THE SHIFT WORKER'S GUIDE

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THE SHIFT WORKER'S GUIDE
BEST SHIFT WORK INSPIRED SLEEP SUPPORT PLATFORM
2022 - CANADA

CLINICAL TRIAL COMPARES CANNABINOIDS & MELATONIN FOR SLEEP OUTCOME

shiftworker
The Radicle Discovery Sleep Study was an Institutional Review Board approved, blinded, randomized, controlled clinical trial evaluating the effects of different cannabinoid products relative to melatonin. Five cannabinoid products that all contained cannabidiol (CBD), with some containing additional cannabinoids such as cannabinol (CBN) and cannabichromene (CBC) and one containing additional 5 mg of melatonin, were compared against a control product containing 5 mg of melatonin only.

One thousand eight hundred participants (56% female, 44% male) across the United States were enrolled and then randomized to take one of the cannabinoid products or melatonin only daily for four weeks. Participants reported regularly on their usage, side effects, sleep quality, and other health outcomes, including pain and anxiety.

CBD Users Report Less Grogginess Than Those on Melatonin Alone
Participants in all study groups saw significant improvements in sleep quality, well-being, anxiety, and pain. The onset of effects from all cannabinoid products were similar to the melatonin control product, with most participants noticing an effect within one hour of taking their product.

Throughout the study, the amount of average increased sleep that participants experienced from each different product ranged from 34 to 76 additional minutes nightly, though there was not a statistically significant difference between products.

The majority (>60%) of participants across all study groups experienced meaningful improvements (defined by “clinically important difference” thresholds) in their sleep.

Seventy-one percent (71%) of participants taking melatonin alone or melatonin in combination with CBD and CBN in a defined ratio also experienced meaningful improvement and 69% of participants taking a combination of CBD, CBN, and CBC in a defined ratio experienced meaningful improvement as well.

All study products exhibited a favorable safety profile. Side effects were mostly mild in nature, and there were no significant differences in the frequency (~10%) of reported side effects between all six study groups. However, the participants receiving products containing cannabinoids (including the product containing cannabinoids + melatonin) reported lower incidences of grogginess than those who received melatonin alone.

Of those who also reported pain and anxiety in addition to sleep disturbance at the start of the study, the greatest proportion of participants who experienced a meaningful improvement in their pain and anxiety were those taking the combination of CBD, CBN, and CBC. This was greater than any other study product (including the melatonin control), though not with a statistically significant difference.

Melatonin Versus CBD for Sleep: Key Takeaways
A blinded, randomized controlled trial to compare cannabinoid products against melatonin finds meaningful improvements in sleep across all products. Results reveal no significant differences in sleep improvement between melatonin compared to all of the cannabinoid-containing products (including those with only cannabinoids and no melatonin) with the exception of one that performed significantly worse than melatonin.

Study results suggest that the combination of certain cannabinoids and melatonin may confer greater improvement in sleep duration than melatonin alone, calling for further research into these combinations—especially given animal studies suggesting interplay between the endocannabinoid system and the pineal gland that produces melatonin.

While the cannabinoid study products had similar incidence of total side effects relative to melatonin, the participants receiving products with cannabinoids (including cannabinoids in combination with melatonin) reported lower incidences of grogginess relative to melatonin only. Therefore, cannabinoid products warrant further attention and research as effective alternatives or additions to melatonin that may avoid or reduce one of its most common and cumbersome side effects.

Moreover, the combination of CBD, CBN, and CBC in a defined ratio may be a particularly promising alternative to melatonin, especially in those who have concurrent pain or anxiety in addition to their sleep disturbance, warranting further exploration.

“This is fascinating data that is the first-of-its-kind,” says Dave Neundorfer, CEO of Open Book Extracts (OBX), the company whose products were used in this study. “We have always been committed to industry-leading R&D, and this historic data further bolsters our endeavors to create the most effective formulations that enhance wellbeing. What’s especially interesting is that cannabinoid formulations for sleep can also help people who also experience pain or anxiety. Instead of having to take several products to address their ailments, they may be able to take just one.”

Jeff Chen, MD, MBA, Radicle Science’s CEO and co-founder, says in a release, “With sleep issues impacting 50 to 70 million Americans, scientifically-validated research is needed more than ever on how to help improve rest. Sleep is among one of the most popular therapeutic usages for cannabinoids, and we’re excited to have begun this groundbreaking work in researching formulations and dosages to discover those with greatest effect.”

Radicle Science and OBX’s next study will be a blinded, randomized controlled trial on formulations containing the cannabinoid THCV to explore effects on energy, focus and appetite.

Radicle Science is an artificial intelligence-driven healthtech B-corp offering history’s first easy path for non-pharmaceutical products to prove their true effects.

Link to Radicle Science study data

Illustration 242602406 © VectorMine | Dreamstime.com

Originally posted on Sleep Review Magazine

EVEN AFTER YEARS OF NIGHT SHIFT MANY DO NOT ADJUST

The Shift Workers Guide not used to no sleep
Scientists at the University of Warwick, jointly with those at Université Paris-Saclay, Inserm, and Assistance Publique-Hôpitaux de Paris (France), have challenged the widespread belief that shift workers adjust to the night shift, using data drawn from wearable tech.

By monitoring groups of French hospital workers working day or night shifts during their working and free time, the researchers have not only shown that night work significantly disrupts both their sleep quality and their circadian rhythms but also that workers can experience such disruption even after years of night shift work.

Their findings, reported in a study in the Lancet group journal eBioMedicine, demonstrates the value of telemonitoring technology for identifying early warning signs of disease risks associated with night-shift work opening up intervention opportunities to improve the health of workers.

The study compared 63 night shift workers, working three or more nights of 10 hours each per week, and 77 day shifters alternating morning and afternoon shifts at a single university hospital (Paul Brousse Hospital in Villejuif, near Paris). Both groups wore accelerometers with chest surface temperature sensors throughout the day and night for a full week, with the data collected by the research team at Université Paris-Saclay and Inserm.

The accelerometer measured movement intensity and allowed the researchers to estimate how much sleep the participants had, how regular were their circadian rhythms, and whether that sleep was disrupted by movement. Patterns in the chest surface temperature gave a further indication of the participants’ circadian rhythm, the internal body clock that coordinates rest-activity phases, varying core body temperature, and an array of other bodily rhythms.

