Light Treatment for NASA Shiftworkers

Intense artificial light can phase-shift circadian rhythms and improve performance, sleep, and well-being during shiftwork simulations. In real shiftworkers, however, exposure to sunlight and other time cues may decrease the efficacy of light treatment, and occupational and family responsibilities may make it impractical. With these considerations in mind, we designed and tested light-treatment protocols for NASA personnel who worked on shifted schedules during two Space Shuttle missions. During the prelaunch week, treatment subjects self-administered light of ∼10,000 lux at times of day that phase-delay circadian rhythms. Treatment continued during the missions and for several days afterward. No treatment was administered to subjects in the control group. Treatment subjects reported better sleep, performance, and physical and emotional well-being than control subjects and rated the treatment as highly effective for promoting adjustment to their work schedules. Light treatment is both feasible and beneficial for NASA personnel who must work on shifted schedules during Space Shuttle missions.     

Mood,Alertness, and Performance in Response to Sleep Deprivation and Recovery Sleep in Experienced Shiftworkers Versus Non-Shiftworkers

Previous studies have shown increased sleepiness and mood changes in shiftworkers, which may be due to sleep deprivation or circadian disruption. Few studies, however, have compared responses of experienced shiftworkers and non-shiftworkers to sleep deprivation in an identical laboratory setting. The aim of this laboratory study, therefore, was to compare long-term shiftworkers and non-shiftworkers and to investigate the effects of one night of total sleep deprivation (30.5?h of continuous wakefulness) and recovery sleep on psychomotor vigilance, self-rated alertness, and mood. Eleven experienced male shiftworkers (shiftwork ≥5 yrs) were matched with 14 non-shiftworkers for age (mean?±?SD: 35.7?±?7.2 and 32.5?±?6.2 yrs, respectively) and body mass index (BMI) (28.7?±?3.8 and 26.6?±?3.4?kg/m², respectively). After keeping a 7-d self-selected sleep/wake cycle (7.5/8?h nocturnal sleep), both groups entered a laboratory session consisting of a night of adaptation sleep and a baseline sleep (each 7.5/8?h), a sleep deprivation night, and recovery sleep (4-h nap plus 7.5/8?h nighttime sleep). Subjective alertness and mood were assessed with the Karolinska Sleepiness Scale (KSS) and 9-digit rating scales, and vigilance was measured by the visual psychomotor vigilance test (PVT). A mixed-model regression analysis was carried out on data collected every hour during the sleep deprivation night and on all days (except for the adaptation day), at .25, 4.25, 5.25, 11.5, 12.5, and 13.5?h after habitual wake-up time. Despite similar circadian phase (melatonin onset), demographics, food intake, body posture, and environmental light, shiftworkers felt significantly more alert, more cheerful, more elated, and calmer than non-shiftworkers throughout the laboratory study. In addition, shiftworkers showed a faster median reaction time (RT) compared to non-shiftworkers, although four other PVT parameters did not differ between the groups. As expected, both groups showed a decrease in subjective alertness and PVT performance during and following the sleep deprivation night. Subjective sleepiness and most aspects of PVT performance returned to baseline levels after a nap and recovery sleep. The mechanisms underlying the observed differences between shiftworkers and non-shiftworkers require further study, but may be related to the absence of shiftwork the week prior to and during the laboratory study as well as selection into and out of shiftwork. (Author correspondence: sophie.wehrens@surrey.ac.uk)     

Reataining Home-Base Sleep Hours to Prevent Jet Lag in Connection with a Westward Flight Across Nine Time Zones

The aim of this study was to test a possible countermeasure to jet lag: letting air crew retain their home-base sleep/wake pattern during layover. Instead of their usual adoption of local sleep hours, 19 flight attendants were scheduled to a westward layover (50h) flight (Copenhagen-Los Angeles, -9h) on two occasions. On one trip, crews adopted the local sleep pattern, and on the other trip, the crew retained home-base sleep hours. Subjects were monitored for 10 days before, during, and after the flight; they wore activity loggers and gave ratings through sleep/wake diaries and a questionnaire. Ratings of jet lag symptoms and sleepiness were greatly reduced during layover, but not at home, for the home-base condition. It was also found that jet lag feelings seemed to be related mainly to mean sleepiness ratings (multiple regression; 16%, beta = 0.46) and to the number of awakenings (6%, beta = 0.29) during sleep. It is concluded that retaining the home-base sleep pattern may reduce jet lag during layover.     

