Treatment of Circadian Disruption from Shiftwork in Older Adults

老年人轮班工作造成的昼夜节律紊乱的治疗

• 批准号: 8481650
• 负责人: Jeanne F Duffy
• 金额: $ 49.82万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-06-15 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8481650
• 关键词: Accidents; Address; Adverse effects; Affect; Aging; American; Biological Clocks; Cardiovascular Diseases; Circadian Rhythm Sleep Disorders; Circadian Rhythms; Combined Modality Therapy; Commuting; Control Groups; Elderly; Future; Gastrointestinal Diseases; Health; Home environment; Hour; Individual; Inflammatory Response; Instruction; Intervention; Lead; Life; Light; Lighting; Malignant Neoplasms; Medical; Melatonin; Mental Depression; Metabolic syndrome; Myocardial Infarction; Obesity; Occupations; Participant; Performance; Performance at work; Phase; Productivity; Quality of life; Regimen; Reporting; Risk; Safety; Schedule; Sleep; Societies; Testing; Time; Treatment Protocols; Work; adverse outcome; alertness; cardiovascular disorder risk; experience; improved; inattention; light intensity; light treatment; operation; public health relevance; shift work; social; treatment effect; trend; vigilance; young adult

DESCRIPTION (provided by applicant): Night and rotating shift work leads to a mismatch between the timing of circadian rhythms and the timing of the work/sleep schedule. This in turn leads to sleepiness during nighttime work, with greater risk for performance errors and accidents. In addition, daytime sleep is disrupted and shortened, which exacerbates the performance problems on the subsequent night shifts. Problems with night shift adaption are reported to be greater in older workers than in younger workers, and this is hypothesized to be due to their greater inability to sleep during the day. We have shown previously that in young adults, bright light during the night shift can improve circadian adaptation to a night-work, day-sleep schedule, leading to increased alertness at night and longer daytime sleep. Subsequent studies in young adults found that a light treatment could be effective with light of moderate intensity for only half of the work shift. Furthermore, we have shown that in young adults, scheduling sleep before (rather than after) the night shift, when combined with enhanced lighting on the night shift, can improve alertness and vigilance to nearly day shift levels after only one night. However, such studies have not yet been performed in older adults, and we will therefore test that enhanced lighting and scheduled sleep regimen in a group of older adults. In addition to comparing the on-shift alertness, vigilance and performance of older adults in the treatment group to a group of control participants, we will also test each component separately (enhanced lighting only; scheduled evening sleep only) in order to determine how much each contributes to the combined treatment effect. The number of Americans who work during the night has continued to increase as more aspects of our society have moved to round-the-clock operations and the number older workers who work at night is estimated by the US Department of Labor to be as high as 3 million. Thus, countermeasures for older night shift workers have the potential to benefit many individuals. Given our increasing understanding of how inadequate sleep contributes not only to issues of performance and safety, but to risk for cardiovascular disease, obesity and metabolic syndrome, and inflammatory responses, a night treatment regimen could also have future implications for improving the health of older people who must work at night.

描述（由申请人提供）：夜间和旋转班次工作导致昼夜节律时间与工作/睡眠时间表的时间之间的不匹配。反过来，这会导致夜间工作中的嗜睡，并出现更大的性能错误和事故风险。此外，白天的睡眠被破坏和缩短，这加剧了随后夜班的性能问题。据报道，老年工人的夜班改编问题要比在年轻工人中更大，这是由于他们白天无法入睡。我们先前表明，在年轻人中，夜班时明亮的光线可以改善昼夜节律适应夜间工作，一日睡眠的时间表，从而在夜间增加警觉性和白天长时间的睡眠。随后在年轻人中进行的研究发现，轻度治疗只能在工作中的一半转移时有效地有效。此外，我们已经表明，在年轻人中，安排在夜班之前（而不是之后）睡眠，结合夜班增强的照明，可以在一个晚上仅在一个晚上后提高机敏性和警惕性，以提高近日班级水平。但是，这些研究尚未在老年人中进行，因此我们将测试一组老年人的照明和预定睡眠方案。除了比较治疗组中老年人的迁移警觉性，警惕性和表现与一组对照参与者外，我们还将分别测试每个组件（仅增强照明；仅计划的夜间睡眠），以确定每个组件对每种组合有多少贡献对合并治疗效应的贡献。随着我们社会的越来越多方面的全天候运营，夜间工作的美国人人数继续增加，而在夜间工作的年长工人的人数则由美国劳动部估计高达300万。因此，对年长的夜班工人的对策有可能使许多人受益。鉴于我们对睡眠不足如何不仅对性能和安全性问题做出贡献，而且对患心血管疾病，肥胖和代谢综合征的风险以及炎症反应的风险不断贡献，夜间治疗方案也可能对改善必须在夜间工作的老年人的健康产生影响。