorders are prevalent in firefighters and are associated with increased risk of adverse health and safety outcomes. Future research is needed to assess the efficacy of occupational sleep disorders prevention, screening, and treatment programs in fire departments to reduce these safety and health risks.
Collapse
Affiliation(s)
- Laura K. Barger
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA
| | - Shantha M.W. Rajaratnam
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA
- School of Psychology and Psychiatry, Monash University, Clayton VIC, Australia
| | - Wei Wang
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Conor S. O'Brien
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
| | - Jason P. Sullivan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
| | - Salim Qadri
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
| | - Steven W. Lockley
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA
| | - Charles A. Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA
| | - for the Harvard Work Hours, Health and Safety Group
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA
- Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA
- School of Psychology and Psychiatry, Monash University, Clayton VIC, Australia
- Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| |
Collapse
|
24
|
Rotating night shift work can be hazardous to health. Am Nurse 2015; 47:8. [PMID: 26827426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
|
25
|
Canuto R, Pattussi MP, Macagnan JBA, Henn RL, Olinto MTA. Sleep deprivation and obesity in shift workers in southern Brazil. Public Health Nutr 2014; 17:2619-23. [PMID: 24168892 PMCID: PMC10282264 DOI: 10.1017/s1368980013002838] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Revised: 09/07/2013] [Accepted: 09/10/2013] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The objective of our study was to explore the association between sleep deprivation and obesity among shift workers. DESIGN A cross-sectional study was conducted. Obesity was defined as BMI ≥30 kg/m2. Time of sleep was categorized as: >5 h of continuous sleep/d; ≤5 h of continuous sleep/d with some additional rest (sleep deprivation level I); and ≤5 h of continuous sleep/d without any additional rest (sleep deprivation level II). Sociodemographic, parental and behavioural variables were evaluated by means of a standardized pre-tested questionnaire. Potential confounding factors were controlled for in the multivariable model. SETTING A poultry-processing plant in southern Brazil. SUBJECTS Nine hundred and five shift workers (63 % female). RESULTS Obesity was more prevalent in the participants who were female, aged 40 years and older, who had less schooling and reported excess weight in both parents. Sleep deprivation levels I and II were associated with increased income, number of meals consumed throughout the day and nightshift work. All of the workers who exhibited a degree of sleep deprivation worked the night shift. After controlling for potential confounding factors, the prevalence ratios of obesity were 1·4 (95 % CI 0·8, 2·2) and 4·4 (95 % CI 2·4, 8·0) in the workers with sleep deprivation levels I and II, respectively, compared with the reference group. CONCLUSIONS These results show a strong association between sleep deprivation and obesity in shift workers and that sleep deprivation may be a direct consequence of working at night.
Collapse
Affiliation(s)
- Raquel Canuto
- Post-graduate Programme in Endocrinology, Federal University of Rio Grande do Sul State, Department of Nutrition, University of Vale do Rio dos Sinos, São Leopoldo, RS, Brazil
| | - Marcos Pascoal Pattussi
- Post-graduate Programme in Collective Health, University of Vale do Rio dos Sinos, Av. Unisinos 950, CP 275, São Leopoldo, RS 93022-000, Brazil
| | | | - Ruth Liane Henn
- Post-graduate Programme in Collective Health, University of Vale do Rio dos Sinos, Av. Unisinos 950, CP 275, São Leopoldo, RS 93022-000, Brazil
| | - Maria Teresa Anselmo Olinto
- Post-graduate Programme in Collective Health, University of Vale do Rio dos Sinos, Av. Unisinos 950, CP 275, São Leopoldo, RS 93022-000, Brazil
- Nutrition Department, Federal University of Health Science of Porto Alegre, Porto Alegre, RS, Brazil
| |
Collapse
|
26
|
Hemming K. Causation or association: running before we can walk? BJOG 2014; 121:1385. [PMID: 25379575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
|
27
|
Okura T, Higaki J. [Metabolic syndrome]. Nihon Rinsho 2014; 72:1424-1428. [PMID: 25167747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Circadian rhythms occur in all species and even in a cell. Epidemiological studies have supported that disrupt of the circadian cycle evidenced by individuals working night or rotating shifts is strongly associated with metabolic disorder. Some genetically engineered mouse models which are disrupted circadian related genes show hallmark sign of the metabolic syndrome. Disrupted of circadian rhythms leads to obesity and metabolic disorder, and a high fat diet leads to disrupted circadian expression of metabolic factors and obesity. However, recently time restricted high fat feeding prevents metabolic diseases even if without reducing caloric intake. These findings suggest that circadian rhythm is a key regulation of metabolic systems.
