Clocks & Sleep, Volume 1, Issue 1 (March 2019) – 17 articles

Light, through its non-imaging forming effects, plays a dominant role on a myriad of physiological functions, including the human sleep–wake cycle. The non-image forming effects of light heavily rely on specific properties such as intensity, duration, timing, pattern, and wavelengths. Here, we address how specific properties of light influence sleep and wakefulness in humans through acute effects, e.g., on alertness, and/or effects on the circadian timing system. Of critical relevance, we discuss how different characteristics of light exposure across the 24-h day can lead to changes in sleep–wake timing, sleep propensity, sleep architecture, and sleep and wake electroencephalogram (EEG) power spectra. Ultimately, knowledge on how light affects sleep and wakefulness can improve light settings at home and at the workplace to improve health and well-being and optimize treatments of chronobiological disorders. Full article

The on-call schedule is a common work arrangement that allows for the continuance of services during periods of low demand or emergencies. Even though 17%–25% of the world’s population participate in on-call work, the human impacts of on-call are generally poorly described in the literature. Of the studies available on the effects of on-call work on workers, disturbances to sleep duration and sleep quality are the most commonly reported, along with negative sleep-related consequences on sleepiness, fatigue, stress and mood. Research has shown that for couples sharing a bed, disturbances to sleep can impair relationship conflict resolution and reduce relationship quality. In the ‘off-site’ on-call scenario where workers are sleeping at home, their co-sleeping partner may be at risk of sleep disturbances and the subsequent detrimental consequences of this disturbed sleep for themselves and their relationship. To date, few studies have investigated the impact of on-call work for partners’ sleep and the potential sleep-related consequences. Therefore, further studies are needed to specifically address whether on-call work impacts the sleep of partners and whether these sleep disturbances also impact the partner’s daily performance and relationship quality. Our aim was to provide a narrative around the existing, relevant literature that both investigate and inform the potential impact of on-call for workers’ partners’ sleep and related consequences. Full article

Sleep and circadian rhythms are regulated across multiple functional, spatial and temporal levels: from genes to networks of coupled neurons and glial cells, to large scale brain dynamics and behaviour. The dynamics at each of these levels are complex and the interaction between the levels is even more so, so research have mostly focused on interactions within the levels to understand the underlying mechanisms—the so-called reductionist approach. Mathematical models were developed to test theories of sleep regulation and guide new experiments at each of these levels and have become an integral part of the field. The advantage of modelling, however, is that it allows us to simulate and test the dynamics of complex biological systems and thus provides a tool to investigate the connections between the different levels and study the system as a whole. In this paper I review key models of sleep developed at different physiological levels and discuss the potential for an integrated systems biology approach for sleep regulation across these levels. I also highlight the necessity of building mechanistic connections between models of sleep and circadian rhythms across these levels. Full article

Hospitalized patients frequently have disordered and poor-quality sleep due to a variety of both intrinsic and extrinsic factors. These include frequent nighttime intrusions, insomnia related to pain and unfamiliar environments, dark conditions during the day with loss of natural light, and disruption of the natural sleep cycle due to illness. Sleep wake disturbances can result in a deleterious consequence on physical, emotional, and cognitive status, which may impact patient satisfaction, clinical recovery, and hospital length of stay. Despite this, clinicians frequently fail to document sleep disturbances and are generally unaware of the best practices to improve sleep quality in the hospital. A PubMed search was conducted using the terms: (“sleep and hospitalized patients”) and (“sleep and hospitalization”) to review the published data on the topic of sleep in hospitalized medical patients. The search was limited to English-language articles published between 2000 and 2018. Subsequent PubMed searches were performed to clarify the data described in the initial search, including the terms “hospital sleep protocols,” “hospitalized patients sleep documentation,” and “hospitalized patients sleep quality”. The purpose of this review is to discuss sleep disturbances in hospitalized patients with a focus on causes of sleep disturbance, the effect of poor-quality sleep, high risk populations, considerations for surveillance and prevention, and pharmacologic and non-pharmacologic options for treatment. Full article

