Two oscillatory components detected by forced splitting of the sleep-wake cycle in humans.

The sleep-wake cycle of human subjects was artificially split into two episodes by imposing an 8-h light and 4-h dark cycle (LD 8:4) twice a day for 7 days, which was followed by a 3-day free-running session. Sleep was permitted only in the dark period. The subjects in the ordinary group were exposed to ordinary light (ca. 500 lx) in the 8-h light period, and those in the bright light group to bright (ca. 5,000 lx) and ordinary light alternatively with bright light after the first dark period (2400-400). Split sleeps persisted in the free-running session with the major episode around the first dark period and the minor episode around the second dark period. By contrast, circadian melatonin rhythm in the free-running session significantly phase delayed in the ordinary light group, but phase advanced in the bright light group, keeping the melatonin rhythm unsplit. The length of nocturnal melatonin secretion (NMS) was significantly shortened in the bright light group. Interestingly, the falling phase of NMS advanced significantly further than the rising phase. Such a difference was not detected in the ordinary light group. Similar differences were observed in the body temperature rhythm. These findings indicated oscillatory mechanisms underlying split sleeps distinct from the circadian pacemaker and suggested an involvement of different circadian oscillators in the rising and falling phases of NMS, which is consistent with the dual oscillator model proposed for the circadian system of nocturnal rodents.NEW & NOTEWORTHY The present study demonstrated that human sleep was separated into two essentially identical components, which persisted under constant conditions, suggesting circadian oscillator underlying split-sleep episodes. The study also indicated differential light sensitivities in the rising and falling phases of circadian melatonin rhythm, indicating the involvement of two different oscillators. These results consisted of the evening and morning dual-oscillator hypothesis for the circadian pacemaker and the hierarchical model for the pacemaker and sleep-wake cycle.

Reciprocal Coupling of Circadian Clocks in the Compound Eye and Optic Lobe in the Cricket Gryllus bimaculatus.

The circadian system comprises multiple clocks, including central and peripheral clocks. The central clock generally governs peripheral clocks to synchronize circadian rhythms throughout the animal body. However, whether the peripheral clock influences the central clock is unclear. This issue can be addressed through a system comprising a peripheral clock (compound eye clock [CE clock]) and central clock (the optic lobe [OL] clock) in the cricket Gryllus bimaculatus. We previously found that the compound eye regulates the free-running period (τ) and the stability of locomotor rhythms driven by the OL clock, as measured by the daily deviation of τ at 30°C. However, the role of the CE clock in this regulation remains unexplored. In this study, we investigated the importance of the CE clock in this regulation using RNA interference (RNAi) of the period (per) gene localized to the compound eye (perCE-RNAi). The perCE-RNAi abolished the compound eye rhythms of the electroretinogram (ERG) amplitude and clock gene expression but the locomotor rhythm driven by the OL clock was maintained. The locomotor rhythm of the tested crickets showed a significantly longer τ and greater daily variation of τ than those of control crickets treated with dsDsRed2. The variation of τ was comparable with that of crickets with the optic nerve severed. The τ was considerably longer but was comparable with that of crickets with the optic nerve severed. These results suggest that the CE clock regulates the OL clock to maintain and stabilize τ.

Do blue light filter applications improve sleep outcomes? A study of smartphone users' sleep quality in an observational setting.

