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Geneva II. The circadian rhythm of human body temperature - Clinical implications and review of the literature. Chronobiol Int 2025:1-14. [PMID: 40433988 DOI: 10.1080/07420528.2025.2511268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2024] [Revised: 04/15/2025] [Accepted: 05/20/2025] [Indexed: 05/29/2025]
Abstract
Human body temperature remains an essential vital sign that had been used to judge our health given its strong correlation with human disease. Body temperature is also a manifestation of our circadian rhythm, with a predictable rise during the day peaking in the evenings and steady decrease during the night reaching a minimum around the time of awakening. Yet, the rhythm is believed to be endogenous and to exist independently of any external stimuli, including day light. Human illnesses such as infections, autoimmune conditions, and cancer had been associated with a disruption in the circadian rhythm. This is of significant clinical interest because measurements of the specific disruptions of the rhythm appear to carry diagnostic and prognostic value. This is a review of the literature with a focus on the determinants of human body temperature and the circadian rhythm of body temperature. The last section provides potential new research avenues in our search for chronotherapy clinical applications.
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Wei Q, Rojas D, Wang Q, Zapata-Pérez R, Xuan X, Molinero-Fernández Á, Crespo GA, Cuartero M. Wearable 3D-Printed Microneedle Sensor for Intradermal Temperature Monitoring. ACS Sens 2025. [PMID: 40230020 DOI: 10.1021/acssensors.4c03681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/16/2025]
Abstract
Accurate temperature monitoring plays a crucial role in understanding the physiological status of patients and the early diagnosis of diseases commonly associated with local and global infections. Intradermal temperature measurement is, in principle, more precise than skin surface detection, as it prevents interference from environmental temperature changes and skin secretions. However, to date, precise and reliable intradermal temperature monitoring in a real-time and continuous manner remains a challenge. We propose herein high-resolution 3D printing to fabricate a mechanically robust and biocompatible hollow microneedle, filled with a temperature-responsive conducting polymer (poly(3,4-ethylenedioxythiophene): polystyrenesulfonate, PEDOT:PSS) to develop a microneedle temperature sensor (T-MN). The significance is 2-fold: rational design of robust MNs with high resolution in the micrometer domain and the implementation of a conducting polymer in a MN format for temperature sensing. The analytical performance of the developed T-MN is in vitro evaluated under mimicked intradermal conditions, demonstrating good sensitivity (-0.74%° C-1), resolution (0.2 °C), repeatability (RSD = 2%), reproducibility (RSD = 2%), reversibility, and medium-term stability. On-body temperature monitoring is performed on six euthanized rats for 80 min. The results presented good agreement with those obtained using a commercial optical temperature probe, which was intradermally inserted into the rat skin. The reliability of utilizing the T-MN for precise and continuous intradermal temperature monitoring was successfully demonstrated, noting its potential use for patient monitoring in the near future but also temperature compensation for MN (bio)sensors that may need it.
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Affiliation(s)
- Qikun Wei
- Department of Chemistry, KTH Royal Institute of Technology, Teknikringen 30, Stockholm SE-114 28, Sweden
| | - Daniel Rojas
- UCAM-SENS, Universidad Católica San Antonio de Murcia, UCAM HiTech, Avda. Andres Hernandez Ros 1, Murcia 30107, Spain
| | - Qianyu Wang
- Department of Chemistry, KTH Royal Institute of Technology, Teknikringen 30, Stockholm SE-114 28, Sweden
| | - Ruben Zapata-Pérez
- Group of Metabolism and Genetic Regulation of Disease, Universidad Católica San Antonio de Murcia, UCAM HiTech, Avda. Andres Hernandez Ros 1, Murcia 30107, Spain
| | - Xing Xuan
- UCAM-SENS, Universidad Católica San Antonio de Murcia, UCAM HiTech, Avda. Andres Hernandez Ros 1, Murcia 30107, Spain
| | - Águeda Molinero-Fernández
- UCAM-SENS, Universidad Católica San Antonio de Murcia, UCAM HiTech, Avda. Andres Hernandez Ros 1, Murcia 30107, Spain
| | - Gastón A Crespo
- Department of Chemistry, KTH Royal Institute of Technology, Teknikringen 30, Stockholm SE-114 28, Sweden
- UCAM-SENS, Universidad Católica San Antonio de Murcia, UCAM HiTech, Avda. Andres Hernandez Ros 1, Murcia 30107, Spain
| | - María Cuartero
- Department of Chemistry, KTH Royal Institute of Technology, Teknikringen 30, Stockholm SE-114 28, Sweden
- UCAM-SENS, Universidad Católica San Antonio de Murcia, UCAM HiTech, Avda. Andres Hernandez Ros 1, Murcia 30107, Spain
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Adam T, Barateau L, Tanty J, Dauvilliers Y. Absence of dysregulation in amplitude and phase of circadian rhythm of core body temperature in idiopathic hypersomnia: a case-control study. Sleep 2025; 48:zsae246. [PMID: 39432668 DOI: 10.1093/sleep/zsae246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2024] [Revised: 10/09/2024] [Indexed: 10/23/2024] Open
Abstract
STUDY OBJECTIVES To investigate the amplitude and phase of the circadian rhythm of core body temperature (CBT) via the continuous measure of the gastrointestinal temperature in participants with idiopathic hypersomnia (IH), non-specified hypersomnia (NSH) compared to healthy controls (HC) in a constant routine standardized bedrest (BR) protocol. METHODS Consecutive participants evaluated in a National Reference Center for Rare Hypersomnias benefited from an extensive evaluation with one-night polysomnography, followed by a modified Multiple Sleep Latency Test (mMSLT), and a continuous 32-hour BR recording in standardized conditions. CBT was recorded via a telemetry pill (e-Celsius) during the BR, modeled by a Cosinor, with extraction of MESOR, amplitude, and phase. Participants with IH, diagnosed according to the International Classification of Sleep Disorders-3, were compared with participants with NSH (complaint of hypersomnolence but normal mMSLT and BR), and HC. Participants were divided into four groups based on their mMSLT mean sleep latency (mMSLT+,≤8 minutes) and their BR total sleep time (BR+, ≥19 hours). RESULTS A total of 108 participants (80% women, 28.3 ± 7.8 years old) were included in the analyses, 81 IH (83% women), 16 NSH (75% women), and 11 HC (64% women). Cosinor amplitude and phase of CBT did not differ between IH, NSH, and HC, nor in the subgroup analysis (37 BR+/mMSLT+, 35 BR+/mMSLT-, 9 BR-/mMSLT+, 27 BR-/mMSLT-). No difference in chronotypes was observed between groups. Women had a greater MESOR and reduced CBT amplitude compared to men. CONCLUSIONS The circadian rhythm of CBT showed no difference in amplitude or phase between IH, NSH, and HC, and was not related to prolonged sleep time or objective daytime sleepiness.
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Affiliation(s)
- Tugdual Adam
- Institute of Neurosciences of Montpellier (INM), University of Montpellier, INSERM, Montpellier, France
| | - Lucie Barateau
- Institute of Neurosciences of Montpellier (INM), University of Montpellier, INSERM, Montpellier, France
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France
- National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France
| | - Jérôme Tanty
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France
| | - Yves Dauvilliers
- Institute of Neurosciences of Montpellier (INM), University of Montpellier, INSERM, Montpellier, France
- Sleep-Wake Disorders Unit, Department of Neurology, Gui-de-Chauliac Hospital, CHU Montpellier, Montpellier, France
- National Reference Centre for Orphan Diseases, Narcolepsy, Idiopathic Hypersomnia, and Kleine-Levin Syndrome, Montpellier, France
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Aksan A, Dilbaz B. Sleep Disorders in Women: What Should a Gynecologist Know? Geburtshilfe Frauenheilkd 2024; 84:1043-1049. [PMID: 39524035 PMCID: PMC11543111 DOI: 10.1055/a-2371-0763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/21/2024] [Indexed: 11/16/2024] Open
Abstract
Women often face sleep disturbances during key life stages such as adolescence, pregnancy, postpartum period, and perimenopause, influenced by hormonal fluctuations and conditions like polycystic ovary syndrome (PCOS) and premenstrual syndrome (PMS). The goal is to explore women's sleep disorders as classified in the International Classification of Sleep Disorders-3 (ICSD-3). Through a literature review, this study assesses the management of sleep disorders in women, particularly focusing on the link between gynecological disease and sleep disorders. It scrutinizes landmark research in diagnosing and treating women's sleep disorders. Observations indicate that physiological changes during adolescence, pregnancy, postpartum, and perimenopause can cause sleep issues, commonly addressed by gynecologists. Conditions like PCOS and PMS are notably linked to increased sleep disorder occurrences. The conclusion underscores the importance of gynecologists' awareness of the heightened risk of sleep disturbances in women, who often present these issues during consultations.
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Affiliation(s)
- Alperen Aksan
- Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
| | - Berna Dilbaz
- Ankara Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim ve Araştırma Hastanesi, Ankara, Turkey
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Nexha A, Caropreso L, de Azevedo Cardoso T, Suh JS, Tonon AC, Frey BN. Biological rhythms in premenstrual syndrome and premenstrual dysphoric disorder: a systematic review. BMC Womens Health 2024; 24:551. [PMID: 39375682 PMCID: PMC11457342 DOI: 10.1186/s12905-024-03395-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 09/29/2024] [Indexed: 10/09/2024] Open
Abstract
BACKGROUND Women with premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) typically experience a range of psychological and physiological symptoms that negatively affect their quality of life. Disruption in biological rhythms, including alterations of the sleep-wake cycle, have been implicated in PMS/PMDD, though literature is still growing to substantiate these findings. The objective of this study is to systematically review the available literature on biological rhythms disruption in PMS/PMDD. METHODS A literature search was conducted on four databases (Pubmed, Embase, Medline, and Web of Science) on December 3rd, 2021. This search yielded a total of 575 articles that assessed the relationship between biological rhythms and PMS/PMDD/premenstrual symptoms. RESULTS After the exclusion of irrelevant articles and hand-searching references, 25 articles were included in this systematic review. Some studies showed that women with PMS/PMDD present lower melatonin levels, elevated nighttime core body temperature, and worse subjective perception of sleep quality when compared to women without PMS/PMDD. Other biological rhythms parameters showed either no differences between groups (wrist actimetry) or conflicting results (objective sleep parameters, cortisol, prolactin, and thyroid stimulating hormone). CONCLUSION Current research demonstrates that women with PMS/PMDD experience lower melatonin levels, higher body temperature, and worse subjective perception of sleep quality. This review outlines some possible mechanisms behind these findings and proposes recommendations for future research. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under registration number CRD42020149921.
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Affiliation(s)
- Adile Nexha
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5 Street, Hamilton, ON, L8N 3K7, Canada.
| | - Luisa Caropreso
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5 Street, Hamilton, ON, L8N 3K7, Canada
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Taiane de Azevedo Cardoso
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
| | - Jee Su Suh
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5 Street, Hamilton, ON, L8N 3K7, Canada
| | - André C Tonon
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5 Street, Hamilton, ON, L8N 3K7, Canada
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Mood Disorders Treatment and Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
| | - Benicio N Frey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, 100 West 5 Street, Hamilton, ON, L8N 3K7, Canada
- Women's Health Concerns Clinic, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Mood Disorders Treatment and Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
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Convit L, Kelly MK, Jardine WT, Périard JD, Carr AJ, Warmington S, Bowe SJ, Snipe RMJ. Influence of acute heat mitigation strategies on core temperature, heart rate and aerobic performance in females: A systematic literature review. J Sports Sci 2024; 42:1491-1511. [PMID: 39262133 DOI: 10.1080/02640414.2024.2396225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2024] [Accepted: 08/17/2024] [Indexed: 09/13/2024]
Abstract
This review examined the effect of acute heat mitigation strategies on physiological strain and exercise performance in females exercising in the heat. Three databases were searched for original research with an acute heat mitigation (intervention) and control strategy in active females and reporting core temperature, heart rate and/or aerobic exercise performance/capacity with ≥ 24°C wet bulb globe temperature. Hedges' g effect sizes were calculated to evaluate outcomes. Thirteen studies (n = 118) were included. Most studies that applied an acute heat mitigation strategy to females did not reduce thermal (9/10) or cardiovascular (6/6) strain or improve exercise performance/capacity (8/10). The most effective strategies for attenuating thermal strain were pre-cooling with ice-slurry (effect size = -2.2 [95% CI, -3.2, -1.1]) and ice-vests (-1.9 [-2.7, -1.1]), and pre- and per-cooling with an ice-vest (-1.8 [-2.9, -0.7]). Only pre-cooling with an ice-vest improved running performance (-1.8 [-2.9, -0.7]; ~0.43 min) whilst sodium hyperhydration improved cycling capacity at 70% V O2peak (0.8 [0.0, 1.6]; ~20.1 min). There is currently limited research on acute heat mitigation strategies in females, so the evidence for the efficacy is scarce. Some studies show beneficial effects with ice-slurry, ice-vests and sodium hyperhydration, which can guide future research to support female exercise performance in the heat.
