Cheng, Philip

Fischer, Dorothee

Johnson, Dayna A

McHill, Andrew W

English

Henry Ford Health System Scholarly Commons

Henry Ford Health Henry Ford Health Scholarly Commons Sleep Medicine Articles Sleep Medicine 8-22-2023 Editorial: Influence of sleep and recurrent circadian disruption on cardiometabolic health, wellbeing, and safety: from shiftwork to Monday mornings Philip Cheng Dorothee Fischer Dayna A. Johnson Andrew W. McHill Follow this and additional works at: https://scholarlycommons.henryford.com/sleepmedicine_articles Editorial: Influence of sleep andrecurrent circadian disruption oncardiometabolic health,wellbeing, and safety: fromshiftwork to Monday morningsPhilip Cheng1†, Dorothee Fischer2†, Dayna A. Johnson3†and Andrew W. McHill4,5*†1Thomas Roth Sleep Disorders & Research Center, Henry Ford Health + Michigan State UniversityHealth Sciences, Detroit, MI, United States, 2Department of Sleep and Human Factors Research,Institute for Aerospace Medicine, German Aerospace Center, Cologne, Germany, 3Department ofEpidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States, 4Sleep,Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University,Portland, OR, United States, 5Oregon Institute of Occupational Health Sciences, Oregon Health &Science University, Portland, OR, United StatesKEYWORDScircadian rhythm, circadian misalignment, jet lag, sleep disruption, sleep restrictionEditorial on the Research TopicInfluence of sleep and recurrent circadian disruption oncardiometabolic health, wellbeing, and safety: from shiftwork toMonday morningsThe modern 24-hour society is contributing to insufficient sleep and a misalignmentbetween behaviors and internal physiology, which have negative health consequences (1).A growing literature points to increased activity during the biological night (e.g.,technology use and work hours) that disrupts sleep and circadian rhythms (2, 3).Despite strong evidence for the connection between recurrent sleep and circadiandisruption and poor health, exact mechanisms driving these impairments remainunclear. Therefore, this Research Topic sought to highlight research on the mechanismsby which recurrent sleep and circadian disruption impair health and wellbeing.In this editorial, we briefly summarize the publications within the Research Topic,which span the life course and provide insight regarding sleep/circadian disruptionand health.Cardiovascular disease (CVD) is the leading cause of on-duty death among USfirefighters, with work hours that are characteristically long and that extend intonighttime hours (i.e., biological night). Current evidence suggests that dimensions ofsleep (e.g., sleep quality and quantity), may reduce the risk of CVD death. Romero Cabreraet al. assessed whether sleep quality and quantity were associated with cardiometabolic riskamong firefighters. They found that poor quality sleep and insufficient sleep (i.e., shortsleep) increased cardiometabolic risk and a higher prevalence of hypertension and obesity.Short-sleep, however, may not be the only factor resulting in poor health outcomes,particularly given the U-shaped relationship between sleep duration and health. Li et al. soughtFrontiers in Endocrinology frontiersin.org01OPEN ACCESSEDITED AND REVIEWED BYHubert Vaudry,Université de Rouen, France*CORRESPONDENCEAndrew W. McHillmchill@ohsu.edu†These authors have contributed equally tothis workRECEIVED 28 July 2023ACCEPTED 11 August 2023PUBLISHED 22 August 2023CITATIONCheng P, Fischer D, Johnson DA andMcHill AW (2023) Editorial: Influenceof sleep and recurrent circadiandisruption on cardiometabolic health,wellbeing, and safety: from shiftworkto Monday mornings.Front. Endocrinol. 14:1268940.doi: 10.3389/fendo.2023.1268940COPYRIGHT© 2023 Cheng, Fischer, Johnson and McHill.This is an open-access article distributedunder the terms of the Creative CommonsAttribution License (CC BY). The use,distribution or reproduction in otherforums is permitted, provided the originalauthor(s) and the copyright owner(s) arecredited and that the original publication inthis journal is cited, in accordance withaccepted academic practice. No use,distribution or reproduction is permittedwhich does not comply with these terms.TYPE EditorialPUBLISHED 22 August 2023DOI 10.3389/fendo.2023.1268940to examine if the U-shaped relationship is found in a meta-analysis ofstudies