Exposure to blue light at bedtime, suppresses melatonin secretion, postponing the sleep onset and interrupting the sleep process. Some smartphone manufacturers have introduced night-mode functions, which have been claimed to aid in improving sleep quality. In this study, we evaluate the impact of blue light filter application on decreasing blue light emissions and improving sleep quality. Participants in this study recorded the pattern of using their mobile phones through a questionnaire. In order to evaluate sleep quality, we used a PSQI questionnaire. Blue light filters were used by 9.7% of respondents, 9.7% occasionally, and 80% never. The mean score of PSQI was more than 5 in 54.10% of the participants and less than 5 in 45.90%. ANOVA test was performed to assess the relationship between using blue light filter applications and sleep quality (p-value = 0.925). The findings of this study indicate a connection between the use of blue light filter apps and habitual sleep efficiency in the 31-40 age group. However, our results align only to some extent with prior research, as we did not observe sustained positive effects on all parameters of sleep quality from the long-term use of blue light filtering apps. Several studies have found that blue light exposure can suppress melatonin secretion, exacerbating sleep problems. Some studies have reported that physical blue light filters, such as lenses, can affect melatonin secretion and improve sleep quality. However, the impact of blue light filtering applications remains unclear and debatable.

Using smartphones before bedtime and being exposed to its blue light can make it harder to fall asleep and disrupt your sleep. Some smartphone makers have introduced a night mode feature claiming it can help improve your sleep. In this study, we wanted to find out if using these blue light filters on smartphones really makes a difference. We asked people how often they used blue light filters on their phones and also had them fill out a questionnaire about their sleep quality. Only about 10% of people said they used blue light filters regularly, another 10% used them occasionally, and the majority, around 80%, never used them. When we looked at the results, more than half of the participants had sleep scores higher than 5, indicating they might have sleep problems. Less than half had sleep scores lower than 5, suggesting better sleep quality. We used some statistical tests to see if using blue light filters had any link to sleep quality, and the results showed that there was only a connection between the use of blue light filter apps and habitual sleep efficiency in the 31­40 age group. Our findings matched what other studies have found before, that using blue light filters on smartphones may not significantly help improve sleep. So, while it might be a good idea to limit smartphone use before bed, using a blue light filter app may not be the magic solution for better sleep.

The Compound Eye Regulates Free-Running Period and Stability of the Circadian Locomotor Rhythm in the Cricket Gryllus bimaculatus.

The circadian system of many multicellular organisms consists of a hierarchical structure of multiple clocks, including central and peripheral clocks. The temporal structure has been analyzed in terms of central-to-peripheral regulation but rarely from the opposite perspective. In this study, the potential control of the central clock in the optic lobe by the peripheral clock in the compound eye was investigated in the cricket Gryllus bimaculatus. The locomotor activity rhythm of crickets in which one of the two bilateral optic lobe clocks was surgically removed was tested in constant darkness at three environmental temperatures (20°C, 25°C, and 30°C) and compared with that of crickets in which the optic nerve connecting between the compound eye and optic lobe of the intact side was also severed. When the optic nerve was severed at 30°C, the free-running period and its stability were significantly increased and decreased, respectively, compared to those of intact and sham-operated crickets, whereas at 20°C, only the free-running period was significantly lengthened, and at 25°C, no significant changes were observed in these parameters. At 30°C, the changes in these two parameters were reproduced when the anterior half of the compound eye was removed, while the removal of the posterior half induced period lengthening only. Together with previous data, these results suggest that the free-running period and stability of the locomotor rhythm are regulated through reciprocal coupling between the clocks in the compound eye and the optic lobe.

Daily rhythms of REV-ERBα and its role as transcriptional repressor of clock genes in fish hepatic oscillator.

The REV-ERBα nuclear receptor is a key component of the molecular machinery of circadian oscillators in mammals. While the rhythmic expression of this receptor has been described in teleosts, several critical aspects of its regulation remain unknown, such as which synchronizers entrain its rhythm, and whether it can modulate the expression of other clock genes. The objective of this study was to gain deeper understanding of the role of REV-ERBα in the fish circadian system. To this end, we first investigated the cues that entrain the rhythm of rev-erbα expression in the goldfish (Carassius auratus) liver and hypothalamus. A 12-h shift in feeding time induced a parallel shift in the hepatic rhythm of rev-erbα expression, confirming that this gene is food-entrainable in the goldfish liver. In contrast, light seems the main driver of rev-erbα rhythmic expression in the hypothalamus. Next, we examined the effects of REV-ERBα activation on locomotor activity and hepatic expression of clock genes. Subchronic treatment with the REV-ERBα agonist SR9009 slightly decreased locomotor activity anticipating light onset and food arrival, and downregulated hepatic bmal1a, clock1a, cry1a, per1a and pparα expression. This generalized repressing action of REV-ERBα on the expression of hepatic clock genes was confirmed in vitro by using agonists (SR9009 and GSK4112) and antagonist (SR8278) of this receptor. Overall, the present work reveals that REV-ERBα modulates the daily expression of the main genes of the teleostean liver clock, reinforcing its role in the liver temporal homeostasis, which seems highly conserved in both fish and mammals.

