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1.
J Pineal Res ; 72(3): e12791, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35133678

RESUMO

The daily rhythm of plasma melatonin concentrations is typically unimodal, with one broad peak during the circadian night and near-undetectable levels during the circadian day. Light at night acutely suppresses melatonin secretion and phase shifts its endogenous circadian rhythm. In contrast, exposure to darkness during the circadian day has not generally been reported to increase circulating melatonin concentrations acutely. Here, in a highly-controlled simulated night shift protocol with 12-h inverted behavioral/environmental cycles, we unexpectedly found that circulating melatonin levels were significantly increased during daytime sleep (p < .0001). This resulted in a secondary melatonin peak during the circadian day in addition to the primary peak during the circadian night, when sleep occurred during the circadian day following an overnight shift. This distinctive diurnal melatonin rhythm with antiphasic peaks could not be readily anticipated from the behavioral/environmental factors in the protocol (e.g., light exposure, posture, diet, activity) or from current mathematical model simulations of circadian pacemaker output. The observation, therefore, challenges our current understanding of underlying physiological mechanisms that regulate melatonin secretion. Interestingly, the increase in melatonin concentration observed during daytime sleep was positively correlated with the change in timing of melatonin nighttime peak (p = .002), but not with the degree of light-induced melatonin suppression during nighttime wakefulness (p = .92). Both the increase in daytime melatonin concentrations and the change in the timing of the nighttime peak became larger after repeated exposure to simulated night shifts (p = .002 and p = .006, respectively). Furthermore, we found that melatonin secretion during daytime sleep was positively associated with an increase in 24-h glucose and insulin levels during the night shift protocol (p = .014 and p = .027, respectively). Future studies are needed to elucidate the key factor(s) driving the unexpected daytime melatonin secretion and the melatonin rhythm with antiphasic peaks during shifted sleep/wake schedules, the underlying mechanisms of their relationship with glucose metabolism, and the relevance for diabetes risk among shift workers.


Assuntos
Melatonina , Transtornos do Sono do Ritmo Circadiano , Ritmo Circadiano/fisiologia , Humanos , Melatonina/metabolismo , Sono/fisiologia , Tolerância ao Trabalho Programado/fisiologia
2.
J Pineal Res ; 73(2): e12817, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-35833316

RESUMO

The Antarctic environment presents an extreme variation in the natural light-dark cycle which can cause variability in the alignment of the circadian pacemaker with the timing of sleep, causing sleep disruption, and impaired mood and performance. This study assessed the incidence of circadian misalignment and the consequences for sleep, cognition, and psychological health in 51 over-wintering Antarctic expeditioners (45.6 ± 11.9 years) who completed daily sleep diaries, and monthly performance tests and psychological health questionnaires for 6 months. Circadian phase was assessed via monthly 48-h urine collections to assess the 6-sulphatoxymelatonin (aMT6s) rhythm. Although the average individual sleep duration was 7.2 ± 0.8 h, there was substantial sleep deficiency with 41.4% of sleep episodes <7 h and 19.1% <6 h. Circadian phase was highly variable and 34/50 expeditioners had sleep episodes that occurred at an abnormal circadian phase (acrophase outside of the sleep episode), accounting for 18.8% (295/1565) of sleep episodes. Expeditioners slept significantly less when misaligned (6.1 ± 1.3 h), compared with when aligned (7.3 ± 1.0 h; p < .0001). Performance and mood were worse when awake closer to the aMT6s peak and with increased time awake (all p < .0005). This research highlights the high incidence of circadian misalignment in Antarctic over-wintering expeditioners. Similar incidence has been observed in long-duration space flight, reinforcing the fidelity of Antarctica as a space analog. Circadian misalignment has considerable safety implications, and potentially longer term health risks for other circadian-controlled physiological systems. This increased risk highlights the need for preventative interventions, such as proactively planned lighting solutions, to ensure circadian alignment during long-duration Antarctic and space missions.


