copyright catherine m. burns 1 circadian rhythms and shiftwork text chapter 13 p. 343-348

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Copyright Catherine M. Burns

1

Circadian Rhythms and Shiftwork

Text Chapter 13 p. 343-348

Copyright Catherine M. Burns 2

Sleep Loss

Have you ever pulled an “all-nighter”? Flown the “red-eye” flight? How did you feel afterwards?

Copyright Catherine M. Burns

3

Who is sleep deprived right now?

Copyright Catherine M. Burns 4

The Epworth Sleepiness Scale

A standardized scale used by sleep experts Assess your chance of dozing

0 would never dose 1 slight chance of dozing 2 moderate chance of dozing 3 high chance of dozing

Scale: National Sleep Foundation

Copyright Catherine M. Burns 5

Sitting and reading? Watching television? Sitting still in a public place (theatre or movie)? Passenger in a car for an hour? Lying down in the afternoon? Sitting and talking to someone? Sitting quietly after lunch? In a car while stopped in traffic?

Copyright Catherine M. Burns 6

Causes of Sleep Loss

deliberately staying awake sleeping at unnatural times

during daylight counter to one’s circadian rhythms

sleeping with the effects of caffeine or alcohol

Copyright Catherine M. Burns 7

Circadian Rhythms

natural physiological cycle the body goes through every day

temperature, metabolism, and chemical level changes

low temperature in the morning rises during the day then drops (6:30-6:30 roughly)

slightly longer than 24 hours People with circadian rhythm disorders

Copyright Catherine M. Burns 8

Body Temperature

6am 6pm

36.5

37.0

Text p. 345 Figure 13.5

Copyright Catherine M. Burns 9

Circadian Rhythms

Cycle correlates with sleepiness sleep efficiency (how long we sleep) performance

Strong correlation with errors and accidents

Copyright Catherine M. Burns 10

Performance

6am 6pm

6am 6pm

6am 6pm

6am 6pm

Psychomotor Performance

Symbol cancellation

Reaction Time

Digit summation

Text Figure 13.6 p 346

Copyright Catherine M. Burns 11

Circadian Rhythms and Driving

When would you expect more accidents? With the spring time change? With the fall time change? Why?

Copyright Catherine M. Burns 12

Accidents in Canada 1991-1992

Spring Fall

Day of the change

Day before, of, after the change

Source: Sleep thieves

Copyright Catherine M. Burns 13

Accidents in Israel

# of

accidents

Time4am 4pm

Source: Sleep thieves,

Stanley Coren

Copyright Catherine M. Burns 14

Circadian Rhythms and Driving

Copyright Catherine M. Burns 15

Circ Rhythms and Accidents

Which of the cases we’ve studied could have been influenced by circadian rhythms?

Copyright Catherine M. Burns 16

Effects of Sleep Disruption

impaired judgement reduced ability to learn reduced ability to store new material inability to plan

Copyright Catherine M. Burns 17

Assessing Sleep Debt

Do you need an alarm clock to wake up? Do you hit the snooze to get a few more minutes? Getting out of bed is a struggle Sleeping through the alarm Sleeping longer on weekends than during the week Getting sleepy sitting and reading Dozing off when watching TV? Feeling dozy after lunch Drink more than four cups of coffee or tea?

Copyright Catherine M. Burns 18

Solutions

get more sleep! some sleep is better than no sleep napping (even 15 minutes) is proven to

improve performance caffeine for short runs avoiding shiftwork or planning it properly

Copyright Catherine M. Burns 19

Shiftwork

Circadian Desynchronisation: Shiftwork is counter to circadian rhythms

Issues: alertness, hunger patterns, urinary patterns, quality of sleep, cardiac health, asthsma

Solutions permanent assignment (people don’t usually like this) slow rotation fixed for 2-3 weeks then time to resynchronize between

shifts

Copyright Catherine M. Burns 20

Shiftwork

Shifts should rotate later “delay” Eg. 12am-8am then to 8am-4pm. Due to length of rhythm it is easier to adjust

to a later shift than an earlier one Shifts are easier for younger person Older people have less physiological

capacity to adapt

Copyright Catherine M. Burns 21

People who should not do shift work

Over 40 Cardiac problems Asthsma Diabetes Epilepsy Past experience with depression

Copyright Catherine M. Burns 22

Jet lag

UK statistics show that most holiday accidents happen on the drive home from the airport

Drivers 4am-6am have 13 TIMES the accident risk

Copyright Catherine M. Burns 23

Circadian Resynchronization

Can be artificially stimulated Cues:

Light/dark Food Activity

Exposure to bright light during “daytime” Full spectrum lights, melatonin?

Copyright Catherine M. Burns 24

Melatonin studies

Unlike mice, people who are totally blind cannot set the clock in their SCN. As a result, their circadian rhythm drifts out of phase with the actual cycle of day and night. These people often are bothered by feeling sleepy during the day and wide awake when they want to be asleep at night. A recent (12 October 2000) report in the New England Journal of Medicine tells of a group of blind people who were able to set their clocks with the help of a dose (10 mg) of melatonin at bedtime. However, this treatment worked only when the subject's circadian rhythm had drifted so that the normal rise in melatonin from the pineal gland was occurring in the early evening; that is, the dose of melatonin had to be given when it could boost the endogenous level of the hormone.

Copyright Catherine M. Burns 25

http://www.sleepfoundation.org/nsaw/sleepiq99i.cfm

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