The Influence of Internal Time,Time Awake,and Sleep Duration on Cognitive Performance in Shiftworkers

To date, studies investigating the consequences of shiftwork have predominantly focused on external (local) time. Here, we report the daily variation in cognitive performance in rotating shiftworkers under real-life conditions using the psychomotor vigilance test (PVT) and show that this function depends both on external and internal (biological) time. In addition to this high sensitivity of PVT performance to time-of-day, it has also been extensively applied in sleep deprivation protocols. We, therefore, also investigated the impact of shift-specific sleep duration and time awake on performance. In two separate field studies, 44 young workers (17 females, 27 males; age range 20–36 yrs) performed a PVT test every 2?h during each shift. We assessed chronotype by the MCTQ^Shift (Munich ChronoType Questionnaire for shiftworkers). Daily sleep logs over the 4-wk study period allowed for the extraction of shift-specific sleep duration and time awake in a given shift, as well as average sleep duration (“sleep need”). Median reaction times (RTs) significantly varied across shifts, depending on both Local Time and Internal Time. Variability of reaction times around the 24 h mean (≈ ±5%) was best explained by a regression model comprising both factors, Local Time and Internal Time (p < .001). Short (15th percentile; RT_15%) and long (85th percentile; RT_85%) reaction times were differentially affected by Internal Time and Local Time. During night shifts, only median RT and RT_85% were impaired by the duration of time workers had been awake (p?<?.01, consistent with the highest sleep pressure), but not RT_15%. Proportion of sleep before a test day (relative to sleep need) significantly affected median RT and RT_85% during morning shifts (p?<?.01). RT_15% was worst in the beginning of the morning shift, but improved to levels above average with increasing time awake (p < .05), whereas RT_85% became worse (p < .05). Hierarchical mixed models confirmed the importance of chronotype and sleep duration on cognitive performance in shiftworkers, whereas the effect of time awake requires further research. Our finding that both Local Time and Internal Time, in conjunction with shift-specific sleep behavior, strongly influence performance extends predictions derived from laboratory studies. (Author correspondence: roenneberg@lmu.de)     

Wearing Blue-Blockers in the Morning Could Improve Sleep of Workers on a Permanent Night Schedule: A Pilot Study

Night shiftworkers often complain of disturbed sleep during the day. This could be partly caused by morning sunlight exposure during the commute home, which tends to maintain the circadian clock on a daytime rhythm. The circadian clock is most sensitive to the blue portion of the visible spectrum, so our aim was to determine if blocking short wavelengths of light below 540 nm could improve daytime sleep quality and nighttime vigilance of night shiftworkers. Eight permanent night shiftworkers (32–56 yrs of age) of Quebec City's Canada Post distribution center were evaluated during summertime, and twenty others (24–55 yrs of age) during fall and winter. Timing, efficacy, and fragmentation of daytime sleep were analyzed over four weeks by a wrist activity monitor, and subjective vigilance was additionally assessed at the end of the night shift in the fall–winter group. The first two weeks served as baseline and the remaining two as experimental weeks when workers had to wear blue-blockers glasses, either just before leaving the workplace at the end of their shift (summer group) or 2 h before the end of the night shift (fall–winter group). They all had to wear the glasses when outside during the day until 16:00 h. When wearing the glasses, workers slept, on average ±SD, 32±29 and 34±60 more min/day, increased their sleep efficacy by 1.95±2.17% and 4.56±6.1%, and lowered their sleep fragmentation by 1.74±1.36% and 4.22±9.16% in the summer and fall–winter group, respectively. Subjective vigilance also generally improved on Fridays in the fall–winter group. Blue-blockers seem to improve daytime sleep of permanent night-shift workers.     