Analysis by the University of Warwick statisticians of interruptions to sleep and rhythmic variations in core body temperature showed that night shift workers had less than half the median regularity and quality of sleep of their day-shift colleagues. 48% of the night-shift workers had a disrupted circadian temperature rhythm.

Using information from questionnaires on the participants’ chronotypes, they also found that the center of sleep for those working the night shift didn’t correlate with their respective chronotype.. This meant they were not sleeping in sync with their internal clocks

FROM SLEEP REVIEW MAGAZINE

LANCET RESEARCH PAPER PUBLICATION

If the Lancet link doesn't work for you — email info@theshiftworkersguide.com and I will forward you the PDF of the report. Very medical.

MEDIA USE BEFORE BED BENEFICIAL

the shift workers guide candy crush media use
Time spent watching television, playing video games or listening to music just prior to going to sleep might not be as bad for you as you think. The relationship between media use and sleep quality is a complicated union, with multiple factors that can either improve or disrupt a good night’s rest, according to the results of a new study by a UB researcher.

“We found that media use just prior to the onset of sleep is associated with an earlier bedtime and more total sleep time, as long as the duration of use is relatively short and you’re not multitasking, like texting or simultaneously scrolling social media,” says Lindsay Hahn, assistant professor of communication, College of Arts and Sciences. “Watching a streaming service or listening to a podcast before bed can serve as a passive, calming activity that improves aspects of your sleep.”

But you have to do it right, and effectively using media as an instrument to improve sleep depends on staying within certain boundaries.
Hahn’s research focused exclusively on legacy media, such as television, radio, video games and books.  

“We intentionally looked only at what you might call ‘entertainment media,’” says Hahn, a co-author on the paper and an expert in media psychology and media effects. “Despite social media getting a lot of attention both in research circles and in popular culture, American time-use surveys show that people still spend a lot of time with television, music and books. 
“Investigating their use remains important because we aren’t always using social media.”

Poor quality sleep can affect both physical and mental health, and sleep problems have been linked to obesity, cardiovascular diseases, depression and anxiety. And the problem of insufficient sleep has been increasing in the U.S. Hahn says previous research has suggested how media use might contribute to sleep problems, but because many of these results are inconsistent, her team wanted to explore the media-sleep relationship using different methodology.

Earlier work relied on self-reporting, asking participants to recall their media use. Many of those studies also had participants sleep in a lab, or asked people to self-determine the quality of their sleep. Hahn’s study relied on a media diary to chronicle use as it occurred. She also trained the 58 adult participants how to use an electroencephalography (EEG) machine, a non-intrusive device that measures electrical activity in the brain. The EEG provided an objective measure of sleep quality and duration.

In general, results suggest that media use one hour before bed was associated with an earlier bedtime and with more sleep, but the effects diminished as the duration of media increased or when participants multitasked. Hahn’s team also found that, contrary to some previous research, being in bed during media use was associated with more total sleep time, and the amount of deep sleep or rapid eye movement (REM) sleep was unaffected by media use before bed.

“These results show the potential benefits of media use and point to the possibility of interventions that allow for media use before bed in ways that improve, rather than disrupt sleep,” says Hahn. “People tend to worry a lot about media use affecting their health or well-being, but our findings repeatedly show that media use can be good for us, too.”


WRONG COUNTRY 911

wrong 911 country call durham the shiftworkers guide
Emergency dispatchers in Durham, England were able to assist a woman in Durham, Ont. in a moment of crisis after she called the wrong police station.
Durham Constabulary in England said they received a report in the afternoon of Wednesday February 9, afternoon using their ‘live chat facility’ from an Ontario woman, more than 4,500 kilometres away, who claimed an intruder was attempting to break into her Ajax home.

According to the English police force, the woman typed the message: “I need help, he is going to come, he is in the house” before falling silent.
The force said their dispatcher realized the mistake and was able to contact Durham Regional Police here in Ontario, who were sent to the scene and found a 35-year-old male in the home. Police said the suspect fled but was found in a nearby yard “where he refused to obey officers’ requests,” adding that the man was tasered during the altercation.

The suspect was arrested, police say, “approximately 30 minutes after his victim first contacted police on the other side of the Atlantic.”
Durham Regional Police confirmed the arrest and said the suspect has now been charged with one count of breaking and entering, one count of assault, one count of forcible confinement, one count of forcible detainer, one count of failing to comply with release order and one count of disobeying lawful order of court.

“This was an unusual incident and a very distressing situation for the victim, but the team remained calm and managed to help our Canadian colleagues resolve the situation quickly and professionally,” Insp. Andrea Arthur, head of the force’s control room in Durham, Eng., said in a statement issued Friday.

“If we can assist in rescuing a vulnerable victim in immediate danger, regardless of where they live, we will do all we can to help. In this case, we’re glad to learn there has been an arrest and, more importantly, the victim is out of danger and receiving the help she needs.”

Abby Neufeld, CTV News Toronto Multi-Platform Writer
@abbyjneufeld

SHIFT WORK ROSTER FOR HEALTH

sleeping panda shift workers guide
(Using a pic of a tired sleeping panda because I’m tired of non-shiftworkers having an opinion on tired shift workers.. Not gonna post a pic of a nurse or a dispatcher or fire or police personnel etc… not gonna do it. Just saying)

Monash University (Australia) researchers and Opturion, an optimization technology company, have developed a cloud-based rostering system to improve alertness, productivity, and safety among shift workers.

The AlertSafe rostering system has been trialed in hospitals across Victoria, Australia, including Austin Health and Monash Health.

The AlertSafe system is capable of alertness analysis, roster design, roster building and management, leading to better outcomes for staff and management.
The platform was developed in a collaboration with the Faculty of Information Technology (IT) and the Turner Institute for Brain and Mental Health at Monash University, the Institute for Breathing and Sleep at Austin Health, and the University of Sydney.

The algorithms developed by the department of data science and artificial intelligence in the faculty of IT use a mathematical model based on the underlying biology of sleep to estimate the impact of work schedules on alertness levels.