Insulin Controls Clock Gene Expression in the Liver of Goldfish Probably via Pi3k/Akt Pathway.

The liver circadian clock plays a pivotal role in driving metabolic rhythms, being primarily entrained by the feeding schedule, although the underlying mechanisms remain elusive. This study aimed to investigate the potential role of insulin as an intake signal mediating liver entrainment in fish. To achieve this, the expression of clock genes, which form the molecular basis of endogenous oscillators, was analyzed in goldfish liver explants treated with insulin. The presence of insulin directly increased the abundance of per1a and per2 transcripts in the liver. The dependency of protein translation for such insulin effects was evaluated using cycloheximide, which revealed that intermediate protein translation is seemingly unnecessary for the observed insulin actions. Furthermore, the putative interaction between insulin and glucocorticoid signaling in the liver was examined, with the results suggesting that both hormones exert their effects by independent mechanisms. Finally, to investigate the specific pathways involved in the insulin effects, inhibitors targeting PI3K/AKT and MEK/ERK were employed. Notably, inhibition of PI3K/AKT pathway prevented the induction of per genes by insulin, supporting its involvement in this process. Together, these findings suggest a role of insulin in fish as a key element of the multifactorial system that entrains the liver clock to the feeding schedule.

Transcriptome profiling reveals toxicity mechanisms following sertraline exposure in the brain of juvenile zebrafish (Danio rerio).

Sertraline (SER) is one of the most commonly detected antidepressants in the aquatic environment that can negatively affect aquatic organisms at low concentrations. Despite some knowledge on its acute toxicity to fish, the effects of chronic SER exposure remain poorly understood along with any underlying mechanisms of SER-induced toxicity. To address this knowledge gap, the effects of chronic exposure to three SER concentrations from low to high were investigated in zebrafish. Juvenile zebrafish were exposed to three concentrations of 1, 10, or 100 µg/L of SER for 28 d, after which indicators of oxidative stress and neurotoxicity in the brain were measured. Superoxide dismutase (SOD) activity was significantly enhanced by SER at 1 up to 100 µg/L, and catalase (CAT) activity was significantly induced by SER at 1 or 10 µg/L. The activity of acetylcholinesterase (AChE) was significantly induced by 10 and 100 µg/L of SER, and the serotonin (5-HT) level was significantly increased by all three concentrations of SER. To ascertain mechanisms of SER-induced toxicity, transcriptomics was conducted in the brain of zebrafish following 100 µg/L SER exposure. The molecular signaling pathways connected with circadian system and the immune system were significantly altered in the zebrafish brain. Based on transcriptomic data, the expression levels of six circadian clock genes were measured, and three genes were significantly altered in relative abundance in fish from all experimental treatments with SER, including cryptochrome circadian regulator 2 (cry2), period circadian clock 2 (per2), and period circadian clock 3 (per3). We hypothesize that the circadian system may be related to SER-induced neurotoxicity and oxidative stress in the central nervous system. This study reveals potential mechanisms and key events (i.e., oxidative stress and neurotoxicity) associated with SER-induced toxicity, and improves understanding of the molecular and biochemical pathways putatively perturbed by SER.

Time-restricted eating and circadian rhythms: the biological clock is ticking.