Photic Resetting in Night-Shift Work: Impact on Nurses' Sleep

The objective of this study was to quantify daytime sleep in night-shift workers with and without an intervention designed to recover the normal relationship between the endogenous circadian pacemaker and the sleep/wake cycle. Workers of the treatment group received intermittent exposure to full-spectrum bright light during night shifts and wore dark goggles during the morning commute home. All workers maintained stable 8-h daytime sleep/darkness schedules. The authors found that workers of the treatment group had daytime sleep episodes that lasted 7.1?±?.1?h (mean?±?SEM) versus 6.6?±?.2?h for workers in the control group (p?=?.04). The increase in total sleep time co-occurred with a larger proportion of the melatonin secretory episode during daytime sleep in workers of the treatment group. The results of this study showed reestablishment of a phase angle that is comparable to that observed on a day-oriented schedule favors longer daytime sleep episodes in night-shift workers. (Author correspondence: diane.boivin@douglas.mcgill.ca)     

Aircrew fatigue in trans-Atlantic morning and evening flights

The aim of the investigation was to compare sleepiness and sleep on westward morning and evening flights. Seven morning-crew pilots and seven evening-crew pilots participated. Data were collected before, during, and after outward-bound (westward) and homeward-bound (eastward) flights across six time zones. A sleep/wake diary (with repeated sleepiness and performance ratings) and wrist actigraphy were used for data collection. Maximum sleep was obtained after return and minimum sleep before the outward-bound flights. Actigraphy measures and sleep efficiency over the course of the study showed no significant differences between the morning and evening crews. There was a trend for a significant effect of morning vs. evening flight for time with heavy eyelids, with the homeward-bound flight showing more time with heavy eyelids. There were no significant differences between morning and evening crews with regard to napping during the flight. The duration of wakefulness was longer for the evening flight crew. There were significant interactions for Karolinska sleepiness scale (KSS) self-ratings on both the outward-bound and homeward-bound flights, and KSS was elevated during a considerable portion of the evening flights. Rated performance showed a significant time effect, but there was no difference in self-ratings between morning and evening crews. Evening flights involve higher levels of sleepiness than morning flights, presumably because of the close proximity in time to the circadian trough of alertness.     

Duration of Sleep Inertia after Napping during Simulated Night Work and in Extended Operations

Due to the mixed findings of previous studies, it is still difficult to provide guidance on how to best manage sleep inertia after waking from naps in operational settings. One of the few factors that can be manipulated is the duration of the nap opportunity. The aim of the present study was to investigate the magnitude and time course of sleep inertia after waking from short (20-, 40- or 60-min) naps during simulated night work and extended operations. In addition, the effect of sleep stage on awakening and duration of slow wave sleep (SWS) on sleep inertia was assessed. Two within-subject protocols were conducted in a controlled laboratory setting. Twenty-four healthy young men (Protocol 1: n?=?12, mean age?=?25.1 yrs; Protocol 2: n?=?12, mean age?=?23.2 yrs) were provided with nap opportunities of 20-, 40-, and 60-min (and a control condition of no nap) ending at 02:00?h after ～20?h of wakefulness (Protocol 1 [P1]: simulated night work) or ending at 12:00?h after ～30?h of wakefulness (Protocol 2 [P2]: simulated extended operations). A 6-min test battery, including the Karolinska Sleepiness Scale (KSS) and the 4-min 2-Back Working Memory Task (WMT), was repeated every 15?min the first hour after waking. Nap sleep was recorded polysomnographically, and in all nap opportunities sleep onset latency was short and sleep efficiency high. Mixed-model analyses of variance (ANOVA) for repeated measures were calculated and included the factors time (time post-nap), nap opportunity (duration of nap provided), order (order in which the four protocols were completed), and the interaction of these terms. Results showed no test x nap opportunity effect (i.e., no effect of sleep inertia) on KSS. However, WMT performance was impaired (slower reaction time, fewer correct responses, and increased omissions) on the first test post-nap, primarily after a 40- or 60-min nap. In P2 only, performance improvement was evident 45?min post-awakening for naps of 40?min or more. In ANOVAs where sleep stage on awakening was included, the test x nap opportunity interaction was significant, but differences were between wake and non-REM Stage 1/Stage 2 or wake and SWS. A further series of ANOVAs showed no effect of the duration of SWS on sleep inertia. The results of this study demonstrate that no more than 15?min is required for performance decrements due to sleep inertia to dissipate after nap opportunities of 60?min or less, but subjective sleepiness is not a reliable indicator of this effect. Under conditions where sleep is short, these findings also suggest that SWS, per se, does not contribute to more severe sleep inertia. When wakefulness is extended and napping occurs at midday (i.e., P2), nap opportunities of 40- and 60-min have the advantage over shorter duration sleep periods, as they result in performance benefits ～45?min after waking.     

