Treatment of Circadian Disruption from Shiftwork in Older Adults

老年人轮班工作造成的昼夜节律紊乱的治疗

• 批准号: 8849330
• 负责人: Jeanne F Duffy
• 金额: $ 48.6万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-06-15 至 2016-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8849330
• 关键词: Accidents; Address; Adverse effects; Affect; Aging; American; Biological Clocks; Cardiovascular Diseases; Circadian Rhythm Sleep Disorders; Circadian Rhythms; Combined Modality Therapy; Commuting; Control Groups; Elderly; Future; Gastrointestinal Diseases; Health; Home environment; Hour; Individual; Inflammatory Response; Instruction; Intervention; Lead; Life; Light; Lighting; Malignant Neoplasms; Medical; Melatonin; Mental Depression; Metabolic syndrome; Myocardial Infarction; Obesity; Occupations; Participant; Performance; Performance at work; Phase; Phototherapy; Productivity; Quality of life; Regimen; Reporting; Risk; Safety; Schedule; Sleep; Societies; Testing; Time; Treatment Protocols; Work; adverse outcome; alertness; cardiovascular disorder risk; experience; improved; inattention; light intensity; operation; shift work; social; treatment effect; trend; vigilance; young adult

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.

描述（由申请人提供）：夜间和轮班工作导致昼夜节律的时间与工作/睡眠时间表的时间不匹配。这反过来又会导致夜间工作时困倦，从而增加性能错误和事故的风险。此外，白天的睡眠被打乱和缩短，这加剧了随后夜班的表现问题。据报道，老年工人的夜班适应问题比年轻工人更严重，这被假设是由于他们在白天无法入睡。我们之前已经证明，在年轻人中，夜班期间的明亮光线可以改善昼夜适应夜间工作，白天睡眠时间表，导致夜间警觉性增加和白天睡眠时间延长。随后在年轻人中进行的研究发现，只有一半的工作班次使用中等强度的光治疗可能有效。此外，我们已经证明，在年轻人中，在夜班之前（而不是之后）安排睡眠，当与夜班的增强照明相结合时，可以在一个晚上之后将警觉性和警惕性提高到接近白班的水平。然而，这些研究尚未在老年人中进行，因此我们将在一组老年人中测试增强照明和预定的睡眠方案。除了将治疗组中老年人的轮班警觉性、警惕性和表现与对照组参与者进行比较外，我们还将分别测试每个组件（仅增强照明;仅计划的夜间睡眠），以确定每个组件对综合治疗效果的贡献程度。美国人在夜间工作的人数持续增加，因为我们社会的更多方面已经转向24小时运作，美国劳工部估计夜间工作的老年工人人数高达300万。因此，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导致性能和安全问题，而且会导致心血管疾病，肥胖和代谢综合征以及炎症反应的风险，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未来的影响。