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Affiliation(s)
- Lilia Convit
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Monica K Kelly
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - William T Jardine
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Julien D Périard
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Bruce, Australia
| | - Amelia J Carr
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Stuart Warmington
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
| | - Steven J Bowe
- School of Health, Wellington Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Rhiannon M J Snipe
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
- Centre for Sport Research, School of Exercise and Nutrition Sciences, Deakin University, Burwood, Victoria, Australia
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7
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Dittmar M, Möllgaard L, Engelhard F. Menstrual cycle phases and dosage of synthetic hormonal contraceptives influence diurnal rhythm characteristics of distal skin temperature. Chronobiol Int 2024; 41:684-696. [PMID: 38634452 DOI: 10.1080/07420528.2024.2342945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024]
Abstract
This study aimed to explore how natural menstrual cycle phases and dosage of oral hormonal contraceptives (OC) influence the diurnal rhythm of distal skin temperature (DST) under real-life conditions. Participants were 41 healthy females (23.9 ± 2.48 y), comprising 27 females taking monophasic hormonal oral contraceptives (OC users) and 14 females with menstrual cycles (non-OC users). Wrist DST was continuously recorded and averaged over two consecutive 24-hour days during (pseudo)follicular and (pseudo)luteal menstrual phases. Diurnal rhythm characteristics, i.e. acrophase and amplitude, describing timing and strength of the DST rhythm, respectively, were calculated using cosinor analysis. Results show that non-OC users experienced earlier diurnal DST maximum (acrophase, p = 0.019) and larger amplitude (p = 0.016) during the luteal phase than during the follicular phase. This was observed in most (71.4%) but not all individuals. The OC users showed no differences in acrophase or amplitude between pseudoluteal and pseudofollicular phases. OC users taking a higher dosage of progestin displayed a larger amplitude for DST rhythm during the pseudoluteal phase (p = 0.009), while estrogen dosage had no effect. In conclusion, monophasic OC cause changes in diurnal DST rhythm, similar to those observed in the luteal phase of females with menstrual cycles, suggesting that synthetic progestins act in a similar manner on skin thermoregulation as progesterone does.
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Affiliation(s)
- Manuela Dittmar
- Department of Human Biology, Zoological Institute, Christian-Albrechts-University, Kiel, Germany
| | - Leefke Möllgaard
- Department of Human Biology, Zoological Institute, Christian-Albrechts-University, Kiel, Germany
| | - Felicia Engelhard
- Department of Human Biology, Zoological Institute, Christian-Albrechts-University, Kiel, Germany
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Moyen NE, Ediger TR, Taylor KM, Hancock EG, Holden LD, Tracy EE, Kay PH, Irick CR, Kotzen KJ, He DD. Sleeping for One Week on a Temperature-Controlled Mattress Cover Improves Sleep and Cardiovascular Recovery. Bioengineering (Basel) 2024; 11:352. [PMID: 38671774 PMCID: PMC11048088 DOI: 10.3390/bioengineering11040352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 03/19/2024] [Accepted: 03/31/2024] [Indexed: 04/28/2024] Open
Abstract
Body temperature should be tightly regulated for optimal sleep. However, various extrinsic and intrinsic factors can alter body temperature during sleep. In a free-living study, we examined how sleep and cardiovascular health metrics were affected by sleeping for one week with (Pod ON) vs. without (Pod OFF), an active temperature-controlled mattress cover (the Eight Sleep Pod). A total of 54 subjects wore a home sleep test device (HST) for eight nights: four nights each with Pod ON and OFF (>300 total HST nights). Nightly sleeping heart rate (HR) and heart rate variability (HRV) were collected. Compared to Pod OFF, men and women sleeping at cooler temperatures in the first half of the night significantly improved deep (+14 min; +22% mean change; p = 0.003) and REM (+9 min; +25% mean change; p = 0.033) sleep, respectively. Men sleeping at warm temperatures in the second half of the night significantly improved light sleep (+23 min; +19% mean change; p = 0.023). Overall, sleeping HR (-2% mean change) and HRV (+7% mean change) significantly improved with Pod ON (p < 0.01). To our knowledge, this is the first study to show a continuously temperature-regulated bed surface can (1) significantly modify time spent in specific sleep stages in certain parts of the night, and (2) enhance cardiovascular recovery during sleep.
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Bódizs R, Schneider B, Ujma PP, Horváth CG, Dresler M, Rosenblum Y. Fundamentals of sleep regulation: Model and benchmark values for fractal and oscillatory neurodynamics. Prog Neurobiol 2024; 234:102589. [PMID: 38458483 DOI: 10.1016/j.pneurobio.2024.102589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 01/26/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
Homeostatic, circadian and ultradian mechanisms play crucial roles in the regulation of sleep. Evidence suggests that ratios of low-to-high frequency power in the electroencephalogram (EEG) spectrum indicate the instantaneous level of sleep pressure, influenced by factors such as individual sleep-wake history, current sleep stage, age-related differences and brain topography characteristics. These effects are well captured and reflected in the spectral exponent, a composite measure of the constant low-to-high frequency ratio in the periodogram, which is scale-free and exhibits lower interindividual variability compared to slow wave activity, potentially serving as a suitable standardization and reference measure. Here we propose an index of sleep homeostasis based on the spectral exponent, reflecting the level of membrane hyperpolarization and/or network bistability in the central nervous system in humans. In addition, we advance the idea that the U-shaped overnight deceleration of oscillatory slow and fast sleep spindle frequencies marks the biological night, providing somnologists with an EEG-index of circadian sleep regulation. Evidence supporting this assertion comes from studies based on sleep replacement, forced desynchrony protocols and high-resolution analyses of sleep spindles. Finally, ultradian sleep regulatory mechanisms are indicated by the recurrent, abrupt shifts in dominant oscillatory frequencies, with spindle ranges signifying non-rapid eye movement and non-spindle oscillations - rapid eye movement phases of the sleep cycles. Reconsidering the indicators of fundamental sleep regulatory processes in the framework of the new Fractal and Oscillatory Adjustment Model (FOAM) offers an appealing opportunity to bridge the gap between the two-process model of sleep regulation and clinical somnology.
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Affiliation(s)
- Róbert Bódizs
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.
| | - Bence Schneider
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Péter P Ujma
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Csenge G Horváth
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Martin Dresler
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands
| | - Yevgenia Rosenblum
- Radboud University Medical Centre, Donders Institute for Brain, Cognition and Behavior, Nijmegen, the Netherlands
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10
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Johnson CE, Duncan MJ, Murphy MP. Sex and Sleep Disruption as Contributing Factors in Alzheimer's Disease. J Alzheimers Dis 2024; 97:31-74. [PMID: 38007653 PMCID: PMC10842753 DOI: 10.3233/jad-230527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2023]
Abstract
Alzheimer's disease (AD) affects more women than men, with women throughout the menopausal transition potentially being the most under researched and at-risk group. Sleep disruptions, which are an established risk factor for AD, increase in prevalence with normal aging and are exacerbated in women during menopause. Sex differences showing more disrupted sleep patterns and increased AD pathology in women and female animal models have been established in literature, with much emphasis placed on loss of circulating gonadal hormones with age. Interestingly, increases in gonadotropins such as follicle stimulating hormone are emerging to be a major contributor to AD pathogenesis and may also play a role in sleep disruption, perhaps in combination with other lesser studied hormones. Several sleep influencing regions of the brain appear to be affected early in AD progression and some may exhibit sexual dimorphisms that may contribute to increased sleep disruptions in women with age. Additionally, some of the most common sleep disorders, as well as multiple health conditions that impair sleep quality, are more prevalent and more severe in women. These conditions are often comorbid with AD and have bi-directional relationships that contribute synergistically to cognitive decline and neuropathology. The association during aging of increased sleep disruption and sleep disorders, dramatic hormonal changes during and after menopause, and increased AD pathology may be interacting and contributing factors that lead to the increased number of women living with AD.
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Affiliation(s)
- Carrie E. Johnson
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
| | - Marilyn J. Duncan
- University of Kentucky, College of Medicine, Department of Neuroscience, Lexington, KY, USA
| | - M. Paul Murphy
- University of Kentucky, College of Medicine, Department of Molecular and Cellular Biochemistry, Lexington, KY, USA
- University of Kentucky, Sanders-Brown Center on Aging, Lexington, KY, USA
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11
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Niggli A, Rothenbühler M, Sachs M, Leeners B. Can Wrist-Worn Medical Devices Correctly Identify Ovulation? SENSORS (BASEL, SWITZERLAND) 2023; 23:9730. [PMID: 38139575 PMCID: PMC10747116 DOI: 10.3390/s23249730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/03/2023] [Accepted: 12/07/2023] [Indexed: 12/24/2023]
Abstract
(1) Background: Hormonal fluctuations across the menstrual cycle lead to multiple changes in physiological parameters such as body temperature, cardiovascular function, respiratory rate and perfusion. Electronic wearables analyzing those parameters might present a convenient alternative to urinary ovulation tests for predicting the fertile window. (2) Methods: We conducted a prospective observational study including women aged 18-45 years without current hormonal therapy who used a wrist-worn medical device and urinary ovulation tests for a minimum of three cycles. We analyzed the accuracy of both the retrospective and prospective algorithms using a generalized linear mixed-effects model. The findings were compared to real-world data from bracelet users who also reported urinary ovulation tests. (3) Results: A total of 61 study participants contributing 205 cycles and 6081 real-life cycles from 3268 bracelet users were included in the analysis. The mean error in identifying ovulation with the wrist-worn medical device retrospective algorithm in the clinical study was 0.31 days (95% CI -0.13 to 0.75). The retrospective algorithm identified 75.4% of fertile days, and the prospective algorithm identified 73.8% of fertile days correctly within the pre-specified equivalence limits (±2 days). The quality of the retrospective algorithm in the clinical study could be confirmed by real-world data. (4) Conclusion: Our data indicate that wearable sensors may be used to accurately detect the periovulatory period.
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Affiliation(s)
- Angela Niggli
- Department of Reproductive Endocrinology, University Hospital of Zürich, Frauenklinikstrasse 10, 8091 Zürich, Switzerland; (M.S.); (B.L.)
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
| | | | - Maike Sachs
- Department of Reproductive Endocrinology, University Hospital of Zürich, Frauenklinikstrasse 10, 8091 Zürich, Switzerland; (M.S.); (B.L.)
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
| | - Brigitte Leeners
- Department of Reproductive Endocrinology, University Hospital of Zürich, Frauenklinikstrasse 10, 8091 Zürich, Switzerland; (M.S.); (B.L.)
- Faculty of Medicine, University of Zurich, 8032 Zurich, Switzerland
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12
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Chiang MH, Lin YC, Wu T, Wu CL. Thermosensation and Temperature Preference: From Molecules to Neuronal Circuits in Drosophila. Cells 2023; 12:2792. [PMID: 38132112 PMCID: PMC10741703 DOI: 10.3390/cells12242792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 12/23/2023] Open
Abstract
Temperature has a significant effect on all physiological processes of animals. Suitable temperatures promote responsiveness, movement, metabolism, growth, and reproduction in animals, whereas extreme temperatures can cause injury or even death. Thus, thermosensation is important for survival in all animals. However, mechanisms regulating thermosensation remain unexplored, mostly because of the complexity of mammalian neural circuits. The fruit fly Drosophila melanogaster achieves a desirable body temperature through ambient temperature fluctuations, sunlight exposure, and behavioral strategies. The availability of extensive genetic tools and resources for studying Drosophila have enabled scientists to unravel the mechanisms underlying their temperature preference. Over the past 20 years, Drosophila has become an ideal model for studying temperature-related genes and circuits. This review provides a comprehensive overview of our current understanding of thermosensation and temperature preference in Drosophila. It encompasses various aspects, such as the mechanisms by which flies sense temperature, the effects of internal and external factors on temperature preference, and the adaptive strategies employed by flies in extreme-temperature environments. Understanding the regulating mechanisms of thermosensation and temperature preference in Drosophila can provide fundamental insights into the underlying molecular and neural mechanisms that control body temperature and temperature-related behavioral changes in other animals.
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Affiliation(s)
- Meng-Hsuan Chiang
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (M.-H.C.); (Y.-C.L.)
| | - Yu-Chun Lin
- Graduate Institute of Biomedical Sciences, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan; (M.-H.C.); (Y.-C.L.)
| | - Tony Wu
- Department of Neurology, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei City 23652, Taiwan;
| | - Chia-Lin Wu
- Department of Neurology, New Taipei Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei City 23652, Taiwan;
- Department of Biochemistry, College of Medicine, Chang Gung University, Taoyuan 33302, Taiwan
- Brain Research Center, National Tsing Hua University, Hsinchu 30013, Taiwan
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13
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Bezerra AG, Pires GN, Andersen ML, Tufik S, Hachul H. The Effects of Hormonal Contraceptives on the Sleep of Women of Reproductive Age. Sleep Med Clin 2023; 18:435-448. [PMID: 38501516 DOI: 10.1016/j.jsmc.2023.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Research about the effects of hormonal contraceptives on sleep has been performed but is subjected to important levels of methodological heterogeneity. Hormonal contraceptives impact sleep, but the direction of this association is not clear. Most studies describe a negative sleep profile among contraceptive users, including increased sleepiness, insomnia symptoms, decreased sleep efficiency, and a reduced overall sleep quality. Hormonal intrauterine contraceptives are associated with less negative effects. More research on the field, especially randomized controlled trials, is needed to increase the level and certainty of evidence about the effects of hormonal contraceptives on sleep.