Professor Mark Wallace, PhD, from the faculty of IT, says AlertSafe tracks the impact of shift work on each individual staff member during the rostering process and takes into consideration new alertness management guidelines.

“AlertSafe generates rosters using artificial intelligence-based optimization, which infers the consequences of each assignment of a shift to a person who can and cannot be assigned to other shifts. The platform then determines smarter ways to improve a roster time until it meets the preference needs of the roster and the people working within it,” Wallace says in a release.

Associate professor Mark Howard, MBBS, FRACP, GDEB, PhD, a sleep and respiratory physician from Austin Health, adds “There’s been a lack of a systematic approach when it comes to effectively rostering shift workers so that they perform their roles safely and effectively. The trialing of AlertSafe allowed Austin Health to implement rostering changes for our medical staff who are working in an extremely high-pressure environment,” Howard says in a release. “The rostering changes have allowed us to carry out shorter rotations which minimized staff burnout and stress, as well as lowering the adverse medical implications for patients.”

Director of engagement and translation at the Turner Institute for Brain and Mental Health and chair of the Sleep Health Foundation, Professor Shantha Rajaratnam, PhD, says in a release, “Sleep is integral to optimal health, productivity, and safety in the workplace. Interventions, like the AlertSafe, that improve sleep, can significantly reduce accidents and improve the health and  wellbeing of shift workers.”
The platform, which was commercialized by Opturion, has also been used in various construction projects, engineering applications, and medical transport. Ambulance Victoria and the Victorian Level Crossing Removal Program have implemented AlertSafe within their rostering schedules.

Managing director of Opturion, Alan Dormer, PhD, says the system has applications across a number of sectors. “The AlertSafe system makes irregular working hours and shift work safer and more productive by dramatically reducing incidents and improving service outcomes. This means the platform can be applied across a variety of industries including healthcare, the police force, emergency services, airlines, trucking, construction, and mining,” Dormer says in a release.

AlertSafe was developed alongside a personalized sleep schedule app, called Zest, which optimizes individual sleep to AlertSafe was developed alongside a personalized sleep schedule app, called Zest, which optimizes individual sleep to improve mental health outcomes. The mobile phone app, which is currently in the testing phase, has already shown improvements amongst shift workers who have reported improved sleep and overall mental wellbeing.

ALERTSAFE | Opturion

HANGXIETY … FOR REAL?

hangover anxiety hangxiety
Shiftwork lends itself to self soothing. We do things that help us get by and that help us sleep, but those drinks before bed on your day off might not be the way to go. Beyond the fall asleep quick but then wake up in a few hours (the alcohol & broken sleep combo) the act of drinking also has some additional negative impacts on our body our mind and our mood.

The morning after a night of drinking is never fun if you’ve got a hangover. For most people, hangovers involve a headache, fatigue, thirst or nausea. But some people also report experiencing what many have dubbed “hangxiety” – feelings of anxiety during a hangover. By some estimates, anxiety during a hangover affects around 12% of people, and can vary in severity depending on the person.

As the body recovers from a night of drinking, a hangover creates a state of physiological stress. Generally speaking, physiological stress happens when the body is under pressure – such as from an illness or injury. A hangover kind of works the same way. Not only does it cause changes to our immune system, it also increases cortisol levels (often called the “stress hormone”), blood pressure and heart rate – changes which also happen with anxiety.

The brain also experiences changes. Research shows that brain activity involving dopamine (a type of neurotransmitter) is lower during a hangover. This is important, as dopamine plays an important role in regulating anxiety. The heightened stress during a hangover can also make it difficult for someone to cope with any additional stress that may happen throughout the period.

Interestingly, stress and sleep deprivation in combination (reflecting aspects of a hangover), can lead to declines in both mood and cognitive function (including attention and memory). Fatigue, stress and dealing with other unpleasant hangover symptoms can also make it difficult to manage daily tasks. For example, someone with a hangover may be too preoccupied with nursing their feelings of nausea, headache or fatigue to be able to effectively deal with anxious thoughts.

Research has shown that people experience a negative shift in their emotions during a hangover. Many also reported feeling like they had more trouble regulating their emotions compared to when they aren’t hungover. In other words, people feel bad during a hangover and find it difficult to pick themselves back up.

But when participants were asked to actually regulate their emotions in a computer task, they were able to regulate them to the same extent as they could when they aren’t hungover – but with increased effort. Participants were shown pictures that evoked various emotions (including positive or negative emotions) and were asked to experience their emotions without expressing them outwardly. Having greater difficulty regulating emotions during a hangover might also explain why some people experience anxiety.

In another study, the team looked at how hangovers influence executive functions (mental skills which are important for many aspects of our daily life, including working memory, flexible thinking and self control). Participants were given a series of tasks that tested these mental skills, such as remembering a series of letter and recalling it when prompted.

People who were hungover had worse performance in key aspects of executive functions. Executive functions help people cope with anxiety and inhibit anxious thoughts. If these mental skills are poorer during a hangover, it may help explain why some people struggle with anxiety.

Feeling anxious?

But why do some people experience hangxiety, while others don’t?

Pain is part of almost every hangover – whether its a headache or muscle aches. But research shows that people who “catastrophize” pain (a tendency to exaggerate pain or expect the worst) are more likely to experience anxiety. Research also shows that this group are more likely to experience severe hangovers. This might explain why some people experience anxiety, while others don’t.

People who are likely to experience anxiety in general may also be particularly susceptible to hangxiety. Negative life events, depression or anger while drinking, guilt from drinking and even certain personality traits (such as neuroticism) are all also linked to mood changes during a hangover. Hangxiety has even been reported to be higher in people who say they’re very shy and may be linked to symptoms of alcohol use disorder.

Combined, these factors highlight why hangxiety can affect people differently, and why it’s a part of hangovers worth taking seriously. Mood changes during a hangover are not just unpleasant, but may even be linked to problematic drinking, increased conflict with others and reduced productivity at work.

If you’re someone who experiences hangxiety, the same techniques that help with anxiety will also be useful. This might include meditation, practising mindfulness and general self care. Planning ahead of your night out to make sure you have the following day free to recover and avoid other stressors (such as work or family problems) may also help deal with the additional psychological stress. For some, a hangover can even be used as a bonding exercise where people can discuss their previous night of drinking with friends and even cope with feelings of anxiety together.

