Rebuttal from Saurabh S. Thosar, Nicole P. Bowles and Andrew W. McHill.
Rebuttal from Saurabh S. Thosar, Nicole P. Bowles and Andrew W. McHill.
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DOI：
10.1113/jp282835
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发表时间：
2022-04
期刊：
影响因子：
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通讯作者：
McHill AW
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文献类型：
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作者：
Thosar SS;Bowles NP;McHill AW
在这场辩论中，里奇和布鲁萨尔博士认为，睡眠不足是轮班工人患代谢疾病风险增加的主要原因。他们系统地强调了睡眠不足对心脏代谢健康的有害影响，我们同意这一点。然而，他们认为睡眠不足是轮班工作中健康状况不佳的主要原因，这在某种程度上削弱了他们的论点，因为他们的推理基于以下研究：1）无法区分昼夜节律失调和睡眠不足的影响，2）不清楚睡眠不足和睡眠中断之间的区别，这可能通过不同的机制起作用，3）假定昼夜节律失调是轮班工人代谢功能障碍的机制，以及4）仅研究睡眠丧失的急性效应（Repubkerstedt，2003;布鲁萨尔等人，2015; Anothaisintawee等人，2016; Brouwer等人，2020; Peñalvo等人，为了解决作者关于轮班工作和睡眠密不可分的说法，我们在他们的论点中指出，要么在调查昼夜节律失调时控制睡眠时间，要么证明昼夜节律失调对代谢的影响与睡眠无关。荟萃分析（Anothaisintawee等人，2016）得出结论，即使在控制了传统的风险因素（包括体力活动，吸烟，饮食选择和饮酒）之后，轮班工作仍然与代谢疾病的风险增加有关。虽然荟萃分析的研究人员控制了可能的罪魁祸首，但他们没有控制昼夜节律失调，这是轮班工作固有的阴险特征，不可能分开。此外，这项荟萃分析还发现，长时间睡眠与更高的
In this debate, Drs. Ritchie and Broussard argue that insufficient sleep is primarily responsible for the increased risk for metabolic disease in shift workers. They have systematically highlighted the deleterious effects of sleep loss on cardiometabolic health, to which we agree. However, their argument that sleep loss is the primary driver for poor health in shift-work is somewhat undercut by the fact that they based their reasoning on studies that 1) are unable to separate the effects of circadian misalignment and insufficient sleep, 2) are unclear about the distinction between insufficient and disrupted sleep, which potentially act through separate mechanisms, 3) postulate circadian misalignment as the mechanism for metabolic dysfunction in shift workers, and 4) only investigate the acute effects of sleep loss (Åkerstedt, 2003; Broussard et al., 2015; Anothaisintawee et al., 2016; Brouwer et al., 2020; Peñalvo et al., 2021).To address the authors’ claim that shift work and sleep are inextricably linked, we point to work in their argument that either controls for sleep duration while investigating circadian misalignment or demonstrates the metabolic impact of circadian misalignment independent of sleep. Meta-analysis by (Anothaisintawee et al., 2016) concluded that shift work remains associated with increased risk for metabolic disease even after controlling for traditional risk factors, including physical activity, smoking, dietary choices, and alcohol consumption. While the investigators of the meta-analysis control for likely culprits, they do not control for circadian misalignment, an inherent insidious trait of shift-work and impossible to separate. Moreover, this meta-analysis also found that long sleep is associated with a higher