BRIGHT LIGHT TREATMENT OF SHIFT ROTATION INSOMNIA

强光治疗轮班失眠

• 批准号: 2230718
• 负责人: Charles A Czeisler
• 金额: $ 44.98万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 1994
• 资助国家: 美国
• 起止时间: 1994-07-10 至 1999-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/2230718
• 关键词: attention; blood chemistry; body temperature; chronotherapy; circadian rhythms; cortisol; electroencephalography; human subject; human therapy evaluation; melatonin; phototherapy; psychomotor reaction time; short term memory; sleep; sleep disorders; urinalysis; visible light; visual tracking; wakefulness

More than one-third of working men and one-quarter of working women in the U. S. report being exposed to a variable schedule that includes both day and night work. Of these, approximately 7.3 million must regularly work overnight, either on permanent night shifts or rotations between day, evening, and night shifts, requiring them to forego nocturnal sleep and attempt to sleep during the day. Despite this nocturnal deprivation of sleep, these workers typically experience daytime insomnia, leading to diminished alertness and cognitive performance and increased sleep tendency during waking hours at night. In fact, 55 percent of night shift workers report nodding off or falling asleep at work at least once per week, with more than 30 percent reporting that such incidents occur more than three times per week. Recent research has demonstrated that properly timed exposure to bright light and darkness can rapidly reset the human circadian pacemaker that-controls the timing of the sleep-wake cycle, enabling the circadian pacemakers of individuals working at night to fully adapt to their desired schedules within 2-3 days. On the basis of these results, four testable hypotheses are proposed: (l) that bright light can rapidly shift the endogenous circadian rhythms of plasma melatonin secretion of individuals working at night, such that their circadian timing system remains adapted to their inverted sleep-wake schedule; (2) that bright light can increase sleep efficiency, and reduce the number and duration of awakenings during the daytime sleep of individuals working at night; (3) that bright light can reduce the frequency of involuntary microsleep episodes and decrease sleep propensity during scheduled wakefulness at night; and (4) that bright light can improve the alertness and cognitive performance of individuals working at night. An experiment is proposed to evaluate the impact of bright light treatment on the daytime sleep and nocturnal cognitive performance of individuals during a combined laboratory- and field-based simulation of a complete, 3- month shift rotation. Subjects exposed to an appropriate schedule of bright light while working in the laboratory will be compared to a control group of subjects without bright light exposure. Sleep, activity, and light exposure will be monitored with ambulatory recording devices, circadian phase will be assessed from serum melatonin levels, and cognitive performance will be evaluated with a computer-administered battery of tests. This work has significant implications for shiftworker health and population safety. Shiftwork is associated with cardiovascular disease, depression, increased drug use, and digestive disorders. Many catastrophic accidents (e.g., Exxon Valdez, Bhopal, Three-Mile Island, Chernobyl) have occurred during the night shift with fatigue identified as a contributor. An effective countermeasure to the personal and societal risks of shiftwork could substantially improve public health and safety.

超过三分之一的工作男人和四分之一的职业女性 美国报告暴露于包括两天的可变时间表 和夜间工作。 其中，大约有730万个必须定期工作 一夜之间，无论是在永久性的夜班还是在一天之间轮换， 傍晚和夜班，要求他们放弃夜间睡眠和 尝试在白天睡觉。 尽管有这种夜间剥夺 睡眠，这些工人通常会遇到白天失眠，导致 警报和认知表现降低并增加了睡眠 晚上醒来的趋势。 实际上，夜班的55％ 工人报告至少每次工作一次点头或入睡一次 一周，有超过30％的人报告了此类事件发生的更多 比每周三次。 最近的研究表明，正确 定时暴露于明亮的光明和黑暗可以迅速重置人类 昼夜节奏起搏器控制睡眠觉醒周期的时机， 使夜间工作的人的昼夜节律动摇者完全 在2-3天内适应他们所需的时间表。 根据这些结果，提出了四个可检验的假设：（l） 明亮的光可以快速移动内源性的昼夜节律 晚上工作的个体的血浆褪黑激素分泌，以至于 他们的昼夜节律系统仍然适应了他们的倒睡眠觉醒 日程; （2）明亮的光可以提高睡眠效率，并降低 白天睡眠中觉醒的数量和持续时间 晚上工作的人； （3）明亮的光可以减少 非自愿微渗的频率并减少睡眠倾向 在晚上预定的清醒期间； （4）明亮的光可以 提高工作人员的机敏性和认知表现 夜晚。 提出了一个实验来评估明亮光处理的影响 在白天睡眠和个人的夜间认知表现 在一个完整的3--的实验室和现场模拟过程中 月轮换旋转。 接触适当时间表的受试者 在实验室工作时的明亮光将与对照进行比较 一组没有明亮光照的受试者。 睡眠，活动和 光曝光将通过卧床记录设备监视， 昼夜节律将从血清褪黑激素水平进行评估，并 认知表现将通过计算机管理评估 电池测试。 这项工作对Shiftworker Health和 人口安全。 班次与心血管疾病有关， 抑郁症，药物使用增加和消化系统疾病。 许多 灾难性事故（例如，埃克森·瓦尔德斯（Exxon Valdez），博帕尔（Bhopal），三英里岛， 切尔诺贝利发生在夜班期间，疲劳被确定为 贡献者。与个人和社会的有效对策 轮班工作的风险可以大大改善公共卫生和安全性。