in populations of middle-aged and older adults. Incidence ofdepression was related to sleep duration in a U-shaped dose–responsemanner, with both shorter and longer sleeping durations conferringincreased risk of depression compared to 7 hours of sleep. The findingsfrom both studies reinforce the importance of sleep duration as a riskfactor for health and depression.Insufficient sleep duration is a hallmark problem in night shiftworkers. Over 20% of the US workforce work shift work hours,including sleep and circadian disrupting shifts (4). Chronic sleeprestriction and recurrent circadian disruption (e.g., rotating shiftwork) can increase an individual’s risk of cardiovascular (5) andkidney disease (6), though mechanisms remain unclear. McMullanet al. utilized a 32-day in-laboratory protocol in which all behaviors(e.g., eating, activity, and sleep) were equally spread across allcircadian phases, thereby desynchronizing the influence of sleepand circadian phase on physiological outcomes (i.e., “forceddesynchrony”). Additionally, half of the participants wererandomized to a sleep restriction condition, thereby allowing theexamination of sleep restriction vs circadian disruption oncardiovascular and renal outcomes. They find that sleeprestriction increases blood pressure and that renal outcomes differdepending on circadian timing versus behavioral influences; theseresults may provide mechanistic insights into contributing factorsof CVD and renal impairments observed in shift work.In addition to increased risk of CVD, shift workers also exhibitincreased risk for poor glucose tolerance (7). While prior studiesindicate that sleep restriction decreases insulin sensitivity and glucosetolerance, precise mechanisms are unclear as sleep restriction is oftenaccompanied with circadian disruption. Using a forced desynchronyprotocol, Yuan et al. aimed to experimentally dissociate sleep restrictionfrom circadian disruption and examine its contribution to glucosetolerance in healthy adults. They found that minimizing circadiandisruption during sleep restriction may mitigate adverse outcomes inglucose tolerance, perhaps due to the preservation of slow wave sleepwhen circadian disruption was minimized. These findings furtheremphasize the importance of circadian rhythms to health.Authors within this Research Topic also explored how sleep andcircadian processes interact with hormone levels. Upon awakening,humans excrete a bolus of cortisol (8), referred to as the cortisolawakening response (CAR). Concurrently, cortisol also follows arobust circadian rhythm, peaking in the early morning hours (9).However, how the CAR is influenced by circadian timing isunknown. Using two forced desynchrony protocols, Bowles et al.measured the CAR as participants were awakened at differingcircadian times. They report that the CAR follows a circadianrhythm, peaking in the morning and a nadir in the afternoon.These findings have implications for shift workers that awaken atdiffering circadian phases and for individuals that use cortisol as adiagnostic tool and thus need to consider circadian timing. Molzofet al. examined 24-hour rhythms in insulin and leptin levels amongday and nightshift nurses. The authors found that nightshift nurses,compared to dayshift, had higher insulin and leptin levels across the24-hour day. Moreover, nurses who consumed most of theircalories during the nighttime on workdays exhibited higher 24-hour insulin and leptin levels compared to nurses whopredominantly ate during the daytime. These findings suggestshiftwork and/or eating at night may increase risk for elevatedinsulin and leptin levels. Thus, eating during the daytime onworkdays may reduce the negative effects of shiftwork onmetabolism, but this should be further studied in a larger sample.Last, previous studies have found that children’s body mass index(BMI) increases in the summer, but Moreno et al. sought to determinewhether this increase is mediated by seasonal changes in height orweight. They found evidence of seasonality in children’s height but notweight gain; children gained height at a slightly faster rate during theschool year compared to the summer, but the rate of weight gain didnot differ across seasons. Comparing different BMI trajectoriesthroughout elementary school, the authors suggest that seasonality inheight may be associated