The relationship between assessments of jet lag and some of its symptoms

The power of the symptoms of jet lag in predicting the amount of jet lag measured at the same and different times of the day has been investigated. A total of 85 subjects was studied for 6 days after a flight from the UK to Australia (10 time zones to the east). At 08:00, 12:00, 16:00, 20:00, and 24:00h, the subjects recorded their jet lag and fatigue. At 08:00h, they also assessed their sleep. At 12:00 and 16:00h, they assessed their attitude to a meal, as well as their motivation, commitment, and irritability. On retiring, they recorded bowel activity. Assessments were by visual analog scales. Jet lag was treated as the dependent variable and the symptoms as covariates in ANCOVAs. Fatigue was a powerful predictor of jet lag, provided it was measured at the same time, and some aspects of sleep predicted jet lag measured on retiring or rising. The other symptoms predicted jet lag less powerfully and/or at a wider range of times. It is concluded that, even though jet lag at any time of the day can be predicted from contemporaneous assessments of fatigue and that it can be predicted on retiring or rising from some aspects of changed sleep, jet lag is predicted less reliably from other symptoms, including aspects of mental performance. These findings question exactly what causes jet lag at a particular time of day, and so are relevant to studies which use this measurement to investigate the problems associated with time-zone transitions, and ways to ameliorate them.     

Comparative Study to Determine the Optimal Melatonin Dosage form for the Alleviation of Jet Lag

To compare the impact of various dosage forms of melatonin and placebo on jet lag symptoms, 320 volunteers who had flights over 6 to 8 time zones were recruited for a double-blind, randomized, placebo-controlled study. The volunteers received either melatonin 0.5-mg fast-release (FR) formulation, melatonin 5-mg FR formulation, melatonin 2-mg controlled-release (CR) formulation, or placebo. The study medication was taken once daily at bedtime during 4 days after an eastward flight. The volunteers completed the Profile of Mood States (POMS), sleep log, and symptoms questionnaires once daily and the Karolinska Sleepiness Scale (KSS) three times daily prior to departure and during the 4 days of medication intake postflight. A total of 234 (73.1%) participants were compliant and completed the study. The FR melatonin formulations were more effective than the slow-release formulation. The 5-mg FR formulation significantly improved the self-rated sleep quality (p <. 05), shortened sleep latency (p <. 05), and reduced fatigue and daytime sleepiness (p <. 05) after intercontinental flight. The lower physiological dose of 0.5 mg was almost as effective as the pharmacological dose of 5.0 mg. Only the hypnotic properties of melatonin, sleep quality and sleep latency, were significantly greater with the 5.0-mg dose. (Chronobiology International, 15(6), 655-666, 1998)     