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Affiliation(s)
- Andréia Gomes Bezerra
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 - CEP: 04024-002, São Paulo, Brazil
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 - CEP: 04024-002, São Paulo, Brazil; Sleep Institute, Rua Marselhesa, 500 - CEP: 04020-060, São Paulo, Brazil
| | - Monica L Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 - CEP: 04024-002, São Paulo, Brazil; Sleep Institute, Rua Marselhesa, 500 - CEP: 04020-060, São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 - CEP: 04024-002, São Paulo, Brazil; Sleep Institute, Rua Marselhesa, 500 - CEP: 04020-060, São Paulo, Brazil
| | - Helena Hachul
- Departamento de Psicobiologia, Universidade Federal de São Paulo, Rua Napoleão de Barros, 925 - CEP: 04024-002, São Paulo, Brazil; Sleep Institute, Rua Marselhesa, 500 - CEP: 04020-060, São Paulo, Brazil.
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14
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Alzueta E, Baker FC. The Menstrual Cycle and Sleep. Sleep Med Clin 2023; 18:399-413. [PMID: 38501513 PMCID: PMC11562818 DOI: 10.1016/j.jsmc.2023.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Aspects of sleep change across the menstrual cycle in some women. Poorer sleep quality in the premenstrual phase and menstruation is common in women with premenstrual symptoms or painful menstrual cramps. Although objective sleep continuity remains unchanged across the regular, asymptomatic menstrual cycle, activity in the sleep electroencephalogram varies, with a prominent increase in sleep spindle activity in the postovulatory luteal phase, when progesterone is present, relative to the follicular phase. Menstrual cycle phase, reproductive stage, and menstrual-related disorders should be considered when assessing women's sleep complaints.
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Affiliation(s)
- Elisabet Alzueta
- Human Sleep Research Program, SRI International, Menlo Park, CA, USA
| | - Fiona C Baker
- Human Sleep Research Program, SRI International, Menlo Park, CA, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa.
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15
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Polo-Kantola P, Toffol E. The Relationship Between Mood and Sleep in Different Female Reproductive States. Sleep Med Clin 2023; 18:385-398. [PMID: 38501512 DOI: 10.1016/j.jsmc.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/20/2024]
Abstract
Mood and sleep are tightly interrelated. Mood and sleep symptoms and disorders are more common in women than in men and often associated with reproductive events. This article reviews the current literature on the reciprocal relationships between mood and sleep across reproductive phases in women, such as menstrual cycle and related disorders, pregnancy, climacteric, and use of hormonal contraception and hormone replacement therapy. Mood and sleep symptoms seem to covary in relation to physiologic and pathologic reproductive conditions, although the relationship seems more clear for subjective than objective sleep.
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Affiliation(s)
- Päivi Polo-Kantola
- Department of Obstetrics and Gynecology, Turku University Hospital, University of Turku, Turku, Finland.
| | - Elena Toffol
- Department of Public Health, University of Helsinki, PO Box 20, Helsinki 00014, Finland
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16
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Bruce LK, Kasl P, Soltani S, Viswanath VK, Hartogensis W, Dilchert S, Hecht FM, Chowdhary A, Anglo C, Pandya L, Dasgupta S, Altintas I, Gupta A, Mason AE, Smarr BL. Variability of temperature measurements recorded by a wearable device by biological sex. Biol Sex Differ 2023; 14:76. [PMID: 37915069 PMCID: PMC10619297 DOI: 10.1186/s13293-023-00558-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 10/16/2023] [Indexed: 11/03/2023] Open
Abstract
BACKGROUND Females have been historically excluded from biomedical research due in part to the documented presumption that results with male subjects will generalize effectively to females. This has been justified in part by the assumption that ovarian rhythms will increase the overall variance of pooled random samples. But not all variance in samples is random. Human biometrics are continuously changing in response to stimuli and biological rhythms; single measurements taken sporadically do not easily support exploration of variance across time scales. Recently we reported that in mice, core body temperature measured longitudinally shows higher variance in males than cycling females, both within and across individuals at multiple time scales. METHODS Here, we explore longitudinal human distal body temperature, measured by a wearable sensor device (Oura Ring), for 6 months in females and males ranging in age from 20 to 79 years. In this study, we did not limit the comparisons to female versus male, but instead we developed a method for categorizing individuals as cyclic or acyclic depending on the presence of a roughly monthly pattern to their nightly temperature. We then compared structure and variance across time scales using multiple standard instruments. RESULTS Sex differences exist as expected, but across multiple statistical comparisons and timescales, there was no one group that consistently exceeded the others in variance. When variability was assessed across time, females, whether or not their temperature contained monthly cycles, did not significantly differ from males both on daily and monthly time scales. CONCLUSIONS These findings contradict the viewpoint that human females are too variable across menstrual cycles to include in biomedical research. Longitudinal temperature of females does not accumulate greater measurement error over time than do males and the majority of unexplained variance is within sex category, not between them.
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Affiliation(s)
- Lauryn Keeler Bruce
- UC San Diego Health Department of Biomedical Informatics, University of California San Diego, San Diego, CA, USA
| | - Patrick Kasl
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, 9500 Gilman Dr, , La Jolla, San Diego, CA, USA
| | - Severine Soltani
- Bioinformatics and Systems Biology, University of California San Diego, San Diego, CA, USA
| | - Varun K Viswanath
- Department of Electrical and Computer Engineering, University of California San Diego, La Jolla, CA, USA
| | - Wendy Hartogensis
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Stephan Dilchert
- Department of Management, Zicklin School of Business, Baruch College, The City University of New York, New York, NY, USA
| | - Frederick M Hecht
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Anoushka Chowdhary
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Claudine Anglo
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Leena Pandya
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Subhasis Dasgupta
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA, USA
| | - Ilkay Altintas
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA, USA
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA, USA
| | - Amarnath Gupta
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA, USA
- San Diego Supercomputer Center, University of California San Diego, San Diego, CA, USA
| | - Ashley E Mason
- Osher Center for Integrative Health, University of California San Francisco, San Francisco, CA, USA
| | - Benjamin L Smarr
- Shu Chien-Gene Lay Department of Bioengineering, University of California San Diego, 9500 Gilman Dr, , La Jolla, San Diego, CA, USA.
- Halıcıoğlu Data Science Institute, University of California San Diego, San Diego, CA, USA.
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17
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Liu X, Rosenberg C, Reaso JN, Lee AM, Ricafrente J, Ebinger JE, Chen LS, Li X, Bairey Merz CN, Rader F, Chen PS. Skin sympathetic nerve activity and nocturnal blood pressure nondipping in patients with postural orthostatic tachycardia syndrome. J Hypertens 2023; 41:1290-1297. [PMID: 37195245 PMCID: PMC10330228 DOI: 10.1097/hjh.0000000000003465] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
OBJECTIVE Postural orthostatic tachycardia syndrome (POTS) is associated with abnormal blood pressure (BP) regulation and increased prevalence of nocturnal nondipping. We hypothesized that nocturnal nondipping of BP is associated with elevated skin sympathetic nerve activity (SKNA) in POTS. METHOD We used an ambulatory monitor to record SKNA and electrocardiogram from 79 participants with POTS (36 ± 11 years, 72 women), including 67 with simultaneous 24-h ambulatory BP monitoring. RESULTS Nocturnal nondipping of BP was present in 19 of 67 (28%) participants. The nondipping group had a higher average SKNA (aSKNA) from midnight of day 1 to 0100 h on day 2 than the dipping group ( P = 0.016, P = 0.030, respectively). The differences (Δ) of aSKNA and mean BP between daytime and night-time were more significant in the dipping group compared with the nondipping group (ΔaSKNA 0.160 ± 0.103 vs. 0.095 ± 0.099 μV, P = 0.021, and Δmean BP 15.0 ± 5.2 vs. 4.9 ± 4.2 mmHg, P < 0.001, respectively). There were positive correlations between ΔaSKNA and standing norepinephrine (NE) (r = 0.421, P = 0.013) and the differences between standing and supine NE levels ( r = 0.411, P = 0.016). There were 53 (79%) patients with SBP less than 90 mmHg and 61 patients (91%) with DBP less than 60 mmHg. These hypotensive episodes were associated with aSKNA of 0.936 ± 0.081 and 0.936 ± 0.080 μV, respectively, which were both significantly lower than the nonhypotensive aSKNA (1.034 ± 0.087 μV, P < 0.001 for both) in the same patient. CONCLUSION POTS patients with nocturnal nondipping have elevated nocturnal sympathetic tone and blunted reduction of SKNA between day and night. Hypotensive episodes were associated with reduced aSKNA.
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Affiliation(s)
- Xiao Liu
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Carine Rosenberg
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Jewel N. Reaso
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Andrew M. Lee
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Joselyn Ricafrente
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Joseph E. Ebinger
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Lan S. Chen
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Xiaochun Li
- Biostatistics and Health Data Science, Indiana University
School of Medicine, Indianapolis, IN
| | - C. Noel Bairey Merz
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
- Barbra Streisand Women’s Heart Center, Smidt Heart
Institute, Cedars-Sinai Medical Center, Los Angeles, CA
| | - Florian Rader
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
| | - Peng-Sheng Chen
- Department of Cardiology and Smidt Heart Institute,
Cedars-Sinai Medical Center, Los Angeles, CA
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18
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Bigalke JA, Cleveland EL, Barkstrom E, Gonzalez JE, Carter JR. Core body temperature changes before sleep are associated with nocturnal heart rate variability. J Appl Physiol (1985) 2023; 135:136-145. [PMID: 37262106 PMCID: PMC10292981 DOI: 10.1152/japplphysiol.00020.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/08/2023] [Accepted: 05/25/2023] [Indexed: 06/03/2023] Open
Abstract
Core body temperature (CBT) reductions occur before and during the sleep period, with the extent of presleep reductions corresponding to sleep onset and quality. Presleep reductions in CBT coincide with increased cardiac parasympathetic activity measured via heart rate variability (HRV), and while this appears to persist into the sleep period, individual differences in presleep CBT decline and nocturnal HRV remain unexplored. The purpose of the current study was to assess the relationship between individual differences in presleep CBT reductions and nocturnal heart rate (HR) and HRV in a population of 15 objectively poor sleeping adults [10 males, 5 females; age, 33 ± 4 yr; body mass index (BMI) 27 ± 1 kg/m2] with the hypothesis that blunted CBT rate of decline would be associated with elevated HR and reduced nocturnal HRV. Following an adaptation night, all participants underwent an overnight, in-laboratory sleep study with simultaneous recording of polysomnographic sleep including electrocardiography (ECG) and CBT recording. Correlations between CBT rate of change before sleep and nocturnal HRV were assessed. Blunted rate of CBT decline was significantly associated with increased heart rate (HR) in stage 2 (N2; R = 0.754, P = 0.001), stage 3 (N3; R = 0.748, P = 0.001), and rapid-eye movement (REM; R = 0.735, P = 0.002). Similarly, blunted rate of CBT decline before sleep was associated with reduced HRV across sleep stages. These findings indicate a relationship between individual differences in presleep thermoregulatory processes and nocturnal cardiac autonomic function in poor sleeping adults.NEW & NOTEWORTHY Core body temperature (CBT) reductions before sleep onset coincide with increases in heart rate variability (HRV) that persist throughout the sleep period. However, the relationship between individual differences in the efficiency of presleep core temperature regulation and nocturnal heart rate variability remains equivocal. The present study reports an association between the magnitude of presleep core body temperature changes and nocturnal parasympathetic activity, highlighting overlap between thermoregulatory processes before sleep and nocturnal cardiac autonomic function.
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Affiliation(s)
- Jeremy A Bigalke
- Department of Health and Human Development, Montana State University, Bozeman, Montana, United States
- Department of Psychology, Montana State University, Bozeman, Montana, United States
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
| | - Emily L Cleveland
- Microbiology and Cell Biology, Montana State University, Bozeman, Montana, United States
| | - Elyse Barkstrom
- Department of Health and Human Development, Montana State University, Bozeman, Montana, United States
| | - Joshua E Gonzalez
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
- Oregon Institute of Occupational Health Sciences, Oregon Health and Science University, Portland, Oregon, United States
| | - Jason R Carter
- Department of Kinesiology and Integrative Physiology, Michigan Technological University, Houghton, Michigan, United States
- Robbins College of Health and Human Sciences, Department of Health, Human Performance, and Recreation, Baylor University, Waco, Texas, United States
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19
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Seol J, Kokudo C, Park I, Zhang S, Yajima K, Okura T, Tokuyama K. Energy metabolism and thermoregulation during sleep in young and old females. Sci Rep 2023; 13:10416. [PMID: 37369712 DOI: 10.1038/s41598-023-37407-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Accepted: 06/21/2023] [Indexed: 06/29/2023] Open
Abstract
Core body temperature (CBT) shows a diurnal rhythm, and the nocturnal decrease in CBT is blunted in older people. The physiological mechanisms responsible for the blunted nocturnal decrease in CBT in older people remain to be revealed. The aim of this study was to compare heat production and heat dissipation in young and old subjects during sleep, as assessed by indirect calorimetry and the distal-proximal temperature gradient (DPG) of skin temperature. A complete dataset of 9 young (23.3 ± 1.1 years) and 8 old (72.1 ± 2.5 years) females was analyzed. CBT and energy metabolism were monitored during sleep using an ingestible temperature sensor in a metabolic chamber maintained at 25 °C. Skin temperature was measured at proximal and distal parts of the body. CBT, distal skin temperature, and DPG in older subjects were higher than in young subjects. Protein oxidation was similar between the two groups, but fat oxidation was lower and carbohydrate oxidation was higher in old subjects compared to young subjects. On the other hand, energy expenditure was similar between the two age groups. Thus, the elevated CBT in older subjects was not attributed to deteriorated heat dissipation or enhanced heat production, suggesting an alternative explanation such as deteriorated evaporative heat loss in old subjects.
