Shift Work Abstracts:
	• Related Shift Work Abstracts

Related Shift Work Abstracts

The following abstracts are provided to help you better understand sleep problems, shift work and using light therapy as treatment.

Medium-intensity Light Produces Circadian Rhythm Adaptation to Simulated Night-shift Work

Sleep 1998 Mar 15;21(2):154-65
Martin SK, Eastman CI. - Biological Rhythms Research Lab, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Ill. 60612, USA.

STUDY OBJECTIVES: To assess the effect of nocturnal light intensity on circadian adaptation to simulated night work.

SETTING AND PARTICIPANTS: Normal young men and women, simulated night work, home sleep.

DESIGN AND MEASUREMENTS: We compared temperature rhythm phase shifts following timed exposure to high (approximately 5700 lux 3 hours/day), medium (approximately 1230 lux 3 hours/day) or constant low-intensity (< 250 lux) light during consecutive night shifts. Subjects (n = 35) followed a schedule of 7 days baseline, 6 days of 8-hour night shifts (with day sleep delayed 10 hours from baseline sleep), and 4 days of recovery. Subjects wore dark sunglasses while outdoors during daylight. Sleep logs were completed after each 8-hour sleep/dark period. Night work fatigue was rated by questionnaire.

RESULTS: During the 3rd through 5th days of night work, most subjects in the high and medium groups (100% and 85%) exhibited phase delays large enough that their body temperature minima occurred within the daytime sleep/dark period. Only 42% of subjects in the low group exhibited phase delays large enough to meet this criterion of circadian adaptation. The phase shifts of the high and medium groups were not significantly different, and were significantly different from the low group. Larger phase shifts were correlated with more sleep and less fatigue.

CONCLUSIONS: Extremely "bright" light may not be necessary for circadian adaptation in shift work situations similar to our study protocol (e.g., regular daytime sleep/dark periods, sunglasses).

Phase-shifting Human Circadian Rhythms: Influence of Sleep Timing, Social Contact and Light Exposure

J Physiol 1996 Aug 15;495 ( Pt 1):289-97
Duffy JF, Kronauer RE, Czeisler CA. - Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.

SUMMARY:

1. Both the timing of behavioural events (activity, sleep and social interactions) and the environmental light-dark cycle have been reported to contribute to entrainment of human circadian rhythms to the 24 h day. Yet, the relative contribution of those putative behavioural synchronizers to that of light exposure remains unclear.
2. To investigate this, we inverted the schedule of rest, sedentary activity and social contact of thirty-two young men either with or without exposure to bright light.
3. On this inverted schedule, the endogenous component of the core temperature rhythm of subjects who were exposed to bright light showed a significant phase shift, demonstrating that they were adapting to the new schedule. In contrast, the core temperature rhythm of subjects who were not exposed to bright light moved on average 0.2 h later per day and after 10 days had not significantly adapted to the new schedule.
4. The direction of phase shift in the groups exposed to bright light was dependent on the time of bright light exposure, while control subjects drifted to a later hour regardless of the timing of their schedule of sleep timing, social contact and meals.
5. These results support the concept that the light-dark cycle is the most important synchronizer of the human circadian system. They suggest that inversion of the sleep-wake, rest-activity and social contact cycles provides relatively minimal drive for resetting the human circadian pacemaker.
6. These data indicate that interventions designed to phase shift human circadian rhythms for adjustment to time zone changes or altered work schedules should focus on properly timed light exposure.

Dark Goggles and Bright Light Improve Circadian Rhythm Adaptation to Night-shift Work

Sleep 1994 Sep;17(6):535-43
Eastman CI, Stewart KT, Mahoney MP, Liu L, Fogg LF. - Biological Rhythms Research Laboratory, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612-3864.

SUMMARY: We compared the contributions of bright light during the night shift and dark goggles during daylight for phase shifting the circadian rhythm of temperature to realign with a 12-hour shift of sleep. After 10 baseline days there were 8 night-work/day-sleep days. Temperature was continuously recorded from 50 subjects. There were four groups in a 2 x 2 design: light (bright, dim), goggles (yes, no). Subjects were exposed to bright light (about 5,000 lux) for 6 hours on the first 2 night shifts. Dim light was < 500 lux. Both bright light and goggles were significant factors for producing circadian rhythm phase shifts. The combination of bright light plus goggles was the most effective, whereas the combination of dim light and no goggles was the least effective. The temperature rhythm either phase advanced or phase delayed when it aligned with daytime sleep. However, when subjects did not have goggles only phase advances occurred. Goggles were necessary for producing phase delays. The most likely explanation is that daylight during the travel-home window after a night shift inhibits phase-delay shifts, and goggles can prevent this inhibition. Larger temperature-rhythm phase shifts were associated with better subjective daytime sleep, less subjective fatigue and better mood.