The Relationship Between Assessments of Jet Lag and Some of Its Symptoms

The power of the symptoms of jet lag in predicting the amount of jet lag measured at the same and different times of the day has been investigated. A total of 85 subjects was studied for 6 days after a flight from the UK to Australia (10 time zones to the east). At 08:00, 12:00, 16:00, 20:00, and 24:00h, the subjects recorded their jet lag and fatigue. At 08:00h, they also assessed their sleep. At 12:00 and 16:00h, they assessed their attitude to a meal, as well as their motivation, commitment, and irritability. On retiring, they recorded bowel activity. Assessments were by visual analog scales. Jet lag was treated as the dependent variable and the symptoms as covariates in ANCOVAs. Fatigue was a powerful predictor of jet lag, provided it was measured at the same time, and some aspects of sleep predicted jet lag measured on retiring or rising. The other symptoms predicted jet lag less powerfully and/or at a wider range of times. It is concluded that, even though jet lag at any time of the day can be predicted from contemporaneous assessments of fatigue and that it can be predicted on retiring or rising from some aspects of changed sleep, jet lag is predicted less reliably from other symptoms, including aspects of mental performance. These findings question exactly what causes jet lag at a particular time of day, and so are relevant to studies which use this measurement to investigate the problems associated with time‐zone transitions, and ways to ameliorate them.     

Aircrew Fatigue in Trans‐Atlantic Morning and Evening Flights

The aim of the investigation was to compare sleepiness and sleep on westward morning and evening flights. Seven morning‐crew pilots and seven evening‐crew pilots participated. Data were collected before, during, and after outward‐bound (westward) and homeward‐bound (eastward) flights across six time zones. A sleep/wake diary (with repeated sleepiness and performance ratings) and wrist actigraphy were used for data collection. Maximum sleep was obtained after return and minimum sleep before the outward‐bound flights. Actigraphy measures and sleep efficiency over the course of the study showed no significant differences between the morning and evening crews. There was a trend for a significant effect of morning vs. evening flight for time with heavy eyelids, with the homeward‐bound flight showing more time with heavy eyelids. There were no significant differences between morning and evening crews with regard to napping during the flight. The duration of wakefulness was longer for the evening flight crew. There were significant interactions for Karolinska sleepiness scale (KSS) self‐ratings on both the outward‐bound and homeward‐bound flights, and KSS was elevated during a considerable portion of the evening flights. Rated performance showed a significant time effect, but there was no difference in self‐ratings between morning and evening crews. Evening flights involve higher levels of sleepiness than morning flights, presumably because of the close proximity in time to the circadian trough of alertness.     

Shiftwork and Metabolic Dysfunction

Many of the health problems that are more prevalent among shiftworkers are thought to be linked to their heightened susceptibility to metabolic syndrome, i.e., the association of even moderate degrees of visceral obesity, dyslipidemia, abnormal blood pressure, and serum glucose levels in the same individual. Although previous studies have identified associations between shiftwork and metabolic syndrome, there is relatively little evidence to date of how the risk of developing it varies as a function of exposure to shiftwork. The current study seeks to confirm earlier findings of an association between shiftwork exposure and metabolic dysfunction, and to examine the impact of exposure duration, while adjusting for a number of covariates in the analyses. The analyses were based on data from VISAT, a study involving the measurement of physiological, behavioral, and subjective outcomes from 1757 participants, 989 being current or former shiftworkers. The sample comprised employed and retired wage earners, male and female, who were 32, 42, 52, and 62 yrs old. The first analysis sought to confirm previous findings of an association between exposure to shiftwork and the risk of developing metabolic syndrome. It indicated that participants who were or who had previously been shiftworkers (i.e., working schedules that involved rotating shifts; not being able to go to bed before midnight; having to get up before 05:00?h; or being prevented from sleeping during the night) were more likely to exhibit symptoms of metabolic syndrome, after adjusting for age, sex, socioeconomic status, smoking, alcohol intake, perceived stress, and sleep difficulty (odds ratio [OR] 1.78; 95% confidence interval [CI] 1.03–3.08). The results suggest the association between shiftwork and metabolic syndrome cannot be fully accounted for by either higher levels of strain or increased sleep difficulty among shiftworkers, although it remains a possibility that either one or both of these factors may have played a contributing role. The second analysis addressed the issue of duration of exposure to shiftwork. Participants with >10 yrs' experience of working rotating shifts were more likely to exhibit symptoms of metabolic syndrome than participants without exposure to shiftwork, i.e., dayworkers, even after adjusting for age and sex (OR 1.96; 95% CI 1.03–3.75). Thus, the current study confirms the association between shiftwork exposure and metabolic syndrome. It also provides new information regarding the time course of the development of the illness as function of exposure duration, although this was only examined in relation to rotating shiftwork. It is concluded that those responsible for monitoring workers' health should pay particular attention to indices of metabolic dysfunction in workers who have been exposed to shiftwork for >10 yrs. (Author correspondence: p.t.tucker@swansea.ac.uk)     

