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Rotating and permanent night shiftwork schedules typically result in acute and sometimes chronic sleep deprivation plus acute and sometimes chronic disruption of the circadian time structure. Immune system processes and functionalities are organized as circadian rhythms, and they are also strongly influenced by sleep status. Sleep is a vital behavioral state of living beings and a modulator of immune function and responsiveness. Shiftworkers show increased risk for developing viral infections due to possible compromise of both innate and acquired immunity responses. Short sleep and sleep loss, common consequences of shiftwork, are associated with altered integrity of the immune system. We discuss the possible excess risk for COVID-19 infection in the context of the common conditions among shiftworkers, including nurses, doctors, and first responders, among others of high exposure to the contagion, of sleep imbalance and circadian disruption. ACE2: Angiotensin-converting enzyme 2; APC: Antigen.-presenting.cells; CCL: Chemokine (C-C motif) ligand; CD+:.Adhesion molecule expression; COVID-19: 2019 coronavirus disease; DCs: Dendritic cells; GH: Growth hormone; HPA: Hypothalamic-pituitary-adrenal; HSF: Heat shock factor; HSP70: Heat shock protein 70; HSP90: Heat shock protein 90; IL: Interleukin; INFγ: Interferon-gamma; LT/LB: T/B lymphocytes; MHC: Major histocompatibility complex; NK: Natural.killer; RAAS: renin–angiotensin–aldosterone system; SARS:.Severe acute respiratory syndrome; SCN: Suprachiasmatic nucleus;SD: Sleep deprivation; SNS: Sympathetic nervous system; Th1/Th2: T helper lymphocytes 1/2; TLR2/TLR4: Toll-like receptor 2/4; TNF-α: Tumor.necrosis.factor alpha; VEGF: Vascular endothelial growth factor [ABSTRACT FROM AUTHOR]

Introduction: The aim was observe the influence of sleep deprivation (SD) and sleep recovery on muscle regeneration process in rats submitted to cryolesion. Methods: Thirty-two Wistar rats were randomly allocated in four groups: control (CTL), SD for 96 h (SD96), control plus sleep recovery period (CTL + R) and SD96h plus 96 h of sleep recovery (SD96 + R). The animals were submitted to muscle injury by cryolesioning, after to SD and sleep recovery. Results: The major outcomes of this study were the reduction of muscular IGF-1 in both legs (injured and uninjured) and a delay in muscle regeneration process of animals submitted to SD compared to animals that slept, with increase connective tissue, inflammatory infiltrate and minor muscle fibers. Conclusions: SD impairs muscle regeneration in rats, moreover reduces muscular IGF-1 and sleep recovery was able to restore it to basal levels, but it was not enough to normalize the muscle regeneration. [ABSTRACT FROM PUBLISHER]

An individual’s chronotype is a trait which reflects his/her diurnal preferences for the times of rest and activities, and displays a continuum from morningness to eveningness. Studies have shown that eveningness tends to be associated with a less healthy lifestyle, including increased likelihood of developing obesity. In this study, we examined the relationship between chronotype and food intake, physical sleep and activity in 72 resident physicians (52 women and 20 men). Assessments included chronotype evaluation by the Horne and Ostberg Morningness-Eveningness questionnaire (MEQ); food intake pattern through a self-administered food diary that was kept over the course of 3 non-successive days; physical activity level, using the Baecke questionnaire (BQ); sleep quality and quantity using the Pittsburgh Sleep Quality Index (PSQI); and sleepiness, Epworth Sleepiness Scale (ESS). Linear regression analyses, after adjustments for age, sex, body mass index (BMI), hours of additional work per week ESS and total physical activity score, showed that the chronotype score was negatively associated with cholesterol (coefficient = −0.24;p= 0.04), sweets (coefficient = −0.27,p= 0.03) and vegetables (coefficient = −0.26;p= 0.04) intakes. Following the same statistical adjustments, the chronotype score was positivity associated with leisure-time index (coefficient = 0.26,p= 0.03) and BQ total score (coefficient = 0.27,p= 0.03). We concluded that most issues related to nutrition problems and unhealthy lifestyle were associated with scores indicative of eveningness. These findings emphasize the importance of assessing an individual’s chronotype when examining feeding behavior. [ABSTRACT FROM PUBLISHER]

The organizing committee of the 2016 Rio Olympic Games recently announced that some of the preliminary and final competitions will be held at night. The present article discusses the potential harmful effects of these late-night competitions on sleep, circadian rhythms and athletic performance during the Olympic Games. Specifically, night-time competition could lead to injury and may compromise an athlete’s decision-making, attentional, physiological and other processes. Consequently, these impacts could negatively affect the performance of athletes and their teams. Thus, it is suggested that technical commissions take special care when creating strategies to minimize harm to the athletes by considering factors such as light exposure, melatonin intake, sleep hygiene and scheduled naps, and training at local competition time. Furthermore, it is necessary for specialists in chronobiology and sleep to engage with members of the national teams to develop an activity schedule for physical, technical, tactical and psychological preparation that accounts for circadian rhythms, thereby creating the best possible environment for the athletes to achieve their ideal performance. [ABSTRACT FROM AUTHOR]

