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      Circadian Adaptation to Night Shift Work Influences Sleep, Performance, Mood and the Autonomic Modulation of the Heart

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          Abstract

          Our aim was to investigate how circadian adaptation to night shift work affects psychomotor performance, sleep, subjective alertness and mood, melatonin levels, and heart rate variability (HRV). Fifteen healthy police officers on patrol working rotating shifts participated to a bright light intervention study with 2 participants studied under two conditions. The participants entered the laboratory for 48 h before and after a series of 7 consecutive night shifts in the field. The nighttime and daytime sleep periods were scheduled during the first and second laboratory visit, respectively. The subjects were considered “adapted” to night shifts if their peak salivary melatonin occurred during their daytime sleep period during the second visit. The sleep duration and quality were comparable between laboratory visits in the adapted group, whereas they were reduced during visit 2 in the non-adapted group. Reaction speed was higher at the end of the waking period during the second laboratory visit in the adapted compared to the non-adapted group. Sleep onset latency (SOL) and subjective mood levels were significantly reduced and the LF∶HF ratio during daytime sleep was significantly increased in the non-adapted group compared to the adapted group. Circadian adaptation to night shift work led to better performance, alertness and mood levels, longer daytime sleep, and lower sympathetic dominance during daytime sleep. These results suggest that the degree of circadian adaptation to night shift work is associated to different health indices. Longitudinal studies are required to investigate long-term clinical implications of circadian misalignment to atypical work schedules.

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          Impact of Reduced Heart Rate Variability on Risk for Cardiac Events: The Framingham Heart Study

          Although heart rate variability (HRV) is altered in a variety of pathological conditions, the association of reduced HRV with risk for new cardiac events has not been studied in a large community-based population. The first 2 hours of ambulatory ECG recordings obtained on subjects of the Framingham Heart Study who were free of clinically apparent coronary heart disease or congestive heart failure were reprocessed to assess HRV. Five frequency-domain measures and three time-domain measures were obtained. The associations between HRV measures and the incidence of new cardiac events (angina pectroris, myocardial infarction, coronary heart disease death, or congestive heart failure) were assessed with proportional hazards regression analyses. There were 2501 eligible subjects with a mean age of 53 years. During a mean follow-up of 3.5 years, cardiac events occurred in 58 subjects. After adjustment for age, sex, cigarette smoking, diabetes, left ventricular hypertrophy, and other relevant risk factors, all HRV measures except the ratio of low-frequency to high-frequency power were significantly associated with risk for a cardiac event (P = .0016 to .0496). A one-standard deviation decrement in the standard deviation of total normal RR intervals (natural log transformed) was associated with a hazard ratio of 1.47 for new cardiac events (95% confidence interval of 1.16 to 1.86). The estimation of HRV by ambulatory monitoring offers prognostic information beyond that provided by the evaluation of traditional cardiovascular disease risk factors.
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            Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4-5 hours per night.

            To determine whether a cumulative sleep debt (in a range commonly experienced) would result in cumulative changes in measures of waking neurobehavioral alertness, 16 healthy young adults had their sleep restricted 33% below habitual sleep duration, to an average 4.98 hours per night [standard deviation (SD) = 0.57] for seven consecutive nights. Subjects slept in the laboratory, and sleep and waking were monitored by staff and actigraphy. Three times each day (1000, 1600, and 2200 hours) subjects were assessed for subjective sleepiness (SSS) and mood (POMS) and were evaluated on a brief performance battery that included psychomotor vigilance (PVT), probed memory (PRM), and serial-addition testing, Once each day they completed a series of visual analog scales (VAS) and reported sleepiness and somatic and cognitive/emotional problems. Sleep restriction resulted in statistically robust cumulative effects on waking functions. SSS ratings, subscale scores for fatigue, confusion, tension, and total mood disturbance from the POMS and VAS ratings of mental exhaustion and stress were evaluated across days of restricted sleep (p = 0.009 to p = 0.0001). PVT performance parameters, including the frequency and duration of lapses, were also significantly increased by restriction (p = 0.018 to p = 0.0001). Significant time-of-day effects were evident in SSS and PVT data, but time-of-day did not interact with the effects of sleep restriction across days. The temporal profiles of cumulative changes in neurobehavioral measures of alertness as a function of sleep restriction were generally consistent. Subjective changes tended to precede performance changes by 1 day, but overall changes in both classes of measure were greatest during the first 2 days (P1, P2) and last 2 days (P6, P7) of sleep restriction. Data from subsets of subjects also showed: 1) that significant decreases in the MSLT occurred during sleep restriction, 2) that the elevated sleepiness and performance deficits continued beyond day 7 of restriction, and 3) that recovery from these deficits appeared to require two full nights of sleep. The cumulative increase in performance lapses across days of sleep restriction correlated closely with MSLT results (r = -0.95) from an earlier comparable experiment by Carskadon and Dement (1). These findings suggest that cumulative nocturnal sleep debt had a dynamic and escalating analog in cumulative daytime sleepiness and that asymptotic or steady-state sleepiness was not achieved in response to sleep restriction.
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              Carcinogenicity of shift-work, painting, and fire-fighting.

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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                1932-6203
                2013
                26 July 2013
                : 8
                : 7
                : e70813
                Affiliations
                [1 ]Centre for Study and Treatment of Circadian Rhythms, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal, Quebec, Canada
                [2 ]Integrated Program in Neuroscience, McGill University, Montreal, Quebec, Canada
                [3 ]Department of Electrical and Computer Engineering, University of British Colombia, Vancouver, British Colombia, Canada
                Pennsylvania State University, United States of America
                Author notes

                Competing Interests: DB Boivin is the founder/CEO of Alpha Logik Consultants Inc. Under this company, she did receive honoraria for lectures, did consultation work, medico-legal expertises. She received travel grants from Servier Canada and a small financial support from Servier Canada for a book launch on sleep for the general public. The other authors have declared that no competing interests exist. This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

                Conceived and designed the experiments: DBB. Performed the experiments: PB DBB. Analyzed the data: PB GAD DBB. Contributed reagents/materials/analysis tools: PB GAD DBB. Wrote the paper: PB GAD DBB.

                Article
                PONE-D-13-07149
                10.1371/journal.pone.0070813
                3724779
                23923024
                44110f75-02a7-4b1f-b65e-5e68537d21f6
                Copyright @ 2013

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 15 February 2013
                : 23 June 2013
                Page count
                Pages: 14
                Funding
                This work was supported by the Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology
                Neuroscience
                Cognitive Neuroscience
                Cognition
                Medicine
                Anatomy and Physiology
                Physiological Processes
                Chronobiology
                Sleep
                Diagnostic Medicine
                Clinical Neurophysiology
                Electroencephalography
                Electromyography
                Mental Health
                Psychology
                Psychometrics
                Neurology
                Autonomic Nervous System
                Sleep Disorders

                Uncategorized
                Uncategorized

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