Evaluation of a fast forward rotating shift schedule in the steel industry with a special focus on ageing and sleep

The aim of this study was to explore the effect of a change in the speed and direction of shift rotation on the sleep and wakefulness of younger and older workers. A continuous three-shift schedule was changed from a slow backward rotating (EEE-MMMNNN-----) to a fast forward rotating system (MMEENN----). Sixteen subjects (mean age 42 years) were studied before and one year after the change in schedule. Two age groups were compared: ten younger men (mean age 35 years) and six older men (mean age 53 years). The effects of the new work schedule were evaluated by a questionnaire (modified SSI), and on-site registrations with an actigraph and sleep log for one shift cycle (10-15 days) before and after the new schedule. After the change in schedule, subjective sleep problems decreased and alertness increased during the morning shifts. The change in schedule influenced sleep differently in the two age-groups. Both the subjective and objective quality of sleep improved among the older workers. The results indicate that a fast forward rotating shift schedule is more suitable for older workers than a slower backward rotating system.     

Electroencephalographic characteristics of sleep in subjects with paleo and neocerebellar lesions

The research was performed in order to study: 1) paleo and neocerebellar contributions in the sleep organization and 2) the electrical sleep activities at different time intervals during the functional compensation which follows the cerebellar lesion. Polygraphic sleep records (EEG, EMG, EOG) were performed on four subjects with surgical lesions more than 6 months old in cerebellar cortex (two subjects in paleo and two in neocerebellum). Another subject was studied before a surgical paleocerebellar lesion and at different time intervals after that (8th, 30th, 60th, and 90th day). Paleo and neocerebellar lesions showed different sleep abnormalities. The former induced both quantitative and qualitative alterations in the cyclic sleep organization, the latter did not show significant alterations in this organization but rather in transition between sleeping and waking and in sleep maintenance. The acute paleocerebellar lesion showed at the 8th and 30th day a strong reduction of the synchronized sleep (SS) and an increase of the desynchronized one (DS). In the successive records, 30th and 90th day, the SS/DS ratio increased to the values observed in the chronic paleocerebellar lesioned subjects.     

Twenty-Four-Hour Prolactin Profiles in Night Workers

In addition to sleep processes, it has been suggested that an intrinsic circadian rhythmicity is involved in the temporal organization of prolactin (PRL) secretion. Eight night workers were studied to determine whether the PRL rhythm is adapted to their rest-activity schedule and whether this provides evidence in favor of an endogenous clock-driven component. Ten day-active subjects, sleeping once during the night and once after an 8-h delay in their sleep period, were used as a control group. Plasma PRL, body temperature, and plasma melatonin were measured at 10-min intervals. Twenty-four-hour PRL profiles did not differ between night workers sleeping as usual during the daytime and day-active subjects submitted to an abrupt sleep shift to daytime. For the two groups of subjects a transient PRL peak, similar in size and time of occurrence, was observed during the night. Melatonin, a strong marker of the primary circadian oscillator, displayed a phase shift that differed widely among night workers. Body temperature, on the other hand, was found to be more regularly adapted despite the persistence of a small decrease or leveling off during the night. Although no relationship was found between the melatonin increase and the nocturnal PRL peak, a concomitance with this transient temperature decrease could be demonstrated. The persistence of this PRL peak in night workers raises the question of its significance. (Chronobiology International, 13(4), 283-293, 1996)     

Effect of Personality on Changes of Sleep Structure Caused by Emotional Stress

Effects of personality characteristics on the structure of sleep in ten normal subjects between the ages of 21–33 under stressors of various modalities were studied. Several psychological tests and polygraph recording of sleep during three nights (adaptation, background, and after emotional stress, which was modeled using the pretension level paradigm) were conducted. Statistical cluster analysis of the psychological test results revealed two groups of subjects. The first group predominantly used active coping mechanisms and was characterized by more pronounced alterations of sleep structure in response to adaptation stress (the first night in the laboratory). The second group used nonadaptation coping strategy. The sleep structure in these subjects more significantly changed in response to emotional stress.     

