Low-dose repeated caffeine administration for circadian-phase-dependent performance degradation during extended wakefulness.
Low-dose repeated caffeine administration for circadian-phase-dependent performance degradation during extended wakefulness.
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DOI：
10.1093/sleep/27.3.374
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发表时间：
2004-05
期刊：
影响因子：
5.6
通讯作者：
J. Wyatt;C. Cajochen;A. Ritz-de Cecco;C. Czeisler;D. Dijk
中科院分区：
文献类型：
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作者：
J. Wyatt;C. Cajochen;A. Ritz-de Cecco;C. Czeisler;D. Dijk
目的：探讨一种新型高频低剂量咖啡因治疗方案在长时间清醒状态下对抗运动表现恶化的有效性是否与体内平衡或昼夜节律信号调节运动表现和睡眠倾向的相互作用有关。设计：双盲、安慰剂对照、平行组设计，在29天的强迫非同步范式中，睡眠-觉醒周期被安排为42.85小时，即远离昼夜节律范围。该设计允许单独评估睡眠稳态、昼夜节律和咖啡因对表现缺陷或改善的贡献。设置普通临床研究中心的私人套房，在没有时间信息的情况下。参与者16名健康正常睡眠的男性（18-30岁）干预措施：在28.57小时的清醒期间，每小时给予咖啡因（每公斤每小时0.3毫克）或安慰剂。结果清醒时血浆咖啡因浓度呈指数饱和上升。咖啡因水平的上升显著减轻了许多认知表现指标的清醒依赖性恶化，尤其是在昼夜节律表现的最低点。此外，咖啡因增强了受试者长时间保持清醒的能力，阻止了受试者完成完全的睡眠过渡，但代价是增加了主观困倦感。结论：高频率低剂量咖啡因可有效对抗长时间清醒对运动表现的不利影响。这些数据与假设一致，即腺苷是与长时间清醒相关的表现下降的中介，并可能导致在神经行为功能受到睡眠不足影响的情况下使用咖啡因的新策略。
OBJECTIVE To investigate whether the effectiveness of a novel high-frequency low-dose caffeine regimen in counteracting the deterioration of performance during extended wakefulness is related to its interaction with homeostatic or circadian signals modulating performance and sleep propensity. DESIGN Double-blind, placebo-controlled, parallel-group design in a 29-day forced desynchrony paradigm in which the period of the sleep-wake cycle was scheduled to be 42.85 hours, i.e., far removed from the circadian range. This design allowed for separate estimation of the sleep homeostatic, circadian, and caffeine contributions to performance deficits or improvements. SETTING Private suite of a general clinical research center, in the absence of time of day information. PARTICIPANTS Sixteen healthy normal-sleeping men (aged 18-30 years) INTERVENTIONS Caffeine (0.3 mg per kg per hour) or placebo was administered hourly during the 28.57-hour wake episodes. RESULTS Plasma caffeine concentrations rose in an exponential saturating manner during wakefulness. Rising caffeine levels markedly attenuated wake-dependent deterioration of a number of measures of cognitive performance, particularly at the circadian performance nadir. Moreover, caffeine enhanced the ability of subjects to remain consistently awake for extended periods, holding subjects back from completing the full transition to sleep, but at the expense of increasing subjective sleepiness. CONCLUSIONS High-frequency low-dose caffeine administration is effective in countering the detrimental performance effects of extended wakefulness. These data are in accordance with the hypothesis that adenosine is a mediator of performance decrements associated with extended wakefulness and may lead to new strategies to use caffeine in situations in which neurobehavioral functioning is affected by sleep loss.