Relation of Chronotype to Sleep Complaints in the General Finnish Population

Individuals show variation in their preference for the daily timing of activities. In this study the authors analyzed whether chronotypes associate with sleep duration and sleep-related complaints. The authors used the National FINRISK Study 2007 Survey data on 3696 women and 3162 men, representative of the Finnish population aged 25 yrs and older, for the assessment of chronotype and self-reported sleep. Evening types experienced insomnia symptoms, had nightmares, and had used recently hypnotics significantly more often than other chronotypes among both men and women. In a multinominal logistic regression model predicting insufficient sleep, the association of eveningness with insufficient sleep was not abolished after adjustment for sex, age, and sleep duration. The prevalence of short sleepers was significantly higher in evening types among men than among women, whereas that of long sleepers was significantly higher in evening types among both men and women, as compared with the other chronotypes. These results indicate that eveningness predisposes individuals to a range of sleep complaints. (Author correspondence: ilona.merikanto@helsinki.fi)     

汶川地震救援官兵睡眠质量与睡眠自适应的关系研究*

目的:考察汶川地震救援官兵在连续作业状态下睡眠质量及其与睡眠自适应的关系。方法:采用匹兹堡睡眠质量问卷,在地震爆发后约65天左右,对122名救援官兵进行调查;采用匹兹堡睡眠质量问卷和军人睡眠自适应量表,在地震爆发后约102天,对2000名救援官兵进行调查。结果:地震救援官兵在执行任务中睡眠质量差者占72%,结束任务后睡眠质量差者占30%。两组睡眠质量各分量表得分除"催眠药物"因素外均有显著差异;救援官兵的睡眠自适应水平偏低,平均分为2.74,低于理论中点分3分;睡眠质量与睡眠自适应水平之间的关系较为密切,除了与对睡眠的影响因素相关不显著外(相关系数为-.027),与睡眠自适应总体水平及其5个因子的相关在.16-.533之间(P<0.001);睡眠的积极暗示、睡眠的抗干扰力和睡眠的积极态度等3个因子是影响军人睡眠质量总体水平的主要因素。结论:使官兵形成和睡眠有关的积极、正确的信念与态度能够有效改善人们的睡眠质量。     

Sleep and Sleepiness among Brazilian Shift-Working Bus Drivers

The aim of this study was to evaluate daytime and nighttime sleep, as well as daytime and nighttime sleepiness of professional shift-working bus drivers. Thirty-two licensed bus drivers were assessed by nocturnal and diurnal polysomnography (PSG) recording and multiple sleep latency testing (MSLT) sessions. Sleep length was shorter and sleep efficiency reduced during daytime sleep compared with nighttime sleep. Thirty-eight percent of the drivers had indices of obstructive apnea and hypopnea syndrome (>5/h sleep) during nighttime and daytime sleep; more drivers snored during daytime than nighttime sleep (50% vs. 35%, p < 0.05), and 38% of the drivers evidenced periodic leg movements. The MSLT revealed that 42 and 38% of the bus drivers met the criteria for sleepiness when the test was conducted during the day and night, respectively. The daytime as compared to nighttime sleep of shift-working bus drivers was shorter and more fragmented and was associated in many with evidence of excessive sleepiness. Respiratory disorder was a common finding among the professional shift-working bus drivers. All these sleep deficiencies may adversely affect on the job driving performance.     