Assuntos
Expedições , Melatonina , Regiões Antárticas , Ritmo Circadiano/fisiologia , Sono/fisiologia
3.
J Pineal Res ; 71(1): e12719, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-33512714

RESUMO

Light influences diverse aspects of human physiology and behaviour including neuroendocrine function, the circadian system and sleep. A role for melanopsin-expressing intrinsically photosensitive retinal ganglion cells (ipRGCs) in driving such effects is well established. However, rod and/or cone signals routed through ipRGCs could also influence "non-visual" spectral sensitivity. In humans, this has been most extensively studied for acute, light-dependent, suppression of nocturnal melatonin production. Of the published action spectra for melatonin suppression, one demonstrates a spectral sensitivity consistent with that expected for melanopsin while our own (using briefer 30 minute light exposures) displays very high sensitivity to short wavelength light, suggesting a contribution of S-cones. To clarify that possibility, six healthy young male participants were each exposed to 30 minutes of five irradiances of 415 nm monochromatic light (1-40 µW/cm2 ) across different nights. These data were then combined with the original action spectrum. The aggregated data are incompatible with the involvement of any single-opsin and multi-opsin models based on the original action spectrum (including Circadian Stimulus) fail to predict the responses to 415 nm stimuli. Instead, the extended action spectrum can be most simply approximated by an ~2:1 combination of melanopsin and S-cone signals. Such a model also better describes the magnitude of melatonin suppression observed in other studies using an equivalent 30 minute mono- or polychromatic light paradigm but not those using longer (90 minute) light exposures. In sum, these data provide evidence for an initial S-cone contribution to melatonin suppression that rapidly decays under extended light exposure.


Assuntos
Melatonina/biossíntese , Células Fotorreceptoras Retinianas Cones/metabolismo , Adulto , Ritmo Circadiano/fisiologia , Humanos , Luz , Masculino , Células Fotorreceptoras Retinianas Cones/efeitos da radiação , Opsinas de Bastonetes/metabolismo
4.
J Pineal Res ; 69(3): e12675, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32598502

RESUMO

Studying communities at different stages of urbanisation and industrialisation can teach us how timing and intensity of light affect the circadian clock under real-life conditions. We have previously described a strong tendency towards morningness in the Baependi Heart Study, located in a small rural town in Brazil. Here, we tested the hypothesis that this morningness tendency is associated with early circadian phase based on objective measurements (as determined by dim light melatonin onset, DLMO, and activity) and light exposure. We also analysed how well the previously collected chronotype questionnaire data were able to predict these DLMO values. The average DLMO observed in 73 participants (40 female) was 20:03 ± 01:21, SD, with an earlier average onset in men (19:38 ± 01:16) than in women (20:24 ± 01:21; P ≤ .01). However, men presented larger phase angle between DLMO and sleep onset time as measured by actigraphy (4.11 hours vs 3.16 hours; P ≤ .01). Correlational analysis indicated associations between light exposure, activity rhythms and DLMO, such that early DLMO was observed in participants with higher exposure to light, higher activity and earlier light exposure. The strongest significant predictor of DLMO was morningness-eveningness questionnaire (MEQ) (beta=-0.35, P ≤ .05), followed by age (beta = -0.47, P ≤ .01). Sex, light exposure and variables derived from the Munich chronotype questionnaire were not significant predictors. Our observations demonstrate that both early sleep patterns and earlier circadian phase have been retained in this small rural town in spite of availability of electrification, in contrast to metropolitan postindustrial areas.


Assuntos
Relógios Circadianos/fisiologia , Ritmo Circadiano/fisiologia , Melatonina/metabolismo , População Rural , Sono/fisiologia , Inquéritos e Questionários , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
5.
Gen Comp Endocrinol ; 258: 250-258, 2018 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-28526480

