Presentaties ISMC - Chronobiology
27 important questions on Presentaties ISMC - Chronobiology
What are the personalized treatment strategies for CRSWD?
- Cognitive Behavioural Therapy for treatment enhancement.
- Light Treatment: 30min, 10,000 lux, timing per PRC.
- Dim Light: 3 hours before bed (DSWPD) or after waking (ASWPD).
- Melatonin: 0.5-1mg, fast release, timing per PRC (~4-5 hours before sleep for DSWPS).
How is saliva collected for Dim Light Melatonin Onset (DLMO)?
- Saliva collection uses Salivette® with a cotton swab.
- Collect samples every hour; every 2 hours for a 24h curve.
- Collect in dim light, just enough to read.
What are the key aspects of using diaries or actigraphy for sleep disorders?
- ASWPD/DSWPD: Advanced/Delayed Sleep-Wake Phase Disorders.
- Non-24H SWD: Non-24-Hour Sleep-Wake Disorder.
- Shift Work Disorder: Sleep disturbance due to work shifts.
- Duration: At least 7 days monitoring, preferably 14-21 days.
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What are the key examples of saliva collection times for DLMO?
- DLMO: Start collection at 18:00, hourly until sleep.
- 24h Curve: Start collection at 16:00, every 2 hours.
- Align collection with time relative to sleep onset.
What is involved in the evaluation of CRSWD diagnosis?
- CRSWD stands for Circadian Rhythm Sleep-Wake Disorders.
- Diagnosis requires comprehensive evaluation.
- This includes sleep diaries, questionnaires, and actigraphy.
- Polysomnography might be used if other sleep disorders are suspected.
What disturbances to the circadian rhythm can lead to health problems?
- Circadian rhythm disturbance affects:
- - Disturbed recovery
- - Disturbed sleep
- - Disturbed hormones
- - Disturbed metabolism
What are the average total sleep times for day, night, and rotating workers?
- Day Workers: 6.8 ± 1.2 hours
- Night Workers: 6.1 ± 1.5 hours
- Rotating Workers: 6.7 ± 1.5 hours
What are some detrimental health effects of circadian rhythm disturbances?
- Health effects include:
- - Sleep disorders
- - Diabetes type II
- - Cardiovascular disease
How does the prevalence of insomnia vary among day, night, and rotating workers?
- Day Workers: 8.6%
- Night Workers: 18.5%
- Rotating Workers: 15.7%
What recommendations are made to address circadian rhythm disturbances?
- Recommendations:
- - Limit nightwork
- - Use powernaps
What are the key characteristics of shift work disorder?
- Insomnia or excessive sleepiness related to work schedules overlapping usual sleep times.
- Symptoms persist with the work schedule for at least one month.
- Supported by a sleep log or actigraphy for at least 7 days.
- Not explained by other sleep disorders, medication, or substance abuse.
What is the "True Prevalence" of SWSD among different worker groups?
- Day Workers: 0%
- Night Workers: 14.1%
- Rotating Workers: 8.1%
What are the short-term consequences of shiftwork?
- Sleepiness at night
- Higher risks at night
- Sleep deficit with night and early shifts
- Mood disturbance
- Gastro-intestinal problems (75% in shiftworkers vs. 25% in dayworkers)
How should treatment be adjusted based on schedule changes?
- Treatment adjustments:
- - Irregular or fast forward: Keep clock entrained to 24h day
- - >2 night shifts and late chronotype: Compromised phase shift
What are some alterations of the circadian timekeeping system?
- DSWPD: Delayed sleep-wake phase disorder
- ASWPD: Advanced sleep-wake phase disorder
- Non-24h: Sleep-wake phase disorder (e.g., blind)
- Irregular: Sleep-wake phase disorder (e.g., dementia)
What are the long-term consequences of shiftwork according to evidence strength?
- Strong evidence: Diabetes, Cardiovascular disorders, Sleep disorders
- Weak evidence: Metabolic syndrome
- Inconsistent proof: Breast cancer
- Too small evidence: Other potential diseases
What is the ESS score range for day, night, and rotating workers?
- Day Workers: 8.0 ± 4.5
- Night Workers: 9.2 ± 5.2
- Rotating Workers: 8.6 ± 4.6
How can sugar and carbohydrate intake at night be managed?
- Recommendations:
- - Limit sugar/carbohydrate intake at night
- - Maintain a 10–12h fasting period per 24h
What are the characteristics of non-24h sleep problems in the visually impaired?
- Recurrent pattern in sleep cycles.
- Daytime light and evening darkness may be beneficial.
- Melatonin or melatonin agonists are treatment options.
- Causes can include low light exposure, autism spectrum disorder, and late chronotype.
What disorders result from misalignment between external and internal signals?
- Shift work disorder
- Jet lag disorder
What is the sleep efficiency percentage across different worker types?
- Day Workers: 91.5 ± 14.4%
- Night Workers: 88.2 ± 28.0%
- Rotating Workers: 90.5 ± 19.0%
What does the graph show about endogenous periods in blind subjects?
- Endogenous Periods: Vary among blind subjects.
- Faster Rhythm: -0.3h/day, 23.7-hour period.
- Slower Rhythm: +0.9h/day, 24.9-hour period.
- Time Frame: Observed over 390 days.
- Clock Hours (MO): Represented on the x-axis.
What treatments are suggested for non-24h sleep disorders?
- Treatment options include melatonin or melatonin agonists.
- Adhering to light exposure: light during the day and darkness in the evening may improve symptoms.
Compare the time in bed for day, night, and rotating workers.
- Day Workers: 7.4 ± 1.1 hours
- Night Workers: 7.3 ± 2.1 hours
- Rotating Workers: 7.6 ± 1.6 hours
What are the percentages for visually impaired individuals with light perception?
- Entrained - normal phase: 69%
- Non-Entrained: 10%
- Entrained - advanced phase: 9%
- Entrained - delayed phase: 11%
What is the prevalence of insomnia or ESS ≥ 10% among the different worker types?
- Day Workers: 18.0%
- Night Workers: 32.1%
- Rotating Workers: 26.1%
What are the percentages for visually impaired individuals with no light perception?
- Entrained - normal phase: 37%
- Non-Entrained: 39%
- Entrained - advanced phase: 17%
- Entrained - delayed phase: 7%
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