Meal timing may be a critical modulator of health outcomes due to complex interactions between circadian biology, nutrition and human metabolism. As such, approaches that aim to align food consumption with endogenous circadian rhythms are emerging in recent years. Time-restricted eating (TRE) consists of limiting daily nutrient consumption to a period of 4 to 12 hours in order to extend the time spent in the fasted state. TRE can induce positive effects on the health of individuals with overweight and obesity, including sustained weight loss, improvement in sleep patterns, reduction in blood pressure and oxidative stress markers and increased insulin sensitivity. However, it is not fully clear whether positive effects of TRE are due to reduced energy intake, body weight or the truncation of the daily eating window. In addition, null effects of TRE in some populations and on some parameters of cardiometabolic health have been documented. Some evidence indicates that greater promotion of health via TRE may be achieved if the nutrient intake period occurs earlier in the day. Despite some promise of this dietary strategy, the effects of performing TRE at different times of the day on human cardiometabolic health, as well as the safety and efficacy of this dietary approach in individuals with cardiometabolic impairments, need to be evaluated in additional controlled and long-term studies.

How Psychoactive Drugs and the Circadian Clock Are Enlightening One Another.

Psychoactive drugs are a popular way to induce pleasant feelings, but also to modify wakefulness and sleep. In turn, insomnia and circadian often impact on drug-taking behavior. This book chapter explores the interplay between drugs and the circadian system. The reader will be introduced to the main classes of psychoactive drugs and the role they play in circadian pathways and behaviors. The importance of circadian interventions on drug-taking and implications for our society are discussed.

Circadian alterations in patients with neurodegenerative diseases: Neuropathological basis of underlying network mechanisms.

Circadian organization of physiology and behavior is an important biological process that allows organisms to anticipate and prepare for daily changes and demands. Disruptions in this system precipitates a wide range of health issues. In patients with neurodegenerative diseases, alterations of circadian rhythms are among the most common and debilitating symptoms. Although a growing awareness of these symptoms has occurred during the last decade, their underlying neuropathophysiological circuitry remains poorly understood and consequently no effective therapeutic strategies are available to alleviate these health issues. Recent studies have examined the neuropathological status of the different neural components of the circuitry governing the generation of circadian rhythms in neurodegenerative diseases. In this review, we will dissect the potential contribution of dysfunctions in the different nodes of this circuitry to circadian alterations in patients with neurodegenerative diseases. A deeper understanding of these mechanisms will provide not only a better understanding of disease neuro-pathophysiology, but also hold the promise for developing effective and mechanisms-based therapies.

Sex differences in circadian endocrine rhythms: Clinical implications.

Organisms have developed a highly conserved and tightly regulated circadian system, to adjust their daily activities to day/night cycles. This system consists of a central clock, which is located in the hypothalamic suprachiasmatic nucleus, and the peripheral clocks that are ubiquitously expressed in all tissues. Both the central and peripheral clocks communicate with each other and achieve circadian oscillations of gene expression through transcriptional/translational loops mediated by clock transcription factors. It is worth mentioning that circadian non-transcriptional/non-translational rhythms also occur in non-nucleated cells. Interestingly, sex has been identified as an important factor influencing the activity of the circadian system. Indeed, several sex differences have been documented in the anatomy, physiology and pathophysiology that pertain to circadian rhythms. In this review, we present the historical milestones of understanding circadian rhythms, describe the central and peripheral components of the circadian clock system, discuss representative examples of sexual dimorphism of circadian rhythms, and present the most relevant clinical implications.

Circadian misalignment: A biological basis for mood vulnerability in shift work.