Case study of circadian rhythm sleep disorder following haloperidol treatment: reversal by risperidone and melatonin

A patient with Gilles de la Tourette syndrome treated with haloperidol, ingested once daily after awakening from sleep, exhibited an irregular sleep-wake pattern with a free-running component of approximately 48 h. Transfer to risperidone, ingested once daily after awakening from sleep, was beneficial resulting in a sleep-wake cycle more synchronized at the appropriate phase to the external zeitgebers, and fewer nocturnal disturbances. The circadian sleep-wake schedule was fully synchronized when the patient had been subsequently treated with melatonin at 21:00h, before intended nocturnal sleep, in addition to risperidone in the morning. Restoration of the sleep-wake circadian pattern was accompanied by the patient's subjective report of significant improvement in his quality of life, social interactions, and occupational status. This observation suggests that circadian rhythm sleep disorders can be related to the typical neuroleptic haloperidol and restored by the atypical neuroleptic risperidone. Similar findings reported in patients suffering from other disorders support the hypothesis that the described disruption of the sleep-wake schedule is medication rather than illness-related. Therefore, it is very important to realize that circadian rhythm sleep disorders may be a side effect of neuroleptics.     

Sleep Disturbances Among Female Nurses: Comparing Shift to Day Work

Recently, attention has focused in Israel on the possible legal and health consequences of shift work. We decided to study sleep disorders among female nursing personnel working a shift schedule, in comparison with day nurses, in a large metropolitan general hospital. The study population was composed of 131 female certified nurses working shifts and 44 working days only. Inclusion criteria for the survey was at least 1 year of shift work alternating between day, evening, and night shifts, or at least 1 year of day work. All participants completed a self-report sleep questionnaire encompassing (a) demographic data, (b) sleep survey, and (c) employment details. Statistical analysis was performed using the Pearson correlation test and analysis of variance multiple range test (according to Scheffe's procedure). No significant correlation was found between sleep disorders and age of subjects. No sleep disorders were reported by 19.8% of shift workers versus 76.5% of day workers. Statistically significant findings were that the number of shifts per week >4.1 (p = 0.001) and duration of shift work >13.6 years (p = 0.007) correlated with the presence of sleep disorders. An additional significant finding (p = 0.014) was the impact of evening shifts on sleep disorders. The present small study confined to women supports the growing body of data on sleep complaints among shift workers.     

Event-related desynchronization (ERD) patterns during memory processes: effects of aging and task difficulty

Event-related desynchronization (ERD) was studied in 10 young (mean age = 19.1) and 10 older (mean age = 62.8) subjects during two recognition tasks: verbal and visuo-spatial. The difficulty of these tasks varied according to the difficulty to distinguish between targets and distractors. EEGs recorded from 29 electrodes were used to compute ERDs from 14 source derivations in 125 msec intervals. Thereafter, they were displayed as spatio-temporal maps. The results show that desynchronization was more widespread in the visuo-spatial compared to the verbal task. This was observed in the two age groups, although it was more pronounced in the young subjects. The effect of task complexity was also influenced by the kind of material to be remembered: more differences between the two levels of difficulty were observed during the verbal task.The results revealed significant influences of the task and time variables on the ERD patterns. A distinct time course of the desynchronization phenomenon was observed to be related to the kind of recognition task. Age and task complexity interacted with the other variables.     

Characteristics of activity of "fast" and "slow" Purkinje cells of the cerebellum