Previous studies have reported a shift in the timing of sleep during adolescence toward a later time. To date, it is unclear whether hormonal changes during puberty might contribute to this change in sleeping behavior. We systematically assessed pubertal development and sleep timing in a cross-sectional case-control study in girls with precocious (n = 42) and boys with delayed pubertal development (n = 19). We used the Munich ChronoType Questionnaire and the Children’s ChronoType Questionnaire to assess sleep timing in patients and age- and sex-matched controls (n = 309) and used the midpoint of sleep on free days, corrected for potential sleep debt accumulated during the school week, as a marker for sleep timing. Compared to the controls, girls with central precocious puberty showed a delay in sleep timing of 54 min, and girls with premature pubarche slept on average 30 min later. Male adolescents with delayed pubertal development showed an average sleep midpoint that was 40 min earlier compared to the control group. The results of this pilot study suggest an association between pubertal onset and shifts in sleep timing, which is a novel finding in human sleep behavior. Prospective studies in larger cohorts will be needed to examine the robustness and generalizability of the findings. Full article

This study aimed at examining potential associations of mid sleep timing (chronotype) and social jetlag with intake of alcohol and caffeine, depressive symptoms, and body mass index (BMI) in a sample of healthy young women. Furthermore, it was explored whether these behavioral sleep–wake parameters are associated with adverse childhood experiences (ACEs). In total, 146 women (21.7 ± 1.7 years) took part in a two-week assessment on daily consumption of alcohol and caffeine. They completed questionnaires on ACEs, chronotype, sleep quality and depressive symptoms. Partial correlations and Chi-Square tests were calculated to assess the relationships between the assessed variables. Results show an association on a trend level for chronotype (r = 0.162, p = 0.053) and a significant association for social jetlag (r = 0.169, p = 0.044) with average alcohol intake. Furthermore, participants with above-median ACEs were more likely to be late chronotypes compared to the below-median group (X2(2) = 6.595, p = 0.037). We could replicate the association among late chronotype, social jetlag and higher alcohol consumption in a sample of healthy, young women. Furthermore, our results suggest a relationship between ACEs and chronotype. Although it can be hypothesized that it is rather ACEs that have an impact on chronotype, further research is needed to explore this relationship more and to shed more light on the direction of the association between chronotype and ACEs as well as on underlying mechanisms and possible mediators. Full article

Snoring may be an important predictor of sleep-disordered breathing. Factors related to snoring among First Nations people are not well understood in a population with high rates of smoking and excess body weight. An interviewer-administered survey was conducted among 874 individual participants from 406 households in 2012 and 2013 in two Canadian First Nations communities. The survey collected information on demographic variables, individual and contextual determinants of respiratory health and snoring (classified as present versus absent) and self-reported height and weight. Multiple logistic regression analyses were conducted to examine relationships between snoring and potential risk factors adjusting for age and sex. Snoring was present in 46.2% men and 47.0% women. Considering body mass index, 259 people (30.3%) were overweight and 311 (36.4%) were considered obese. The combined current/former smoking rate was 90.2%. Being overweight, obesity, sinus trouble, current smoking status and former smoking were significantly associated with snoring. Exposure to home dampness and mold were suggestive of an association with snoring. To the degree that snoring may be a predictor of possible sleep-disordered breathing, these results indicate that environmental conditions such as smoking and home exposures may be important factors in the pathogenesis of these conditions. Full article

Natural daylight exposures in arctic regions vary substantially across seasons. Negative consequences have been observed in self-reports of sleep and daytime functions during the winter but have rarely been studied in detail. The focus of the present study set out to investigate sleep seasonality among indoor workers using objective and subjective measures. Sleep seasonality among daytime office workers (n = 32) in Kiruna (Sweden, 67.86° N, 20.23° E) was studied by comparing the same group of workers in a winter and summer week, including work and days off at the weekend, using actigraphs (motion loggers) and subjective ratings of alertness and mood. Actigraph analyses showed delayed sleep onset of 39 min in winter compared to the corresponding summer week (p < 0.0001) and shorter weekly sleep duration by 12 min (p = 0.0154). A delay of mid-sleep was present in winter at workdays (25 min, p < 0.0001) and more strongly delayed during days off (46 min, p < 0.0001). Sleepiness levels were higher in winter compared to summer (p < 0.05). Increased morning light exposure was associated with earlier mid-sleep (p < 0.001), while increased evening light exposure was associated with delay (p < 0.01). This study confirms earlier work that suggests that lack of natural daylight delays the sleep/wake cycle in a group of indoor workers, despite having access to electric lighting. Photic stimuli resulted in a general advanced sleep/wake rhythm during summer and increased alertness levels. Full article