BACKGROUND: Approximately one in five workers perform night shift work. Epidemiological studies suggest that night shift workers are at a 25-30% higher risk for mental illnesses, including depression and anxiety, which is an increasingly important socioeconomic burden for the workforce. Thus, it is important to determine how shift work negatively affects mood, as it will help identify mechanisms that underlie a night shift worker's higher risk for developing mood disturbances. METHODS: This opinion discusses recently identified, potential biological mechanisms-including the role of the circadian system and circadian misalignment-underlying mood vulnerability in shift workers. Studies included are recent epidemiological, human laboratory studies and animal preclinical work on night shift work or circadian misalignment. Target biological mechanisms of interest discussed here include circadian misalignment effects on brain activity and brain-gut axis, essential for mood regulation. RESULTS: Circadian misalignment, which corresponds to the misalignment between biological (circadian) system and daily sleep-wake behaviours, can adversely affect mood levels and cortical activity underlying mood regulation. Furthermore, animal preclinical work shows that the brain-gut axis function is not only implicated in mood regulation but can disrupt specific metabolites essential for mood regulation when animals are exposed to circadian disruption. CONCLUSIONS: Circadian misalignment is a key mechanism underlying mood in e.g. shift workers. Therefore, understanding its role and applying sleep/circadian behavioural interventions to mitigate the adverse consequences of circadian misalignment on mood have the potential to improve quality of life, which is tightly associated with mood and sleep quality, in shift workers.

Insomnia and menopause: a narrative review on mechanisms and treatments.

The menopausal transition is associated with an increased frequency of sleep disturbances. Insomnia represents one of the most reported symptoms by menopausal women. According to its pathogenetic model (3-P Model), different predisposing factors (i.e. a persistent condition of past insomnia and aging per se) increase the risk of insomnia during menopause. Moreover, multiple precipitating and perpetuating factors should favor its occurrence across menopause, including hormonal changes, menopausal transition stage symptoms (i.e. hot flashes, night sweats), mood disorders, poor health and pain, other sleep disorders and circadian modifications. Thus, insomnia management implies a careful evaluation of the psychological and somatic symptoms of the individual menopausal woman by a multidisciplinary team. Therapeutic strategies encompass different drugs but also behavioral interventions. Indeed, cognitive behavioral therapy represents the first-line treatment of insomnia in the general population, regardless of the presence of mood disorders and/or vasomotor symptoms (VMS). Different antidepressants seem to improve sleep disturbances. However, when VMS are present, menopausal hormone therapy should be considered in the treatment of related insomnia taking into account the risk-benefit profile. Finally, given its good tolerability, safety, and efficacy on multiple sleep and daytime parameters, prolonged-released melatonin should represent a first-line drug in women aged ≥ 55 years.

Circadian rhythm and its association with birth and infant outcomes: research protocol of a prospective cohort study.

BACKGROUND: Circadian rhythm plays an important role as our internal body's clock that synchronizes behavior and physiology according to the external 24-h light-dark cycle. Past studies have associated disrupted circadian rhythm with higher risk of miscarriages, preterm birth and low birth weights. This paper described the protocol of a prospective cohort study which aims to determine the circadian rhythm in pregnant women, identify its association with maternal factors during pregnancy, gestational weight gain, birth and infant outcomes. METHODS: Ten government maternal and child health clinics in Kuala Lumpur, Malaysia will be randomly selected. Sample size of 438 first-trimester pregnant women will be followed-up until the birth of their infant. Salivary melatonin and cortisol concentration among subsample will be determined using enzyme-linked immunosorbent assay. Data on sleep quality, psychological distress and morningness/eveningness chronotype of pregnant women will be collected using validated questionnaires. Pedometer will be used to measure 5-day physical activity data. Total gestational weight gain will be determined at the end of pregnancy. Utilization of 3-day food record is to capture meal timing and nutrient intake. All measurements will be done in 2nd and 3rd trimester. Birth outcomes will be collected through clinic records and Centers for Disease Control and Prevention (CDC) Neonatal questionnaire. Infants will be followed-up at 6 and 12 months old to obtain anthropometric measurements. DISCUSSION: There is a growing recognition of the role of maternal circadian rhythm, which entrains fetal circadian rhythms that may subsequently have long-term health consequences. The present study will identify the effect of circadian rhythm on pregnancy outcomes and infant growth in the first year of life.