RESUMO

Living for extended periods in Antarctica exposes base personnel to extremes of daylength (photoperiod) and temperature. At the British Antarctic Survey base of Halley, 75°S, the sun does not rise for 110 d in the winter and does not set for 100 d in summer. Photoperiod is the major time cue governing the timing of seasonal events such as reproduction in many species. The neuroendocrine signal providing photoperiodic information to body physiology is the duration of melatonin secretion which reflects the length of the night: longer in the short days of winter and shorter in summer. Light of sufficient intensity and spectral composition serves to suppress production of melatonin and to set the circadian timing and the duration of the rhythm. In humans early observations suggested that bright (>2000 lux) white light was needed to suppress melatonin completely. Shortly thereafter winter depression (Seasonal Affective Disorder or SAD) was described, and its successful treatment by an artificial summer photoperiod of bright white light, sufficient to shorten melatonin production. At Halley dim artificial light intensity during winter was measured, until 2003, at a maximum of approximately 500 lux in winter. Thus a strong seasonal and circadian time cue was absent. It seemed likely that winter depression would be common in the extended period of winter darkness and could be treated with an artificial summer photoperiod. These observations, and predictions, inspired a long series of studies regarding human seasonal and circadian status, and the effects of light treatment, in a small overwintering, isolated community, living in the same conditions for many months at Halley. We found little evidence of SAD, or change in duration of melatonin production with season. However the timing of the melatonin rhythm itself, and/or that of its metabolite 6-sulphatoxymelatonin (aMT6s), was used as a primary marker of seasonal, circadian and treatment changes. A substantial phase delay of melatonin in winter was advanced to summer phase by a two pulse 'skeleton' bright white light treatment. Subsequently a single morning pulse of bright white light was effective with regard to circadian phase and improved daytime performance. The circadian delay evidenced by melatonin was accompanied by delayed sleep (logs and actigraphy): poor sleep is a common complaint in Polar regions. Appropriate extra artificial light, both standard white, and blue enriched, present throughout the day, effectively countered delay in sleep timing and the aMT6s rhythm. The most important factor appeared to be the maximum light experienced. Another manifestation of the winter was a decline in self-rated libido (men only on base at this time). Women on the base showed lower aspects of physical and mental health compared to men. Free-running rhythms were seen in some subjects following night shift, but were rarely found at other times, probably because this base has strongly scheduled activity and leisure time. Complete circadian adaptation during a week of night shift, also seen in a similar situation on North Sea oil rigs, led to problems readapting back to day shift in winter, compared to summer. Here again timed light treatment was used to address the problem. Sleep, alertness and waking performance are critically dependent on optimum circadian phase. Circadian desynchrony is associated with increased risk of major disease in shift workers. These studies provide some groundwork for countering/avoiding circadian desynchrony in rather extreme conditions.


Assuntos
Aclimatação/fisiologia , Comportamento/fisiologia , Ritmo Circadiano/fisiologia , Estações do Ano , Actigrafia , Adulto , Regiões Antárticas , Escuridão , Feminino , Frequência Cardíaca/fisiologia , Humanos , Libido , Luz , Masculino , Melatonina/sangue , Fotoperíodo , Sono/fisiologia , Adulto Jovem
6.
J Sleep Res ; 20(1 Pt 2): 154-61, 2011 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20723022

RESUMO

Delayed sleep phase (and sometimes free-run) is common in the Antarctic winter (no natural sunlight) and optimizing the artificial light conditions is desirable. This project evaluated sleep when using 17,000 K blue-enriched lamps compared with standard white lamps (5000 K) for personal and communal illumination. Base personnel, 10 males, five females, 32.5±8 years took part in the study. From 24 March to 21 September 2006 light exposure alternated between 4-5-week periods of standard white (5000 K) and blue-enriched lamps (17,000 K), with a 3-week control before and after extra light. Sleep and light exposure were assessed by actigraphy and sleep diaries. General health (RAND 36-item questionnaire) and circadian phase (urinary 6-sulphatoxymelatonin rhythm) were evaluated at the end of each light condition. Direct comparison (rmanova) of blue-enriched light with white light showed that sleep onset was earlier by 19 min (P=0.022), and sleep latency tended to be shorter by 4 min (P=0.065) with blue-enriched light. Analysing all light conditions, control, blue and white, again provided evidence for greater efficiency of blue-enriched light compared with white (P<0.05), but with the best sleep timing, duration, efficiency and quality in control natural light conditions. Circadian phase was earlier on average in midwinter blue compared with midwinter white light by 45 min (P<0.05). Light condition had no influence on general health. We conclude that the use of blue-enriched light had some beneficial effects, notably earlier sleep, compared with standard white light during the polar winter.


Assuntos
Ritmo Circadiano/fisiologia , Clima Frio , Luz , Sono/fisiologia , Adulto , Feminino , Humanos , Masculino , Prontuários Médicos , Inquéritos e Questionários , Fatores de Tempo
7.
Occup Med (Lond) ; 60(1): 10-20, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20051441

RESUMO

The internal circadian clock adapts slowly, if at all, to rapid transitions between different shift schedules. This leads to misalignment (desynchrony) of rhythmic physiological systems, such as sleep, alertness, performance, metabolism and the hormones melatonin and cortisol, with the imposed work-rest schedule. Consequences include sleep deprivation and poor performance. Clock gene variants may influence tolerance of sleep deprivation. Shift work is associated with an increased risk of major disease (heart disease and cancer) and this may also, at least in part, be attributed to frequent circadian desynchrony. Abnormal metabolism has been invoked as a contributory factor to the increased risk of heart disease. There is recent evidence for an increased risk of certain cancers, with hypothesized causal roles of light at night, melatonin suppression and circadian desynchrony. Various strategies exist for coping with circadian desynchrony and for hastening circadian realignment (if desired). The most important factor in manipulating the circadian system is exposure to and/or avoidance of bright light at specific times of the 'biological night'.