In the guinea pig cerebellar cortex, three types of Purkinje cells were identified according to the properties of complex spikes: fast, intermediate, and slow cells. Fast Purkinje cells have following properties as compared with slow Purkinje cells: (i) salient components with short intervals in complex impulses (on the average, five components with a period of about 2 ms versus two components with a period of about 4 ms); (ii) a short duration of simple spikes (in the average, 2.13 +/- 0.53 ms versus 3.9 +/- 0.65 ms) and a quick restoration of their amplitude after preceding simple spikes (in the mean, 2.83 +/- 0.75 ms versus 11.0 +/- 2.82 ms); and (iii) a more pronounced rebound in the auto-correlation histogram of simple spikes (3.09 +/- 2.12 versus 1.45 +/- 0.36) and a short-latency excitation of simple spikes after complex spikes (2.81 +/- 1.64 versus 1.26 +/- 0.52). A decrease of interspike intervals in simple spike activity of all Purkinje cells was revealed (5.25 +/- 2.71 ms versus 9.71 +/- 3.48 ms in activity fragments without complex spikes). It is supposed that the properties of complex spikes depend on the type of Purkinje cells and may be one of the basic factors determining the interactions between the inputs of climbing and parallel fibers in Purkinje cells.     

Phase-dependent effect of room light exposure in a 5-h advance of the sleep-wake cycle: implications for jet lag

The acute disruption in sleep quality, vigilance levels, and cognitive and athletic performance observed after transmeridian flights is presumed to be the result of a transient misalignment between the endogenous circadian pacemaker and the shifted sleep schedule. Several laboratory and field experiments have demonstrated that exposure to bright artificial light can accelerate circadian entrainment to a shifted sleep-wake schedule. In the present study, the authors investigated whether the schedule of exposure to indoor room light, to which urban dwellers are typically exposed, can substantially affect circadian adaptation to a simulated eastward voyage. We enrolled 15 healthy young men in a laboratory simulation of a Montreal-to-London voyage. Subjects were exposed to 6 h of room light (mean +/- SD: 379+/-10) prior to bedtime (n = 7) or when on a progressively advancing schedule (n = 8) early in the day. The remaining 10 hours of wakefulness were spent in dim light (4+/-1 lux). Circadian assessments, performed via the constant routine procedure, evaluated the phase of the endogenous circadian rhythms of core body temperature and plasma melatonin before and after 1 week on the shifted schedule. At the end of the study, only subjects exposed to room light on the advancing schedule expressed oscillations of the endogenous circadian pacemaker in phase with the new sleep-wake cycle. In this group, a mean advance shift of the nadir of core body temperature of +5:22+/-0:15 h was observed, with parallel shifts in plasma melatonin concentration and subjective alertness. The circadian rhythms of subjects exposed to room light later in the day remained much more adjusted to the departure than to the destination time zone. These results demonstrate that the schedule of exposure to room light can substantially affect circadian adaptation to a shifted sleep-wake schedule.     

Sleep Complaints and Polysomnographic Findings: A Study of Nuclear Power Plant Shift Workers

The literature widely recognizes that shift workers have more health complaints than the general population. The objective of this study was to describe the prevalence of sleep complaints and verify the polysomnographic (PSG) variables of shift workers in two Brazilian nuclear power plants. We carried out a subjective evaluation with a sleep questionnaire. Based on these results, the interviewees that reported sleep‐related complaints were referred for polysomnographic evaluation. Of the 327 volunteers initially evaluated by the sleep questionnaire, 113 (35%) reported sleep complaints; they were significantly older, had higher body mass index (BMI), and worked more years on shifts than those without sleep complaints. Of these 113, 90 met criteria for various sleep disorders: 30 (9%) showed obstructive sleep apnea (OSA), 18 (5.5%) showed limb movement, and 42 (13%) evidenced both sleep problems and had a significantly higher proportion of sleep stage 1 and arousals compared with the 23 shift workers that had no indices of sleep problems. The present study found that 90 (27.5%) of the evaluated participants met the PSG criteria of some type of clinical sleep disorder. This high proportion should be investigated for associations with other aspects of work, such as working hours, working schedule, years performing shift work, and access to health services. Due to the strong association between sleep disorders and the incidence of fatigue and sleepiness, the evaluation of the sleep patterns and complaints of shift workers is essential and should be considered to be one of the basic strategies of industry to prevent accidents.     

