Phase advancing human circadian rhythms with morning bright light, afternoon melatonin, and gradually shifted sleep: can we reduce morning bright-light duration?
Phase advancing human circadian rhythms with morning bright light, afternoon melatonin, and gradually shifted sleep: can we reduce morning bright-light duration?
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DOI：
10.1016/j.sleep.2014.12.004
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发表时间：
2015-02
期刊：
影响因子：
4.8
通讯作者：
Eastman CI
中科院分区：
文献类型：
--
作者：
Crowley SJ;Eastman CI
需要有效的治疗方法来推进人类昼夜节律，以减轻昼夜节律失调以及伴随清晨轮班工作、早期上学时间、时差和延迟睡眠相位障碍的相关负面健康结果。这项研究比较了三个上午明亮的光暴露模式，从一个单一的灯箱（模仿家庭治疗）结合下午褪黑激素。50名年龄为25.9±5.1岁的成年人（27名男性）参加了研究。睡眠/黑暗提前1小时/天，持续3个治疗日。参与者在治疗第1天的基线睡前5小时服用0.5 mg褪黑激素，每个治疗日提前一小时服用。每天早晨醒来时，他们暴露于三种明亮的光线（~5000勒克斯）模式之一：四次30分钟的暴露，间隔30分钟的室内光线（2小时组）;四次15分钟的暴露，间隔45分钟的室内光线（1小时组），以及一次30分钟的暴露（0.5小时组）。治疗前后暗光褪黑激素起始（DLMOs）决定相位提前。与2 h组（相移=2.4±0.8 h）相比，在1 h（1.7±0.7 h）和0.5 h（1.8±0.8 h）组中观察到较小的相位提前偏移。2小时的图案产生最大的相位提前;然而，单次30分钟的强光暴露与1小时的强光在3.25小时内传播一样有效，并且产生了2小时强光下观察到的75%的相移。上午30分钟的强光照射和下午的褪黑激素是一种有效的治疗方法，可以使人类的昼夜节律提前。
Efficient treatments to phase advance human circadian rhythms are needed to attenuate circadian misalignment and the associated negative health outcomes that accompany early morning shift work, early school start times, jet lag, and delayed sleep phase disorder. This study compared three morning bright light exposure patterns from a single light box (to mimic home treatment) in combination with afternoon melatonin. Fifty adults (27 males) aged 25.9±5.1 years participated. Sleep/dark was advanced 1 hour/day for 3 treatment days. Participants took 0.5 mg melatonin 5 hours before baseline bedtime on treatment day 1, and an hour earlier each treatment day. They were exposed to one of three bright light (~5000 lux) patterns upon waking each morning: four 30-minute exposures separated by 30 minutes of room light (2 h group); four 15-minute exposures separated by 45 minutes of room light (1 h group), and one 30-minute exposure (0.5 h group). Dim light melatonin onsets (DLMOs) before and after treatment determined the phase advance. Compared to the 2 h group (phase shift=2.4±0.8 h), smaller phase advance shifts were seen in the 1 h (1.7±0.7 h) and 0.5 h (1.8±0.8 h) groups. The 2-hour pattern produced the largest phase advance; however, the single 30-minute bright light exposure was as effective as 1 hour of bright light spread over 3.25 h, and produced 75% of the phase shift observed with 2 hours of bright light. A 30-minute morning bright light exposure with afternoon melatonin is an efficient treatment to phase advance human circadian rhythms.
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