Assuntos
Adaptação Psicológica , Ritmo Circadiano , Tolerância ao Trabalho Programado/fisiologia , Carga de Trabalho/psicologia , Ritmo Circadiano/genética , Ritmo Circadiano/fisiologia , Humanos , Luz , Melatonina/metabolismo , Melatonina/efeitos da radiação
8.
Trends Endocrinol Metab ; 31(3): 192-204, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-31901302

RESUMO

The past decade has witnessed a revival of interest in the hormone melatonin, partly attributable to the discovery that genetic variation in MTNR1B - the melatonin receptor gene - is a risk factor for impaired fasting glucose and type 2 diabetes (T2D). Despite intensive investigation, there is considerable confusion and seemingly conflicting data on the metabolic effects of melatonin and MTNR1B variation, and disagreement on whether melatonin is metabolically beneficial or deleterious, a crucial issue for melatonin agonist/antagonist drug development and dosing time. We provide a conceptual framework - anchored in the dimension of 'time' - to reconcile paradoxical findings in the literature. We propose that the relative timing between elevated melatonin concentrations and glycemic challenge should be considered to better understand the mechanisms and therapeutic opportunities of melatonin signaling in glycemic health and disease.


Assuntos
Metabolismo dos Carboidratos/genética , Glucose/metabolismo , Melatonina/fisiologia , Receptor MT2 de Melatonina/fisiologia , Animais , Glicemia/genética , Glicemia/metabolismo , Ritmo Circadiano/genética , Ritmo Circadiano/fisiologia , Diabetes Mellitus Tipo 2/genética , Diabetes Mellitus Tipo 2/metabolismo , Variação Genética/fisiologia , Humanos , Insulina/metabolismo , Polimorfismo de Nucleotídeo Único
9.
Pharmacol Rep ; 61(3): 383-410, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19605939

RESUMO

Melatonin is an evolutionarily conserved molecule that serves a time-keeping function in various species. In vertebrates, melatonin is produced predominantly by the pineal gland with a marked circadian rhythm that is governed by the central circadian pacemaker (biological clock) in the suprachiasmatic nuclei of the hypothalamus. High levels of melatonin are normally found at night, and low levels are seen during daylight hours. As a consequence, melatonin has been called the "darkness hormone". This review surveys the current state of knowledge regarding the regulation of melatonin synthesis, receptor expression, and function. In particular, it addresses the physiological, pathological, and therapeutic aspects of melatonin in humans, with an emphasis on biological rhythms.


Assuntos
Ritmo Circadiano/efeitos dos fármacos , Ritmo Circadiano/fisiologia , Melatonina/farmacologia , Melatonina/fisiologia , Glândula Pineal/fisiologia , Animais , Arilalquilamina N-Acetiltransferase/fisiologia , Depressão/tratamento farmacológico , Depressão/fisiopatologia , Humanos , Transdução de Sinal Luminoso , Melatonina/biossíntese , Melatonina/uso terapêutico , Estrutura Molecular , Fotoperíodo , Glândula Pineal/fisiopatologia , Receptores de Melatonina/agonistas , Receptores de Melatonina/antagonistas & inibidores , Receptores de Melatonina/classificação , Receptores de Melatonina/metabolismo , Estações do Ano , Transtornos do Sono-Vigília/tratamento farmacológico , Transtornos do Sono-Vigília/fisiopatologia , Núcleo Supraquiasmático/metabolismo , Núcleo Supraquiasmático/fisiologia
10.
Artigo em Inglês | MEDLINE | ID: mdl-31379733