Sleep complaints and polysomnographic findings: a study of nuclear power plant shift workers

The literature widely recognizes that shift workers have more health complaints than the general population. The objective of this study was to describe the prevalence of sleep complaints and verify the polysomnographic (PSG) variables of shift workers in two Brazilian nuclear power plants. We carried out a subjective evaluation with a sleep questionnaire. Based on these results, the interviewees that reported sleep-related complaints were referred for polysomnographic evaluation. Of the 327 volunteers initially evaluated by the sleep questionnaire, 113 (35%) reported sleep complaints; they were significantly older, had higher body mass index (BMI), and worked more years on shifts than those without sleep complaints. Of these 113, 90 met criteria for various sleep disorders: 30 (9%) showed obstructive sleep apnea (OSA), 18 (5.5%) showed limb movement, and 42 (13%) evidenced both sleep problems and had a significantly higher proportion of sleep stage 1 and arousals compared with the 23 shift workers that had no indices of sleep problems. The present study found that 90 (27.5%) of the evaluated participants met the PSG criteria of some type of clinical sleep disorder. This high proportion should be investigated for associations with other aspects of work, such as working hours, working schedule, years performing shift work, and access to health services. Due to the strong association between sleep disorders and the incidence of fatigue and sleepiness, the evaluation of the sleep patterns and complaints of shift workers is essential and should be considered to be one of the basic strategies of industry to prevent accidents.     

Working “out-of-phase” with reference to chronotype compromises sleep quality in police officers

The aim of this work was to study the sleep characteristics, blood pressure (BP) and heart rate (HR) of the police officers working during out-of-phase (OP) and in-phase (IP) duty schedules with respect to their chronotypes. Adult male and female police officers (n = 85) were asked to answer Hindi/English version of different questionnaires to assess their chronotype (morningness–eveningness questionnaire; MEQ), PSQI scores (Pittsburgh sleep quality index), daytime sleepiness (Epworth sleepiness scale, ESS) and fatigue levels (fatigue severity scale, FSS) and fill a sleep log. Based on their PSQI scores, the participating subjects (n = 85) were divided into two categories: good sleepers (58/85) and poor sleepers (27/85). Of these 85 subjects, 23 subjects (good sleepers n = 13; poor sleepers n = 10) volunteered for the next part of the study. At the beginning of the study, the existing duty schedule of these subjects was OP and lasted for 4 days (OP1). Thereafter, they were allotted their preferred (IP) duty schedule for 4 days, followed by OP2 for further 4 days. Over the 12-day period, subjects were monitored for their BP and sleep–wake cycle. Results showed that the poor sleepers improved their sleep quality and HR during IP duty schedule; however, good sleepers were not affected significantly.     

Sleep processes exert a predominant influence on the 24-h profile of heart rate variability

Adverse cardiovascular events are known to exhibit 24-h variations with a peak incidence in the morning hours and a nonuniform distribution during the night. The authors examined whether these 24-h variations could be related to circadian or sleep-related changes in heart rate (HR) and in HR variability (HRV). To differentiate the effect of circadian and sleep-related influences, independent of posture and of meal ingestion, seven normal subjects were studied over 24 h, once with nocturnal sleep from 2300 to 0700 h and once after a night of sleep deprivation followed by 8 h of daytime sleep from 0700 to 1500 h. The subjects were submitted to constant conditions (continuous enteral nutrition and bed rest). HRV was calculated every 5 min using two indexes: the standard deviation of normal R-R intervals (SDNN) and the ratio of low-frequency to low-frequency plus high-frequency power. Sleep processes exerted a predominant influence on the 24-h profiles of HR and HRV, with lowest HRV levels during slow wave sleep, high levels during REM sleep and intrasleep awakenings, and abrupt increases in HR at each transition from deeper sleep to lighter sleep or awakenings. The circadian influence was smaller, except for SDNN, which displayed a nocturnal increase of 140% whether the subjects slept or not. This study demonstrates that 24-h variations in HR and HRV are little influenced by the circadian clock andare mainly sleep-stage dependent. The results suggest an important role for exogenous factors in the morning increase in cardiovascular events. During sleep, the sudden rises in HR at each transition from deeper sleep to lighter sleep or awakenings might precipitate the adverse cardiac events.     

