a Department of Somnology , Tokyo Medical University , Tokyo , Japan.
b Japan Somnology Center, Institute of Nueropsychiatry , Tokyo , Japan.
Chronobiol Int. 2018 Nov;35(12):1637-1646. doi: 10.1080/07420528.2018.1499666. Epub 2018 Aug 1.
Social jetlag has recently attracted attention as the circadian misalignment between biological and social clocks. We aimed to examine social jetlag and its effect on daytime sleepiness and daily functions in patients with narcolepsy, behaviorally induced insufficient sleep syndrome (BIISS) and delayed sleep-wake phase disorder (DSPD). The levels of social jetlag (SJL) and sleep-corrected social jetlag (SJL) were calculated for each patient, and the effect of these social jetlag-related parameters on daytime sleepiness and daily functions were examined. Objective sleepiness measured by the mean sleep latency in the multiple sleep latency test, subjective sleepiness assessed by the Epworth sleepiness scale (ESS), health-related quality of life (HRQoL) assessed by the SF-8 health survey, and incidences of mistakes in daily activities, traffic accidents and near-miss events related to daytime sleepiness were compared among the narcolepsy (n = 39), BIISS (n = 87) and DSPD (n = 28) groups. Both SJL and SJL showed a negative correlation with physical HRQoL in patients with narcolepsy and a positive correlation with the ESS score in patients with DSPD. In patients with BIISS, SJL reflected sleep loss rather than circadian misalignment; moreover, SJL was not associated with daytime sleepiness and daily functions. Social jetlag was not associated with incidences of mistakes in daily activities, traffic accidents and near-miss events. The state of social jetlag and its association with daily functions differed among the narcolepsy, BIISS and DSPD groups. Social jetlag represented sleep debt in BIISS, circadian misalignment in narcolepsy and both in DSPD. Our results thus show that the clinical manifestations and significance of social jetlag differ depending on the underlying sleep disorders.
社会时差最近引起了人们的关注，因为它是生物钟和社会钟之间的昼夜节律失调。我们旨在研究社会时差及其对发作性睡病、行为性睡眠不足综合征（BIISS）和睡眠时相延迟障碍（DSPD）患者日间嗜睡和日常功能的影响。计算每位患者的社会时差（SJL）和睡眠校正后的社会时差（SJL）水平，并检查这些与社会时差相关的参数对日间嗜睡和日常功能的影响。使用多次睡眠潜伏期试验中的平均睡眠潜伏期测量客观嗜睡程度，使用 Epworth 嗜睡量表（ESS）评估主观嗜睡程度，使用 SF-8 健康调查评估健康相关生活质量（HRQoL），并比较发作性睡病（n=39）、BIISS（n=87）和 DSPD（n=28）组中与日间嗜睡相关的日常活动错误发生率、交通事故和险些事故发生率。SJL 和 SJL 均与发作性睡病患者的身体 HRQoL 呈负相关，与 DSPD 患者的 ESS 评分呈正相关。在 BIISS 患者中，SJL 反映的是睡眠不足，而不是昼夜节律失调；此外，SJL 与日间嗜睡和日常功能无关。社会时差与日常活动中的错误、交通事故和险些事故的发生率无关。社会时差在发作性睡病、BIISS 和 DSPD 组中的状态及其与日常功能的关系不同。BIISS 中的社会时差代表睡眠债务，发作性睡病中的社会时差代表昼夜节律失调，而 DSPD 中则同时存在这两种情况。因此，我们的研究结果表明，社会时差的临床表现和意义因潜在的睡眠障碍而异。
