More than one-third of working men and one-quarter of working women in the
U. S. report being exposed to a variable schedule that includes both day
and night work. Of these, approximately 7.3 million must regularly work
overnight, either on permanent night shifts or rotations between day,
evening, and night shifts, requiring them to forego nocturnal sleep and
attempt to sleep during the day. Despite this nocturnal deprivation of
sleep, these workers typically experience daytime insomnia, leading to
diminished alertness and cognitive performance and increased sleep
tendency during waking hours at night. In fact, 55 percent of night shift
workers report nodding off or falling asleep at work at least once per
week, with more than 30 percent reporting that such incidents occur more
than three times per week. Recent research has demonstrated that properly
timed exposure to bright light and darkness can rapidly reset the human
circadian pacemaker that-controls the timing of the sleep-wake cycle,
enabling the circadian pacemakers of individuals working at night to fully
adapt to their desired schedules within 2-3 days.
On the basis of these results, four testable hypotheses are proposed: (l)
that bright light can rapidly shift the endogenous circadian rhythms of
plasma melatonin secretion of individuals working at night, such that
their circadian timing system remains adapted to their inverted sleep-wake
schedule; (2) that bright light can increase sleep efficiency, and reduce
the number and duration of awakenings during the daytime sleep of
individuals working at night; (3) that bright light can reduce the
frequency of involuntary microsleep episodes and decrease sleep propensity
during scheduled wakefulness at night; and (4) that bright light can
improve the alertness and cognitive performance of individuals working at
night.
An experiment is proposed to evaluate the impact of bright light treatment
on the daytime sleep and nocturnal cognitive performance of individuals
during a combined laboratory- and field-based simulation of a complete, 3-
month shift rotation. Subjects exposed to an appropriate schedule of
bright light while working in the laboratory will be compared to a control
group of subjects without bright light exposure. Sleep, activity, and
light exposure will be monitored with ambulatory recording devices,
circadian phase will be assessed from serum melatonin levels, and
cognitive performance will be evaluated with a computer-administered
battery of tests.
This work has significant implications for shiftworker health and
population safety. Shiftwork is associated with cardiovascular disease,
depression, increased drug use, and digestive disorders. Many
catastrophic accidents (e.g., Exxon Valdez, Bhopal, Three-Mile Island,
Chernobyl) have occurred during the night shift with fatigue identified as
a contributor. An effective countermeasure to the personal and societal
risks of shiftwork could substantially improve public health and safety.
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