Our understanding of non-rapid eye movement (NREM) parasomnias has improved considerably over the last two decades, with research that characterises and explores the causes of these disorders. However, our understanding is far from complete. The aim of this paper is to provide an updated review focusing on adult NREM parasomnias and highlighting new areas in NREM parasomnia research from the recent literature. We outline the prevalence, clinical characteristics, role of onset, pathophysiology, role of predisposing, priming and precipitating factors, diagnostic criteria, treatment options and medico-legal implications of adult NREM parasomnias. Full article

MicroRNAs (miRNAs) are small, abundant, non-coding RNA fragments that regulate gene expression and silencing at the post-transcriptional level. The miRNAs each control various downstream targets and play established roles in different biological processes. Given that miRNAs were recently proposed to contribute to the molecular control of sleep–wake regulation in animal models and narcoleptic patients, we investigated the impact of acute sleep deprivation on blood miRNA expression in healthy adult men of two different age groups. Twenty-two young (mean age: 24 ± 3 years) and nine older (65 ± 1 years) volunteers completed a controlled in-lab study, consisting of 8 h baseline sleep, followed by 40 h of extended wakefulness, and a 10-h recovery sleep opportunity. At the same circadian time in all three conditions (at 4:23 p.m. ± 23 min), qPCR expression profiling of 86 miRNAs was performed in blood serum. Thirteen different miRNAs could be reliably quantified and were analyzed using mixed-model ANOVAs. It was found that miR-30c and miR-127 were reliably affected by previous sleep and wakefulness, such that expression of these miRNAs was upregulated after extended wakefulness and normalized after recovery sleep. Together with previous findings in narcolepsy patients, our preliminary data indicate that miR-30c and its target proteins may provide a biomarker of elevated sleep debt in humans. Full article

The interplay between the circadian system and metabolism may give animals an evolutionary advantage by allowing them to anticipate food availability at specific times of the day. Physiological adaptation to feeding time allows investigation of animal parameters and comparison of food anticipation between groups of animals with genetic alterations and/or post pharmacological intervention. Such an approach is vital for understanding gene function and mechanisms underlying the temporal patterns of both food anticipation and feeding. Exploring these mechanisms will allow better understanding of metabolic disorders and might reveal potential new targets for pharmacological intervention. Changes that can be easily monitored and that represent food anticipation on the level of the whole organism are a temporarily restricted increase of activity and internal body temperature. Full article

Scale-free analysis of brain activity reveals a complexity of synchronous neuronal firing which is different from that assessed using classic rhythmic quantifications such as spectral analysis of the electroencephalogram (EEG). In humans, scale-free activity of the EEG depends on the behavioral state and reflects cognitive processes. We aimed to verify if fractal patterns of the mouse EEG also show variations with behavioral states and topography, and to identify molecular determinants of brain scale-free activity using the ‘multifractal formalism’ (Wavelet-Leaders). We found that scale-free activity was more anti-persistent (i.e., more different between time scales) during wakefulness, less anti-persistent (i.e., less different between time scales) during non-rapid eye movement sleep, and generally intermediate during rapid eye movement sleep. The scale-invariance of the frontal/motor cerebral cortex was generally more anti-persistent than that of the posterior cortex, and scale-invariance during wakefulness was strongly modulated by time of day and the absence of the synaptic protein Neuroligin-1. Our results expose that the complexity of the scale-free pattern of organized neuronal firing depends on behavioral state in mice, and that patterns expressed during wakefulness are modulated by one synaptic component. Full article

