Clinical translation of phenotypes of shift work disorder

轮班工作障碍表型的临床转化

• 批准号: 10208934
• 负责人: Philip Cheng
• 金额: $ 15.22万
• 依托单位: HENRY FORD HEALTH SYSTEM
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-08-15 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10208934
• 关键词: Accidents; Address; Area; Assessment tool; Automobile Driving; Behavior Therapy; Biological Assay; Biological Clocks; Chronic; Circadian desynchrony; Clinic; Clinical; Clinical Research; Clinical assessments; Cognitive; Cognitive Therapy; Data; Development; Diagnostic; Drowsiness; Effectiveness; Exhibits; Foundations; Functional disorder; Funding; Goals; Gold; Health; Heterogeneity; High Prevalence; Industrial Accidents; Industry; Injury; Intervention; K-Series Research Career Programs; Laboratories; Lead; Measurement; Medicine; Melatonin; Methodology; Methods; Mindfulness Training; Outcome; Pathway interactions; Patients; Pattern; Performance; Phase; Phenotype; Phototherapy; Physiological; Populations at Risk; Productivity; Public Health; Research; Risk; Safety; Schedule; Screening procedure; Sensitivity and Specificity; Shift-Work Sleep Disorder; Sleep; Sleep disturbances; Sleeplessness; Symptoms; Time; Training; Training Activity; Translating; Translational Research; Translations; Underserved Population; United States; Work; base; career; circadian; clinical development; clinical implementation; clinical translation; cognitive function; cognitive performance; cost; cost effective; disabling symptom; effective intervention; effective therapy; efficacy testing; environmental stressor; experience; flexibility; functional disability; impaired driving performance; improved; indexing; individual response; novel; personalized intervention; preempt; prevent; public health relevance; risk prediction; shift work; tool; trait; translational research program

PROJECT SUMMARY/ABSTRACT Shift work disorder (SWD) is a significant threat to public health and safety; over 6 million shift workers in the United States experience the debilitating symptoms of excessive sleepiness and insomnia, and suffer functional impairments that increases the risk of catastrophic industrial accidents. However, patients with SWD are often inadequately treated because the pathophysiology is not well-characterized, and current diagnostic assessments do not identify specific treatment targets. Consequently, clinicians are unable to deliver precise interventions that target the underlying causes of SWD. The proposed project in this career development award will address these gaps by taking the initial steps of translating two phenotypes of SWD for clinical use. Previous research has indicated that SWD can arise from two independent pathways that can be categorized as pathophysiological phenotypes. The first is the circadian misalignment phenotype, characterized by poor adjustment of the biological clock to the nocturnal work schedule. The second is the sleep reactivity phenotype, characterized by a trait vulnerability to sleep disturbance triggered by environmental stressors. Both phenotypes lead to symptoms of sleepiness and insomnia in SWD, and is not currently distinguished in the clinic; however, the requisite treatments for each pathophysiological phenotype are entirely different. As such, the appropriate intervention of SWD requires that these phenotypes be adequately characterized and identified in the clinic. The proposed aims will complete the requisite foundational research to launch the translation of these phenotypes of SWD for clinical use. The first research aim will examine the stability of each phenotype in shift workers to characterize them as either state or trait phenotypes, which will impact both assessments of interventions. The second research aim will identify the specific clinical attributes that can be used to index the phenotypes in a brief, accurate, and cost-effective assessment tool. Finally, the third research aim will identify differences in cognitive and performance deficits between the two phenotypes so that accidents and injuries can be preempted with targeted interventions.To successfully complete the research aims, and to support my long term goal of conducting translational research to improve the health and productivity of shift workers, this career development award will provide further training in the following areas: (1) development of clinical screening tools, (2) advanced methodologies in clinical and translation research, (3) feasibility of “real-world” behavioral interventions for shift work disorder, and (4) advanced field measurement of circadian phase. In combination, the training activities outlined in this career development award will provide the necessary expertise for a sustained career in translational research and circadian medicine.