Collapse
|
28
|
Tannen A. [Sleep disorders and cardiovascular diseases]. Pflege Z 2014; 67:429. [PMID: 25087284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
|
29
|
Abstract
Breast cancer is the leading cause of cancer death among women worldwide, and there is only a limited explanation of why. Risk is highest in the most industrialized countries but also is rising rapidly in the developing world. Known risk factors account for only a portion of the incidence in the high-risk populations, and there has been considerable speculation and many false leads on other possibly major determinants of risk, such as dietary fat. A hallmark of industrialization is the increasing use of electricity to light the night, both within the home and without. It has only recently become clear that this evolutionarily new and, thereby, unnatural exposure can disrupt human circadian rhythmicity, of which three salient features are melatonin production, sleep, and the circadian clock. A convergence of research in cells, rodents, and humans suggests that the health consequences of circadian disruption may be substantial. An innovative experimental model has shown that light at night markedly increases the growth of human breast cancer xenografts in rats. In humans, the theory that light exposure at night increases breast cancer risk leads to specific predictions that are being tested epidemiologically: evidence has accumulated on risk in shift workers, risk in blind women, and the impact of sleep duration on risk. If electric light at night does explain a portion of the breast cancer burden, then there are practical interventions that can be implemented, including more selective use of light and the adoption of recent advances in lighting technology and application.
Collapse
Affiliation(s)
- Richard G Stevens
- Professor, Department of Community Medicine, University of Connecticut Health Center, Farmington, CT
| | | | | | | | | |
Collapse
|
30
|
Bayon V, Léger D. [Occupational diseases and night-shift work]. Rev Prat 2014; 64:363-368. [PMID: 24851373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Shift and night work concern every year more and more workers, specifically women. Recent recommendations on good practice for the medical surveillance of shift and night workers have been edited in France. They confirmed that this kind of organisation, unavoidable in some economical sectors is associated with a significant higher risk of sleep and wake disorders, cardiovascular disorders, overweight and obesity, breath cancer. Specific surveillance of shift and night workers is recommended in occupational health.
Collapse
|
31
|
Yoshihara S, Yoshizawa M, Shirata A, Matsuda M, Tamashiro M, Saito I, Sakamoto K, Fujimura Y, Tamura Y, Chiba S. [Effects of ramelteon on a patient with circadian rhythm sleep disorder and mood disorder]. Seishin Shinkeigaku Zasshi 2014; 116:746-751. [PMID: 25711117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Ramelteon is a novel hypnotic characterized by its action as a melatonin receptor (MT1/MT2) agonist. It has been reported that ramelteon can alter the phase of the sleep period. We report a patient with circadian rhythm sleep disorder and mood disorder who improved with ramelteon. A 25-year-old man had a 5-year history of emotional instability, excessive daytime sleepiness, and difficulty awakening. He had been diagnosed with mood disorder and narcolepsy by a psychiatrist. Sertraline, milnacipran, valproate, and methylphenidate were ineffective, and so he presented to our hospital. Interview data and a sleep log demonstrated a delayed sleep phase. As other examinations such as actigraphy and video-polysomnography indicated no other diseases, the patient was diagnosed with circadian rhythm sleep disorder, delayed sleep phase type (ICSD-2). In addition, his mental symptoms were consistent with the criteria for cyclothymia (ICD-10). After the administration of ramelteon, the phase of his sleep period gradually advanced and his emotional instability improved. Because of the high rate of comorbidity between these two diseases, we should be aware of circadian rhythm sleep disorders that are masked by mood disorders.