孕期运动时间与睡眠障碍的相关性研究

摘要 目的：孕期睡眠障碍的发生率较孕前明显升高，可引起妊娠期糖尿病、妊娠期高血脂、产后抑郁等疾病的发生。本研究拟探讨孕期运动对睡眠障碍的影响。方法：选取2021年1月至3月在我院产检建卡的孕妇进行问卷调查，收集孕妇的一般资料、妊娠情况、生活习惯以及运动情况，再根据匹兹堡睡眠质量指数量表（PSQI），对孕妇的睡眠情况进行评分。根据每日运动情况，分为运动时间≤30分钟和＞30分钟两组，分析运动时间对睡眠质量的影响。再选取出睡眠障碍（PSQI评分＞5分）的孕妇，进行生活方式指导，增加每日运动时间，坚持四周后，再次进行睡眠评分。结果：发放问卷320份，有效问卷293份。其中运动时间≤30分钟的共238人，平均睡眠评分为5.88分，运动时间＞30分钟的共55人，平均睡眠评分为4.83分，两组差异具有统计学意义。运动时间≤30分钟的孕妇睡眠障碍的发生率为45.22%，运动时间＞30分钟的孕妇，睡眠障碍的发生率为27.28%，两者差异具有统计学意义。对睡眠障碍的孕妇增加运动时间，四周后24%的人改善了睡眠质量。结论：对比运动少的孕妇，每日运动超过30分钟可以带来更好的睡眠质量。对于睡眠障碍的孕妇，增加每日运动量（＞30分钟），可以改善睡眠，从而改善围产结局。     

Transient changes in the pattern of food intake following a simulated time-zone transition to the east across eight time zones

Twelve healthy adults were studied, singly or in groups of up to four, in an Isolation Unit before (control days) and for 3 days after a simulated time-zone transition to the east across 8 time zones (the clock being changed from 15:00 to 23:00 h). Subjects were free to choose how to pass their waking hours (though naps were forbidden), and to eat what and when they wanted. A wide selection of food was provided, though the subjects had to prepare it. Subjects completed food intake questionnaire on waking and at 3 h intervals during the waking day. This questionnaire assessed the reasons for choosing not to eat a meal or, if a meal was eaten, the reasons for doing so, the type of meal chosen and the reasons for this choice, and subjective responses to the meal (hunger before, enjoyment during, and satiety afterwards). Subjects also recorded the incidence and degree of indigestion and jet lag at 3 h intervals after the time-zone transition. Following the time-zone transition, the subjects experienced significant amounts of jet lag and recorded a significant increase in the incidence of indigestion. They also showed significant changes in their pattern of food intake, but, whereas the patterns of food intake were no longer significantly different from control days by the third post-shift day, the symptoms of jet lag and indigestion were still present then. The distribution of daytime meals was significantly affected on the first post-shift day, with a redistribution of the times that the main, hot meals were eaten; these times indicated some influence of an unadjusted body clock. On this day also, the reasons for determining food intake continued to be dominated by hunger and appetite (hunger even increasing in the frequency with which it was cited), and the reason for not eating a meal, by a lack of hunger. On both control and post-shift days, there was a marked effect of meal type upon the responses to food intake, with cold food being rated least and large hot meals most when appetite before the meal, enjoyment during it, and satiety afterward were considered. However, evidence suggested that the degree to which larger hot meals were preferred to cold meals was significantly less marked after the time-zone transition. On control days, sleep was unbroken; whereas, after the time-zone transition, all subjects woke on at least one of the 3 nights studied. During the first post-shift night, about half of the subjects ate a meal, the reason given being that they were “hungry.” On those occasions when subjects woke but did not eat a meal, the reason cited was because they “could not be bothered” as frequently as because they were “not hungry.”. A simulated time-zone transition is associated with significant changes to the incidence of indigestion, pattern of food intake, and subjective responses to food. However, these changes are generally transient and are only weakly linked to the sensation of jet lag.     

