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Background: Nurses and other first responders are at high risk of exposure to the SARS-CoV2 virus, and many have developed severe COVID-19 infection. A better understanding of the factors that increase the risk of infection after exposure to the virus could help to address this. Although several risk factors such as obesity, diabetes, and hypertension have been associated with an increased risk of infection, many first responders develop severe COVID-19 without established risk factors. As inflammation and cytokine storm are the primary mechanisms in severe COVID-19, other factors that promote an inflammatory state could increase the risk of COVID-19 in exposed individuals. Alcohol misuse and shift work with subsequent misaligned circadian rhythms are known to promote a pro-inflammatory state and thus could increase susceptibility to COVID-19. To test this hypothesis, we conducted a prospective, cross-sectional observational survey-based study in nurses using the American Nursing Association network. Method(s): We used validated structured questionnaires to assess alcohol consumption (the Alcohol Use Disorders Identification Test) and circadian typology or chronotype (the Munich Chronotype Questionnaire Shift -MCTQ-Shift). Result(s): By latent class analysis (LCA), high-risk features of alcohol misuse were associated with a later chronotype, and binge drinking was greater in night shift workers. The night shift was associated with more than double the odds of COVID-19 infection of the standard shift (OR 2.67, 95% CI: 1.18 to 6.07). Binge drinkers had twice the odds of COVID-19 infection of those with low-risk features by LCA (OR: 2.08, 95% CI: 0.75 to 5.79). Conclusion(s): Working night shifts or binge drinking may be risk factors for COVID-19 infection among nurses. Understanding the mechanisms underlying these risk factors could help to mitigate the impact of COVID-19 on our at-risk healthcare workforce.Copyright © 2023 The Authors. Alcohol: Clinical and Experimental Research published by Wiley Periodicals LLC on behalf of Research Society on Alcohol.
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In the face of the COVID-19 pandemic experienced around the world, new student lifestyles have had an impact on their daily behavior. The purpose of this study was to examine post-traumatic stress associated with the initial COVID-19 crisis in students (N = 280) with a mean age of 13 +/- 1.70 and to determine the relationship between their reported daily behaviors in terms of their gender. The study was conducted primarily in Casablanca and Marrakech, the two cities most affected by the pandemic at the time of the study in Morocco in May 2020. Our sample consists of 133 high school students and 147 middle school students, 83.6% of whom are females. Students were asked to answer questions based on an Activity Biorhythm Questionnaire, the Post-Traumatic Stress Scale (Weathers et al., 1993), the Hamilton Scale (Hamilton, 1960), the Worry Domains Questionnaire (Tallis, Eyzenck, Mathews, 1992), and the Visual Analog Scale of Moods (VASM) (Stern et al., 1997). The results obtained confirm that there is a significant relationship between the circadian rhythm of some variables and gender in some activities such as academic study (p < 0.05) and TV and Internet use (p < 0.05) and was highly significant for physical activity (p = 0.001), while others are not significant in relation to other schedules of the same variables or in relation to others. Likewise, for the psychological conditions, significant relationships with mood states and depressive tendencies were confirmed. In lockdown, the students' daily lives underwent changes in circadian rhythm and lifestyle. Therefore, it is necessary to treat their current psychological problems and avoid future complications. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Lockdown is an important measure that has been globally adopted to reduce the spread of the contagious disease caused by SARS CoV-2. The imposed schedule and confinement led to extensive use of digital media and rise in sedentary activity drastically. The escalated duration of screen exposure causes disruption in sleep behavior. An online survey was conducted to comprehend the effect of lockdown on sleep behavior and screen exposure time on school children. Screen exposure time involved with various electronic gadgets was also analyzed. It was observed that the social jet lag and sleep debt were significantly less during lockdown than before it. Inertia during lockdown significantly increased. The difference between screen exposure time on weekdays before lockdown and weekends during lockdown was identified to be the highest. Three clusters based on sleep behavior and duration of screen time were identified of which Cluster 2 revealed simultaneous existence of high sleep duration and screen time. These baseline data on sleep parameters and duration of exposure to the screen will help us in devising approaches to mitigate the evident disruption this unprecedented phase has brought about. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
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Background and objective: This study aimed to evaluate the sleep patterns of students and employees working onsite versus those working from home during the COVID-19 pandemic using actigraphy. Methods: A total of 75 students/employees (onsite: Nâ¯= 40, home-office: Nâ¯= 35; age range: 19-56 years; 32% male; 42.7% students, 49.3% employees) were studied between December 2020 and January 2022 using actigraphy, a sleep diary, and an online questionnaire assessing sociodemographics and morningness-eveningness. Independent-sample t-tests, paired-sample tests, and a multivariate general linear model adjusting for age (fixed factors: sex and work environment) were applied. Results: Overall, onsite workers had significantly earlier rise times (7:05 [SD: 1:11] versus 7:44 [1:08] hours) and midpoints of sleep (2:57 [0:58] versus 3:33 [0:58] hours) on weekdays compared to home-office workers. Sleep efficiency, sleep duration, variability of sleep timing, and social jetlag did not differ between the groups. Discussion: Home-office workers showed a delay in sleep timing that did not affect any other sleep parameters such as sleep efficiency or nighttime sleep duration. The work environment had only marginal impact on sleep patterns and thus sleep health in this sample. Sleep timing variability did not differ between groups. Supplementary Information: The online version of this article (10.1007/s11818-023-00408-5) contains supplementary material 1 and 2, which is available to authorized users.