Collapse
|
32
|
Guo Y, Liu Y, Huang X, Rong Y, He M, Wang Y, Yuan J, Wu T, Chen W. The effects of shift work on sleeping quality, hypertension and diabetes in retired workers. PLoS One 2013; 8:e71107. [PMID: 23976988 PMCID: PMC3745433 DOI: 10.1371/journal.pone.0071107] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Accepted: 06/25/2013] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Shift work has been associated with adverse health effects by disturbing circadian rhythms. However,its potential long-term health effects and the persistent effects after leaving shifts have not been well established. METHODS AND RESULTS We studied 26,463 workers from Tongji-Dongfeng Cohort in China. All the participants are retired employees of Dongfeng Motor Company. Information on demographics, occupational history and medical history were gathered through questionnaires. After adjusting potential confounders in the logistic regression models, shift work was associated with poor sleeping quality, diabetes and hypertension independently. We observed significant effects of shift work on poor sleeping quality, diabetes and hypertension; the ORs (95%CI) are 1.18 (1.09-1.27), 1.10 (1.03-1.17) and 1.05 (1.01-1.09) respectively. In the further analysis, we found elevated ORs (95%CI) for participants with poor sleeping quality, the ORs (95%CI) are 1.34 (1.08-1.60), 1.13 (1.05-1.21), 1.05 (1.03-1.07) and 1.05 (1.01-1.09) for 1-4, 5-9, 10-19, ≥20 years of shift work respectively. However, with the extension of leaving shift work duration, the effects of shift work on sleep quality gradually reduced. CONCLUSIONS Shift work may be an independent risk factor for sleeping quality, diabetes and hypertension even in retired workers. Applicable intervention strategies are needed for prevention of sleep loss, diabetes, and hypertension for shift workers.
Collapse
Affiliation(s)
- Yanjun Guo
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Environment and Health in Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuewei Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Environment and Health in Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiji Huang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Environment and Health in Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Rong
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Environment and Health in Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meian He
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Environment and Health in Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Youjie Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Environment and Health in Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Yuan
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Environment and Health in Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Environment and Health in Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Key Laboratory of Environment and Health in Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
33
|
Fanfulla F, Grassi M, Marandola P, Taino G, Fulgoni P, Imbriani M. Excessive daytime sleepiness works together with other sleep disorders in determining sleepiness-related events in shift workers. G Ital Med Lav Ergon 2013; 35:151-156. [PMID: 24734321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Shift-workers may experience sleep disturbances more frequently than day-workers. Interactions between obstructive sleep apnea (OSA), shift-work and other factors promoting sleepiness have never been studied. The present study was designed to assess the prevalence of excessive daytime sleepiness (EDS), high risk for OSA (HR) and insomnia in shift-workers and day-workers and to evaluate their mutual effects on the risk of home-to-work commuting car accidents or episodes of falling asleep during work. METHODS Workers (153 shift-workers, 85 day-workers) were evaluated for the presence of sleep disorders including HR and EDS. The relationships between sleepiness-related events, shift-work and sleep disorders were investigated by path analysis. RESULTS Forty-nine subjects had HR. EDS was more frequent in shift-workers than in day-workers (16.3% vs. 5.9%, P = 0.01) and in workers with HR (28.6% vs. 8.4%, P < 0.001) or insomnia (35.7% vs. 9.5%, P < 0.001). Path analysis support the evidence that EDS was directly linked to shift-work, HR and insomnia. Car accidents or falling asleep at work were directly associated with EDS and shift-work, and indirectly (via EDS) with HR and insomnia. CONCLUSIONS Development of EDS in shift-workers is not only due to work schedule, but also to the presence of sleep disorders. OSA and insomnia co-promote falling asleep during work and sleepiness-related car accidents.