Of course, the best way to avoid experiencing hangxiety is to avoid drinking altogether – or at least drink in moderation.

original article The Conversation reposted under creative common licence

SHOULD FATIGUED DRIVING BE A CRIME?

the shiftworkers guide fatigued driving
A proposal, submitted to the Tennessee General Assembly last week, by Senator Becky Duncan Massey, would make driving while fatigued or with no sleep for a 24 hour period a crime if it leads to another driver being killed. Senator Massey said she created the bill after a concerned citizen had a close family member killed by a drowsy driver.

Lawyers say it would be difficult to prove.
Sleep Dr. says our judgement is off and we take more risks when deprived.

The implications for sleep deprived shift workers… is it the worker or is it the employer?

Full story: NEWSCHANNEL9

SCIENTISTS DISCOVER CIRCADIAN RYTHMS IN HEART CELLS

heart cells circadian the shift workers guide
A new study has shown how circadian rhythms in heart cells help to change heart function over the course of the day and may explain why shift workers are more vulnerable to heart problems.

Scientists have shown that heart cells regulate their circadian rhythms through daily changes in the levels of sodium and potassium ions inside the cell. The different levels of sodium and potassium ions inside and outside heart cells allow the electrical impulse that causes their contraction and drives the heartbeat. Cellular ion concentrations were thought to be fairly constant, but scientists have now found heart cells actually alter their internal sodium and potassium levels across the day and night. This anticipates the daily demands of our lives, allowing the heart to better accommodate and sustain increased heart rate when we’re active.

It is already known there are daily clocks in heart cells, and other tissues; normally synchronized by hormonal signals that align our internal daily rhythms with the day/ night cycle. Daily rhythms of heart function have been known about for years and thought to be due to greater stimulation by the nervous system during the day. This new study, supported by the Medical Research Council and AstraZeneca Blue Sky Initiative, shows circadian rhythms within each heart cell can also affect heart rate.

The team, led by scientists at the MRC Laboratory for Molecular Biology in Cambridge, UK, in collaboration with AstraZeneca, say understanding how these changes in ion levels alter heart function over the day may help to explain why shift workers are more vulnerable to heart problems because ion rhythms are driven by clocks in the heart get “out of sync” with their stimulation from clocks in the brain. This new understanding could lead to better treatments and preventative measures for combatting heart conditions, according to the authors.

The study, published in the journal Nature Communications, found these daily rhythms in sodium and potassium occur to allow changes in cellular proteins, with ions being pumped out to make room for daily increases in protein levels. The study’s lead author, Alessandra Stangherlin, says in a statement that she was amazed to find sodium/potassium levels changing by as much as 30% in isolated cells and heart tissue. This imparts a striking two-fold daily variation to the electrical activity of isolated heart cells. In mice, this appears to be just as relevant to understanding daily changes in heart rate as nervous control.

Lead author John O’Neill, from the MRC Laboratory of Molecular Biology, in a release:

“The ways in which heart function changes around the clock turn out to be more complex than previously thought. The ion gradients that contribute to heart rate vary over the daily cycle,” he says. “This likely helps the heart cope with increased demands during the day, when changes in activity and cardiac output are much greater than at night, when we normally sleep. It opens up the exciting possibility of more effective treatments for cardiovascular conditions, for example by delivering drugs at the right time of day.”

Original sleepreviewmag.com © Lisa Spear

DOES FATIGUE AFFECT LEVEL OF CARE?

The basic finding in this research is that even though Nurses & the Military are fatigued, the level of care or service does not drop significantly. What was a concern was that, within the confines of the research, their likelihood of running off the road on the way home was higher. Even though this is a Nurse focused study, the parallels cannot be ignored as it relates to all other "care" professions: Ambulance, Fire, Police, Doctor. More likely all shift workers. What is, IMHO, obvious, is that we show up, do the work, but struggle to both get there and to get home…
nurses and fatigue
Respiratory therapist Gina McCarthy cares for COVID-19 patients in overflowing MultiCare Tacoma General Hospital. Never in her 28 years in the profession has she worked hours like she does now.

"I mean, I worked 84 hours in one seven day stretch," McCarthy said. "We're all working long hours. But I just know that everybody I work with is doing it. If I felt I was being dumped on or something, that would be one thing. But I know the entire place is on the same page."

McCarthy said there's a "we're all in this together" spirit in her work group that keeps the caregivers going despite incredible fatigue and emotional strain.

"None of our vacations are getting approved," McCarthy said. "I'm going to physical therapy on my days off because we're working so hard. We're working 16 hour shifts and we're exhausted."

Long hours. Extreme fatigue. You couldn't miss it in the faces of soldiers and refugees at Kabul Airport last month and you can't miss it now in the faces of caregivers in hospitals here at home. It just so happens that Washington State University Spokane is in the midst of a series of studies of how sleep deprivation affects people in high stress, high risk jobs.

Washington State University College of Nursing researcher Lois James designed a realistic experiment to explore the risks. She recruited nurses from two Spokane-area hospitals to stop by her lab at the end of three 12s. That's a common schedule where nurses work 12 hours on, 12 off, 12 on, 12 off, 12 on and then get four days off.

"What we did is we brought nurses into our simulation lab and tested them both on patient care scenarios and then also in a driving simulator to see how much their patient care performance, but also their driving safety was impaired," James explained.

To evaluate quality of care, the nurses entered a mock patient room and treated a talking, coughing mannequin. For comparison, the nurses also ran through the tests when rested after three consecutive days off. The data collection with real-life nurses was completed right before the pandemic hit.

James summarized the study results as encouraging for patients, but not so good for commuters.

"Nursing performance on the patient care scenarios — with some exceptions — overall didn't suffer tremendously," James said. "In terms of patient care, it seems that many nurses seem to be fairly resilient to the effects of fatigue."

However, James said she is concerned about nurse safety on the drive home. Especially nurses on the night shift risked running off the road based on their performance in the driving simulator.

The study results are coming out in multiple papers. The International Journal of Nursing Studies published the first one in July.