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Affiliation(s)
- Jaehoon Seol
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
- Research Center for Overwork-Related Disorders, National Institute of Occupational Safety and Health, Kawasaki, Japan
- R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba, Japan
| | - Chihiro Kokudo
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
- Graduate School of Comprehensive Human Science, University of Tsukuba, Tsukuba, Japan
| | - Insung Park
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Simeng Zhang
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
| | - Katsuhiko Yajima
- Faculty of Pharmaceutical Sciences, Josai University, Saitama, Japan
| | - Tomohiro Okura
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan
- R&D Center for Tailor-Made QOL, University of Tsukuba, Tsukuba, Japan
- Institute of Health and Sports Sciences, University of Tsukuba, Tsukuba, Japan
| | - Kumpei Tokuyama
- International Institute for Integrative Sleep Medicine (WPI-IIIS), University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, Japan.
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20
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Romero-Perales E, Sainz-de-Baranda Andujar C, López-Ongil C. Electronic Design for Wearables Devices Addressed from a Gender Perspective: Cross-Influences and a Methodological Proposal. SENSORS (BASEL, SWITZERLAND) 2023; 23:5483. [PMID: 37420649 DOI: 10.3390/s23125483] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 06/01/2023] [Accepted: 06/06/2023] [Indexed: 07/09/2023]
Abstract
The design of wearable devices has been approached from many perspectives over the years, mainly from a functionality, electronics, mechanics, usability, wearability, or product design perspective. However, there is a missing point in these approaches: the gender perspective. Gender intersects with every approach and, considering the interrelationships and dependencies, can achieve a better adherence, reach a wider audience, and even change the conception of the wearables design paradigm. The electronics design addressed from a gender perspective must consider both the morphological and anatomical impacts and those emanating from socialization. This paper presents an analysis of the different factors to consider when designing the electronics of a wearable device, including the functionality to implement, sensors, communications, or the location, together with their interdependencies, and proposes a user-centered methodology that contemplates a gender perspective at every stage. Finally, we present a use case that validates the proposed methodology in a real design of a wearable device for the prevention of gender-based violence cases. For the application of the methodology, 59 experts have been interviewed, 300 verbatims have been extracted and analyzed, a dataset from the data of 100 women has been created and the wearable devices have been tested for a week by 15 users. The electronics design needs to be addressed from a multidisciplinary approach, by rethinking the decisions taken for granted and analyzing the implications and interrelationships from a gender perspective. We need to enroll more diverse people at every design stage and include gender as one of the variables to study.
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Affiliation(s)
- Elena Romero-Perales
- Departamento de Tecnología Electrónica, Universidad Carlos III Madrid, 28911 Leganés, Spain
- Instituto de Estudios de Género, Universidad Carlos III Madrid, 28903 Getafe, Spain
| | - Clara Sainz-de-Baranda Andujar
- Instituto de Estudios de Género, Universidad Carlos III Madrid, 28903 Getafe, Spain
- Departamento de Comunicación, Universidad Carlos III Madrid, 28903 Getafe, Spain
| | - Celia López-Ongil
- Departamento de Tecnología Electrónica, Universidad Carlos III Madrid, 28911 Leganés, Spain
- Instituto de Estudios de Género, Universidad Carlos III Madrid, 28903 Getafe, Spain
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21
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Bezerra AG, Andersen ML, Pires GN, Tufik S, Hachul H. The effects of hormonal contraceptive use on sleep in women: A systematic review and meta-analysis. J Sleep Res 2023; 32:e13757. [PMID: 36319606 DOI: 10.1111/jsr.13757] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 09/11/2022] [Accepted: 09/27/2022] [Indexed: 05/10/2023]
Abstract
Hormonal contraceptives are some of the most widely used medications worldwide, but studies on their effects on sleep are contradictory, with some reporting a sleep-promoting effect, while others a sleep-inhibiting effect. Our objective was, therefore, to undertake a systematic review and meta-analysis of the literature on this subject to try to clarify their effects. A search was conducted in three databases (PubMed, Scopus and Web of Science). Only studies evaluating hormonal contraception use were considered eligible, and both objective and subjective sleep-related outcomes were considered. Individual effect size was calculated for each article, and meta-analyses were performed using a DerSimonian and Laird random effects method. The initial search identified 2076 articles, of which 13 met the criteria for the study after full text evaluation. A total of 33 meta-analyses were performed, three of them related to subjective measures and 30 considering data from polysomnography. The only statistically significant result between contraceptive users and non-contraceptive users was observed in respect of wake after sleep onset, which was 7 min shorter among contraceptive users (-7.12 [-12.80; -1.44]; I2 = 65%; p = 0.01). In conclusion, hormonal contraceptives are not associated with clinically relevant changes in sleep patterns in women.
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Affiliation(s)
| | - Monica Levy Andersen
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Helena Hachul
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil
- Departamento de Ginecologia, Casa de Saúde Hospital Santa Marcelina, São Paulo, Brazil
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22
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Wolf ST, Havenith G, Kenney WL. Relatively minor influence of individual characteristics on critical wet-bulb globe temperature (WBGT) limits during light activity in young adults (PSU HEAT Project). J Appl Physiol (1985) 2023; 134:1216-1223. [PMID: 36995912 PMCID: PMC10211460 DOI: 10.1152/japplphysiol.00657.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 03/22/2023] [Accepted: 03/23/2023] [Indexed: 03/31/2023] Open
Abstract
Critical environmental limits are temperature-humidity thresholds above which heat balance cannot be maintained for a given metabolic heat production. This study examined the association between individual characteristics [sex, body surface area (AD), aerobic capacity (V̇o2max), and body mass (mb)] and critical environmental limits in young adults at low metabolic rates. Forty-four (20 M/24 F; 23 ± 4 yr) subjects were exposed to progressive heat stress in an environmental chamber at two low net metabolic rates (Mnet); minimal activity (MinAct; Mnet = ∼160 W) and light ambulation (LightAmb; Mnet = ∼260 W). In two hot-dry (HD; ≤25% rh) environments, ambient water vapor pressure (Pa = 12 or 16 mmHg) was held constant and dry-bulb temperature (Tdb) was systematically increased. In two warm-humid (WH; ≥50% rh) environments, Tdb was held constant at 34°C or 36°C, and Pa was systematically increased. The critical wet-bulb globe temperature (WBGTcrit) was determined for each condition. During MinAct, after entry of Mnet into the forward stepwise linear regression model, no individual characteristics were entered into the model for WH (R2adj = 0.01, P = 0.27) or HD environments (R2adj = -0.01, P = 0.44). During LightAmb, only mb was entered into the model for WH environments (R2adj = 0.44, P < 0.001), whereas only V̇o2max was entered for HD environments (R2adj = 0.22; P = 0.002). These data demonstrate negligible importance of individual characteristics on WBGTcrit during low-intensity nonweight-bearing (MinAct) activity with a modest impact of mb and V̇o2max during weight-bearing (LightAmb) activity in extreme thermal environments.NEW & NOTEWORTHY Our laboratory has recently published a series of papers establishing the upper ambient temperature-humidity thresholds for maintaining heat balance, termed critical environmental limits, in young adults. However, no studies have investigated the relative influence of individual characteristics, such as sex, body size, and aerobic fitness, on those environmental limits. Here, we demonstrate the contributions of sex, body mass, body surface area, and maximal aerobic capacity on critical wet-bulb globe temperature (WBGT) limits in young adults.
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Affiliation(s)
- S Tony Wolf
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
| | - George Havenith
- Environmental Ergonomics Research Centre, Loughborough Design School, Loughborough University, Loughborough, United Kingdom
| | - W Larry Kenney
- Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania, United States
- Graduate Program in Physiology, The Pennsylvania State University, University Park, Pennsylvania, United States
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Horiuchi D, Shimono T, Tatekawa H, Tsukamoto T, Takita H, Matsushita S, Miki Y. Brain temperature remains stable during the day: a study of diffusion-weighted imaging thermometry in healthy individuals. Neuroradiology 2023:10.1007/s00234-023-03142-9. [PMID: 36949255 DOI: 10.1007/s00234-023-03142-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 03/16/2023] [Indexed: 03/24/2023]
Abstract
PURPOSE To investigate the daily fluctuations in brain temperature in healthy individuals using magnetic resonance (MR) diffusion-weighted imaging (DWI) thermometry and to clarify the associations between the brain and body temperatures and sex. METHODS Thirty-two age-matched healthy male and female volunteers (male = 16, 20-38 years) were recruited between July 2021 and January 2022. Brain MR examinations were performed in the morning and evening phases on the same day to calculate the brain temperatures using DWI thermometry. Body temperature was also measured in each MR examination. Group comparisons of body and brain temperatures between the two phases were performed using paired t-tests. A multiple linear regression model was used to predict the morning brain temperature using sex, evening brain temperature, and the interaction between sex and evening brain temperature as covariates. RESULTS Body temperatures were significantly higher in the evening than in the morning in all participants, male group, and female group (p < 0.001, = 0001, and < 0.001, respectively). Meanwhile, no significant difference was observed between the morning and evening brain temperatures in each analysis (p = 0.23, 0.70, and 0.16, respectively). Multiple linear regression analysis showed significant associations of morning brain temperature with sex (p = 0.038), evening brain temperature (p < 0.001), and the interaction between sex and evening brain temperature (p = 0.036). CONCLUSION Unlike body temperature, brain temperature showed no significant daily fluctuations; however, daily fluctuations in brain temperature may vary depending on sex.
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Affiliation(s)
- Daisuke Horiuchi
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan.
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
| | - Taro Shimono
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hiroyuki Tatekawa
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Taro Tsukamoto
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Hirotaka Takita
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka City University, 1-4-3, Asahi-machi, Abeno-ku, Osaka, 545-8585, Japan
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Shu Matsushita
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
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24
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Onus KJ, Cannon J, Marino FE. Heat shock protein response during fixed intensity and self-paced exercise in the heat in young, healthy women on oral contraceptives compared with young healthy men. SOUTH AFRICAN JOURNAL OF SPORTS MEDICINE 2023; 34:v34i1a11757. [PMID: 36815907 PMCID: PMC9924522 DOI: 10.17159/2078-516x/2022/v34i1a11757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background Heat shock proteins respond to a variety of physiological and environmental stresses, including heat stress, ischemia and endotoxic shock. Hormonal changes during the female menstrual cycle can have a thermogenic effect on body temperature. The monophasic oral contraceptive (OC) pill provides low doses of progesterone and oestrogen over the course of the normal menstrual phase. There is little evidence regarding the combined effects of OC on exercise performance and heat stress with respect to heat shock protein response. Objectives This study aimed to determine the response of heat shock proteins (Hsp72) during fixed-intensity and self-paced exercise in the heat in young, healthy women on oral contraceptives compared with young healthy men. Methods Sixteen physically active men and women performed 30 min fixed-intensity cycling at 50% of maximum workload, followed by 30 min of a self-paced time trial (TT) interspersed by 30 s maximal sprint at 9, 19 and 29 min respectively. Trials were undertaken in cool (20°C; 48±3% relative humidity (RH)) and warm (32°C; 66±2% RH) ambient conditions. Core (T c) and skin temperature, heart rate (HR) and subjective responses were measured before, during and post exercise. Results The distance, mean and peak power output, mean and peak speed during the self-paced time trial showed no difference between the ambient temperatures for men and women. Hsp72 in females was higher than males at all sample points at both 20°C and 32°C, except for pre-exercise at 20°C (p< 0.04). Women also attained a higher T c than men at the end of the TT in the heat (38.5°C v 37.9°C for women and men, respectively; p<0.03), higher mean HR and perceived exertion. Conclusion This study indicates that females who use oral contraceptives (OC) had higher levels of Hsp72 than males when tested under the same environmental conditions.
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25
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Muacevic A, Adler JR, Shrivastava R, Pathak T, Thakare A, Wakode NS. Assessment of Alternative Body Points for Temperature Screening As Precautionary Screening During the Pandemic Using Infrared Thermometry. Cureus 2022; 14:e31712. [PMID: 36569716 PMCID: PMC9768110 DOI: 10.7759/cureus.31712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The recent coronavirus disease 2019 (COVID-19) pandemic, which swept across the globe in a short period, demonstrated that disease transmission management is a critical step in preventing an outbreak, as is good viral infectious disease screening. Infrared thermography (IRT) has long been considered ideal for screening body temperatures during pandemics. METHODS Single-centre cross-sectional study with 159 participants. Using infrared thermometry, participants were subjected to temperature measurement twice daily on various sites. This was compared to oral temperature. RESULTS The findings of the study revealed that infrared thermometry could be utilised as a proxy approach for screening by both individuals and medical professionals when employed at the glabella, cubits, or axillae. CONCLUSION Temperature screening is implied as a prophylactic method during pandemics. Owing to contact limitations, oral thermometry cannot be used for mass screening during the pandemic. Infrared thermometry is a noncontact method of temperature screening that can readily be applied for mass temperature screening in congested venues such as airports, shopping malls, places of public convenience, and other similar locations.