Collapse
|
34
|
Abstract
Purpose The current study was undertaken to investigate whether glaucoma affects the sleep quality and whether there is any difference between patients with primary glaucoma (primary open angle glaucoma, POAG and primary angle-closure glaucoma, PACG) and healthy subjects, using a validated self-rated questionnaire, the Pittsburgh Sleep Quality Index (PSQI). Methods The sleep quality of patients with POAG and PACG was tested against normal controls. Subjects were divided into three sub-groups according to age. Differences in the frequency of sleep disturbances (PSQI score >7) were assessed. The differences of sleep quality within the three groups and within the POAG group depending on the patients’ intraocular pressure (IOP) and impairment of visual field (VF) were also studied. Results 92 POAG patients, 48 PACG patients and 199 controls were included. Sleep quality declined with age in control and POAG group (tendency chi-square, P<0.05). The prevalence of sleep disturbances was higher in POAG and PACG group than in the control group, the differences were statistically significant. The prevalence of sleep disturbances was higher in patients with PACG, compared to POAG patients in the age interval of 61–80. In POAG group, the ratio of patients with sleep disorders increased with augmented impairment of VF, but the differences were not statistically significant (χ2-test, P>0.05). No significant differences were found in POAG group between patients with a highest IOP in daytime and at nighttime (χ2-test, P>0.05). Conclusions The prevalence of sleep disorders was higher in patients with POAG and PACG than in controls. PACG patients seemed to have a more serious problem of sleep disorders than POAG patients between 61 to 80 years old. No correlation was found between the prevalence of sleep disorders and impairment of VF or the time when POAG patients showed a highest IOP.
Collapse
Affiliation(s)
- Huaizhou Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Vision Science Key Lab, Beijing, China
| | - Ye Zhang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Vision Science Key Lab, Beijing, China
| | - Jianming Ding
- Department of Physiology, Brody School of Medicine, East Carolina University, Greenville, North Carolina, United States of America
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Vision Science Key Lab, Beijing, China
- * E-mail:
| |
Collapse
|
35
|
Maaskant M, van de Wouw E, van Wijck R, Evenhuis HM, Echteld MA. Circadian sleep-wake rhythm of older adults with intellectual disabilities. Res Dev Disabil 2013; 34:1144-1151. [PMID: 23376049 DOI: 10.1016/j.ridd.2012.12.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 12/13/2012] [Accepted: 12/18/2012] [Indexed: 06/01/2023]
Abstract
The circadian sleep-wake rhythm changes with aging, resulting in a more fragmented sleep-wake pattern. In individuals with intellectual disabilities (ID), brain structures regulating the sleep-wake rhythm might be affected. The aims of this study were to compare the sleep-wake rhythm of older adults with ID to that of older adults in the general population, and to investigate which factors are associated with the sleep-wake rhythm in older adults with ID. This study is part of the 'Healthy Aging and Intellectual Disabilities' study (HA-ID). We applied actigraphy in 551 persons with ID and 58 persons in the general population, aged 50 years and over. Outcome measures were stability (interdaily stability), fragmentation (intradaily variability) and amplitude (relative amplitude) of the sleep-wake rhythm. Compared to older adults in the general population, the sleep-wake rhythm of older adults with ID was significantly less stable (p=0.03), more fragmented (p<0.001) and had a lower relative amplitude (p<0.001). Multivariate regression analysis revealed that higher age, dementia, depression, visual impairment, severe hearing impairment, epilepsy and spasticity are independently associated with a more disturbed sleep-wake rhythm in this group. The sleep-wake rhythm is more stable in females and those living at a setting for more intensive care. Higher physical activity levels are strongly associated with both a less fragmented (p<0.001) and a more stable (p<0.001) sleep-wake rhythm. Higher age, dementia and depression are also associated with the sleep-wake rhythm in the general population. Neurological and sensory impairments that were associated with the sleep-wake rhythm in older adults with ID, are frequent known conditions in the ID population. Further research should focus on which factors specifically influence the sleep-wake rhythm in older adults with ID, and on the effects of more physical daytime activity on the sleep-wake rhythm in this population.
Collapse
Affiliation(s)
- Marijke Maaskant
- Intellectual Disability Medicine, Department of General Practice, Erasmus Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
| | | | | | | | | |
Collapse
|
36
|
Abstract
The objective of the study was to perform a literature review on the health consequences of working rotating shifts and implications for structural design. A literature search was performed in June 2012 and a selection of the most relevant peer-review articles was included in the present review. Shift workers are more likely to suffer from a circadian sleep disorder characterized by sleepiness and insomnia. Shift work is associated with decreased productivity, impaired safety, diminished quality of life and adverse effects on health. Circadian disruption resulting from rotating shift work has also been associated with increased risk for metabolic syndrome, diabetes, cardiovascular disease and cancer. This article summarizes the known health effects of shift work and discusses how light can be used as a countermeasure to minimize circadian disruption at night while maintaining alertness. In the context of the lighted environment, implications for the design of newborn intensive care units are also discussed.