ABSTRACT
Delayed sleep-wake phase disorder (DSWPD) is a sleep disorder in which the habitual sleep-wake timing is delayed, resulting in difficulty in falling asleep and waking up at the desired time. Patients with DSWPD frequently experience fatigue, impaired concentration, sleep deprivation during weekdays, and problems of absenteeism, which may be further complicated by depressive symptoms. DSWPD is typically prevalent during adolescence and young adulthood. Although there are no studies comparing internationally, the prevalence of DSWPD is estimated to be approximately 3% with little racial differences between Caucasians and Asians. The presence of this disorder is associated with various physiological, genetic and psychological as well as behavioral factors. Furthermore, social factors are also involved in the mechanism of DSWPD. Recently, delayed sleep phase and prolonged sleep duration in the young generation have been reported during the period of COVID-19 pandemic-related behavioral restrictions. This phenomenon raises a concern about the risk of a mismatch between their sleep-wake phase and social life that may lead to the development of DSWPD after the removal of these restrictions. Although the typical feature of DSWPD is a delay in circadian rhythms, individuals with DSWPD without having misalignment of objectively measured circadian rhythm markers account for approximately 40% of the cases, wherein the psychological and behavioral characteristics of young people, such as truancy and academic or social troubles, are largely involved in the mechanism of this disorder. Recent studies have shown that DSWPD is frequently comorbid with psychiatric disorders, particularly mood and neurodevelopmental disorders, both of which have a bidirectional association with the pathophysiology of DSWPD. Additionally, patients with DSWPD have a strong tendency toward neuroticism and anxiety, which may result in the aggravation of insomnia symptoms. Therefore, future studies should address the effectiveness of cognitive-behavioral approaches in addition to chronobiological approaches in the treatment of DSWPD.
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[This corrects the article DOI: 10.3389/fimmu.2023.980711.].
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BACKGROUND: Falls are among the most common and serious adverse events for hospitalised patients. In-hospital falls pose a major medical and economic challenge for public health worldwide. Nevertheless, the issue is often addressed without regard to certain relevant variables such as the time of the fall. The aim of this study was to determine the effect of the implementation of a nurse-led intervention based on the temporal patterns of falls and their aetiology on the occurrence of falls. METHODS: A mixed-method research design was carried out in three phases: a) a longitudinal prospective study (audits, chronobiological analyses and implementation of a multicentre nurse-led intervention based on temporal patterns of falls); b) a retrospective study of fall records; and c) a qualitative study based on focus groups. The protocol was published in 2021. RESULTS: A difference was observed in the number of fall records before and after the chronopreventive intervention (retrospective: 64.4% vs. 35.6%; p < 0,001). According to the interrupted series analysis, considering the influence of the COVID-19 pandemic, a reduction in falls of 2.96% (95% CI 1.70%-4.17%) was observed. The concepts of falls, the COVID-19 pandemic and the causes of non-registration have emerged as categories for qualitative analysis. CONCLUSIONS: A multicentric nurse-led program based on tailored organisational, educational and behavioural chronopreventive measures seems to lead to a reduction in the number of in-hospital falls. The findings of the present study, highlighting the implementation of chronopreventive measures, can serve as a basis for future health policies. TRIAL REGISTRATION: The project was registered on the Clinical Trials Registry NCT04367298 (29/04/2020).