James said she suspects the risks her team studied are amplified now in light of the extended shifts and incredible stress nurses are under from the surge in hospital admissions.

"I do think it is very relevant" James said. "Our test was fairly conservative and the risks are very, very real for this group."

Not just nurses, military too

A new study now underway at WSU Spokane is measuring how well certain stimulants help sleep deprived people maintain alertness. It will also delve into the underlying brain processes. This experiment is funded by the Department of Defense and led by professor Hans Van Dongen with backing from a big team. WSU College of Nursing Assistant Professor Stephen James, spouse of the sleep researcher Lois James, developed lab simulations applicable to wearied warfighters.

"Within this study, they come into my lab and they have a driving task and they have a shooting task where we have a modified M4 rifle that no longer fires bullets. It now fires infrared beams at a screen," James said. "We ask them to identify friend from foe targets."

James said the closely watched, live-in subjects will be kept awake for 24 hours beforehand. Some will get the benefit of caffeine pills, similar to a shot of espresso, prior to entering the simulators. Some will get a prescription stimulant named modafinil (which is sometimes used to treat narcolepsy in the civilian world) and some will swallow placebos.

"They start taking the pills every four hours to see if the stimulant supports their performance as they're being sleep deprived," James explained. "One of the things it may be important to understand is that it's really difficult to recover from the effects of sleep deprivation. It is more effective to try to support that cognitive function before you are sleep deprived.”

By the time you feel tired, it's too late to reach for that cup of coffee, James added.

"If you do feel that 3 p.m. slump on a regular day, have your cup of coffee at 2 p.m. so it has time to get into your system and support you through that circadian dip in the afternoon,” he said.

James said the WSU Sleep and Performance Research Center is also looking at fatigue risks in other professions including long-distance truck drivers, taxi drivers and in aviation.

Before becoming a sleep researcher, James served many years in the British Army. During combat tours in Kosovo and Afghanistan, he experienced the sorts of extreme sleep deficits that his department is now dissecting. James said he wishes someone had told him when he was a young soldier about the biology of fatigue and the effects of sleep loss on safety and performance.

Because service members have long had to cope with 24-hour shift operations, the military has a rich history with stimulant use and research. The Vietnam War was notorious for use and abuse of amphetamine derivatives such as "speed" to sustain extended combat. In the U.S. military, prescription stimulant drugs such as dextroamphetamine and modafinil are now generally restricted to use under the direction of a flight surgeon by military pilots on long-duration missions, according to a 2021 Department of Defense report on sleep deprivation submitted to House Armed Services Committee Chairman Adam Smith (D-WA) and his Senate counterpart.

The DoD report said surveys of active duty Army, Navy and Marine Corps service members found coffee to be the most popular drowsiness countermeasure overall, with energy drinks being most popular among young male soldiers. The report was commissioned by members of Congress who were concerned about deleterious effects of sleep deprivation on military readiness and service members' health.

KNKX reporter Kari Plog contributed to this story.

Copyright 2021 Northwest News Network

WHO SNORES MORE? MEN OR WOMEN?

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Wellness-focused tech brand Mintal released a sleep habits report that includes insights stemming from its artificial intelligence (AI)-driven Mintal Tracker app to highlight interesting facts about the sleep patterns of men and women in the United States, revealing several notable commonalities and differences.

Key findings include:

Contrary to the popular belief that men snore more than women, Mintal’s app revealed the opposite—out of all users who snore, 52.7% were women and 47.3% were men.
38% of Mintal Tracker users sleep talk, with the breakdown equating to 54.3% women and 45.7% men.
When it comes to average time asleep, both men and women log almost seven hours of sleep each night on average, with women getting slightly more shut eye at 6 hours 53 minutes, and men receiving 6 hours 47 minutes.
“While we know that quality sleep is essential, many people fail to make it a priority—so we want to change that,” says Frank Jiang, founder and CEO of Mintal, in a release. “Our apps help people take a scientific approach to healthier sleep, providing our users with the tools they need to feel fully rested.”

The data in the report covers the sleep habits of Mintal Tracker’s iOS and Android users between August 2020 and July 2021 in the United States. The Mintal Tracker app enables users to gain a deeper understanding of their sleep patterns and habits, as well as leverages AI to alert users about their propensity to snore, sleep talk, and more.

The Shift Worker's Guide is not affiliated with nor endorses this tracker.

STILL NOT RIGHT AFTER DAYS OFF?

sleepy nurse
After 7 days of recovery from a 10-day period of deficient sleep, participants in a small study had recovered their pre-sleep deprivation reaction speed, but had not fully recovered on any other measures of function. Jeremi Ochab of the Jagiellonian University in Kraków, Poland, and colleagues presented these findings in the open-access journal PLOS ONE on September 1, 2021.

Sleep deficiency is well known to negatively impact human functioning. For example, it is associated with deficits in attention and memory, as well as increased risk of car accidents, heart problems, and other medical issues. However, while some research has addressed recovery after chronic sleep deprivation, it has been unclear how much time is needed to fully recover from prolonged periods of deficient sleep.

To shed more light on this topic, Ochab and colleagues conducted a small study with several healthy adults who underwent 10 days of purposeful sleep restriction followed by 7 recovery days of unrestricted sleep. Participants completed the study in their normal day-to-day environments and wore wrist sensors to monitor daily patterns of sleep and activity. They also underwent daily electroencephalography (EEG) to monitor brain activity, and they answered daily questions (Stroop tasks) to measure reaction times and accuracy.

After 7 days of recovery, the participants had not yet returned to pre-sleep deprivation performance on most measures of functioning. These included several EEG measures of brain activity, rest-versus-activity patterns captured by wrist sensors, and accuracy on Stroop tasks. Only their reaction times had recovered to baseline levels.

While the researchers note that it is difficult to compare these results with other studies that employed different methods, the findings contribute new insights into recovery from chronic sleep loss. Future research could expand to a greater number of participants, investigate longer recovery periods, and disentangle the order in which different functions return to normal.

The authors add: "The investigation of the recovery process following an extended period of sleep restriction reveal that the differences in behavioral, motor, and neurophysiological responses to both sleep loss and recovery."