Collapse
Affiliation(s)
- M G Figueiro
- Lighting Research Center, Rensselaer Polytechnic Institute, Troy, NY 12180, USA.
| | | |
Collapse
|
37
|
Pritchett D, Wulff K, Oliver PL, Bannerman DM, Davies KE, Harrison PJ, Peirson SN, Foster RG. Evaluating the links between schizophrenia and sleep and circadian rhythm disruption. J Neural Transm (Vienna) 2012; 119:1061-75. [PMID: 22569850 DOI: 10.1007/s00702-012-0817-8] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 04/20/2012] [Indexed: 12/22/2022]
Abstract
Sleep and circadian rhythm disruption (SCRD) and schizophrenia are often co-morbid. Here, we propose that the co-morbidity of these disorders stems from the involvement of common brain mechanisms. We summarise recent clinical evidence that supports this hypothesis, including the observation that the treatment of SCRD leads to improvements in both the sleep quality and psychiatric symptoms of schizophrenia patients. Moreover, many SCRD-associated pathologies, such as impaired cognitive performance, are routinely observed in schizophrenia. We suggest that these associations can be explored at a mechanistic level by using animal models. Specifically, we predict that SCRD should be observed in schizophrenia-relevant mouse models. There is a rapidly accumulating body of evidence which supports this prediction, as summarised in this review. In light of these emerging data, we highlight other models which warrant investigation, and address the potential challenges associated with modelling schizophrenia and SCRD in rodents. Our view is that an understanding of the mechanistic overlap between SCRD and schizophrenia will ultimately lead to novel treatment approaches, which will not only ameliorate SCRD in schizophrenia patients, but also will improve their broader health problems and overall quality of life.
Collapse
Affiliation(s)
- David Pritchett
- Nuffield Department of Clinical Neurosciences-Nuffield Laboratory of Ophthalmology, University of Oxford, John Radcliffe Hospital, Level 5-6 West Wing, Headley Way, Oxford OX3 9DU, UK
| | | | | | | | | | | | | | | |
Collapse
|
38
|
Keuroghlian AS, Barry AS, Weiss RD. Circadian dysregulation, zolpidem dependence, and withdrawal seizure in a resident physician performing shift work. Am J Addict 2012; 21:576-7. [PMID: 23082842 DOI: 10.1111/j.1521-0391.2012.00273.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
39
|
Jan JE, Bax MCO, Owens JA, Ipsiroglu OS, Wasdell MB. Neurophysiology of circadian rhythm sleep disorders of children with neurodevelopmental disabilities. Eur J Paediatr Neurol 2012; 16:403-12. [PMID: 22264650 DOI: 10.1016/j.ejpn.2012.01.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2011] [Revised: 12/28/2011] [Accepted: 01/01/2012] [Indexed: 01/18/2023]
Abstract
This article reviews circadian rhythm sleep disorders (CRSDs) of children with neurodevelopmental disabilities. These sleep disturbances frequently occur in this population but they are misunderstood and under diagnosed. The causes and features of CRSD in children with brain disorders differ in many ways from those seen in typically developing children. It is the brain, including the eyes, which regulates sleep and circadian rhythmicity by modulating pineal melatonin production/secretion and when there is significant brain damage, the sleep/wake patterns may be modified. In most instances CRSD are not disorders of the suprachiasmatic nuclei because these small hypothalamic structures only adjust their functions to the changing photic and non-photic modulatory influences. Each form of CRSD is accompanied by characteristic changes in serum melatonin levels and clinical features. When nocturnal melatonin production/secretion is inappropriately timed or impaired in relation to the environment, timed melatonin replacement therapy will often be beneficial. In this review an attempt is made to clarify the neurophysiological mechanisms underlying the various forms of CRSD because without understanding the photic and non-photic influences on sleep, these sleep disorders can not be fully characterized, defined or even appropriately treated. In the future, the existing definitions for the different forms of CRSD should be modified by experts in pediatric sleep medicine in order to include children with neurodevelopmental disabilities.
