Reinberg Alain E, Smolensky Michael H, Riedel Marc, Riedel Cedric, Brousse Eric, Touitou Yvan
a Unité de Chronobiologie , Fondation A. de Rothschild , Paris cedex , France.
b Department of Biomedical Engineering, Cockrell School of Engineering , The University of Texas at Austin , Austin , TX , USA.
Chronobiol Int. 2017;34(8):1158-1174. doi: 10.1080/07420528.2017.1343833. Epub 2017 Sep 18.
Systolic (S) and diastolic (D) blood pressures (BP) [SBP and DBP] are circadian rhythmic with period (τ) in healthy persons assumed to be maintained at 24.0h. We tested this assumption in a sample of 30 healthy career (mean >12 yrs) 30-to-46 yr-old male Caucasian French firefighters (FFs) categorized into three groups according to work schedule and duties: Group A - 12 FFs working 12h day, 12h night, and occasionally 24h shifts and whose primary duties are firefighting plus paramedical and road rescue services; Group B - 9 FFs working mostly 12h day and 12h night shifts and whose duties are answering incoming emergency calls and coordinating service vehicle dispatch from fire stations with Group A personnel; Group C - 9 day shift (09:00-17:00h) FFs charged with administrative tasks. SBP and DBP, both in winter and in summer studies of the same FFs, were sampled by ambulatory BP monitoring every 1h between 06:00-23:00h and every 2h between 23:01-05:59h, respectively, their approximate off-duty wake and sleep spans, for 7 consecutive days. Activity (wrist actigraphy) was also sampled at 1-min intervals. Prominent τ of each variable was derived by a power spectrum program written for unequal-interval time series data, and between-group differences in incidence of τ≠24h of FFs were assessed by chi square test. Circadian rhythm disruption (τ≠24h) of either the SBP or DBP rhythm occurred almost exclusively in night and 24h shift FFs of Group A and B, but almost never in day shift FFs of Group C, and it was not associated with altered τ from 24.0h of the circadian activity rhythm. In summer, occurrence of τ≠24 for FFs of Group A and B differed from that for FFs of Group C in SBP (p=0.042) and DBP (p=0.015); no such differences were found in winter (p>0.10). Overall, manifestation of prominent τ≠24h of SBP or DBP time series was greater in summer than winter, 27.6% versus 16.7%, when workload of Group B FFs, i.e. number of incoming emergency telephone calls, and of Group A FFs, i.e. number of dispatches for provision of emergency services, was, respectively, two and fourfold greater and number of 12h night shifts worked by Group B FFs and number of 24h shifts worked by Group A FFs was, respectively, 92% and 25% greater. FFs of the three groups exhibited no winter-summer difference in τ≠24h of SBP or SDP; however, τ≠24h of DBP in Group B FFs was more frequent in summer than winter (p=0.046). Sleep/wake cycle disruption, sleep deprivation, emotional and physical stress, artificial light-at-night, and altered nutrient timings are hypothesized causes of τ≠24h for BP rhythms of affected Groups A and B FFs, but with unknown future health effects.
在健康人群中,收缩压(S)和舒张压(D)[即收缩压(SBP)和舒张压(DBP)]具有昼夜节律,其周期(τ)假定维持在24.0小时。我们在30名健康从业者(平均工作年限>12年)的样本中检验了这一假设,这些从业者为30至46岁的法国白人男性消防员(FFs),根据工作时间表和职责分为三组:A组 - 12名消防员,工作时间为12小时白班、12小时夜班,偶尔有24小时轮班,其主要职责是灭火以及提供辅助医疗和道路救援服务;B组 - 9名消防员,主要工作时间为12小时白班和12小时夜班,其职责是接听来电紧急呼叫,并与A组人员协调消防站服务车辆的调度;C组 - 9名日班(09:00 - 17:00)消防员,负责行政任务。在对同一批消防员进行的冬季和夏季研究中,分别在06:00 - 23:00期间每小时、23:01 - 05:59期间每两小时通过动态血压监测对SBP和DBP进行采样,这分别是他们大致的非工作清醒和睡眠时段,连续7天。活动情况(手腕活动记录仪)也以1分钟的间隔进行采样。每个变量的显著τ值由针对不等间隔时间序列数据编写的功率谱程序得出,FFs中τ≠24小时发生率的组间差异通过卡方检验进行评估。SBP或DBP节律的昼夜节律紊乱(τ≠24小时)几乎只发生在A组和B组的夜班和24小时轮班消防员中,但几乎从未发生在C组的日班消防员中,并且它与昼夜活动节律的τ值偏离24.0小时无关。在夏季,A组和B组消防员的SBP(p = 0.042)和DBP(p = 0.015)中τ≠24小时的发生率与C组消防员不同;冬季未发现此类差异(p>0.10)。总体而言,SBP或DBP时间序列中显著τ≠24小时的表现夏季比冬季更明显,分别为27.6%和16.7%,此时B组消防员的工作量,即来电紧急电话数量,以及A组消防员的工作量,即提供紧急服务的调度次数,分别增加了两倍和四倍,并且B组消防员的12小时夜班工作次数和A组消防员的24小时轮班工作次数分别增加了92%和25%。三组消防员在SBP或SDP的τ≠24小时方面没有冬夏差异;然而,B组消防员DBP的τ≠24小时在夏季比冬季更频繁(p = 0.046)。睡眠/觉醒周期紊乱、睡眠剥夺、情绪和身体压力、夜间人造光以及营养摄入时间改变被假定为受影响的A组和B组消防员BP节律中τ≠24小时的原因,但对未来健康的影响尚不清楚。