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26
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Bragazzi NL, Garbarino S, Puce L, Trompetto C, Marinelli L, Currà A, Jahrami H, Trabelsi K, Mellado B, Asgary A, Wu J, Kong JD. Planetary sleep medicine: Studying sleep at the individual, population, and planetary level. Front Public Health 2022; 10:1005100. [PMID: 36330122 PMCID: PMC9624384 DOI: 10.3389/fpubh.2022.1005100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 09/20/2022] [Indexed: 01/27/2023] Open
Abstract
Circadian rhythms are a series of endogenous autonomous oscillators that are generated by the molecular circadian clock which coordinates and synchronizes internal time with the external environment in a 24-h daily cycle (that can also be shorter or longer than 24 h). Besides daily rhythms, there exist as well other biological rhythms that have different time scales, including seasonal and annual rhythms. Circadian and other biological rhythms deeply permeate human life, at any level, spanning from the molecular, subcellular, cellular, tissue, and organismal level to environmental exposures, and behavioral lifestyles. Humans are immersed in what has been called the "circadian landscape," with circadian rhythms being highly pervasive and ubiquitous, and affecting every ecosystem on the planet, from plants to insects, fishes, birds, mammals, and other animals. Anthropogenic behaviors have been producing a cascading and compounding series of effects, including detrimental impacts on human health. However, the effects of climate change on sleep have been relatively overlooked. In the present narrative review paper, we wanted to offer a way to re-read/re-think sleep medicine from a planetary health perspective. Climate change, through a complex series of either direct or indirect mechanisms, including (i) pollution- and poor air quality-induced oxygen saturation variability/hypoxia, (ii) changes in light conditions and increases in the nighttime, (iii) fluctuating temperatures, warmer values, and heat due to extreme weather, and (iv) psychological distress imposed by disasters (like floods, wildfires, droughts, hurricanes, and infectious outbreaks by emerging and reemerging pathogens) may contribute to inducing mismatches between internal time and external environment, and disrupting sleep, causing poor sleep quantity and quality and sleep disorders, such as insomnia, and sleep-related breathing issues, among others. Climate change will generate relevant costs and impact more vulnerable populations in underserved areas, thus widening already existing global geographic, age-, sex-, and gender-related inequalities.
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Affiliation(s)
- Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada,*Correspondence: Nicola Luigi Bragazzi
| | - Sergio Garbarino
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - Luca Puce
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy
| | - Carlo Trompetto
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucio Marinelli
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal/Child Sciences (DINOGMI), University of Genoa, Genoa, Italy,Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino, Genoa, Italy
| | - Antonio Currà
- Department of Medical-Surgical Sciences and Biotechnologies, Academic Neurology Unit, Ospedale A. Fiorini, Terracina, Italy,Sapienza University of Rome, Rome, Italy
| | - Haitham Jahrami
- Ministry of Health, Manama, Bahrain,College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax, Tunisia,Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax, Tunisia
| | - Bruce Mellado
- School of Physics and Institute for Collider Particle Physics, University of the Witwatersrand, Johannesburg, South Africa,Subatomic Physics, iThemba Laboratory for Accelerator Based Sciences, Somerset West, South Africa
| | - Ali Asgary
- Disaster and Emergency Management Area and Advanced Disaster, Emergency and Rapid-Response Simulation (ADERSIM), School of Administrative Studies, York University, Toronto, ON, Canada
| | - Jianhong Wu
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Jude Dzevela Kong
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
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27
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Orth M, Rasche K. Schlafbezogene Atmungsstörungen und Gynäkologie. SOMNOLOGIE 2022. [DOI: 10.1007/s11818-022-00377-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rzechorzek NM, Thrippleton MJ, Chappell FM, Mair G, Ercole A, Cabeleira M, Rhodes J, Marshall I, O'Neill JS. A daily temperature rhythm in the human brain predicts survival after brain injury. Brain 2022; 145:2031-2048. [PMID: 35691613 PMCID: PMC9336587 DOI: 10.1093/brain/awab466] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 11/03/2021] [Accepted: 11/20/2021] [Indexed: 02/06/2023] Open
Abstract
Patients undergo interventions to achieve a 'normal' brain temperature; a parameter that remains undefined for humans. The profound sensitivity of neuronal function to temperature implies the brain should be isothermal, but observations from patients and non-human primates suggest significant spatiotemporal variation. We aimed to determine the clinical relevance of brain temperature in patients by establishing how much it varies in healthy adults. We retrospectively screened data for all patients recruited to the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) High Resolution Intensive Care Unit Sub-Study. Only patients with direct brain temperature measurements and without targeted temperature management were included. To interpret patient analyses, we prospectively recruited 40 healthy adults (20 males, 20 females, 20-40 years) for brain thermometry using magnetic resonance spectroscopy. Participants were scanned in the morning, afternoon, and late evening of a single day. In patients (n = 114), brain temperature ranged from 32.6 to 42.3°C and mean brain temperature (38.5 ± 0.8°C) exceeded body temperature (37.5 ± 0.5°C, P < 0.0001). Of 100 patients eligible for brain temperature rhythm analysis, 25 displayed a daily rhythm, and the brain temperature range decreased in older patients (P = 0.018). In healthy participants, brain temperature ranged from 36.1 to 40.9°C; mean brain temperature (38.5 ± 0.4°C) exceeded oral temperature (36.0 ± 0.5°C) and was 0.36°C higher in luteal females relative to follicular females and males (P = 0.0006 and P < 0.0001, respectively). Temperature increased with age, most notably in deep brain regions (0.6°C over 20 years, P = 0.0002), and varied spatially by 2.41 ± 0.46°C with highest temperatures in the thalamus. Brain temperature varied by time of day, especially in deep regions (0.86°C, P = 0.0001), and was lowest at night. From the healthy data we built HEATWAVE-a 4D map of human brain temperature. Testing the clinical relevance of HEATWAVE in patients, we found that lack of a daily brain temperature rhythm increased the odds of death in intensive care 21-fold (P = 0.016), whilst absolute temperature maxima or minima did not predict outcome. A warmer mean brain temperature was associated with survival (P = 0.035), however, and ageing by 10 years increased the odds of death 11-fold (P = 0.0002). Human brain temperature is higher and varies more than previously assumed-by age, sex, menstrual cycle, brain region, and time of day. This has major implications for temperature monitoring and management, with daily brain temperature rhythmicity emerging as one of the strongest single predictors of survival after brain injury. We conclude that daily rhythmic brain temperature variation-not absolute brain temperature-is one way in which human brain physiology may be distinguished from pathophysiology.
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Affiliation(s)
| | - Michael J Thrippleton
- Edinburgh Imaging (Royal Infirmary of Edinburgh) Facility, Edinburgh EH16 4SA, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Francesca M Chappell
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Grant Mair
- Edinburgh Imaging (Royal Infirmary of Edinburgh) Facility, Edinburgh EH16 4SA, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - Ari Ercole
- Division of Anaesthesia, University of Cambridge, Box 93 Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | - Manuel Cabeleira
- Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge, Box 167, Cambridge Biomedical Campus, Addenbrooke's Hospital, Cambridge CB2 0QQ, UK
| | | | - Jonathan Rhodes
- Department of Anaesthesia, Critical Care and Pain Medicine, NHS Lothian, Room No. S8208 (2nd Floor), Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK
| | - Ian Marshall
- Edinburgh Imaging (Royal Infirmary of Edinburgh) Facility, Edinburgh EH16 4SA, UK.,Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh EH16 4SB, UK
| | - John S O'Neill
- MRC Laboratory of Molecular Biology, Cambridge CB2 0QH, UK
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29
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Li X, Jiang Y, Hu H, Lou J, Zhang Y, He X, Wu Y, Fang J, Shao X, Fang J. The Moxibustion-Induced Thermal Transport Effect Between the Heart and Lung Meridians With Infrared Thermography. Front Cardiovasc Med 2022; 9:817901. [PMID: 35647050 PMCID: PMC9136163 DOI: 10.3389/fcvm.2022.817901] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES By comparing the differences in the thermal transport effect between the heart and lung meridians induced by moxibustion, this study aimed to investigate the specificity of site-to-site associations on the body surface between different meridians. METHODS Eighty healthy participants were divided into the heart meridian intervention group and the lung meridian intervention group; moxibustion was performed at these two meridians, respectively. Baseline temperature and its change magnitude from baseline induced by moxibustion in 6 measuring sites of the heart and lung meridians were assessed by infrared thermography (IRT). Measuring sites included: Site 1 (Chize, LU5), Site 2 (midpoint of LU9 and LU5), Site 3 (Taiyuan, LU9), Site 4 (Shaohai, HT3), Site 5 (midpoint of HT7 and HT3), and Site 6 (Shenmen, HT7). RESULTS Forty participants (20 male and 20 female, 27.90 ± 0.52 years) were assigned to the heart meridian intervention group, and 40 participants (20 male and 20 female, 28.08 ± 0.54 years) were assigned to the lung meridian intervention group. In the lung meridian intervention group (moxibustion over LU5), the temperature of the distal sites in the lung meridian increased significantly at 5, 10, and 15 min compared with pre-moxibustion (P < 0.001). The temperature of Site 4 in the heart meridian, which was nearest to the moxibustion site, increased significantly compared with pre-moxibustion (P < 0.05), while the temperature in the distal sites of the heart meridian did not differ significantly during moxibustion. Regarding the comparison of temperature change magnitude from baseline (ΔT) between the two meridians, the ΔT of Site 2 in the lung meridian was significantly higher than Site 4 in the heart meridian at 5 and 10 min after moxibustion (P < 0.05), despite that Site 2 was more distal from the moxibustion site than Site 4. Similarly, the ΔT of Site 3 in the lung meridian was significantly higher than Site 5 and Site 6 in the heart meridian at 5, 10, and 15 min after moxibustion (P < 0.05). In the heart meridian invervention group, similar thermal transport effect between the two meridians was observed. The thermal transport effect of the distal sites along the heart meridian was more significant than that of the site closer to the moxibustion site but located in the lung meridian. Taken together, aforementioned results indicated that the moxibustion-induced thermal transport effect between the heart and lung meridians is generally more significant in the distal sites along the corresponding meridian than that in the closer sites of the other meridian. CONCLUSIONS In the heart and lung meridians, the moxibustion-induced thermal transport effect is closely related to meridian routes, not just related to the absolute distance from the moxibustion site, thereby confirming the relative specificity of "site-to-site" associations on the body surface in these two meridians. SYSTEMATIC REVIEW REGISTRATION https://clinicaltrials.gov/ct2/show/NCT05330403, identifier NCT05330403.
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Affiliation(s)
- Xiaoyu Li
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Yongliang Jiang
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Hantong Hu
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Jiali Lou
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yajun Zhang
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaofen He
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuanyuan Wu
- The Third Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Junfan Fang
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaomei Shao
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jianqiao Fang
- Key Laboratory of Acupuncture and Neurology of Zhejiang Province, Department of Neurobiology and Acupuncture Research, The Third Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, China
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30
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Baker FC, Lee KA. Menstrual Cycle Effects on Sleep. Sleep Med Clin 2022; 17:283-294. [DOI: 10.1016/j.jsmc.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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31
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Wolf ST, Cottle RM, Vecellio DJ, Kenney WL. Critical environmental limits for young, healthy adults (PSU HEAT Project). J Appl Physiol (1985) 2022; 132:327-333. [PMID: 34913739 PMCID: PMC8799386 DOI: 10.1152/japplphysiol.00737.2021] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Critical environmental limits are those combinations of ambient temperature and humidity above which heat balance cannot be maintained for a given metabolic heat production, limiting exposure time, and placing individuals at increased risk of heat-related illness. The aim of this study was to establish those limits in young (18-34 yr) healthy adults during low-intensity activity approximating the metabolic demand of activities of daily living. Twenty-five (12 men/13 women) subjects were exposed to progressive heat stress in an environmental chamber at two rates of metabolic heat production chosen to represent minimal activity (MinAct) or light ambulation (LightAmb). Progressive heat stress was performed with either 1) constant dry-bulb temperature (Tdb) and increasing ambient water vapor pressure (Pa) (Pcrit trials; 36°C, 38°C, or 40°C) or 2) constant Pa and increasing Tdb (Tcrit trials; 12, 16, or 20 mmHg). Each subject was tested during MinAct and LightAmb in two to three experimental conditions in random order, for a total of four to six trials per participant. Higher metabolic heat production (P < 0.001) during LightAmb compared with MinAct trials resulted in significantly lower critical environmental limits across all Pcrit and Tcrit conditions (all P < 0.001). These data, presented graphically herein on a psychrometric chart, are the first to define critical environmental limits for young adults during activity resembling those of light household tasks or other activities of daily living and can be used to develop guidelines, policy decisions, and evidence-based alert communications to minimize the deleterious impacts of extreme heat events.NEW & NOTEWORTHY Critical environmental limits are those combinations of temperature and humidity above which heat balance cannot be maintained, placing individuals at increased risk of heat-related illness. Those limits have been investigated in young adults during exercise at 30% V̇o2max, but not during metabolic rates that approximate those of light activities of daily living. Herein, we establish critical environmental limits for young adults at two metabolic rates that reflect activities of daily living and leisurely walking.