Collapse
Affiliation(s)
- James E Jan
- Pediatric Neurology, University of British Columbia, Vancouver, BC, Canada.
| | | | | | | | | |
Collapse
|
40
|
Takaesu Y, Komada Y, Inoue Y. Melatonin profile and its relation to circadian rhythm sleep disorders in Angelman syndrome patients. Sleep Med 2012; 13:1164-70. [PMID: 22841843 DOI: 10.1016/j.sleep.2012.06.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2011] [Revised: 06/05/2012] [Accepted: 06/14/2012] [Indexed: 11/18/2022]
Abstract
BACKGROUND Sleep problems are known to be common in Angelman syndrome (AS), a neurodevelopmental disorder which is associated with an abnormality of chromosome 15q11-q13. However, the circadian aspect of sleep disorders in AS and an effective treatment for the disorder have yet to be established. METHODS We elucidated the sleep-wake patterns of AS patients and its relationship to the serum melatonin levels. The serum melatonin levels of 15 AS patients were measured every 4h for one day and the values were compared with those of age-matched controls. We also examined the effectiveness of the oral administration of melatonin on AS patients with circadian rhythm sleep disorders (CRSD). RESULTS A total of eight of the 15 AS patients had CRSD (irregular sleep-wake type, n=4; free-running type n=2; delayed sleep phase type, n=2). The nighttime serum melatonin levels of the AS patients were significantly lower than those of the controls at the measured time points during the night. The nocturnal melatonin levels were comparably low both in AS patients with and without CRSD except for the cases with delayed sleep phase type, which showed normal but delayed peak melatonin level. Six out of eight CRSD cases were given a daily dose of 1mg of melatonin between 18:00 and 19:00 regularly for three months. After receiving the treatment, the sleep patterns improved in four cases. CONCLUSION This study revealed a high prevalence of CRSD in AS patients, which may be related to abnormal serum melatonin profiles.
Collapse
|
41
|
Masaki T. [Sleep/wake cycle, circadian disruption and the development of obesity]. Nihon Rinsho 2012; 70:1183-1187. [PMID: 22844802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
It is increasingly recognized that obesity is an important health problem. The mechanisms that underlie obesity have not been fully elucidated, and effective therapeutic approaches are currently of general interest. Recent studies have provided evidence that circadian clock is a crucial factor in the development of obesity and related metabolic disease. Genetic disruption of clock genes in mice displayed metabolic dysfunctions of specific tissues at distinct phases of the sleep/wake cycle. In addition, circadian desynchrony, a characteristic of shift work and short sleep, are associated with obesity in human. Here, I describe the advances in understanding the interrelationship among circadian disruption, sleep deprivation and obesity.
Collapse
Affiliation(s)
- Takayuki Masaki
- Department of Internal Medicine 1, Faculty of Medicine, Oita University
| |
Collapse
|
42
|
Schaefer EW, Williams MV, Zee PC. Sleep and circadian misalignment for the hospitalist: a review. J Hosp Med 2012; 7:489-96. [PMID: 22290766 DOI: 10.1002/jhm.1903] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2011] [Revised: 11/05/2011] [Accepted: 11/20/2011] [Indexed: 11/10/2022]
Abstract
Shift work is necessary for hospitalists to provide on-site 24-hour patient care. Like all shift workers, hospitalists working beyond daylight hours are subject to a misalignment between work obligations and the endogenous circadian system, which regulates sleep and alertness patterns. With chronic misalignment, sleep loss accumulates and can lead to shift work disorder or other chronic medical conditions. Hospitalists suffering from sleep deprivation also risk increased rates of medical errors. By realigning work and circadian schedules, a process called circadian adaptation, hospitalists can limit fatigue and potentially improve safety. Adaptation strategies include improving sleep hygiene before work, caffeine use at the start of the night shift, bright light exposure and planned naps during the shift, and short-term use of a mild hypnotic after night work. If these attempts fail and chronic fatigue persists, then a diagnosis of shift work disorder should be considered, which can be treated with stronger pharmacotherapy. Night float scheduling strategies may also help to limit chronic sleep loss. More research is urgently needed regarding the sleep patterns and job performance of hospitalists working at night to improve scheduling decisions and patient safety.