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Prior to the Covid-19 pandemic, an estimated 11 million jet passengers were traveling daily. While many were traveling within the same time zone, a significant portion were subjecting themselves to circadian desynchrony by rapidly crossing across multiple time zones. This phenomenon, commonly known as jet lag, is mechanistically similar to other forms of circadian misalignment such as shift work. Therefore, understanding the pathophysiology and treatment of jet lag has direct implications for high stakes industries such as aviation, military, medicine, and athletics as well other circadian rhythm disorders. © 2023 Elsevier Inc. All rights reserved
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The pandemic affected all branches of the country's economy, all categories of services, but also performance sports. With it, competitions appeared postponed without a precise date or even totally canceled. In performance sports, a major role was played by the uncertainty of the biggest competition in an athlete's life, the Tokyo competition. It was a great challenge for the coach to organize his training periods, so as to bring the athletes in the best shape, but also for the doctors and the medical staff to work on an adequate recovery, to support the physical effort through the most well-rated supplements, always adapting to changes and not least for athletes to resist physically and mentally and to find the motivation to continue the routine to achieve their goal, that of reaching Tokyo.Copyright © 2022 Andreea-Elena Siminiceanu, published by Sciendo.
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The ongoing coronavirus disease 2019 (COVID-19) pandemic is the third global crisis after two epidemics of severe acute respiratory syndromes. It has affected general public besides health care systems and governments. Confinements and lock downs have changed waking up time and going to bed time, ultimately affecting circadian clocks that can disturb sleep quality which can lead to anxiety, stress, and depression. This puts the most susceptible group -young adults and females at risk of psychological disorders and even inflammatory events. Several kinds of sleep disorders due to COVID-19 including insomnia, sleep apnea, sleepiness during daytime, post-traumatic-like sleep dysfunction, abnormal dreams, and restless legs syndrome have been reported. As sleep deprivation can alter circadian clock and weaken immunity which makes human more susceptible to pulmonary inflammatory process of COVID-19 and even enhance its manifestations, it should be considered as an urgent complication that needs to be treated. Furthermore, longstanding effects of sleep disturbances during COVID-19 pandemic need to be elucidated © 2023 The Korean Society of Sleep Medicine
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The emergence of sleep precedes humanity and has always influenced human culture. The modern science of sleep and circadian rhythm medicine is foundationally based to address age old problems such as insomnia and nightmares. The pace of sleep scientific knowledge greatly accelerated with development of all-night sleep recordings and the subsequent illumination of the spectrum of clinical sleep disorders. Much of this fundamental work was influenced by Dr. William C. Dement and several other pioneers described in this article. The history of sleep and circadian science shows us the inexorable, and perhaps destined, path to know the functions of sleep and promote greater sleep health for society. © 2023 Elsevier Inc. All rights reserved
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As consumer sleep technology becomes ubiquitous, sleep clinicians are tasked with navigating these new technologies and must decide if and how to incorporate these technologies into a typical sleep clinical visit. We explore the potential applications of wearables, nearables, and apps in sleep medicine and consider how our acceptance of technology has changed since the COVID-19 pandemic. © 2023 Elsevier Inc. All rights reserved
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Background: The pubertal transition (PT) is characterized by dramatic reproductive hormone fluctuations, a developmental circadian delay, and significant changes in sleep and wake patterns. The PT also marks an abrupt divergence between the sexes in risk for depression and sleep disorders that remains elevated for females across the reproductive lifespan, implicating ovarian hormones (i.e., estradiol (E2)) as a common pathway of risk. Notably, inconsistent schedules during the COVID-19 pandemic have contributed to greater sleep irregularity (especially for adolescents), which is associated with affective impairment and inferior clinical outcomes. The objective of this research is to characterize the pathophysiological impact of E2 on sleep disturbances, endocrine rhythm dysregulation and depressive symptoms in peripubertal females. Method(s): 44 peripubertal females (ages 11-14, within 1-year post-menarche) provided daily hormone (E1G-urinary metabolite of E2) and mood assessments for one menstrual cycle and completed an 8-day sleep assessment (actigraphy, daily sleep diaries), with cortisol and melatonin circadian measurement (over four days) starting at day 7 of the following menstrual cycle. Minute-to-minute consistency in sleep/wake state over 24-hrs was