Treatment of Circadian Disruption from Shiftwork in Older Adults

描述(申请人提供)：夜班和轮班工作导致昼夜节律的计时与工作/睡眠时间表的计时不匹配。这反过来会导致夜间工作时昏昏欲睡，出现性能错误和事故的风险更大。此外，白天的睡眠被打乱和缩短，这加剧了随后的夜班的表现问题。据报道，年龄较大的员工在夜班适应方面的问题比年轻员工更严重，据推测，这是因为他们白天更不能入睡。我们之前已经证明，在年轻人中，夜班期间的强光可以改善昼夜适应夜间工作、白天睡眠的时间表，从而提高夜间的警觉性和更长的白天睡眠时间。随后对年轻人的研究发现，中等强度的光线只对一半的轮班时间有效。此外，我们已经证明，在年轻人中，在夜班之前(而不是在夜班之后)安排睡眠，当与夜班上加强照明相结合时，可以提高警觉性和警觉性，使其在仅一晚后就达到接近白班的水平。然而，这样的研究还没有在老年人身上进行，因此我们将在一组老年人中测试这种增强的照明和预定的睡眠养生法。除了将治疗组中的老年人与一组对照组参与者的当班警觉、警觉和表现进行比较外，我们还将分别测试每个组件(仅限增强照明；仅限夜间睡眠)，以确定每个组件对综合治疗效果的贡献程度。随着我们社会的更多方面转向全天候运营，美国夜间工作的美国人数量持续增加，据美国劳工部估计，夜间工作的老年工人人数高达300万。因此，针对上了年纪的夜班工人的对策有可能使许多人受益。鉴于我们越来越了解睡眠不足不仅会导致表现和安全问题，还会增加心血管疾病、肥胖和代谢综合征以及炎症反应的风险，因此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未来的影响。

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.