Collapse
Affiliation(s)
- Eric W Schaefer
- Division of Hospital Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA.
| | | | | |
Collapse
|
43
|
Muller ME, Heinzer R, Pruijm M, Wuerzner G, Burnier M. [Sleep disorders in patients with chronic renal insufficiency]. Rev Med Suisse 2012; 8:458-461. [PMID: 22452131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Sleep disorders, especially insomnia, daytime sleepiness, sleep apnea syndrome and restless legs syndrome are very frequently encountered in patients with chronic renal failure whether or not they undergo renal replacement therapy. The causes of sleep disorders are multifactorial and not only linked to the renal disease itself, but also to its treatment and its associated psychosocial factors. This article discusses the prevalence and physiopathology of the most frequently encountered sleep disorders in chronic renal failure patients, and highlights the actually available therapeutic options.
Collapse
|
44
|
[Depression: possible etiology: circadian dysregulation]. MMW Fortschr Med 2012; 154:82-3. [PMID: 22642014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
|
45
|
Shemerovskiĭ KA, Ovsiannikov VI, Stoliarov ID, Nikiforova IG, Votintseva MV, Il'ves AG. [Symptoms of circadian desynchronization in patients with multiple sclerosis]. Zh Nevrol Psikhiatr Im S S Korsakova 2012; 112:60-63. [PMID: 22677680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Circadian rhythm of sleep-wakefulness and evacuation function of intestines, symptoms of neuropsychic adaptation were investigated in 36 patients, aged 21-53 years, with multiple sclerosis (MS). Frequencies of circadian rhythm disturbances of brain activity (insomnia in 66% of patients) and circadian rhythm disturbances of intestine evacuation (constipation in 72% of patients) were revealed. Insomnia and irritability in MS patients with bradyenteria occur 1.5 times more frequent than in patients with normal regulative activity of the bowels. The risk of anxiety and depression in MS patients with bradyenteria was 2-3 times higher than in patients with euenteria. The suitability of normalization of circadian desynchronization of MS patients by the restoration of optimal acrophases of circadian rhythms of the brain and bowels is established.
Collapse
|
46
|
Franca EL, Silva NA, Lunardi RR, Honorio-Franca AC, Ferrari CK. Shift work is a source of stress among Military Police in Amazon, Brazil. Neurosciences (Riyadh) 2011; 16:384-386. [PMID: 21983389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Eduardo L Franca
- Institute of Biological and Health Sciences, Federal University of Mato Grosso, Mato Grosso, Brazil.
| | | | | | | | | |
Collapse
|
47
|
Philip P, Sagaspe P. [Sleep and accidents]. Bull Acad Natl Med 2011; 195:1635-1643. [PMID: 22812165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The evolution of society and labor organization (24/7 working) has significantly changed our lifestyles and increased the number of workers with sleep debt and staggered hours. Populations are particularly at risk of excessive sleepiness due to sleep deprivation (professional obligations), circadian factors (e.g. night driving) and sleep disorders (e.g. obstructive sleep apnea syndrome and hypersomnia). Excessive daytime sleepiness (i.e. difficulty staying awake) is estimated to affect about 5 % of the population. Public health studies have shown that sleepiness at the wheel and other risks associated with sleep are responsible for 5% to 30% of road accidents, depending on the type of driver and/or road. Strategies to reduce accidents related to sleepiness include--reliable diagnosis and treatment of sleep disorders,--management of chronobiological conflicts,--adequate catch-up sleep, and--countermeasures against sleepiness at the wheel.