RESUMO

Last year melatonin was 60 years old, or at least its discovery was 60 years ago. The molecule itself may well be almost as old as life itself. So it is time to take yet another perspective on our understanding of its functions, effects and clinical uses. This is not a formal review-there is already a multitude of systematic reviews, narrative reviews, meta-analyses and even reviews of reviews. In view of the extraordinary variety of effects attributed to melatonin in the last 25 years, it is more of an attempt to sort out some areas where a consensus opinion exists, and where placebo controlled, randomized, clinical trials have confirmed early observations on therapeutic uses. The current upsurge of concern about the multiple health problems associated with disturbed circadian rhythms has generated interest in related therapeutic interventions, of which melatonin is one. The present text will consider the physiological role of endogenous melatonin, and the mostly pharmacological effects of exogenous treatment, on the assumption that normal circulating concentrations represent endogenous pineal production. It will concentrate mainly on the most researched, and accepted area of therapeutic use and potential use of melatonin-its undoubted ability to realign circadian rhythms and sleep-since this is the author's bias. It will touch briefly upon some other systems with prominent rhythmic attributes including certain cancers, the cardiovascular system, the entero-insular axis and metabolism together with the use of melatonin to assess circadian status. Many of the ills of the developed world relate to deranged rhythms-and everything is rhythmic unless proved otherwise.

11.
Br J Psychiatry ; 193(4): 267-9, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18827285

RESUMO

The pineal hormone melatonin is able to shift the timing of circadian rhythms, including the sleep-wake cycle, and to promote sleep. Melatonin agonists with similar properties have therapeutic potential for the treatment of circadian rhythm sleep disorders. Depression is specifically targeted by agomelatine, which is also a serotonin-2C (5-HT(2C)) antagonist.


Assuntos
Melatonina , Receptores de Melatonina/antagonistas & inibidores , Acetamidas/administração & dosagem , Benzofuranos/administração & dosagem , Ciclopropanos/administração & dosagem , Esquema de Medicação , Humanos , Indenos/administração & dosagem , Melatonina/agonistas , Melatonina/fisiologia , Melatonina/uso terapêutico
12.
J Sleep Res ; 17(2): 207-16, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18482109

RESUMO

Blind people report disturbances in alertness, mood and performance. In laboratory studies, these waking functions can only be maintained when the wake-dependent deterioration is opposed by appropriately-timed endogenous circadian rhythms. We aimed to quantify whether variations in waking function experienced by blind people living in society were dependent on the phase relationship between the sleep-wake cycle and the circadian pacemaker. The time course of alertness, mood and performance was assessed in 52 blind subjects with and without circadian rhythm disorders every 2 h for 2 days per week for 4 weeks. Sleep-wake timing and circadian phase were assessed from diaries and weekly measurements of urinary 6-sulphatoxymelatonin rhythms, respectively. In those subjects who woke at either a normal circadian phase (n = 26) or abnormally early (n = 5), alertness, mood and performance deteriorated significantly with increased time awake (P < 0.05). In 17 non-entrained ('free-running') subjects, waking function varied significantly with circadian phase such that subjects rated themselves most sleepy (P = 0.03) and most miserable (P = 0.02) when they were awake during the time of peak melatonin production. The internal phase relationship between sleep-wake behaviour and the circadian melatonin rhythm in entrained subjects contributed to predictable differences in the daily profile of alertness, mood and performance. Disruption of this phase relationship in non-entrained blind individuals with circadian rhythm sleep disorders resulted in impaired waking function during the day equivalent to that usually only experienced when awake during the night. Treatment for circadian rhythm disorders should be targeted in normalizing these phase relationships.


Assuntos
Afeto/fisiologia , Nível de Alerta/fisiologia , Atenção/fisiologia , Cegueira/psicologia , Tempo de Reação/fisiologia , Transtornos do Sono do Ritmo Circadiano/psicologia , Vigília/fisiologia , Adulto , Idoso , Cegueira/fisiopatologia , Comportamento de Escolha/fisiologia , Ritmo Circadiano/fisiologia , Feminino , Humanos , Masculino , Melatonina/análogos & derivados , Melatonina/sangue , Melatonina/urina , Pessoa de Meia-Idade , Testes Neuropsicológicos , Desempenho Psicomotor/fisiologia , Aprendizagem Seriada/fisiologia , Transtornos do Sono do Ritmo Circadiano/diagnóstico , Transtornos do Sono do Ritmo Circadiano/fisiopatologia
13.
J Sleep Res ; 17(3): 354-60, 2008 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-18564297