Effects upon circadian rhythmicity of an alteration to the sleep-wake cycle: problems of assessment resulting from measurement in the presence of sleep and analysis in terms of a single shifted component

Experiments were performed upon groups of three or four human subjects in an isolation chamber (total n = 14). Subjects lived initially on a conventional lifestyle and then delayed their hours of sleep by 8 hr (so mimicking some aspects of nightwork) for 2 or 5 days. They also performed two constant routines--protocols designed to minimize any effects due to the environment, mealtimes, and activity. Regular samples of urine were taken when subjects were awake, and were analyzed for sodium, potassium, and chloride; rectal temperature was measured and logged at 6-min intervals throughout. Shifts in circadian rhythms produced by the change in sleep time were assessed by cosinor and cross-correlation techniques. The protocol enabled these assessments to be made on days when sleep was allowed and under constant-routine conditions, so that masking and behavioral effects could be investigated also. The results confirmed that adjustment to the change in sleep time was slow and only partial, and that assessments made on days when sleep was allowed overestimated this adjustment. Furthermore, it was concluded that, whereas cosinor and cross-correlation techniques using only one shifting component were equally useful in describing the observed changes, both were inferior to a cross-correlation technique that made use of two shifting components. Some practical and theoretical implications of these results are discussed.     

Changes in the Cardiovascular Function in Healthy Subjects and Patients with Ischemic Heart Disease during Sleep

The purpose of this study was to investigate the autonomic regulation of the cardiovascular system during sleep in health and disease. The examination included 396 subjects: 29 healthy subjects and 367 patients with ischemic heart disease, of whom 149 had left-ventricular failure and 214 hypertension. Sleep quality and the presence of obstructive sleep apnea syndrome were evaluated by polysomnography; the character of autonomic regulation of cardiac rhythm and hemodynamics was determined by computerized testing during night sleep and an active orthostatic test immediately before and after sleep. The results permitted the authors to conclude that autonomic regulation may be restored to various degrees in health and disease, depending on the pathology level. The sleep quality influenced the restoration of hemodynamics more than that of the cardiac rhythm, mainly when obstructive sleep apnea syndrome was present.     

Circadian periodicity of plasma cortisol levels: Effect of random living schedule in man

Six normal subjects lived for two weeks on disorganized schedules in which they were in bed for four 2-h periods per day at random intervals. Meals were also served on a random schedule. Subjects varied in their ability to adapt their sleep to such schedules. One subject achieved an excellent adaptation, one very good, and two fairly good. Circadian periodicity of plasma corticosteroid levels was not greatly affected by the experiment, but became noisier in most subjects, possibly because of irregularity of individual cortisol secretory episodes within the circadian cycle. The results do not encourage the belief that circadian adrenal periodicity depends upon the cumulative effects of regular living schedules.     

Estimates on the Duration of Sleep and Wakefulness Made in Isolation

Fifteen subjects who lived singly in an isolation unit without temporal cues were asked to note every day after awakening how many hours they thought they had slept, and in the evening before retiring how many hours they had been awake. These estimates of the duration of sleep and wakefulness were compared with the intervals between two signals given by the subjects by pressing a button at the time of waking up and when turning off their bedside reading lamp. The results can be summarized as follows: (a) the daily estimated durations of sleep and wakefulness were positively correlated with the actual durations in all but one subject; (b) sleep and wake times were better estimated in the presence of a light-dark cycle even if the subjects were not entrained by the zeitgeber; (c) for both episodes, there was a consistent trend from an overestimation of relatively short to an underestimation of long durations; (d) with equal durations in the two episodes, sleep was estimated to be shorter than wake time; (e) the most accurate estimates centered around 10.5 h of sleep and 13.5 h of wake time; (f) the sleep and wake times added up to 24 h in subjects who did not deliberately “compensate” for relatively long sleep estimates with a short wake estimate, with the full cycle being adjusted to 24 h.     