calculated to index sleep regularity (SRI). Result(s): A multiple regression model predicted depressive symptoms (CES-DC) from follicular menstrual cycle phase E1G-AUC, sleep regularity index (SRI), cortisol and melatonin AUCs (F(4,18) = 3.833, p=.020, R2=.46). E1G, cortisol-AUC (p<.05) and SRI (marginally, p=.08) contributed to the prediction. Conclusion(s): Results suggest that greater sleep irregularity, greater follicular estradiol and blunted cortisol may contribute to increased depressive symptoms in peripubertal females, providing mechanistic insight into the estradiol-related sleep and affect disruptions experienced during the pubertal transition. Funding Source: K01MH121575;Foundation of Hope for Research and Treatment of Mental Illness (NC) Keywords: Puberty, Sleep Disturbances, Estradiol, Circadian Rhythms, Depressive SymptomsCopyright © 2023
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Sleep changes significantly throughout the human lifespan. Physiological modifications in sleep regulation, in common with many mammals (especially in the circadian rhythms), predispose adolescents to sleep loss until early adulthood. Adolescents are one-sixth of all human beings and are at high risk for mental diseases (particularly mood disorders) and self-injury. This has been attributed to the incredible number of changes occurring in a limited time window that encompasses rapid biological and psychosocial modifications, which predispose teens to at-risk behaviors. Adolescents' sleep patterns have been investigated as a biunivocal cause for potential damaging conditions, in which insufficient sleep may be both a cause and a consequence of mental health problems. The recent COVID-19 pandemic in particular has made a detrimental contribution to many adolescents' mental health and sleep quality. In this review, we aim to summarize the knowledge in the field and to explore implications for adolescents' (and future adults') mental and physical health, as well as to outline potential strategies of prevention.
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Later circadian timing during adolescence is linked to worse sleep, more severe depression and greater alcohol involvement, perhaps due to circadian misalignment imposed by early school schedules. School schedules shifted later during the COVID-19 pandemic, ostensibly reducing circadian misalignment and potentially mitigating problems with depression and alcohol. We used the pandemic as a natural experiment to test whether adolescent drinkers with later circadian timing showed improvements in sleep, depression and alcohol involvement. Participants were 42 adolescents reporting alcohol use. We assessed circadian phase via dim light melatonin onset prior to the pandemic, then conducted remote assessments of sleep, depressive symptoms and alcohol use during the pandemic. Mixed-effects models were used to test for pandemic effects, covarying for age, sex, time since baseline evaluation, and current school/work status. Adolescents with later circadian timing reported less sleep than other teens on school nights, both before and during the pandemic. Although school night sleep increased during the pandemic (F = 28.36, p < 0.001), those increases were not greater for individuals with later circadian timing. Individuals with later circadian timing reported larger increases in alcohol use than other teens during the pandemic (X2 = 36.03, p < 0.001). Depressive symptoms increased during the pandemic (X2 = 46.51, p < 0.001) but did not differ based on circadian timing. Consistent with prior reports, adolescents with later circadian timing obtained less sleep, and later school schedules facilitated increased sleep duration. Nonetheless, individuals with later circadian timing reported the sharpest increases in alcohol use, suggesting that circadian timing contributes to risk for alcohol use beyond the effects of insufficient sleep.
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Circadian rhythms, also known as circadian clocks, are cyclic endogenous biological patterns of an approximately 24-hour cycle which regulate the timing of physiology, metabolism, and behavior. Recent research in the field of circadian science has suggested that the timing of food intake may also play a role in markers of health, in addition to food choice and food quantity. There is emerging evidence suggesting that the timing of dietary intake, so-called chrono-nutrition, may be influenced by an individual<apos;>s chronotype. For example, the evening type has been linked to unhealthy diet, which could indicate a higher possibility of obesity. On the other hand, the continuum of chronotype diversity is largely mediated by genes. The presence of single nucleotide polymorphisms (SNP) of clock genes have been associated with obesity, chronotype, metabolic disturbances, and dietary habits (e.g., breakfast skipping, meal timing, energy/macronutrient intake). In this review, we outline the current knowledge of the interactions between clock genes, chronotype, dietary intake and chrono-nutrition.Additionally, it is emphasized that the COVID-19 pandemichas had a significant impact on the circadian system, dietary choices and meal timing. For this reason, the current review aims to focus on how chronotype/sleep and chrono-nutrition are affected during the COVID-19 pandemic.Copyright © 2022 Informa UK Limited, trading as Taylor & Francis Group.