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Affiliation(s)
- S. Tony Wolf
- 1Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
| | - Rachel M. Cottle
- 1Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania
| | - Daniel J. Vecellio
- 2Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania
| | - W. Larry Kenney
- 1Department of Kinesiology, The Pennsylvania State University, University Park, Pennsylvania,2Center for Healthy Aging, The Pennsylvania State University, University Park, Pennsylvania,3The Graduate Program in Physiology, The Pennsylvania State University, University Park, Pennsylvania
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Boots R, Mead G, Rawashdeh O, Bellapart J, Townsend S, Paratz J, Garner N, Clement P, Oddy D. Temperature Profile and Adverse Outcomes After Discharge From the Intensive Care Unit. Am J Crit Care 2022; 31:e1-e9. [PMID: 34972850 DOI: 10.4037/ajcc2022223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND A predictive model that uses the rhythmicity of core body temperature (CBT) could be an easily accessible clinical tool to ultimately improve outcomes among critically ill patients. OBJECTIVES To assess the relation between the 24-hour CBT profile (CBT-24) before intensive care unit (ICU) discharge and clinical events in the step-down unit within 7 days of ICU discharge. METHODS This retrospective cohort study in a tertiary ICU at a single center included adult patients requiring acute invasive ventilation for more than 48 hours and assessed major clinical adverse events (MCAEs) and rapid response system activations (RRSAs) within 7 days of ICU discharge (MCAE-7 and RRSA-7, respectively). RESULTS The 291 enrolled patients had a median mechanical ventilation duration of 139 hours (IQR, 50-862 hours) and at admission had a median Acute Physiology and Chronic Health Evaluation II score of 22 (IQR, 7-42). At least 1 MCAE or RRSA occurred in 64% and 22% of patients, respectively. Independent predictors of an MCAE-7 were absence of CBT-24 rhythmicity (odds ratio, 1.78 [95% CI, 1.07-2.98]; P = .03), Sequential Organ Failure Assessment score at ICU discharge (1.10 [1.00-1.21]; P = .05), male sex (1.72 [1.04-2.86]; P = .04), age (1.02 [1.00-1.04]; P = .02), and Charlson Comorbidity Index (0.87 [0.76-0.99]; P = .03). Age (1.03 [1.01-1.05]; P = .006), sepsis at ICU admission (2.02 [1.13-3.63]; P = .02), and Charlson Comorbidity Index (1.18 [1.02-1.36]; P = .02) were independent predictors of an RRSA-7. CONCLUSIONS Use of CBT-24 rhythmicity can assist in stratifying a patient's risk of subsequent deterioration during general care within 7 days of ICU discharge.
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Affiliation(s)
- Rob Boots
- Rob Boots is an associate professor, Thoracic Medicine, Royal Brisbane and Women’s Hospital, and Faculty of Medicine, The University of Queensland, Herston, Queensland, Australia
| | - Gabrielle Mead
- Gabrielle Mead is an honors student, School of Biomedical Sciences, Faculty of Medicine, The University of Queensland
| | - Oliver Rawashdeh
- Oliver Rawashdeh is a senior lecturer,, School of Biomedical Sciences, Faculty of Medicine, The University of Queensland
| | - Judith Bellapart
- Judith Bellapart is a senior specialist, Department of Intensive Care Medicine, Royal Brisbane and Women’s Hospital, and Burns, Trauma and Critical Care, The University of Queensland
| | - Shane Townsend
- Shane Townsend is director, Intensive Care Services, Royal Brisbane and Women’s Hospital
| | - Jenny Paratz
- Jenny Paratz is an associate professor and a senior research fellow, Burns, Trauma and Critical Care Research Centre, The University of Queensland School of Medicine
| | - Nicholas Garner
- Nicholas Garner is a PhD student, School of Biomedical Sciences, Faculty of Medicine, The University of Queensland
| | - Pierre Clement
- Pierre Clement is the clinical information systems manager, Department of Intensive Care Services, Royal Brisbane and Women’s Hospital
| | - David Oddy
- David Oddy is the clinical data manager, Department of Intensive Care Services, Royal Brisbane and Women’s Hospital
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Infrared sauna as exercise-mimetic? Physiological responses to infrared sauna vs exercise in healthy women: A randomized controlled crossover trial. Complement Ther Med 2021; 64:102798. [PMID: 34954348 DOI: 10.1016/j.ctim.2021.102798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 11/29/2021] [Accepted: 12/22/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Passive heat therapies have been reported to have similar effects on the cardiovascular system as exercise. Studies supporting these findings in healthy populations have predominantly been done with men using warm water immersions or traditional saunas, rather than newer infrared-based saunas. OBJECTIVE To explore short-term thermal and cardiovascular responses in women using an infrared sauna as compared to moderate-intensity exercise. STUDY DESIGN Randomized controlled crossover trial with balanced allocations. SETTING Brisbane, Australia (August 2019 - March 2020) PARTICIPANTS: Ten healthy women (36 ± 9 years) INTERVENTIONS: 45 min of resting, infrared sauna or indoor bicycling PRIMARY OUTCOME MEASURES: tympanic/skin temperatures; respiratory rate; blood pressure; arterial stiffness; heart rate variability RESULTS: Tympanic temperatures were elevated during infrared sauna as compared to both control (mean diff = +1.05 oC ± SEM 0.12 oC, 95% C.I.: 0.73 - 1.36, p < 0.0005) and exercise (mean diff = +0.79 oC ± SEM 0.12 oC, 95% C.I.: 0.49 - 1.08, p < 0.0005). Respiratory rates were higher during exercise as compared to both control (mean diff = +7.66 ± SEM 1.37, 95% C.I.: 4.09 - 11.23, p < 0.0005) and infrared sauna (mean diff = +6.66 ± SEM 1.33, 95% C.I.: 3.20 - 10.11, p < 0.0005). No significant differences in non-invasive measures of blood pressure, arterial stiffness or heart rate variability were detected between any of the interventions. CONCLUSIONS These findings suggest the physiological effects of infrared sauna bathing are underpinned by thermoregulatory-induced responses, more so than exercise-mimetic cardiorespiratory or cardiovascular activations.
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Brunet JF, McNeil J, Jaeger Hintze L, Doucet É, Forest G. Interindividual differences in energy intake after sleep restriction: The role of personality and implicit attitudes toward food. Appetite 2021; 169:105844. [PMID: 34896388 DOI: 10.1016/j.appet.2021.105844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 11/01/2021] [Accepted: 12/02/2021] [Indexed: 11/02/2022]
Abstract
Sleep restriction (SR) often leads to an increase in energy intake (EI). However, large variability in EI after SR is often observed, which suggests that individual characteristics may affect food intake. The objective of this study was to explore the influence of characteristics generally associated with risk-taking (sensitivity to reward and personality traits: impulsiveness, sensation seeking) and implicit attitudes toward food on EI after sleep loss. 17 subjects completed the NEO-PI-3, an Implicit Association Test measuring implicit attitudes towards healthy and unhealthy foods, and the Sensitivity to Punishment and Sensitivity to Reward Questionnaire. 24h Ad libitum EI was assessed following a habitual sleep night, a 50% SR with an advanced wake time, and a 50% SR with a delayed bedtime. Changes in EI between each SR condition and the control condition (ΔEI) were calculated for each subject. Despite no changes in overall EI between sleep conditions, results showed large interindividual variations (-669 to +899 kcal) across SR conditions. Regression modeling showed that a lower sensation seeking and higher favorable implicit attitudes towards unhealthy food were significantly associated with increased ΔEI in the advanced wake time condition. For the delayed bedtime, lower sensation seeking was associated with increased ΔEI while controlling for age, sex, REM sleep, and implicit attitudes. These results suggest that certain personality traits and implicit attitudes toward food are associated with changes in EI after sleep loss.
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Affiliation(s)
- Jean-François Brunet
- Laboratoire Du Sommeil, Département de Psychoéducation et de Psychologie, Université Du Québec en Outaouais, Gatineau, J8X 3X7, Canada
| | - Jessica McNeil
- Department of Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, Alberta, T2S 3C3, Canada
| | - Luzia Jaeger Hintze
- Behavioral and Metabolic Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, K1N 6N5, Canada
| | - Éric Doucet
- Behavioral and Metabolic Research Unit, School of Human Kinetics, University of Ottawa, Ottawa, K1N 6N5, Canada
| | - Geneviève Forest
- Laboratoire Du Sommeil, Département de Psychoéducation et de Psychologie, Université Du Québec en Outaouais, Gatineau, J8X 3X7, Canada.
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Geneva II, Javaid W. Disruption of the Body Temperature Circadian Rhythm in Hospitalized Patients. Am J Med Sci 2021; 362:578-585. [PMID: 34551353 DOI: 10.1016/j.amjms.2021.06.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 02/16/2021] [Accepted: 06/13/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Dysregulation of the circadian rhythm is linked to immune response deficiencies. Diurnal temperature variation-a surrogate for the circadian rhythm, exists in humans, yet its preservation during illness is not well understood. MATERIALS AND METHODS Temperatures measured within one-half hour of 8 am, 12 pm, 4 pm, 8 pm, 12 am, and 4 am from 16,245 hospitalized patients were statistically analyzed. RESULTS Although we found a diurnal pattern when analyzing the ensemble of temperatures from all patients, stratified by measurement site, the trough-to-peak difference was only 0.2°F, while that for healthy volunteers had been in the 0.5°F to 1.9°F range. The peaks occurred at 8 pm for all patients, regardless of age or sex, which is similar to healthy people. However, the troughs were shifted to later times compared with the 6 am in healthy people-for young patients (age 20-30 years) the trough was at 8 am and for elderly patients (age 70-80 years), at 12 pm, again regardless of patients' sex. Analysis of individual patients showed that less than 20% of patients exhibited diurnal variation and among those showing variation, the trend was present only on the minority of hospitalization days. The presence or absence of an infectious process or fever did not influence the proportion of patients showing diurnal variation. CONCLUSIONS Hospitalization is associated with disruption in the circadian rhythm as reflected by patients' body temperature. Since abnormality in body temperature is known to affect patient outcomes, an understanding of the diurnal cycle during hospitalization is the first step towards devising approaches to re-establish the circadian rhythm.
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Affiliation(s)
- Ivayla I Geneva
- Division of Infectious Diseases, State University of New York Upstate Medical University, Syracuse, New York, USA.
| | - Waleed Javaid
- Division of Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Abstract
Known as metabolic flexibility, oxidized substrate is selected in response to changes in the nutritional state. Sleep imposes an extended duration of fasting, and oxidized substrates during sleep were assumed to progressively shift from carbohydrate to fat, thereby gradually decreasing the respiratory quotient (RQ). Contrary to this assumption, whole-room indirect calorimetry with improved time resolution revealed that RQ re-ascended prior to awakening, and nadir of RQ in non-obese young adults occurred earlier in women than men after bedtime. The transient decrease in RQ during sleep was blunted in metabolically inflexible men with smaller amplitude of diurnal rhythm in RQ. Similarly, the effect of 10 years difference in age on RQ became significant during sleep; the decrease in RQ during sleep was blunted in older subjects. Inter-individual difference in RQ become apparent during sleep, and it might serve as a window to gain insight into the early-stage pathogenesis of metabolic inflexibility.
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Smidt SDE, Hitt T, Zemel BS, Mitchell JA. Sex differences in childhood sleep and health implications. Ann Hum Biol 2021; 48:474-484. [PMID: 35105205 PMCID: PMC9254351 DOI: 10.1080/03014460.2021.1998624] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 06/16/2021] [Accepted: 06/28/2021] [Indexed: 10/19/2022]
Abstract
CONTEXT Sleep is critical for optimal childhood metabolic health and neurodevelopment. However, there is limited knowledge regarding childhood sex differences in sleep, including children with neurodevelopmental disorders, and the impact of such differences on metabolic health. OBJECTIVE To evaluate if sex differences in childhood sleep exist and if sleep associates with metabolic health outcomes equally by sex. Using autism spectrum disorder (ASD) as a case study, we also examine sleep sex differences in children with a neurodevelopmental disorder. METHODS A narrative review explored the literature focussing on sex differences in childhood sleep. RESULTS Sex differences in sleep were not detected among pre-adolescents. However, female adolescents were more likely to report impaired sleep than males. Childhood obesity is more common in males. Shorter sleep duration may be associated with obesity in male pre-adolescents/adolescents; although findings are mixed. ASD is male-predominant; yet, there was an indication that pre-adolescent female children with ASD had more impaired sleep. CONCLUSION Sex differences in sleep appear to emerge in adolescence with more impaired sleep in females. This trend was also observed among pre-adolescent female children with ASD. Further research is needed on sex differences in childhood sleep and metabolic health and the underlying mechanisms driving these differences.