Phase-shifts in Melatonin, 6-sulphatoxymelatonin and Alertness Rhythms After Treatment with Moderately Bright Light at Night

Clin Endocrinol (Oxf) 1994 Mar;40(3):413-20
Deacon SJ, Arendt J. - School of Biological Sciences, University of Surrey, Guildford, UK.

OBJECTIVES: Shift work and rapid travel across several time zones leads to desynchronization of internal circadian rhythms from the external environment and from each other with consequent problems of behaviour, physiology and performance. Field studies of travellers and shift workers are expensive and difficult to control. This investigation concerns the simulation of such rhythm disturbance in a laboratory environment. The main objectives are to assess the ability of controlled exposure to moderately bright light and darkness/sleep to delay circadian rhythms in volunteers without environmental isolation and, secondly, to evaluate the use of different indices of melatonin (MT) secretion together with self-rated alertness as marker rhythms.

PATIENTS: Six normal volunteers aged 22-26 years (mean +/- SD 24.3 +/- 1.4).

DESIGN: Subjects were exposed to the following periods of moderately bright light (1200 lux) on three consecutive days in early December 1991: Day (D)1: 2000-0200 h, D2: 2200-0400 h and D3: 2400-0600 h. Each period was followed by 8 hours of darkness (< 1 lux). Hourly blood, sequential 4-hourly urine (8-hourly when asleep) and hourly saliva (except when asleep) samples were taken throughout a 24-hour period on D0 (baseline), D4 (1 day post-light treatment) and D7 (4 days post-light treatment). During waking hours, subjective alertness was rated every 2 hours on a visual analogue scale.

MEASUREMENTS: MT was measured in plasma and saliva, and its metabolite, 6-sulphatoxymelatonin (aMT6s), was measured in urine. MT, aMT6s and alertness scores were analysed by ANOVA and a cosinor analysis program.

RESULTS: A delay shift was present in the aMT6s, plasma MT and salivary MT rhythms (degree of shift: 2.67 +/- 0.3 h (P < 0.001, n = 5); 2.35 +/- 0.29 h (P < 0.001, n = 6); and 1.97 +/- 0.32 h (P < 0.01, n = 6), mean +/- SEM, respectively) 1 day post-light treatment compared to baseline. Adaptation to the initial phase position was apparent by the 4th post-treatment day. Significant correlations were obtained between plasma MT onset (degree of shift: 3.12 +/- 0.74 h (P < 0.001, n = 6, mean +/- SEM)) and the acrophases (calculated peak times) of plasma MT (P < 0.001), salivary MT (P < 0.05) and urinary aMT6s (P < 0.01). A significant phase delay in the alertness rhythm was also evident 1 day post-treatment (3.08 +/- 0.67 h (P < 0.01, n = 6, mean +/- SEM)) with adaptation by the 2nd post-treatment day.

CONCLUSIONS: This study suggests that these methods of determining MT secretion are comparable and give reliable assessments of the MT circadian phase position even after a phase-shift. Significant phase-shifts of similar magnitude can be induced in both MT and alertness rhythms using moderate intensity bright light at night.

Timed Exposure to Bright Light Improves Sleep and Alertness During Simulated Night Shifts

Sleep 1991 Dec;14(6):511-6
Dawson D, Campbell SS. - Department of Psychiatry, Cornell University Medical College, White Plains, New York.

SUMMARY: Many of the health and safety problems reported by shift workers result from the chronic sleep deprivation associated with shorter, fragmented daytime sleep. This reduction in the quality and duration of sleep has been attributed to a change in the phase relationship between the work period and the circadian system, timing the propensity for sleep and wakefulness. This study examined the extent to which appropriately timed exposure to bright light would accelerate the circadian readjustment of physiological parameters thought to contribute to impaired performance in shift workers. A control (n = 7) and treatment group (n = 6) underwent a 3-day transition to simulated night work. The treatment group received a single 4-hour pulse of bright light (6,000 lux) between 2400 and 0400 hours on the first night shift and dim light (less than 200 lux) for the remainder of the study. The control group received dim light throughout. By the third night shift, the phase position of the core body temperature rhythm for the treatment group had delayed by 5-6 hours whereas the control group had delayed by only 2-3 hours. When compared to the control group, the greater delay in core temperature rhythm for the treatment group was associated with significantly higher alertness across the night shift and improved sleep quality during the day. By the third day sleep, mean sleep efficiency in the treatment group was not significantly different from normal night sleep. Similarly, onshift alertness was improved relative to the control group. The treatment group did not show the typical decline in alertness observed in the control group between 0300 and 0700 hours. These data indicate that a single 4-hour pulse of bright light between midnight and 0400 hours is effective in ameliorating the sleep and alertness problems associated with transition to night shift.