Plasma testosterone during nocturnal sleep in normal men

Plasma testosterone was measured by a competitive protein binding procedure at 10 to 20 minute intervals in five normal adult men during two nights of sleep. Blood samples were obtained by means of an indwelling venous catheter while sleep was monitored polygraphically. There were 1–4 abrupt elevations of plasma testosterone concentration per night in each of the subjects with an average increase of 244 ng/100 ml ± 45.5 (SE) or 59% above the values present at the onset of the episode. The fluctuations in plasma testosterone were superimposed on a nocturnal rise of the hormone observed in seven of the nights. The average of all samples taken during each hour period through the ten nights revealed a highly significant (P<0.001) nocturnal increase in plasma testosterone. The findings did not support the existence of a relation between REM sleep and an increase in testosterone levels.     

Partial sleep deprivation reduces phase advances to light in humans

Partial sleep deprivation is increasingly common in modern society. This study examined for the first time if partial sleep deprivation alters circadian phase shifts to bright light in humans. Thirteen young healthy subjects participated in a repeated-measures counterbalanced design with 2 conditions. Each condition had baseline sleep, a dim-light circadian phase assessment, a 3-day phase-advancing protocol with morning bright light, then another phase assessment. In one condition (no sleep deprivation), subjects had an 8-h sleep opportunity per night during the advancing protocol. In the other condition (partial sleep deprivation), subjects were kept awake for 4 h in near darkness (<0.25 lux), immediately followed by a 4-h sleep opportunity per night during the advancing protocol. The morning bright light stimulus was four 30-min pulses of bright light (~5000 lux), separated by 30-min intervals of room light. The light always began at the same circadian phase, 8 h after the baseline dim-light melatonin onset (DLMO). The average phase advance without sleep deprivation was 1.8 ± 0.6 (SD) h, which reduced to 1.4 ± 0.6 h with partial sleep deprivation (p < 0.05). Ten of the 13 subjects showed reductions in phase advances with partial sleep deprivation, ranging from 0.2 to 1.2 h. These results indicate that short-term partial sleep deprivation can moderately reduce circadian phase shifts to bright light in humans. This may have significant implications for the sleep-deprived general population and for the bright light treatment of circadian rhythm sleep disorders such as delayed sleep phase disorder.     

Stability of melatonin and temperature as circadian phase markers and their relation to sleep times in humans

Circadian rhythms of core body temperature and melatonin are commonly used as phase markers of the circadian clock. Melatonin is a more stable marker of circadian phase when measured under constant routine conditions. However, little is known about the variability of these phase markers under less controlled conditions. Moreover, there is little consensus about the preferred method of analysis. The objective of this study was to assess various methods of calculating melatonin and temperature phase in subjects with regular sleep schedules living in their natural environment. Baseline data were analyzed from 42 healthy young subjects who were studied on at least two occasions. Each hospital admission was separated by at least 3 weeks. Subjects were instructed to maintain a regular sleep schedule, which was monitored for 1 week before admission by sleep logs and actigraphy. Subjects spent one habituation night under controlled conditions prior to collecting baseline temperature and melatonin measurements. The phase of the melatonin rhythm was assessed by 9 different methods. The temperature nadir (Tmin) was estimated using both Cleveland and Cosine curve fitting procedures, with and without demasking. Variability between admissions was assessed by correlation analysis and by the mean absolute difference in timing of the phase estimates. The relationship to sleep times was assessed by correlation of sleep onset or sleep offset with the various phase markers. Melatonin phase markers were more stable and more highly correlated with the timing of sleep than estimates of Tmin. Of the methods for estimating Tmin, simple cosine analysis was the least variable. In addition, sleep offset was more strongly correlated with the various phase markers than sleep onset. The relative measures of melatonin offset had the highest correlation coefficients, the lowest study-to-study variability, and were more strongly associated with sleep timing than melatonin onsets. Concordance of the methods of analysis suggests a tendency for the declining phase of the melatonin profile to be more stable and reliable than either markers of melatonin onset or measures of the termination of melatonin synthesis.