Treatment of Circadian Disruption from Shiftwork in Older Adults

描述（由申请人提供）：夜班和轮班工作导致昼夜节律的时间和工作/睡眠时间表的时间不匹配。这反过来又会导致在夜间工作时困倦，从而增加了工作失误和事故的风险。此外，白天的睡眠被打断和缩短，这加剧了随后夜班的表现问题。据报道，老年员工的夜班适应问题比年轻员工更严重，这可能是由于他们在白天更无法入睡。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节律适应夜间工作、白天睡眠的时间表，从而提高夜间的警觉性，延长白天的睡眠时间。随后对年轻人的研究发现，只有在一半的工作时间里，中等强度的光治疗是有效的。此外，我们已经表明，在年轻人中，在夜班之前（而不是之后）安排睡眠，并在夜班时加强照明，可以在一个晚上后将警觉性和警惕性提高到接近白班的水平。然而，这样的研究还没有在老年人中进行，因此我们将在一组老年人中测试增强照明和安排睡眠方案。除了将治疗组老年人的当班警觉性、警惕性和表现与对照组进行比较外，我们还将单独测试每个组件（仅增强照明；仅安排晚间睡眠），以确定每个组件对综合治疗效果的贡献程度。随着我们社会越来越多的方面转向24小时运转，在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数量高达300万。因此，针对老年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影响工作表现和安全问题，还会增加心血管疾病、肥胖、代谢综合征和炎症反应的风险，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.