RESUMO

Antarctic Base personnel live for 3 months in winter with no natural sunlight. This project compared sleep, by actigraphy, during periods of increased exposure to white light or blue enriched light in 2003. The primary aim was to help define the optimum spectral composition and intensity of artificial environmental light. Nine men and one woman (33 +/- 7 years, mean +/- SD), wore activity and light monitors continuously from 28.2 to 9.10, and kept sleep diaries. Extra light was provided by light boxes (standard white, 5300 K, or prototype blue enriched, 10,000 K, Philips Lighting), which were turned on in bedrooms and in communal/work areas approximately 08.00-18.00 hours. After a no-treatment control period, 28.2-20.3, sequential 4-5 week periods of first white, then blue light, were imposed with a further control period 19.9-9.10. A limited baseline study in 2002 (no interventions) similarly measured light and activity in seven men and one woman (30 +/- 7 years). Daily light exposure in winter (lux, mean +/- SD) was doubled in 2003 (maximum 1039 +/- 281, average 64 +/- 21), compared to 2002 (572 +/- 276 and 30 +/- 11), P < 0.05 and P < 0.01, with no differences between white and blue light. There were no major differences in sleep between light conditions in 2003. A delay in sleep timing was found in midwinter compared to control (2003, bedtime, P < 0.05, sleep start, P < 0.05, sleep end, P < 0.01) and sleep fragmentation increased (P < 0.05). Sleep efficiency was slightly higher during all blue light periods compared to all white periods (P < 0.05). The use of higher intensity light of suitable spectral composition is proposed.


Assuntos
Clima Frio , Escuridão , Iluminação , Estações do Ano , Sono , Adulto , Regiões Antárticas , Ritmo Circadiano/fisiologia , Feminino , Humanos , Masculino , Melatonina/análogos & derivados , Melatonina/sangue , Melatonina/urina , Sono/fisiologia
14.
Clin Med (Lond) ; 8(4): 381-3, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18724603

RESUMO

The hormone melatonin is increasingly used for the treatment of certain sleep disorders, particularly those related to disturbed biological rhythms. This article summarises current knowledge of its mechanism of action and identifies situations where there is good evidence for its efficacy. The authors provide advice, based on their own experience and consistent published data, concerning the dose range of melatonin to be used and the critically important question of the timing of treatment. Anecdotal evidence for the use of melatonin needs to be replaced by data from well-controlled, preferably multi-centre, randomised clinical trials.


Assuntos
Depressores do Sistema Nervoso Central/uso terapêutico , Melatonina/uso terapêutico , Transtornos do Sono-Vigília/tratamento farmacológico , Depressores do Sistema Nervoso Central/administração & dosagem , Humanos , Melatonina/administração & dosagem
15.
Drugs ; 78(14): 1419-1431, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30167980

RESUMO

For many years now a treatment mitigating the debilitating effects of jet lag has been sought. Rapid travel across time zones leads, in most people, to temporary symptoms, in particular poor sleep, daytime alertness and poor performance. Mis-timed circadian rhythms are considered to be the main factor underlying jet-lag symptoms, together with the sleep deprivation from long haul flights. Virtually all aspects of physiology are rhythmic, from cells to systems, and circadian rhythms are coordinated by a central pacemaker or clock in the suprachiasmatic nucleus (SCN) of the hypothalamus. The SCN adapts slowly to changes in time zone, and peripheral clocks or oscillators adapt at different rates, such that the organism is in a state of desynchrony from the external environment and internally. Light exposure is the main factor controlling the circadian system and needs to be considered together with any pharmacological interventions. This review covers the relatively new chronobiotic drugs, which can hasten adaptation of the circadian system, together with drugs directly affecting alertness and sleep propensity. No current treatment can instantly shift circadian phase to a new time zone; however, adaptation can be hastened. The melatoninergic drugs are promising but larger trials in real-life situations are needed. For short stopovers it is recommended to preserve sleep and alertness without necessarily modifying the circadian system. New research suggests that modification of clock function via genetic manipulation may one day have clinical applications.