Source Science Daily

GOUT FLARE UPS INFLUENCED BY CIRCADIAN RYTHMNS

gout and shift work
“There is likely to be a bidirectional relationship between sleep and gout, as gout flares may be influenced by circadian rhythms, and sleep quality is likely to be influenced by gout flares,” investigators explained. “Given the morbidity associated with sleep problems, we should be vigilant regarding sleep health in our patients with gout.”

Patients with either diagnosed or suspected obstructive sleep apnea (OSA) have a higher likelihood of developing gout, according to a study published in BMC Rheumatology.1 Further, patients with gout more frequently reported insomnia, restless legs syndrome, and worry about their sleep.

In this cross-sectional online survey of 2044 Australian adults, investigators assessed self-reported and doctor diagnosed OSA, as well as patient-reported sleep outcomes, to determine the prevalence of sleep disorders and sleep problems within this population. The survey also included a section on other chronic health conditions, including gout. Age, sex, body mass index, and alcohol consumption were recorded. A possible undiagnosed OSA was determined through self-reported loud snoring and observed apnea.

A total of 1948 (95.3%) participants were included in the analysis, of whom 126 (6.5%) had a diagnosis of gout and 124 (6.4%) had sleep apnea. Patients with gout were more likely to be male than female (11.2% vs 2.0%, respectively) and had higher rates of comorbidities, such as diabetes, obesity, heart disease, and high blood pressure.

Participants with either OSA symptoms or doctor diagnosed OSA were 2.6 and 2.8 times more likely to have a concurrent gout diagnosis. Those with gout were 2.5 times more likely to experience restless leg syndrome and 2 times more likely to have anxiety related to sleep when compared with other respondents (31.9% vs 23.5%, respectively). They were also 1.6 times more likely to discuss these concerns with their physician than patients without gout (38.9% vs 28.5%, respectively).

The percentage of respondents with gout who felt they regularly achieved adequate sleep was not significantly different than those without gout. However, 15% of respondents with gout reported restless leg syndrome, compared with only 6.7% of participants without gout.

The study was strengthened by the large sample size that aligned to Australia’s general population. The cross-sectional design of the study was limiting as investigators were not able to comment on causation. Further, recent data has shown that after adjusting for factors such as renal function, heart failure, and diuretic usage, the link between gout and sleep apnea was no longer associated with male gender. As the information in this study was limited to questions asked in the survey, investigators were not able to adjust for renal function. Lastly, there may be an unknown risk factor for both gout and sleep apnea that was not addressed, which may cause potential bias in the results.

“Our study has highlighted that sleep disorders and gout are common and frequently comorbid in the Australian population. Sleep apnea and gout are both associated with significant cardiovascular morbidity and mortality, but are also treatable,” investigators concluded. “An awareness of the co-existence of both conditions should lead to increased screening and appropriate treatment tailored to patient needs. Further research is required to delineate the nature of the relationship between conditions, and also to establish if treatment of one condition may influence the trajectory of the other condition.”

Original info

WHEN YOU EAT IS AS IMPORTANT AS WHAT YOU EAT

best time to eat
If getting a solid eight hours of sleep a night doesn't come easily to you—and unfortunately, that's very much the case for 70 million Americans—you're probably at least vaguely aware of the connection between food and slumber. (A cup of coffee in the late afternoon could spell trouble, not zzzs.)

But it's not just what you eat that affects sleep; when you eat matters, too. According to scientific research, mealtimes directly affect the body's circadian rhythm, aka the natural physical, mental, and behavioral changes that follow a 24-hour cycle. This connection affects health in both short- and long-term ways. Here, three experts explain the connection between mealtime and sleep, breaking down why exactly it's so important. Plus, they give tips on how to use it to your advantage—even when you're traveling or if you work the night shift.

How mealtime affects circadian rhythm
Before we get into the connection between mealtime and sleep, it's helpful to know why exactly circadian rhythm is important in the first place. "Our circadian rhythm is the 24 hour rhythm of activity which is hard-wired into every cell in the body. This helps all our internal systems—such as appetite, metabolism, cardiovascular system, body temperature, and immune function—run in sync with each other," says Sophie Bostock, PhD, also widely known as The Sleep Scientist. "It enables the right things to get to the right places at the right time."

Dr. Bostock explains that the brain relies on signals from the outside world to keep the body clock in sync with the environment, which is how it operates best. "The strongest signal is light, which helps to drive activity and alertness via a master clock in the brain," she says. This is why the majority of society is set up to, for the most part, function during daylight hours and sleep at night.

When we eat, she adds, also affects circadian rhythm. "[Eating] signals to the clocks in the liver, heart, muscles, and kidneys that it's time to get to work," she says. In other words, consuming food alerts the body that it's time to work, not rest. So eating close to when you plan to go to sleep signals to the body that it actually shouldn't be winding down; it needs to stay up to process the meal.

Maj. Allison Brager, PhD, a neuroscientist in the U.S. Army and sleep specialist for Molecule, says this signal doesn't just affect health in the short-term (like how great or not you'll sleep that same night). When mealtimes aren't consistent, the effect can impact long-term health, too. "The [biological] clock exists to predict when to react, eat, drink, mate, and essentially survive. If the clock has predictability with predictable mealtimes, life is good. We know this to be true because the number one threat of night shift work is weight gain, obesity, and metabolic disorders such as type 2 diabetes," Dr. Brager says.

Harvard-trained sleep researcher Rebecca Robbins, PhD, who is a sleep scientist at Brigham and Women’s Hospital, agrees. "Consistency is very important to the body, and that includes sleep times and mealtimes," she says, adding that routinely waking up and going to bed at the same helps keep circadian rhythm on track, and so does eating breakfast, lunch, and dinner roughly at the same time. Working against the clock could lead to chronic health problems, such as the ones Dr. Brager mentioned.

With this in mind, the sleep experts say there are several ways you can use mealtime to keep your circadian rhythm steady, even if you work untraditional hours or are traveling (and thus may be less likely to stick to consistent mealtimes).