The clock is ticking. Ageing of the circadian system: From physiology to cell cycle.

The circadian system is the responsible to organise the internal temporal order in relation to the environment of every process of the organisms producing the circadian rhythms. These rhythms have a fixed phase relationship among them and with the environment in order to optimise the available energy and resources. From a cellular level, circadian rhythms are controlled by genetic positive and negative auto-regulated transcriptional and translational feedback loops, which generate 24h rhythms in mRNA and protein levels of the clock components. It has been described about 10% of the genome is controlled by clock genes, with special relevance, due to its implications, to the cell cycle. Ageing is a deleterious process which affects all the organisms' structures including circadian system. The circadian system's ageing may produce a disorganisation among the circadian rhythms, arrhythmicity and, even, disconnection from the environment, resulting in a detrimental situation to the organism. In addition, some environmental conditions can produce circadian disruption, also called chronodisruption, which may produce many pathologies including accelerated ageing. Finally, some strategies to prevent, palliate or counteract chronodisruption effects have been proposed to enhance the circadian system, also called chronoenhancement. This review tries to gather recent advances in the chronobiology of the ageing process, including cell cycle, neurogenesis process and physiology.

The key role of insomnia and sleep loss in the dysregulation of multiple systems involved in mood disorders: A proposed model.

Mood disorders are amongst the most prevalent and severe disorders worldwide, with a tendency to be recurrent and disabling. Although multiple mechanisms have been hypothesized to be involved in their pathogenesis, just a few integrative theoretical frameworks have been proposed and have yet to integrate comprehensively all available findings. As such, a comprehensive framework would be quite useful from a clinical and therapeutic point of view in order to identify elements to evaluate and target in the clinical practice. Because conditions of sleep loss, which include reduced sleep duration and insomnia, are constant alterations in mood disorders, the aim of this paper was to review the literature on their potential role in the pathogenesis of mood disorders and to propose a novel theoretical model. According to this hypothesis, sleep should be considered the main regulator of several systems and processes whose dysregulation is involved in the pathogenesis of mood disorders. The model may help explain why sleep disturbances are so strikingly linked to mood disorders, and underscores the need to evaluate, assess and target sleep disturbances in clinical practice, as a priority, in order to prevent and treat mood disorders.

Physiological Nocturnal Hand Swelling: A Prospective Evaluation of Healthy Volunteers.

PURPOSE: The goal of this study was to quantify the variation in daily volume that is expected in the normal hand. Our hypothesis is that hand swelling occurs overnight. METHODS: Hand volume measurements of 36 healthy volunteers with no hand pathology were taken daily at 8 am, 2 pm, and 8 pm over a 3-day period. Participants were blinded to the objective of the study. Statistical analysis was performed to determine if any of the time points or patient demographics were associated with an increased change in hand volume. RESULTS: Thirty-six healthy volunteers with mean age of 40.9 years and mean body mass index of 24.2 kg/m2 were enrolled. Twenty-one volunteers were men and 15 were women. Three of the volunteers were left-handed. The key finding from this study was that the change in hand volume overnight (8 pm-8 am) is significantly different than the change in hand volume from 8 am to 2 pm and from 2 pm to 8 pm. Although there was a significant reduction in hand volume from 8 am to 2 pm, the further reduction in hand volume from 2 pm to 8 pm was not significant after correcting for the number of post hoc comparisons. In addition, demographic variables such as age, body mass index, and sex did not influence changes in hand volume. CONCLUSIONS: Physiological hand swelling occurs overnight in individuals without active or prior hand pathology. Hand volume then decreases over the course of the day in these same individuals. CLINICAL RELEVANCE: By investigating the changes in hand volume that occur overnight and throughout the day, we gain a better understanding of the temporal relationship between hand swelling and symptoms of chronic hand disease.