with developing/maintaining a healthy weightstatus and that children who are at greatest risk of developing anunhealthy weight status would likely benefit from obesity preventioninterventions during both the school year and summer.The current Research Topic spans across a wide-range ofprofessions, includes in-laboratory and fieldwork protocols, andidentifies several important physiological outcomes that are alldirectly impacted by sleep and circadian disruption. These studieshighlight how common events and behaviors, such as shift work,influence health and wellbeing. We believe that these importantcontributions to the field will inform intervention strategiesincluding policy changes, behavioral interventions, andpersonalized medicine as the world experiences sleep andcircadian disruption daily.Author contributionsPC: Conceptualization, Writing – original draft, Writing – review& editing. DF: Conceptualization, Writing – original draft, Writing –review & editing. DJ: Conceptualization, Writing – original draft,Writing – review & editing. AM: Conceptualization, Writing –original draft, Writing – review & editing.AcknowledgmentsWe would like to thank all the authors for submitting theirexcellent work to this Research Topic.Conflict of interestAuthor AM reports consulting fees for the company PureSomni Corporation.The remaining authors declare that the research was conductedin the absence of any commercial or financial relationships thatcould be construed as a potential conflict of interest.The authors declared that they were an editorial board memberof Frontiers, at the time of submission. This had no impact on thepeer review process and the final decision.Cheng et al. 10.3389/fendo.2023.1268940Frontiers in Endocrinology frontiersin.org02Publisher's noteAll claims expressed in this article are solely those of the authorsand do not necessarily represent those of their affiliatedorganizations, or those of the publisher, the editors and thereviewers. Any product that may be evaluated in this article, orclaim that may be made by its manufacturer, is not guaranteed orendorsed by the publisher.References1. Chaput J, McHill AW, Cox RC, Broussard JL, Dutil C, da Costa BGG, et al. Therole of insufficient sleep and circadian misalignment in obesity. Nat Rev Endocrinol(2023) 19:82–97. doi: 10.1038/s41574-022-00747-72. Fuller C, Lehman E, Hicks S, Novick MB. Bedtime use of technology and associatedsleep problems in children.Glob Pediatr Health (2017) 4:2333794x17736972. doi: 10.1177/2333794x177369723. James SM, Honn KA, Gaddameedhi S, Van Dongen HPA. Shift work: disruptedcircadian rhythms and sleep-implications for health and well-being. Curr Sleep MedRep (2017) 3:104–12. doi: 10.1007/s40675-017-0071-64. McMenamin TM. Time to work: recent trends in shift work and flexibleschedules, A. Monthly Lab.Rev. (2007) 130:3.5. Vetter C, Devore EE, Wegrzyn LR, Massa J, Speizer FE, Kawachi I, et al.Association between rotating night shift work and risk of coronary heartd i s e a s e among women . JAMA ( 2016 ) 315 : 1726–34 . do i : 10 . 1001 /jama.2016.44546. McMullan CJ, Curhan GC, Forman JP. Association of short sleep duration andrapid decline in renal function. Kidney Int (2016) 89:1324–30. doi: 10.1016/j.kint.2015.12.0487. Kroenke CH, Spiegelman D, Manson J, Schernhammer ES, Colditz GA, KawachiI, et al. Work characteristics and incidence of type 2 diabetes in women. Am J Epidemiol(2007) 165:175–83. doi: 10.1093/aje/kwj3558. Pruessner JC, Wolf OT, Hellhammer DH, Buske-Kirschbaum A, von Auer K, JobstS, et al. Free cortisol levels after awakening: a reliable biological marker for the assessmentof adrenocortical activity. Life Sci (1997) 61:2539–49. doi: 10.1016/s0024-3205(97)01008-49. Czeisler CA, Klerman EB. Circadian and sleep-dependent regulation of hormonerelease in humans. Recent Prog Horm Res (1999) 54:97–130; discussion 130-132.Cheng et al. 10.3389/fendo.2023.1268940Frontiers in Endocrinology frontiersin.org03

Editorial: Influence of sleep and recurrent circadian disruption on cardiometabolic health, wellbeing, and safety: from shiftwork to Monday mornings

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Editorial: Influence of sleep and recurrent circadian disruption on cardiometabolic health, wellbeing, and safety: from shiftwork to Monday mornings

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