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Affiliation(s)
- Stacey D. Elkhatib Smidt
- Division of Neurology, Children’s Hospital of Philadelphia, PA
- Sleep Center, Children’s Hospital of Philadelphia, PA
- Division of Sleep Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Talia Hitt
- Division of Endocrinology and Diabetes, Children’s Hospital of Philadelphia, PA
| | - Babette S. Zemel
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Jonathan A. Mitchell
- Division of Gastroenterology, Hepatology, and Nutrition, Children’s Hospital of Philadelphia, PA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
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The COVID-19 Lockdown and Changes in Routine-Oriented Lifestyle Behaviors and Symptoms of Depression, Anxiety, and Insomnia in South Africa. J Phys Act Health 2021; 18:1046-1057. [PMID: 34186512 DOI: 10.1123/jpah.2020-0863] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 04/28/2021] [Accepted: 04/29/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND The authors assessed the impact of lockdown in response to the COVID-19 pandemic on routine-oriented lifestyle behaviors and symptoms of depression, anxiety, and insomnia in South Africans. METHODS In this observational study, 1048 adults (median age = 27 y; n = 767 females; n = 473 students) responded to an online survey on work, exercise, screen, alcohol, caffeine and sleep behaviors, depression, anxiety, and insomnia before and during lockdown. Comparisons were made between males and females, and students and nonstudents. RESULTS During lockdown, males reported larger reductions in higher intensity exercise and alcohol use than females, while depressive symptoms increased more among females, more of whom also reported poorer sleep quality. Students demonstrated larger delays in work and sleep timing, greater increases in sitting, screen, sleep duration, napping, depression and insomnia and larger decreases in work hours, exercise time, and sleep regularity compared with nonstudents. CONCLUSIONS Students experienced more changes in their routine-oriented behaviors than nonstudents, coupled with larger increases in depression and insomnia. The dramatic change in their work and sleep timing suggests habitual routines that are at odds with their chronotype, with their sleep changes during lockdown likely reflecting "catch-up" sleep in response to accumulated sleep debt under usual routines.
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Facchin F, Buggio L, Roncella E, Somigliana E, Ottolini F, Dridi D, Roberto A, Vercellini P. Sleep disturbances, fatigue and psychological health in women with endometriosis: a matched pair case-control study. Reprod Biomed Online 2021; 43:1027-1034. [PMID: 34756643 DOI: 10.1016/j.rbmo.2021.08.011] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 08/05/2021] [Accepted: 08/10/2021] [Indexed: 02/03/2023]
Abstract
RESEARCH QUESTION What are the associations between endometriosis, pelvic pain symptoms, fatigue and sleep? Psychological health and quality of life in endometriosis patients with good versus bad quality of sleep were also examined. DESIGN This matched pair case-control study included 123 consecutive endometriosis patients and 123 women without a history of endometriosis (matched to patients for age and body mass index). Endometriosis-related pelvic pain severity was rated on a 0-10 numerical rating scale. Fatigue was measured on a 1-5 Likert scale. Women also completed a set of self-report questionnaires for assessing sleep disturbances (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Insomnia Severity Index), psychological health (Hospital Anxiety and Depression Scale) and quality of life (Short Form-12). RESULTS Painful endometriosis had an impact on fatigue (P = 0.006; η2p = 0.041) and sleep (P < 0.001; η2p = 0.051). Women with painful endometriosis reported significantly greater fatigue, poorer quality of sleep, higher daytime sleepiness and more severe insomnia than women without significant pain symptoms and controls. Poorer quality of sleep among endometriosis patients was associated with greater fatigue (P < 0.001; η2p = 0.130), poorer psychological health (P < 0.001; η2p = 0.135), and lower quality of life (P < 0.001; η2p = 0.240). CONCLUSIONS Pelvic pain (rather than endometriosis in itself) is associated with fatigue and sleep disturbances, with poor sleep having a detrimental impact on women's psychological health and quality of life.
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Affiliation(s)
- Federica Facchin
- Department of Psychology, Catholic University of the Sacred Heart, Largo Agostino Gemelli 1, Milan 20123, Italy
| | - Laura Buggio
- Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, Milan 20122, Italy.
| | - Elena Roncella
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Commenda 12, Milan 20122, Italy
| | - Edgardo Somigliana
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Commenda 12, Milan 20122, Italy; Infertility Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, Milan 20122, Italy
| | - Federica Ottolini
- Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Commenda 12, Milan 20122, Italy
| | - Dhouha Dridi
- Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, Milan 20122, Italy
| | - Anna Roberto
- Department of Public Health, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, Milan 20156, Italy
| | - Paolo Vercellini
- Gynecology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Commenda 12, Milan 20122, Italy; Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Via Commenda 12, Milan 20122, Italy
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Kennedy KER, Onyeonwu C, Nowakowski S, Hale L, Branas CC, Killgore WDS, Wills CCA, Grandner MA. Menstrual regularity and bleeding is associated with sleep duration, sleep quality and fatigue in a community sample. J Sleep Res 2021; 31:e13434. [PMID: 34404109 DOI: 10.1111/jsr.13434] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/09/2021] [Accepted: 06/15/2021] [Indexed: 01/11/2023]
Abstract
Female menstrual health and its relationship with sleep is an understudied subject. The aim of this investigation was to determine the association between the two in a community sample. Data were obtained from n = 579 menstruating females who participated in the Sleep and Health Activity, Diet, Environment, and Socialization (SHADES) study, a community-based sample of adults aged 22-60 years. Participants were asked, "How regular is your period?", with response choices of "very regular", "mostly regular", "fairly regular" and "not regular". They were also asked, "How much bleeding do you usually experience during your period?" Response choices were: "very heavy", "heavy", "medium", "light" or "very light". These were evaluated as ordinal outcomes. Sleep-related predictors included sleep duration (in hr; ≤ 6 [short], 7-9 [normal] and ≥ 9 [long]), Insomnia Severity Index score, Pittsburgh Sleep Quality Index score, Epworth Sleepiness Scale score and Fatigue Severity Scale score. Covariates included age, education, income, race/ethnicity and body mass index. Short sleep duration was associated with heavier bleeding (odds ratio = 1.46, p = 0.026) and greater cycle irregularity (odds ratio = 1.44, p = 0.031) as compared with normal sleep. Higher Pittsburgh Sleep Quality Index score was associated with greater cycle irregularity (odds ratio = 1.05, p = 0.022). Higher Fatigue Severity Scale score was associated with heavier bleeding (odds ratio = 1.02, p = 0.003) and greater cycle irregularity (odds ratio = 1.02, p = 0.008). Long sleep, Insomnia Severity Index and Epworth Sleepiness Scale were not associated with either outcome. These results demonstrate an association between short sleep duration, poor sleep quality, fatigue, stress and depression with heavier bleeding and menstrual cycle irregularity, highlighting the need for further studies to improve treatment options.
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Affiliation(s)
- Kathryn E R Kennedy
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | - Chidera Onyeonwu
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | - Sara Nowakowski
- Center for Innovations in Quality, Effectiveness and Safety (IQuESt), Baylor College of Medicine, Houston, TX, USA
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, Program in Public Health, Stony Brook University, Stony Brook, NY, USA
| | - Charles C Branas
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA
| | | | - Chloe C A Wills
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ, USA
| | - Michael A Grandner
- Sleep and Health Research Program, Department of Psychiatry, University of Arizona, Tucson, AZ, USA
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Castanier C, Bougault V, Teulier C, Jaffré C, Schiano-Lomoriello S, Vibarel-Rebot N, Villemain A, Rieth N, Le-Scanff C, Buisson C, Collomp K. The Specificities of Elite Female Athletes: A Multidisciplinary Approach. Life (Basel) 2021; 11:622. [PMID: 34206866 PMCID: PMC8303304 DOI: 10.3390/life11070622] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/21/2021] [Accepted: 06/23/2021] [Indexed: 12/19/2022] Open
Abstract
Female athletes have garnered considerable attention in the last few years as more and more women participate in sports events. However, despite the well-known repercussions of female sex hormones, few studies have investigated the specificities of elite female athletes. In this review, we present the current but still limited data on how normal menstrual phases, altered menstrual phases, and hormonal contraception affect both physical and cognitive performances in these elite athletes. To examine the implicated mechanisms, as well as the potential performances and health risks in this population, we then take a broader multidisciplinary approach and report on the causal/reciprocal relationships between hormonal status and mental and physical health in young (18-40 years) healthy females, both trained and untrained. We thus cover the research on both physiological and psychological variables, as well as on the Athlete Biological Passport used for anti-doping purposes. We consider the fairly frequent discrepancies and summarize the current knowledge in this new field of interest. Last, we conclude with some practical guidelines for eliciting improvements in physical and cognitive performance while minimizing the health risks for female athletes.
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Affiliation(s)
- Carole Castanier
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | | | - Caroline Teulier
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | | | - Sandrine Schiano-Lomoriello
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Nancy Vibarel-Rebot
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Aude Villemain
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Nathalie Rieth
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Christine Le-Scanff
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
| | - Corinne Buisson
- Département des Analyses, AFLD, 92290 Chatenay-Malabry, France;
| | - Katia Collomp
- CIAMS, Université Paris-Saclay, 91405 Orsay, France; (C.C.); (C.T.); (S.S.-L.); (N.V.-R.); (A.V.); (N.R.); (C.L.-S.)
- CIAMS, Université d’Orléans, 45067 Orléans, France
- Département des Analyses, AFLD, 92290 Chatenay-Malabry, France;
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Boots RJ, Mead G, Garner N, Rawashdeh O, Bellapart J, Townsend S, Paratz J, Clement P, Oddy D, Leong M, Zappala C. Temperature rhythms and ICU sleep: the TRIS study. Minerva Anestesiol 2021; 87:794-802. [PMID: 33853269 DOI: 10.23736/s0375-9393.21.15232-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
BACKGROUND Core body temperature (CBT) patterns associated with sleep have not been described in the critically ill. This study aimed to characterize night-time sleep and its relationship to CBT in ICU patients. METHODS A prospective study was performed in a 27-bed tertiary adult intensive care unit of 20 mechanically ventilated patients in the weaning stage of their critical illness. The study assessed sleep by polysomnography (PSG) during the evening between 21:00-7:00 hours, nursing interventions using the Therapeutic Intervention Scoring System (TISS), illness severity using SOFA and APACHE II scores and CBT 24-hour pattern. RESULTS Patients were awake for approximately half the study period (45.04%, IQR 13.81-77-17) with no REM (0%, IQR 0-0.04%) and median arousals of 19.5/hour (IQR 7.1-40.9). The 24-hour CBT had a rhythmic pattern in 13 (65%) patients with a highly variable phase of median peak time at 17:35 hours (IQR 12:40-19:39). No significant associations were found between CBT rhythmicity, sleep stages, sleep EEG frequency density, illness severity scores or TISS on the day of PSG. There was no relationship between time awake and CBT rhythmicity (P=0.48) or CBT peak time (P=0.82). The relationship between circadian rhythms and sleep patterns in the critically ill is complex. CONCLUSIONS Patients recovering in ICU commonly have CBT loss of rhythmicity or a significant phase shift with loss of normal night-time patterns of sleep architecture. Appropriate care plans to promote sleep and circadian rhythm require further investigation of contributing factors such as environment, clinical care routines, illness type and severity.
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Affiliation(s)
- Rob J Boots
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Herston, Australia - .,Faculty of Medicine, University of Queensland, Herston, Australia - .,Department of Burns, Trauma and Critical Care, University of Queensland, Herston, Australia - .,Department of Intensive Care, Bundaberg Base Hospital, Bundaberg, Australia -
| | - Gabrielle Mead
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Nicholas Garner
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Oliver Rawashdeh
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Judith Bellapart
- Department of Burns, Trauma and Critical Care, University of Queensland, Herston, Australia.,Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Shane Townsend
- Department of Burns, Trauma and Critical Care, University of Queensland, Herston, Australia.,Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Jenny Paratz
- Department of Burns, Trauma and Critical Care, University of Queensland, Herston, Australia
| | - Pierre Clement
- Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
| | - David Oddy
- Department of Intensive Care Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Matthew Leong
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
| | - Christopher Zappala
- Department of Thoracic Medicine, Royal Brisbane and Women's Hospital, Herston, Australia
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Grant LK, Gooley JJ, St Hilaire MA, Rajaratnam SMW, Brainard GC, Czeisler CA, Lockley SW, Rahman SA. Menstrual phase-dependent differences in neurobehavioral performance: the role of temperature and the progesterone/estradiol ratio. Sleep 2021; 43:5610591. [PMID: 31670824 DOI: 10.1093/sleep/zsz227] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 08/07/2019] [Indexed: 12/11/2022] Open
Abstract
STUDY OBJECTIVES Women in the luteal phase of the menstrual cycle exhibit better cognitive performance overnight than women in the follicular phase, although the mechanism is unknown. Given the link between core body temperature (CBT) and performance, one potential mechanism is the thermoregulatory role of progesterone (P4), estradiol (E2), and their ratio (P4/E2), which change across the menstrual cycle. We examined the role of P4/E2 in modulating performance during extended wake in premenopausal women. Additionally, we compared the acute effects of nighttime light exposure on performance, CBT, and hormones between the menstrual phases. METHODS Participants were studied during a 50 h constant routine and a 6.5 h monochromatic nighttime light exposure. Participants were 16 healthy, naturally cycling women (eight follicular; eight luteal). Outcome measures included reaction time, attentional failures, self-reported sleepiness, CBT, melatonin, P4, and E2. RESULTS As compared to women in the luteal phase, women in the follicular phase exhibited worse performance overnight. CBT was significantly associated with performance, P4, and P4/E2 but not with other sex hormones. Sex hormones were not directly related to performance. Light exposure that suppressed melatonin improved performance in the follicular phase (n = 4 per group) to levels observed during the luteal phase and increased CBT but without concomitant changes in P4/E2. CONCLUSIONS Our results underscore the importance of considering menstrual phase when assessing cognitive performance during sleep loss in women and indicate that these changes are driven predominantly by CBT. Furthermore, this study shows that vulnerability to sleep loss during the follicular phase may be resolved by exposure to light.