Collapse
Affiliation(s)
- Pierre Philip
- Université de Bordeaux, Sommeil, Attention et NeuroPsychiatrie, USR 3413, Hôpital Pellegrin-Tripode 13e etage, Place Amélie Raba Léon - 33076 Bordeaux cedex.
| | | |
Collapse
|
48
|
Levin II. [Neurophysiological, neurochemical, autonomous and chronobiological basics of sleep medicine]. Ross Fiziol Zh Im I M Sechenova 2011; 97:388-402. [PMID: 21786643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The review discusses various mechanisms of the rapidly growing problem of Sleep Medicine. The "Sleep-wakefulness" cycle is a continuum of different functional states and the diseases that these states might prompt to manifest themselves in various ways. In these cases, we must say that change produces the conditions of disease manifestation rather than the disease itself. The paper describes the dynamics of the autonomous parameters during sleep, emphasizes the role and importance of chronobiological aspects of the "sleep-wakefulness" cycle. The holographic principle of the operation I sleep cycle is described which persists even in the cerebral stroke. From the standpoint of neurochemistry, modern hypnotics and drugs of the nearest future can be divided into 2 groups: proS (pro sleep)--for sleeping, and antiW (anti-wakefulness)--vs. wakefulness.
Collapse
|
49
|
Brown MA, Quan SF, Eichling PS. Circadian rhythm sleep disorder, free-running type in a sighted male with severe depression, anxiety, and agoraphobia. J Clin Sleep Med 2011; 7:93-94. [PMID: 21344043 PMCID: PMC3041617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Circadian rhythm sleep disorder, free-running type (CRSD, FRT) is a disorder in which the intrinsic circadian rhythm is no longer entrained to the 24-hour schedule. A unique case of CRSD, FRT in a 67-year-old sighted male is presented. The patient had a progressively delayed time in bed (TIB) each night, so that he would cycle around the 24-h clock approximately every 30 days. This was meticulously documented each night by the patient over the course of 22 years. The patient's CRSD, FRT was associated with severe depression, anxiety, and agoraphobia. The agoraphobia may have exacerbated the CRSD, FRT. Entrainment and stabilization of his circadian rhythm was accomplished after treatment that included melatonin, light therapy, and increased sleep structure.
Collapse
Affiliation(s)
- Mark A Brown
- Department of Psychiatry, University of Arizona, Tucson, AZ, USA.
| | | | | |
Collapse
|
50
|
George O, Vallée M, Vitiello S, Le Moal M, Piazza PV, Mayo W. Low brain allopregnanolone levels mediate flattened circadian activity associated with memory impairments in aged rats. Biol Psychiatry 2010; 68:956-63. [PMID: 20471631 PMCID: PMC2936666 DOI: 10.1016/j.biopsych.2010.03.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2009] [Revised: 03/17/2010] [Accepted: 03/18/2010] [Indexed: 11/22/2022]
Abstract
BACKGROUND Sleep and cognitive impairments are two of the most prevalent neuropsychiatric disorders in the aged population. Age-related memory dysfunctions can result from alterations in sleep/wake circadian rhythm. However, the underlying mechanism of these alterations is unknown. Here, we demonstrate the role of alterations in brain steroid levels in age-related sleep-dependent memory impairment in rats. METHODS Sleep/wake circadian activity and spatial memory performance were evaluated in adult, middle-aged, and aged rats, and steroid levels were measured in brain structures involved in mediating sleep-dependent memory processes using gas chromatography/mass spectrometry. The causal relationship between circadian activity and allopregnanolone levels was assessed using an inhibitor of allopregnanolone synthesis (indomethacin). RESULTS Similar to observations in humans, a subpopulation of middle-aged and aged rats show flattened amplitude of circadian activity associated with impaired spatial long-term memory performance. Sleep-dependent memory dysfunction was associated with a low level of allopregnanolone in the hypothalamus, pedunculopontine nucleus, and ventral striatum. Inhibition of allopregnanolone synthesis in young rats decreased allopregnanolone in the hypothalamus and produced flattened amplitude of circadian activity similar to aged rats. CONCLUSIONS These findings identify brainstem and basal forebrain allopregnanolone as an essential endogenous substrate involved in mediating sleep-dependent memory function in young and aged rats. Allopregnanolone may play a critical role in preserving individuals from age-induced alterations in sleep and memory processes and may represent a novel target for attenuating age-related declines in sleep and memory.
Collapse
Affiliation(s)
- Olivier George
- Institut National de la Sante et de la Recherche Medical (INSERM), Unite 862, Neurocenter Magendie, Physiopathology of Addiction Group, Bordeaux, France.
| | | | | | | | | | | |
Collapse
|