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Background: Cognitive impairment has been reported in the aftermath of severe acute respiratory syndrome due to coronavirus 2 (SARS-CoV-2) infection. We investigated the possible association between cognitive impairment and the main clinical and functional variables in a cohort of convalescent COVID-19 patients without premorbid diseases. Method(s): Convalescent COVID-19 patients referring to of a post-acute care facility for pulmonary rehabilitation were consecutively screened for inclusion. All the enrolled patients completed standardized tests to assess cognitive functions, features of psychological distress such as anxiety, depression, post-traumatic stress disorder (PTSD) and quality of life, and cardiac and pulmonary functional status. Result(s): The 63 enrolled patients (mean age 59.82+/-10.78, male = 47) showed a high rate of clinically relevant depressive symptoms (76.2%) and anxiety (55.5%), and a high prevalence of PTSD (44.4%). About half of the total sample showed reduced cognitive efficiency (44.4%). Most impaired cognitive domains were verbal fluency and longterm spatial memory. The level of cognitive impairment showed a direct correlation with the alteration of blood pressure circadian rhythm (rho=. 410, p=.002) and an inverse association with PaO2 (rho= -.264, p=. 03) and DLCO% values (rho= -.252, p=. 02). Conclusion(s): Our findings indicated a possible association between the reduced cognitive efficiency after COVID-19 and some cardiological and pneumological variables, including some indirect measures of a residual autonomic disorder, such as the presence of an altered BP circadian rhythm.
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OBJECTIVES: It is necessary to objectively assess the stress state of workers, from the standpoint of holistic palliative care, in order to determine how the rapid change in work styles in the "live with coronavirus era"-in which people will coexist and live with the coronavirus (COVID-19)-will affect their physical and mental health. The aim of this study is to assess the impact of rapid changes in work patterns during the COVID-19 pandemic on the neuroendocrine stress response of workers. DESIGN AND METHODS: A total of sixteen subjects, 9 telecommuters (2 males, 7 females;age, 37.1+/-2.6 years) and 7 office workers (3 males, 4 females;age, 37.3+/-3.0 years) who provided their informed consent were enrolled in this prospective observational study. Saliva was collected four times a day (after waking, noon, evening, and before bedtime) and three times a week (Monday, Wednesday, and Friday) during May and June 2020. The saliva samples were stored at -20degreeC until measurement. Saliva components were analyzed by ELISA for cortisol, melatonin, s-IgA, and oxytocin. RESULT(S): The diurnal variation of salivary components between telecommuting and office work groups was investigated. Cortisol showed diurnal variation with higher secretion during waking hours and lower secretion toward nighttime in both groups, and no modulation was observed. In the office work group Melatonin showed diurnal variation, with increased secretion at night. In contrast, the telecommuting group showed modulation, with higher secretion at waking and lower secretion at night. s-IgA showed diurnal variation with a high level at waking and a low level thereafter in both groups, and no modulation was observed. The telecommuting group showed higher oxytocin levels in comparison to the office work group. CONCLUSION(S): These results suggest that the absence of commuting in the telecommuting group reduces anxiety due to infection, and that the diurnal variation of melatonin may be due to the alteration of circadian rhythm caused by being at home all day.
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[5] Longer usage of mobile phones resulted in poorer sleep quality (delayed sleep phase, sleep duration, altered sleeping patterns, chronotype, and sleep quality), increased fatigue, and insomnia which, in turn, results in several mental health issues. [...]melatonin offers an alternative treatment to the currently available pharmaceutical therapies for sleep disorders with fewer side effects. The individuals who were undergoing medical treatment for any mental health disorders were excluded from the study. [...]sleep in multiple ways restores both normal levels of brain activity and normal "balance" among the different functions of the central nervous system.