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Affiliation(s)
- Leilah K Grant
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Australia.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Joshua J Gooley
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Melissa A St Hilaire
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Shantha M W Rajaratnam
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Australia.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - George C Brainard
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Steven W Lockley
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Australia.,Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
| | - Shadab A Rahman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA
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Périard JD, Eijsvogels TMH, Daanen HAM. Exercise under heat stress: thermoregulation, hydration, performance implications, and mitigation strategies. Physiol Rev 2021; 101:1873-1979. [PMID: 33829868 DOI: 10.1152/physrev.00038.2020] [Citation(s) in RCA: 206] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A rise in body core temperature and loss of body water via sweating are natural consequences of prolonged exercise in the heat. This review provides a comprehensive and integrative overview of how the human body responds to exercise under heat stress and the countermeasures that can be adopted to enhance aerobic performance under such environmental conditions. The fundamental concepts and physiological processes associated with thermoregulation and fluid balance are initially described, followed by a summary of methods to determine thermal strain and hydration status. An outline is provided on how exercise-heat stress disrupts these homeostatic processes, leading to hyperthermia, hypohydration, sodium disturbances, and in some cases exertional heat illness. The impact of heat stress on human performance is also examined, including the underlying physiological mechanisms that mediate the impairment of exercise performance. Similarly, the influence of hydration status on performance in the heat and how systemic and peripheral hemodynamic adjustments contribute to fatigue development is elucidated. This review also discusses strategies to mitigate the effects of hyperthermia and hypohydration on exercise performance in the heat by examining the benefits of heat acclimation, cooling strategies, and hyperhydration. Finally, contemporary controversies are summarized and future research directions are provided.
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Affiliation(s)
- Julien D Périard
- University of Canberra Research Institute for Sport and Exercise, Bruce, Australia
| | - Thijs M H Eijsvogels
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Hein A M Daanen
- Department of Human Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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45
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Schoech L, Allie K, Salvador P, Martinez M, Rivas E. Sex Differences in Thermal Comfort, Perception, Feeling, Stress and Focus During Exercise Hyperthermia. Percept Mot Skills 2021; 128:969-987. [PMID: 33730933 DOI: 10.1177/00315125211002096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
It is unclear whether men and women perceive thermal stress differently when changes in intestinal temperature (ΔTin) and metabolic heat production (MHprod) are matched between sexes during exercise hyperthermia. This study tested the hypothesis that females have enhanced sensitivity to comfort and perception of thermal stress during exercise hyperthermia in these conditions. We had 22 healthy active adults (11 males, 11 females; M age = 22.4 years, SD = 4.9; M height = 169 cm, SD = 7.6; M weight = 68.3 kg, SD = 13) exercise in random order, separated by at least three days at similar MHprod (M = 7.0 W/kg, SD = 1.5; p = 0.32) for 60 minutes on a cycle ergometer in cool (M = 24.00C, SD = 0.0; M = 14.4%Rh, SD = 3.6) and hot (M = 42.3°C, SD = 0.2; M = 10-60%Rh) environments with a progressive increase in humidity conditions. We measured ΔTin, and thermal stress indices for sensation (TS), comfort (TC), pleasantness (TP), and stickiness (S), feeling (FS scale), stress (visual analogue stress scale, VAS), focus (F) and felt arousal (FAS scale). We examined environmental conditions as wet bulb globe temperatures (WBGT). Males and females had similar increases in ΔTin (ME: WBGT; p < 0.0001), and both groups reported increased TS and TC and decreased TP (ME: WBGT, p ≤ 0.01). However, females reported that TS, TC, and TP, felt hotter overall, more uncomfortable, and more unpleasant, compared to males (ME: Sex; p < 0.04). Overall, females felt worse and were more stressed compared to males (ME: Sex; p ≤ 0.05). Females also reported greater internal focus as WBGT increased compared to males (I: WBGT × Sex; p < 0.003). Knowing that females perceive thermal stress during exercise hyperthermia to be hotter, more uncomfortable, more unpleasant, and more stressful compared to males can help coaches/trainers plan different exercise routines for exercisers of both sexes.
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Affiliation(s)
- Lauren Schoech
- Exercise & Thermal Integrative Physiology Laboratory, Texas Tech University, Lubbock, United States
| | - Kyleigh Allie
- Exercise & Thermal Integrative Physiology Laboratory, Texas Tech University, Lubbock, United States
| | - Paolo Salvador
- Exercise & Thermal Integrative Physiology Laboratory, Texas Tech University, Lubbock, United States
| | - Mauricio Martinez
- Exercise & Thermal Integrative Physiology Laboratory, Texas Tech University, Lubbock, United States
| | - Eric Rivas
- Exercise & Thermal Integrative Physiology Laboratory, Texas Tech University, Lubbock, United States.,KBR, Human Physiology, Performance, Protection & Operations Laboratory, NASA, Johnson Space Center, Houston, Texas, United States
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46
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Hazelhoff EM, Dudink J, Meijer JH, Kervezee L. Beginning to See the Light: Lessons Learned From the Development of the Circadian System for Optimizing Light Conditions in the Neonatal Intensive Care Unit. Front Neurosci 2021; 15:634034. [PMID: 33815040 PMCID: PMC8013699 DOI: 10.3389/fnins.2021.634034] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Accepted: 02/19/2021] [Indexed: 11/13/2022] Open
Abstract
The circadian timing system optimizes health by temporally coordinating behavior and physiology. During mammalian gestation, fetal circadian rhythms are synchronized by the daily fluctuations in maternal body temperature, hormones and nutrients. Circadian disruption during pregnancy is associated with negative effects on developmental outcomes in the offspring, highlighting the importance of regular and robust 24-h rhythms over gestation. In the case of preterm birth (before 37 weeks of gestation), maternal cues no longer synchronize the neonate's circadian system, which may adversely affect the neonate. There is increasing evidence that introducing robust light-dark cycles in the Neonatal Intensive Care Unit has beneficial effects on clinical outcomes in preterm infants, such as weight gain and hospitalization time, compared to infants exposed to constant light or constant near-darkness. However, the biological basis for these effects and the relationship with the functional and anatomical development of the circadian system is not fully understood. In this review, we provide a concise overview of the effects of light-dark cycles on clinical outcomes of preterm neonates in the NICU and its alignment with the development of the circadian system.
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Affiliation(s)
- Esther M. Hazelhoff
- Laboratory for Neurophysiology, Department of Cellular and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - Jeroen Dudink
- Department of Neonatology, Wilhelmina Children’s Hospital and Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Johanna H. Meijer
- Laboratory for Neurophysiology, Department of Cellular and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
| | - Laura Kervezee
- Laboratory for Neurophysiology, Department of Cellular and Chemical Biology, Leiden University Medical Center, Leiden, Netherlands
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47
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Diamond A, Lye CT, Prasad D, Abbott D. One size does not fit all: Assuming the same normal body temperature for everyone is not justified. PLoS One 2021; 16:e0245257. [PMID: 33534845 PMCID: PMC7857558 DOI: 10.1371/journal.pone.0245257] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 12/20/2020] [Indexed: 12/05/2022] Open
Abstract
Despite the increasing personalization of medicine, surprisingly ~37.0°C (98.6°F) continues as the estimate of normal temperature. We investigated between-subject and within-subject thermal variability, whether a significant percentage of individuals have a low mean oral temperature, and whether these differ by sex, age, time of day, ethnicity, body mass index (BMI), or menstrual phase. Oral temperature was measured by Life Brand® Fast-Read Digital Oral Thermometers and sampled 14 times over two weeks, seven morning and seven evening readings. The volunteer sample consisted of 96 adults (42 men, 54 women; 27 couples, 42 singletons), ages 18–67 years. We found sizeable individual differences in body temperature and that the normal temperature of many individuals is considerably lower than 37.0°C (98.6°F). Mean temperatures ranged from 35.2°C (95.4°F) to 37.4°C (99.3°F). The mean temperature across all participants was 36.1°C (97.0°F)—lower than most studies have reported, consistent with recent evidence of temperature declining over decades. 77% had mean temperatures at least 0.55°C (1°F) lower than 37.0°C (98.6°F). Mean temperature did not differ by age, but women had higher temperatures than men, even within a couple with room temperature and warmth of clothing equated. Although oral temperature varied widely across individuals, it showed marked stability within individuals over days. Variability of temperature over days did not differ by sex, but was larger among younger adults. Using 37.0°C (98.6°F) as the assumed normal temperature for everyone can result in healthcare professionals failing to detect a serious fever in individuals with a low normal temperature or obtaining false negatives for those individuals when using temperature to screen for COVID-19, mistaking their elevated temperature as normal. Some have called for lowering the estimate of normal temperature slightly (e.g., 0.2°C [0.36°F]). That still seems an overly high estimate. More important, using any standardized “normal” temperature will lead to errors for many people. Individual differences are simply too great. Personalizing body temperature is needed. Temperature could be measured at yearly doctor visits, as blood pressure is now. That would be simple to implement. Since our results show marked thermal stability within an individual, sampling temperature only once yearly could provide an accurate indication of a person’s normal temperature at that time of day. Such records over time would also provide a more accurate understanding of how temperature changes over the lifespan.
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Affiliation(s)
- Adele Diamond
- Developmental Cognitive Neuroscience Program, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- * E-mail:
| | - Carolyn T. Lye
- Sentinel Secondary, West Vancouver, British Columbia, Canada
| | | | - David Abbott
- Developmental Cognitive Neuroscience Program, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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48
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Belon L, Skidmore P, Mehra R, Walter E. Effect of a fever in viral infections — the ‘Goldilocks’ phenomenon? World J Clin Cases 2021; 9:296-307. [PMID: 33521098 PMCID: PMC7812885 DOI: 10.12998/wjcc.v9.i2.296] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 11/23/2020] [Accepted: 12/10/2020] [Indexed: 02/06/2023] Open
Abstract
Acute infections, including those due to Coronaviridae and other viruses, often stimulate a febrile response. A mild fever appears to improve outcome; it appears to diminish viral replication by several mechanisms, including virion entry into host cells and genome transcription, and improving host defence mechanisms against the pathogen. However, a fever may also damage host cellular and tissue function and increase metabolic demands. At temperatures at the lower end of the febrile range, the benefit of the fever appears to outweigh the detrimental effects. However, at higher temperatures, the outcome worsens, suggesting that the disadvantages of fever on the host predominate. A non-infective fever is associated with a worse outcome at lower temperatures, suggesting that hyperthermia carries less benefit in the absence of infection. This review discusses the risks and benefits of a fever on the host response, focusing on the effects of a fever on viral replication and host response, and the detrimental effect on the host.
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Affiliation(s)
- Lucas Belon
- Department of Intensive Care Medicine, Royal Surrey County Hospital, Guildford GU2 7XX, Surrey, United Kingdom
| | - Peter Skidmore
- Department of General Medicine, Royal Surrey County Hospital, Guildford GU2 7XX, Surrey, United Kingdom
| | - Rohan Mehra
- Department of General Medicine, Royal Surrey County Hospital, Guildford GU2 7XX, Surrey, United Kingdom
| | - Edward Walter
- Department of Intensive Care Medicine, Royal Surrey County Hospital, Guildford GU2 7XX, Surrey, United Kingdom
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49
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Dorsey A, de Lecea L, Jennings KJ. Neurobiological and Hormonal Mechanisms Regulating Women's Sleep. Front Neurosci 2021; 14:625397. [PMID: 33519372 PMCID: PMC7840832 DOI: 10.3389/fnins.2020.625397] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 12/22/2020] [Indexed: 01/22/2023] Open
Abstract
Sleep is crucial for optimal well-being, and sex differences in sleep quality have significant implications for women's health. We review the current literature on sex differences in sleep, such as differences in objective and subjective sleep measures and their relationship with aging. We then discuss the convincing evidence for the role of ovarian hormones in regulating female sleep, and survey how these hormones act on a multitude of brain regions and neurochemicals to impact sleep. Lastly, we identify several important areas in need of future research to narrow the knowledge gap and improve the health of women and other understudied populations.
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Affiliation(s)
| | | | - Kimberly J. Jennings
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Stanford University, Stanford, CA, United States
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50
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Managing Travel Fatigue and Jet Lag in Athletes: A Review and Consensus Statement. Sports Med 2021; 51:2029-2050. [PMID: 34263388 PMCID: PMC8279034 DOI: 10.1007/s40279-021-01502-0] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2021] [Indexed: 02/07/2023]
Abstract
Athletes are increasingly required to travel domestically and internationally, often resulting in travel fatigue and jet lag. Despite considerable agreement that travel fatigue and jet lag can be a real and impactful issue for athletes regarding performance and risk of illness and injury, evidence on optimal assessment and management is lacking. Therefore 26 researchers and/or clinicians with knowledge in travel fatigue, jet lag and sleep in the sports setting, formed an expert panel to formalise a review and consensus document. This manuscript includes definitions of terminology commonly used in the field of circadian physiology, outlines basic information on the human circadian system and how it is affected by time-givers, discusses the causes and consequences of travel fatigue and jet lag, and provides consensus on recommendations for managing travel fatigue and jet lag in athletes. The lack of evidence restricts the strength of recommendations that are possible but the consensus group identified the fundamental principles and interventions to consider for both the assessment and management of travel fatigue and jet lag. These are summarised in travel toolboxes including strategies for pre-flight, during flight and post-flight. The consensus group also outlined specific steps to advance theory and practice in these areas.
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