Night shift work is associated with risk of overweight and obesity. In night shift workers, short sleep duration combined with circadian misalignment may contribute to altered food intake regulation, favoring positive energy balance and weight gain. Prior work investigating food intake in shift workers has suffered methodologically due to reliance on subjective self-report for dietary assessment. No study has yet been done to examine the impact of night shift work on food intake in real-life shift workers using objective measures. Female day (n = 12) and night (n = 12) shift workers from a hospital setting participated in a laboratory-based objective food intake assessment. Participants entered the laboratory in the fasted state after awakening from the sleep episode following a final work shift, and underwent an ad libitum 14-item test meal buffet to objectively quantify food choice/intake. Sleep duration (measured via wrist-accelerometry) during the sleep episode before laboratory assessment was significantly longer in day vs. night workers (373.9 ± 127.5 vs. 260.6 ± 102.9 min, p = 0.03). No significant group difference was observed in calories consumed during the test meal (943.08 ± 469.55 vs. 878.58 ± 442.68 kcal, p = 0.74). When expressed as percent of energy consumed, day workers had higher protein consumption vs. night workers (16.03 ± 5.69 vs. 11.82 ± 4.05%; p = 0.05). To our knowledge, this is the first laboratory-based behavioral assessment of food choice/intake in actual night and day shift workers. Although not studied here, work by others has linked protein intake to satiety. This may be a potential pathway placing shift workers at risk for overweight and obesity. Full article

The circadian clock is comprised of two oscillators that independently track sunset (evening) and sunrise (morning), though little is known about how light responses differ in each. Here, we quantified the morning oscillator’s responses to 19 separate pulse trains, collecting observations from over 1300 Drosophila at ZT23. Our results show that the advances in activity onset produced by these protocols depended on the tempo of light administration even when total exposure was conserved across a 15-min window. Moreover, patterns of stimulation previously shown to optimize the evening oscillator’s delay resetting at ZT13 (an hour after dusk) were equally effective for the M oscillator at ZT23 (an hour before dawn), though the morning oscillator was by comparison more photosensitive and could benefit from a greater number of fractionation strategies that better converted light into phase-shifting drive. These data continue to build the case that the reading frames for the pacemaker’s time-of-day estimates at dusk and dawn are not uniform and suggest that the “photologic” for the evening versus morning oscillator’s resetting might be dissociable. Full article

Excessive daytime sleepiness (EDS) is the tendency to sleep at inappropriate times during the day. It can interfere with day-to-day activities and lead to several health issues. The objective of this study was to investigate the association between income, housing conditions, and incidence of EDS in adults living in two Cree First Nations communities. The data for this study involved 317 individuals aged 18 years and older who participated in baseline and follow-up evaluations (after four years) of the First Nations Lung Health Project, which was conducted in Saskatchewan in 2012–2013 and 2016. Both at baseline and follow-up survey after four years, an Epworth Sleepiness Scale (ESS) score >10 was considered to be abnormal. Logistic regression models were used to assess relationships between abnormal ESS and covariates at baseline. In 2016, 7.6% (24/317) of the participants reported an ESS >10 with the mean being 12.8 ± 2.0. For the same group, the mean ESS at baseline was 6.9 ± 2.2. The incidence of subjective EDS based on the ESS >10 was estimated at 7.6% over four years. This study showed an association between incidence of subjective EDS and less money left over at end of the month, having a house in need of repairs, having water or dampness in the past 12 months, and damage caused by dampness. Full article

Previous research has found that elite athletes have insufficient sleep, yet the specific kinds of sleep disturbances occurring as compared to a control group are limited. Here we compare the subjective sleep quality and chronotype of elite athletes to a control group of non-athlete good sleepers. Sixty-three winter Canadian National Team athletes (mean age 26.0 ± 0.0; 32% females) completed the Pittsburgh Sleep Quality Index (PSQI) and the Athlete Morningness Eveningness Scale. They were compared to 83 healthy, non-athlete, good-sleeper controls (aged 27.3 ± 3.7; 51% females) who completed the PSQI and the Composite Scale of Morningness. The elite athletes reported poorer sleep quality (PSQI global score 5.0 ± 2.6) relative to the controls (PSQI global score 2.6 ± 1.3), despite there being no group difference in self-reported sleep duration (athletes 8.1 ± 1.0 h; controls 8.0 ± 0.7 h). Further, athletes’ chronotype distribution showed a greater skew toward morningness, despite there being no group differences in self-reported usual bedtime and wake time. These results suggest that a misalignment of sleep times with circadian preference could contribute to poorer sleep quality in elite athletes. Full article

Exciting new discoveries in the circadian and sleep field have mushroomed in the past 10 years, culminating in the 2017 Nobel Prize in Physiology or Medicine being awarded to Jeffrey C. Hall, Michael Rosbash, and MichaelW. Young for their discoveries of molecular mechanisms controlling the circadian rhythm. [...] Full article