The Effect of a Common Daily Schedule on Human Circadian Rhythms During the Polar Day in Svalbard: A Field Study.

All Arctic visitors have to deal with extreme conditions, including a constant high light intensity during the summer season or constant darkness during winter. The light/dark cycle serves as the most potent synchronizing signal for the biological clock, and any Arctic visitor attending those regions during winter or summer would struggle with the absence of those entraining signals. However, the inner clock can be synchronized by other zeitgebers such as physical activity, food intake, or social interactions. Here, we investigated the effect of the polar day on the circadian clock of 10 researchers attending the polar base station in the Svalbard region during the summer season. The data collected in Svalbard was compared with data obtained just before leaving for the expedition (in the Czech Republic 49.8175°N, 15.4730°E). To determine the circadian functions, we monitored activity/rest rhythm with wrist actigraphy followed by sleep diaries, melatonin rhythm in saliva, and clock gene expression (Per1, Bmal1, and Nr1D1) in buccal mucosa samples. Our data shows that the two-week stay in Svalbard delayed melatonin onset but did not affect its rhythmic secretion, and delayed the activity/rest rhythm. Furthermore, the clock gene expression displayed a higher amplitude in Svalbard compared to the amplitude detected in the Czech Republic. We hypothesize that the common daily schedule at the Svalbard expedition strengthens circadian rhythmicity even in conditions of compromised light/dark cycles. To our knowledge, this is the first study to demonstrate peripheral clock gene expression during a polar expedition.

Peripheral Circadian Oscillators.

Circadian rhythms are ~24-hour cycles of physiology and behavior that are synchronized to environmental cycles, such as the light-dark cycle. During the 20th century, most research focused on establishing the fundamental properties of circadian rhythms and discovering circadian pacemakers that were believed to reside in the nervous system of animals. During this time, studies that suggested the existence of circadian oscillators in peripheral organs in mammals were largely dismissed. The discovery of a single-locus circadian pacemaker in the nervous system of several animals affirmed the single-oscillator model of the circadian system. However, the discovery of the genes that constituted the molecular timekeeping system provided the tools for demonstrating the existence of bona fide circadian oscillators in nearly every peripheral tissue in animals, including rodents, in the late 1990s and early 2000s. These studies led to our current understanding that the circadian system in animals is a hierarchical multi-oscillatory network, composed of master pacemaker(s) in the brain and oscillators in peripheral organs. Further studies showed that altering the temporal relationship between these oscillators by simulating jet-lag and metabolic challenges in rodents caused adverse physiological outcomes. Herein we review the studies that led to our current understanding of the function and pathology of the hierarchical multi-oscillator circadian system.

Differential effects of the circadian system and circadian misalignment on insulin sensitivity and insulin secretion in humans.

Glucose tolerance is lower at night and higher in the morning. Shift workers, who often eat at night and experience circadian misalignment (i.e. misalignment between the central circadian pacemaker and the environmental/behavioural cycles), have an increased risk of type 2 diabetes. To determine the separate and relative impacts of the circadian system, behavioural/environmental cycles, and their interaction (i.e. circadian misalignment) on insulin sensitivity and ß-cell function, the oral minimal model was used to quantitatively assess the major determinants of glucose control in 14 healthy adults using a randomized, cross-over design with two 8-day laboratory protocols. Both protocols involved 3 baseline inpatient days with habitual sleep/wake cycles, followed by 4 inpatient days with the same nocturnal bedtime (circadian alignment) or with 12-hour inverted behavioural/environmental cycles (circadian misalignment). The data showed that circadian phase and circadian misalignment affect glucose tolerance through different mechanisms. While the circadian system reduces glucose tolerance in the biological evening compared to the biological morning mainly by decreasing both dynamic and static ß-cell responsivity, circadian misalignment reduced glucose tolerance mainly by lowering insulin sensitivity, not by affecting ß-cell function.