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及时使用车内暗蓝光和早晨的蓝光阻断剂并不能改善快速轮班工人的昼夜节律适应。

Timely use of in-car dim blue light and blue blockers in the morning does not improve circadian adaptation of fast rotating shift workers.

机构信息

CERVO Brain Research Centre, Université Laval, Québec, Québec, Canada.

ÉCOBES - Recherche et Transfert, Cégep de Jonquière, Saguenay, Québec, Canada.

出版信息

Chronobiol Int. 2021 May;38(5):705-719. doi: 10.1080/07420528.2021.1872592. Epub 2021 Feb 15.

Abstract

Circadian adaptation to night work usually does not occur in naturalistic conditions, largely due to exposure to low levels of light during the night and light in the morning on the way home. This leads to circadian misalignment, which has documented deleterious effects on sleep and functioning during waking hours. Chronic circadian misalignment is also being increasingly associated with long-term health comorbidities. As the circadian system is mostly sensitive to short wavelengths (i.e., blue light) and less sensitive to long wavelengths (i.e., red light), shaping light exposure in a "wavelength-wise" manner has been proposed to promote partial adaptation to night shifts, and, therefore, alleviate circadian rhythms disruption. This report presents results from two cross-over designed studies that aimed to investigate the effects of three different light conditions on circadian phase, sleepiness, and alertness of police patrol officers on a rotating shift schedule. The first study took place during summer (n = 15) and the second study (n = 25) during winter/early spring. In both studies, all participants went through three conditions composed of four consecutive night shifts: 1) in-car dim blue light exposure during the night shift and wearing of blue-blocking glasses (BBG) in the morning after 05:00 h; 2) in-car red light exposure during the night shift and wearing of BBG in the morning after 05:00 h; 3) a control condition with no intervention. To assess circadian phase position, salivary melatonin was collected hourly the night before and the night after each condition. Sleep was monitored by wrist actigraphy. Also, a 10-min Psychomotor Vigilance-Task was administered at the beginning and end of each night shift and the Karolinska Sleepiness Scale was completed every 2 h during each night shift. In the summer study, no difference was found in alertness and sleepiness between conditions. Participants though exhibited greater (≈3 h) phase delay after four consecutive night shifts in the control condition (in which morning light exposure was expected to prevent phase delay) than after the blue and red conditions (≈2 h) (in which wearing BBG were expected to promote phase delay). In the second study performed during the winter/early spring, a comparable ≈2 h phase delay was found in each of the three conditions, with no difference in alertness and sleepiness between conditions. In conclusion, participants in both studies exhibited modest phase delay across the four night shifts, even during the control conditions. Still, re-entrainment was not fast enough to produce partial circadian adaptation after four night shifts. A greater number of consecutive night shifts may be necessary to produce enough circadian alignment to elicit benefits on sleepiness and alertness in workers driving a motorized vehicle during night shifts. In-car dim blue light exposure combined with the wearing of BBG in the morning did not show the expected benefits on circadian adaptation, sleepiness, and alertness in our studies. Higher levels of light may be warranted when implementing light intervention in a motorized vehicle setting.

摘要

昼夜节律适应夜间工作通常不会在自然条件下发生,主要是因为夜间和回家途中早晨暴露在低水平的光线下。这导致昼夜节律失准,有文件记录表明这会对睡眠和清醒时的功能产生有害影响。慢性昼夜节律失准也与长期健康合并症的关系越来越密切。由于生物钟系统对短波长(即蓝光)更为敏感,对长波长(即红光)的敏感性较低,因此,以“波长”的方式塑造光照已被提议用于促进对夜间轮班的部分适应,从而减轻昼夜节律紊乱。本报告介绍了两项交叉设计研究的结果,这些研究旨在调查三种不同光照条件对轮班制警察巡逻员的昼夜节律相位、困倦和警觉性的影响。第一项研究在夏季(n=15)进行,第二项研究(n=25)在冬季/早春进行。在两项研究中,所有参与者都经历了三种条件,包括四个连续的夜班:1)在车内夜间昏暗的蓝光照射下,并在 05:00 后佩戴蓝光阻断眼镜(BBG);2)在车内红光照射下,并在 05:00 后佩戴 BBG;3)无干预的对照条件。为了评估昼夜节律相位位置,在每个条件前后的晚上收集唾液褪黑素每小时一次。通过腕部动作描记法监测睡眠。此外,在每个夜班的开始和结束时进行 10 分钟的精神运动警觉性任务,并且在每个夜班的每 2 小时完成 Karolinska 嗜睡量表。在夏季的研究中,在三种条件下,警觉性和困倦感没有差异。参与者在对照条件下(预期早晨光照会防止相位延迟)连续四个夜班后表现出更大的(≈3 小时)相位延迟,而在蓝色和红色条件下(≈2 小时)则表现出较小的(≈2 小时)相位延迟(预期佩戴 BBG 会促进相位延迟)。在冬季/早春进行的第二项研究中,在三种条件下都发现了类似的≈2 小时的相位延迟,在条件之间没有警觉性和困倦感的差异。总之,两项研究中的参与者在四个夜班期间都表现出适度的相位延迟,即使在对照条件下也是如此。尽管如此,重新调整的速度还不够快,无法在四个夜班后产生部分昼夜节律适应。可能需要更多的连续夜班才能产生足够的昼夜节律对齐,以在夜间驾驶机动车辆的工人中产生对困倦和警觉性的益处。在我们的研究中,车内昏暗的蓝光照射结合早晨佩戴 BBG 并没有显示出对昼夜节律适应、困倦和警觉性的预期益处。在实施机动车光照干预时,可能需要更高水平的光照。

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