4 tips for how to optimize the connection between mealtime and sleep in your life

1. Be consistent with mealtimes
The most straightforward way to use this connection to your advantage is by eating your meals at roughly the same time each day. "We know that the body expects to use certain kinds of fuel at specific times of the day. Your body is best at digesting food and drinks when you are active and light is present," reads a scientific article published in the Journal of Biological Rhythms. "[This means that] eating and drinking when your body expects you to sleep and rest, and it is dark, can disrupt this system and compromise metabolism. In contrast, a consistent daily cycle of eating and fasting may nurture a healthy circadian clock and optimize metabolism." You can put that intel directly to use by eating your meals at regular times, ideally when it's still light outside.

2. Allow the body time to rest (and not digest) before bedtime
Another way to hack your mealtimes for better sleep is to allow your body plenty of time to rest, says Dr. Robbins. Ideally this means not eating at least two hours before bed.

3. For shift workers, eat more meals of a smaller portion—and plan ahead
If you work a night shift, eating your meals while it's still light out may not work for you, so Dr. Bostock says it's better to eat several small meals throughout the day instead of three bigger meals within a 10- to 12-hour window. The body tends to crave sugar and fat more when it's tired, so eating several small meals of protein- and fiber-rich foods helps mitigate this while still allowing plenty of time to rest while you sleep, she says.

Dr. Brager acknowledges that making nutrient-rich food choices and eating at consistent times definitely tends to be trickier when you work untraditional hours, which is why she recommends meal prepping and planning in advance what you'll eat and snack on. "The key is still finding a sense of normalcy and consistency," Dr. Robbins says. This includes when you eat and what time you go to bed and wake up. She also strongly recommends investing in some blackout curtains to "trick" your body into thinking that it's nighttime when you head to bed since light is the strongest signal to the brain in terms of circadian rhythm.

4. Get on a regular sleep-and-meal schedule as soon as possible when traveling
If you're traveling somewhere in a new time zone, Dr. Bostock recommends trying to adjust as quickly as you can in terms of when you eat and sleep. "Airlines will tend to serve food when it is convenient for the crew, rather than necessarily when it's best for your body clock, so it may help to take your own food supplies with you," she says. But even with these tips in mind, she says your first couple of nights in your new locale still may not be perfect in terms of sleep. "The body's clocks only adjust by about an hour every 24 hours, so you cannot suddenly adjust," she says.

While many factors contribute to our sleep quality—like stress, exercise, work schedules, caretaking commitments, and screen time to name just a few—if you have trouble sleeping and tend to have erratic (or late-night) mealtimes, it's certainly worth evaluating. As the experts have so clearly pointed out, working against the body's natural circadian rhythm doesn't just negatively impact sleep, but also overall health. With that in mind, consistent mealtimes just may make all the difference for you. That, and some really good blackout shades.

Original article Well+Good

PREBIOTICS MAY HELP TO RESET BODY CLOCK

prebiotics jet lag reset
Whether it’s from jetting across time zones, pulling all-nighters at school or working the overnight shift, chronically disrupting our circadian rhythm—or internal biological clocks—can take a measurable toll on everything from sleep, mood and metabolism to risk of certain diseases, mounting research shows. But a new University of Colorado Boulder study funded by the U.S. Navy suggests simple dietary compounds known as prebiotics, which serve as food for beneficial gut bacteria, could play an important role in helping us bounce back faster.

“This work suggests that by promoting and stabilizing the good bacteria in the gut and the metabolites they release, we may be able to make our bodies more resilient to circadian disruption,” senior author Monika Fleshner, a professor of integrative physiology, said in a statement.

The animal study, published in the journal Brain, Behavior and Immunity, is the latest to suggest that prebiotics—not to be confused with probiotics found in fermented foods like yogurt and sauerkraut—can influence not only the gut, but also the brain and behavior. Naturally abundant in many fibrous foods—including leeks, artichokes and onions—and in breast milk, these indigestible carbohydrates pass through the small intestine and linger in the gut, serving as nourishment for the trillions of bacteria residing there. The authors’ previous studies showed that rats raised on prebiotic-infused chow slept better and were more resilient to some of the physical effects of acute stress.

For the new study, part of a multi-university project funded by the Office of Naval Research, the researchers sought to learn if prebiotics could also promote resilience to body-clock disruptions from things like jet lag,
irregular work schedules or lack of natural daytime light—a reality many military personnel live with.

“They are traveling all over the world and frequently changing time zones. For submariners, who can be underwater for months, circadian disruption can be a real challenge,” said lead author Robert Thompson, a postdoctoral researcher in the Fleshner lab. “The goal of this project is to find ways to mitigate those effects.”

HOW A HEALTHY GUT MAY PREVENT JET LAG
The researchers raised rats either on regular food or chow enriched with two prebiotics: galactooligosaccharides and polydextrose. They then manipulated the rats’ light-dark cycle weekly for eight weeks—the equivalent of traveling to a time zone 12 hours ahead every week for two months.
Rats that ate prebiotics more quickly realigned their sleep-wake cycles and core body temperature (which can also be thrown off when internal clocks are off) and resisted the alterations in gut flora that often come with stress.

“This is one of the first studies to connect consuming prebiotics to specific bacterial changes that not only affect sleep but also the body’s response to circadian rhythm disruption,” said Thompson.

The study also takes a critical step forward in answering the question: How can simply ingesting a starch impact how we sleep and feel? The researchers found that those on the prebiotic diet hosted an abundance of several health-promoting microbes, including Ruminiclostridium 5 (shown in other studies to reduce fragmented sleep) and Parabacteroides distasonis. They also had a substantially different “metabolome,” the collection of metabolic byproducts churned out by bacteria in the gut.

Put simply: The animals that ingested the prebiotics hosted more good bacteria, which in turn produced metabolites that protected them from something akin to jet lag.

ARE SUPPLEMENTS WORTHWHILE
Clinical trials are now underway at CU Boulder to determine if prebiotics could have similar effects on humans. The research could lead to customized prebiotic mixtures designed for individuals whose careers or lifestyles expose them to frequent circadian disruption.In the meantime, could simply loading up on legumes and other foods naturally rich in the compounds help keep your body clock running on time? It’s not impossible but unlikely, they say—noting that the rats were fed what, in human terms, would be excessive amounts of prebiotics.

Why not just ingest the beneficial bacteria directly, via probiotic-rich foods like yogurt?