项目总结/摘要 轮班工作障碍（SWD）是对公共健康和安全的重大威胁;在美国， 美国的经验，使人衰弱的症状，过度嗜睡和失眠，并遭受 增加灾难性工业事故风险的功能障碍。然而， 通常治疗不充分，因为病理生理学特征不明确，目前的诊断 评估不能确定具体的治疗目标。因此，临床医生无法提供精确的 针对社署问题的根本原因而采取的干预措施。在这个职业发展的建议项目 该奖项将采取初步步骤，翻译两个表型的社会福利署为临床使用，以解决这些差距。 先前的研究表明，社会福利署可以从两个独立的途径，可以归类 作为病理生理表型。第一种是昼夜节律失调表型，其特征是差 调整生物钟以适应夜间工作时间表。二是睡眠反应性 表型，其特征在于对环境应激源引发的睡眠障碍的特质脆弱性。 这两种表型均导致SWD患者的嗜睡和失眠症状，目前在 然而，每种病理生理表型所需的治疗是完全不同的。作为 因此，社署的适当干预需要充分描述这些表型， 在诊所里发现的。拟议的目标将完成必要的基础研究， 翻译这些SWD表型用于临床应用。第一个研究目标将检查每个 表型在倒班工人的特点，无论是状态或性状表型，这将影响两者 评估干预措施。第二个研究目标是确定可以被应用的特定临床属性。 用于索引表型的一个简短的，准确的，具有成本效益的评估工具。第三个 研究目的是确定两种表型之间认知和表现缺陷的差异， 事故和伤害可以通过有针对性的干预措施来预防。为了成功完成研究， 目标，并支持我进行转化研究，以改善健康和 为了提高轮班工人的生产力，该职业发展奖将在以下领域提供进一步培训： (1)开发临床筛查工具，（2）临床和翻译研究的先进方法，（3） 对倒班工作障碍进行“真实世界”行为干预的可行性;（4）先进的现场测量 昼夜节律的阶段。结合起来，在这个职业发展奖概述的培训活动将提供 在转化研究和昼夜节律医学的持续职业生涯所必需的专业知识。

项目成果

Preliminary evidence of psychological improvements and increased maternal-fetal attachment associated with a mindfulness sleep programme: secondary analysis of uncontrolled data in 11 pregnant women with insomnia disorder.

与正念睡眠计划相关的心理改善和母婴依恋增加的初步证据：对 11 名患有失眠症的孕妇的非对照数据的二次分析。

• DOI: 10.1111/jsr.14040
• 发表时间: 2024
• 期刊: Journal of sleep research
• 影响因子: 4.4
• 作者: Kalmbach,DavidA;Reffi,AnthonyN;Ong,JasonC;Cheng,Philip;Walch,Olivia;Pitts,D'AngelaS;Seymour,GraceM;Hirata,Mika;Roth,Andrea;Roth,Thomas;Drake,ChristopherL
• 通讯作者: Drake,ChristopherL

Psychological Impact of Shift Work

轮班工作的心理影响

• DOI: 10.1007/s40675-018-0114-7
• 发表时间: 2018
• 期刊: Current Sleep Medicine Reports
• 影响因子: 1.8
• 作者: P. Cheng;C. Drake
• 通讯作者: C. Drake

Nocturnal cognitive hyperarousal, perinatal-focused rumination, and insomnia are associated with suicidal ideation in perinatal women with mild to moderate depression.

• DOI: 10.1016/j.sleep.2021.03.004
• 发表时间: 2021-05
• 期刊: Sleep medicine
• 影响因子: 4.8
• 作者: Kalmbach DA;Ahmedani BK;Gelaye B;Cheng P;Drake CL
• 通讯作者: Drake CL

DSM-5 insomnia disorder in pregnancy: associations with depression, suicidal ideation, and cognitive and somatic arousal, and identifying clinical cutoffs for detection.

• DOI: 10.1093/sleepadvances/zpac006
• 发表时间: 2022
• 期刊: Sleep advances : a journal of the Sleep Research Society
• 作者: Kalmbach DA;Cheng P;Roth A;Roth T;Swanson LM;O'Brien LM;Fresco DM;Harb NC;Cuamatzi-Castelan AS;Reffi AN;Drake CL
• 通讯作者: Drake CL

Validation of the Entrainment Signal Regularity Index and associations with children's changes in BMI

• DOI: 10.1002/oby.23641
• 发表时间: 2023-01
• 期刊: Obesity
• 影响因子: 6.9
• 作者: J. Moreno;K. Hannay;Amy R Goetz;Olivia J. Walch;P. Cheng