Sleep quality in pregnancy during treatment with Bryophyllum pinnatum: An observational study

IntroductionPoor sleep quality in pregnancy is frequent. A treatment with sedatives is problematic due to possible adverse effects for mother and embryo/foetus. In the present study, we investigated the sedative effect of Bryophyllum pinnatum, a phytotherapeutic medication used in anthroposophic medicine. In previous clinical studies on its tocolytic effect, B. pinnatum showed a good risk/benefit ratio for mother and child. A recent analysis of the prescribing pattern for B. pinnatum in a network of anthroposophic physicians revealed sleep disorders as one of the most frequent diagnoses for which these preparations are prescribed.Materials and methodsIn this prospective, multi-centre, observational study, pregnant women suffering from sleep problems were treated with B. pinnatum (350 mg tablets, 50% leaf press juice, Weleda AG, Arlesheim, dosage at physician's consideration). Sleep quality, daily sleepiness and fatigue were assessed with the aid of standardised questionnaires, at the beginning of the treatment and after 2 weeks. Possible adverse drug reactions perceived by the patients during the treatment were recorded.ResultsThe number of wake-ups, as well as the subjective quality of sleep was significantly improved at the end of the treatment with B. pinnatum. The Epworth Sleeping Scale decreased, indicating a decrease of the tiredness during the day. There was, however, no evidence for prolongation of the sleep duration, reduction in the time to fall asleep, as well as change in the Fatigue Severity Scale after B. pinnatum. No serious adverse drug reactions were detected.ConclusionB. pinnatum is a suitable treatment of sleep problems in pregnancy. The data of this study encourage further clinical investigations on the use of B. pinnatum in sleep disorders.     

Sleep and cortical temperature in the Djungarian hamster under baseline conditions and after sleep deprivation

The Djungarian hamster (Phodopus sungorus) is a markedly photoperiodic rodent which exhibits daily torpor under short photoperiod. Normative data were obtained on vigilance states, electroencephalogram (EEG) power spectra (0.25–25.0 Hz), and cortical temperature (T_CRT) under a 168 h light-dark schedule, in 7 Djungarian hamsters for 2 baseline days, 4 h sleep deprivation (SD) and 20 h recovery.During the baseline days total sleep time amounted to 59% of recording time, 67% in the light period and 43% in the dark period. The 4 h SD induced a small increase in the amount of non-rapid eye movement (NREM) sleep and a marked increase in EEG slow-wave activity (SWA; mean power density 0.75–4.0 Hz) within NREM sleep in the first hours of recovery. T_CRT was lower in the light period than in the dark period. It decreased at transitions from either waking or rapid eye movement (REM) sleep to NREM sleep, and increased at the transition from NREM sleep to waking or REM sleep. After SD, T_CRT was lower in all vigilance states.In conclusion, the sleep-wake pattern, EEG spectrum, and time course of T_CRT in the Djungarian hamster are similar to other nocturnal rodents. Also in the Djungarian hamster the time course of SWA seems to reflect a homeostatically regulated process as was formulated in the two-process model of sleep regulation.Abbreviations EEG electroencephalogram - EMG electromyogram - N NREM sleep - NREM non-rapid eye movement - R REM sleep - REM rapid eye movement - SD sleep deprivation - SWA slow-wave activity - T_CRT cortical temperature - TST total sleep time - VS vigilance state - W waking