That could also help, but prebiotics may have an advantage over probiotics in that they support the friendly bacteria one already has, rather than introducing a new species that may or may not take hold.

What about prebiotic dietary supplements?

“If you are happy and healthy and in balance, you do not need to go ingest a bunch of stuff with a prebiotic in it,” said Fleshner. “But if you know you are going to come into a challenge, you could take a look at some of the prebiotics that are available. Just realize that they are not customized yet, so it might work for you but it won’t work for your neighbor.”

Original article in Sleep Review Magazine

Why 9-5 Isn't the Only Schedule That Can Work

busy family shift work children
For the millions of Americans who work "nonstandard" shifts - evenings, nights or with rotating days off - the schedule can be especially challenging with children at home.
But a new study from the University of Washington finds that consistent hours, at whatever time of day, can give families flexibility and in some cases, improve children's behaviour.

The study, first made available online in December 2017 before being published in the June issue of the Journal of Family Issues, focuses on two-parent families in which one parent works a nonstandard shift, hours that are common in health care, law enforcement and the service sector. The study finds that the impacts of parent work schedules on children vary by age and gender, and often reflect which shift a parent works. Rotating shifts -- a schedule that varies day by day or week by week -- can be most problematic for children.

"Workers often struggle to carve out the work/life balance they want for themselves, and in dual-earner families, balancing partners' schedules remains an issue for many families," said Christine Leibbrand, a graduate student in the UW department of sociology and author of the study. "Parents are facing these decisions of balancing work and caring for their children."

The Top Reasons You Should Go To Bed

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1. "I don't want to die."

While it sounds dramatic, there's a link between chronic sleep deprivation and an early death, "because the defense system of your body will fail," says Roy Raymann, the vice president of sleep science at SleepScore Labs. "You will die from an infection before dying from fatigue."
Sleep deprivation has also been linked to an increased risk of stroke, diabetes, obesity and high blood pressure. "When we have those individual health consequences, those lead to higher risk of cardiovascular disease, which can lead to an earlier death," Dredla says. Indeed, a 2017 review of research published in Journal of the American Heart Association even found that sleeping less than seven hours a night is linked to an increased risk of heart disease – and that the risk increases the less you sleep.

2. "I don't want to 'lose my marbles' when I get old."

Long-term brain health, too, seems to take a hit when we consistently don't get enough high-quality sleep. A 2017 study in the journal Neurology, for example, found that with each percentage lost of rapid eye movement, or REM, sleep (the deep, dream phase), the risk of dementia increases 9 percent. "During the sleep state, we are able to clear toxins from the brain," says Rebecca Robbins, a postdoctoral fellow at the New York University School of Medicine, where she studies the role sleep plays in memory, cognition, health and longevity. "That removal every night is what plays a role in the ability of the brain to rinse [itself] of toxins and stave off long-term neurocognitive decline."

3. "I'm trying to lose or maintain weight."

If you're on a weight-loss mission, or simply want to maintain your weight, you're probably focusing on your diet and exercise. But your sleep is just as important. One analysis of studies found that people who got five or six hours of sleep a night had 20 percent greater odds of being overweight or 57 percent greater odds of being obese than people who slept seven to eight hours. Sleeping even less than that doubled the risk of obesity. The connection seems to be due to the fact that sleep deprivation disrupts your hunger and satiety hormones, making you want to eat more – and eat more sugary, high-carbohydrate foods, Parthasarathy says. Plus, there's the practical matter of being awake long enough to crave another meal or snack. "Together, it does a number on us," he says.

4. "I've got a tough workout in the morning."

When Christine Binnendyk, a pilates studio owner in Portland, Oregon, feels pressure from friends and family to stay awake, she reminds them – and herself – of her morning duties: “I’m the entertainment at 8 a.m. tomorrow, so I need my beauty sleep tonight," she says. But even if you're the one taking an exercise class, sleeping well the night before makes a big difference in what you get out of it. Not only will you feel fatigued and may even put yourself in danger since you're more prone to slipping on a trail run or weakening your grip on bench press, research shows that poor sleep affects athletic performance by compromising the body's ability to use oxygen efficiently, a measure known as VO2 max. "If we don't have quality or quantity of sleep our body needs, we don't perform well from a sports standpoint the next day," Dredla says.

5. "Work is intense right now."

As Mendelsohn knows, a good night's sleep is necessary for peak cognitive performance – whether you're performing a surgery, writing a report or giving a presentation. "When we're well-rested, we're able to fly through tasks, we're much more productive, much more creative," Robbins says. "When we're sleep-deprived, we're more risk-averse, we're less productive, it takes longer to do a given task." Sufficient sleep is also key after those brain-draining days, since that's when your brain "integrates" what you've learned – so save the celebratory night out for Saturday. "Missing out on sleep after learning prevents all knowledge to be optimally stored for long time use and benefit," Raymann says.

6. "I'm going to be no fun to be around tomorrow if I don't sleep enough tonight."

Whether it's your boss, spouse or best friend urging you to stay up, remind them that they'll have to deal with your snappy mood the next day if you don't give in to the sandman. "Mood is one of the first things to go when we wake up with not enough sleep – we're irritable, anxious, not our full dynamic selves," Robbins says. Part of that has to do with the sleep deprivation's detrimental effect on your ability to take others' perspectives, she adds. "When we're well-rested, we're able to say: Let's step back; let's look at the bigger picture." When you're not, you're more likely to say or do something you – and those around you – regret.

7. "I don't want to hurt anyone."

Sleep deprivation doesn't just make you more likely to hurt others' feelings, it can also quite frankly make you a danger to others. One recent, comprehensive report out of the AAA Foundation for Traffic Safety found that 9.5 percent of all car crashes involved drowsiness. An earlier report from the foundation found sleeping only five or six hours doubles your risk of crashing as compared to logging at least seven hours of shuteye in the previous 24 hours. In some states, drowsy driving is a punishable offense; it can be criminal in New Jersey, for instance. So if you won't go to sleep for your own health; do it for others' safety. "If you don't snooze," Dredla says, "you lose."

From an article in US News by Anna Medaris Miller. Follow her on Twitter or email her at amiller@usnews.com.

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