Assuntos
Síndrome do Jet Lag/tratamento farmacológico , Animais , Relógios Circadianos/fisiologia , Ritmo Circadiano/efeitos dos fármacos , Humanos , Síndrome do Jet Lag/fisiopatologia , Luz , Melatonina/metabolismo , Melatonina/uso terapêutico , Sono , Viagem
16.
Sleep Med ; 8(6): 651-5, 2007 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-17420154

RESUMO

People who are blind, in addition to having to cope with partial or no sight, have an added handicap; the transmission of ocular light from the retina to their circadian clock is impaired. At its worse, for example in people with both eyes enucleated, this lesion results in desynchronisation of the biological clock (located in the hypothalamic suprachiasmatic nuclei) from the 24h day/night environment. While in a desynchronised state, symptoms akin to jet lag are experienced (e.g., daytime sleepiness, poor night sleep, reduced alertness and performance during waking). This is a lifelong condition. Daily administration of exogenous melatonin is the current treatment of choice for this so-called "non-24h sleep/wake disorder". Melatonin has been shown to correct the underlying circadian rhythm abnormality as well as improve sleep and reduce daytime napping. The effectiveness of melatonin therapy depends upon its time of administration relative to the timing of the person's circadian clock. If practicable, assessment of an individual's circadian phase (by measurement of the endogenous melatonin rhythm in plasma, saliva or urine) is recommended prior to commencing treatment to optimise melatonin's effectiveness.


Assuntos
Cegueira/complicações , Melatonina/administração & dosagem , Transtornos do Sono do Ritmo Circadiano/tratamento farmacológico , Transtornos do Sono do Ritmo Circadiano/etiologia , Cronoterapia , Ritmo Circadiano/efeitos dos fármacos , Humanos , Sono/efeitos dos fármacos , Resultado do Tratamento
17.
Dialogues Clin Neurosci ; 9(3): 301-14, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17969867

RESUMO

Many aspects of human physiology and behavior are dominated by 24-hour circadian rhythms that have a major impact on our health and well-being, including the sleep-wake cycle, alertness and performance patterns, and many daily hormone profiles. These rhythms are spontaneously generated by an internal "pacemaker" in the hypothalamus, and daily light exposure to the eyes is required to keep these circadian rhythms synchronized both internally and with the external environment. Sighted individuals take this daily synchronization process for granted, although they experience some of the consequences of circadian desynchrony when "jetlagged" or working night shifts. Most blind people with no perception of light, however, experience continual circadian desynchrony through a failure of light information to reach the hypothalamic circadian clock, resulting in cyclical episodes of poor sleep and daytime dysfunction. Daily melatonin administration, which provides a replacement synchronizing daily "time cue, " is a promising therapeutic strategy, although optimal treatment dose and timing remain to be determined.


Assuntos
Transtornos Cronobiológicos/fisiopatologia , Transtornos da Visão/complicações , Animais , Depressores do Sistema Nervoso Central/metabolismo , Depressores do Sistema Nervoso Central/uso terapêutico , Transtornos Cronobiológicos/tratamento farmacológico , Transtornos Cronobiológicos/patologia , Humanos , Melatonina/metabolismo , Melatonina/uso terapêutico , Transtornos da Visão/tratamento farmacológico , Transtornos da Visão/metabolismo
18.
Aviat Space Environ Med ; 78(7): 645-52, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17679560

RESUMO

INTRODUCTION: The Canadian Forces has initiated a multiple study project to optimize circadian phase changes using appropriately timed phototherapy and/or ingestion of melatonin for those personnel on long-range deployments and shift workers. The work reported here compared four phototherapeutic devices for efficacy in effecting circadian phase delays. METHODS: In a partially counterbalanced treatment order, 14 subjects (7 men and 7 women), ages 18-51 yr, participated in 5 weekly experimental sessions of phototherapy with 4 different phototherapy devices (light tower, light visor, Litebook, LED spectacles) and a no-phototherapy control. Phototherapy was applied from 24:00 to 02:00 on night. (1) Dim light melatonin onset (DLMO) was assessed on night 1 and night. (2) Subjects were tested for psychomotor performance (serial reaction time, logical reasoning, and serial subtraction tasks) and completed the Stanford Sleepiness Scale on night 1 at 19:00, 23:00, 01:00, 02:00, and 03:00. After phototherapy, subjects completed a phototherapy side-effects questionnaire. RESULTS: All phototherapy devices produced melatonin suppression and significant phase delays. Sleepiness was significantly decreased with the light tower, the light visor, and the Litebook. Task performance was only slightly improved with phototherapy. The LED spectacles and light visor caused greater subjective performance impairment, more difficulty viewing the computer monitor and reading printed text than the light tower or the Litebook. The light visor, the Litebook, and the LED spectacles caused more eye discomfort than the light tower. CONCLUSIONS: The light tower was the best device, producing melatonin suppression and circadian phase change while relatively free of side effects.


Assuntos
Transtornos Cronobiológicos/terapia , Melatonina/análise , Fototerapia/instrumentação , Adolescente , Adulto , Medicina Aeroespacial , Análise de Variância , Fadiga/prevenção & controle , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Desempenho Psicomotor , Saliva/química , Inquéritos e Questionários , Vigília
19.
J Biol Rhythms ; 21(3): 214-21, 2006 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-16731661

RESUMO

Numerous factors influence the increased health risks of seamen. This study investigated sleep (by actigraphy) and the adaptation of the internal clock in watch-keeping crew compared to day workers, as possible contributory factors. Fourteen watch keepers, 4 h on, 8 h off (0800-1200/2000-2400 h, 1200-1600/2400-0400 h, 1600-2000/0400-0800 h) (fixed schedule, n = 6; rotating by delay weekly, n = 8), and 12 day workers participated during a voyage from the United Kingdom to Antarctica. They kept daily sleep diaries and wore wrist monitors for continuous recording of activity. Sleep parameters were derived from activity using the manufacturer's software and analyzed by repeated-measures ANOVA using SAS 8.2. Sequential urine samples were collected for 48 h weekly for 6-sulphatoxymelatonin measurement as an index of circadian rhythm timing. Individuals working watches of 1200-1600/2400-0400 h and 1600-2000/0400-0800 h had 2 sleeps daily, analyzed separately as main sleep (longest) and 2nd sleep. Main sleep duration was shorter in watch keepers than in day workers (p < 0.0001). Objective sleep quality was significantly compromised in rotaters compared to both day workers and fixed watch keepers, the most striking comparisons being sleep efficiency (percentage desired sleep time spent sleeping) main sleep (p < 0.0001) and sleep fragmentation (an index of restlessness) main sleep (p < 0.0001). The 2nd sleep was substantially less efficient than was the main sleep (p < 0.0001) for all watch keepers. There were few significant differences in sleep between the different watches in rotating watch keepers. Circadian timing remained constant in day workers. Timing of the 6-sulphatoxymelatonin rhythm was later for the watch of 1200-1600/2400-0400 h than for all others (1200-1600/2400-0400 h, 5.90 +/- 0.85 h; 1600-2000/0400-0800 h, 1.5 +/- 0.64 h; 0800-1200/ 2000-2400 h, 2.72 +/- 0.76 h; days, 2.09 +/- 0.68 h [decimal hours, mean +/- SEM]: ANOVA, p < 0.01). This study identifies weekly changes in watch time as a cause of poor sleep in watch keepers. The most likely mechanism is the inability of the internal clock to adapt rapidly to abrupt changes in schedule.


Assuntos
Ritmo Circadiano/fisiologia , Melatonina/análogos & derivados , Sono/fisiologia , Tolerância ao Trabalho Programado/fisiologia , Adulto , Feminino , Humanos , Masculino , Melatonina/urina , Pessoa de Meia-Idade , Navios
20.
Neurosci Lett ; 399(1-2): 96-100, 2006 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-16490309

RESUMO

In humans a range of non-image-forming (NIF) light responses (melatonin suppression, phase shifting and alertness) are short wavelength sensitive (440-480 nm). The aim of the current study was to assess the acute effect of three different short wavelength light pulses (420, 440 and 470 nm) and 600 nm light on subjective alertness. Healthy male subjects (n = 12, aged 27 +/- 4 years, mean +/- S.D.) were studied in 39, 4-day laboratory study sessions. The subjects were maintained in dim light (<8 lx) and on day 3 they were exposed to a single 4-h light pulse (07:15-11:15 h). Four monochromatic wavelengths were administered at two photon densities: 420 and 440 nm at 2.3 x 10(13)photons/cm(2)/s and 440, 470 and 600 nm at 6.2 x 10(13)photons/cm(2)/s. Subjective mood and alertness were assessed at 30 min intervals during the light exposure, using four 9-point VAS scales. Mixed model regression analysis was used to compare alertness and mood ratings during the 470 nm light to those recorded with the other four light conditions. There was a significant effect of duration of light exposure (p < 0.001) on alertness but no significant effect of subject. Compared to 470 nm light, alertness levels were significantly higher in 420 nm light and significantly lower in the 600 nm light (p < 0.05). These data (420 nm>470 nm>600 nm) suggest that subjective alertness may be maximally sensitive to very short wavelength light.


Assuntos
Afeto , Nível de Alerta , Luz , Adulto , Humanos , Masculino
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