Shift work and long hours of work are common in medical training and have been associated with a higher propensity for developing nutritional problems and obesity. Changes in leptin and ghrelin concentrations - two hormones that contribute importantly to the central regulation of food intake - are poorly described in this population. The aim of this study was to identify possible negative associations between sleep patterns, nutritional status and serum levels of adipokines. The study included 72 resident physicians (52 women and 20 men) who underwent the following assessments: nutritional assessment (3-day dietary recall evaluated by the Adapted Healthy Eating Index), anthropometric variables, fasting metabolism, physical activity level, sleep quality and sleepiness. Resident physicians with poor sleep quality reported greater weight gain after the beginning of residency (5.1 and 3.0 kg, respectively; p = 0.01) and higher frequency of abnormal waist circumference (44.2 and 17.6%, respectively; p = 0.04) than those with better sleep quality. Mean ghrelin concentration was greater in volunteers with poor sleep quality (64.6 ± 67.8 and 26.2 ± 25.0 pg/mL, respectively; p = 0.04). Women identified as having excessive daytime sleepiness had lower levels of leptin (9.5710.4 ng/mL versus 16.4911.4 ng/mL, respectively; p = 0.03) than those without excessive sleepiness. Furthermore, correlations were found between hours of additional work per week and: intake of cereals, bread and pasta ( r = 0.22, p = 0.01); intake of servings of fruits ( r = −0.20; p = 0.02) and beans ( r = −0.21; p = 0.01); and global score for Adapted Healthy Eating Index ( r = −0.23; p = 0.008; Table 3). The sleep quality total score correlated with servings of beans ( r = −0.22; p = 0.01) and servings of oils ( r = 0.23; p = 0.008). Significant correlations were found between mean of time of sleep and servings of cereals, bread and pasta ( r = 0.20; p = 0.02), servings of meat ( r = −0.29; p = 0.02) and cholesterol levels ( r = 0.27; p = 0.03). These observations indicate that sleep patterns and long working hours of resident physicians are negatively associated with biological markers related to central food control, the lipid profile, cholesterol levels and eating healthy foods. These factors may predispose these shift workers to become overweight and develop metabolic disorders. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine whether aerobic plus resistance training (AT + RT) is more effective than aerobic training (AT) at reducing inflammatory markers and cardiovascular risk in obese adolescents. A total of 139 obese adolescents were enrolled, aged 15–19 years, body mass index (BMI) ≥ 95th percentile and participated in 1 year of interdisciplinary intervention. They were randomised into two groups: AT (n = 55), AT + RT (n = 61). Blood samples were collected to analyse glycaemia, insulin, the lipid profile, leptin and adiponectin concentrations. Insulin resistance was measured by homeostasis model assessment of insulin resistance index (HOMA-IR). The AT + RT group showed better results with regard to decreased body fat mass, low-density lipoprotein concentration (LDL-c) levels, subcutaneous and visceral fat and increased body lean mass. Indeed, a reduction of hyperleptinaemia and an increase in adiponectin concentrations, promoting an improvement in the leptin/adiponectin ratio, was observed. Important clinical parameters were improved in both types of exercise; however, AT + RT was more effective in improving the visceral adiposity, metabolic profile and inflammatory markers than AT alone, suggesting clinical applications for the control of intra-abdominal obesity and cardiovascular risk in the paediatric population. [ABSTRACT FROM AUTHOR]

Shiftwork is common in medical training and is necessary for 24-h hospital coverage. Shiftwork poses difficulties not only because of the loss of actual sleep hours but also because it can affect other factors related to lifestyle, such as food intake, physical activity level, and, therefore, metabolic patterns. However, few studies have investigated the nutritional and metabolic profiles of medical personnel receiving training who are participating in shiftwork. The aim of the present study was to identify the possible negative effects of food intake, anthropometric variables, and metabolic and sleep patterns of resident physicians and establish the differences between genders. The study included 72 resident physicians (52 women and 20 men) who underwent the following assessments: nutritional assessment (3-day dietary recall evaluated by the Adapted Healthy Eating Index), anthropometric variables (height, weight, body mass index, and waist circumference), fasting metabolism (lipids, cortisol, high-sensitivity C-reactive protein [hs-CRP], glucose, and insulin), physical activity level (Baecke questionnaire), sleep quality (Pittsburgh Sleep Quality Index; PSQI), and sleepiness (Epworth Sleepiness Scale; ESS). We observed a high frequency of residents who were overweight or obese (65% for men and 21% for women; p = 0.004). Men displayed significantly greater body mass index (BMI) values ( p = 0.002) and self-reported weight gain after the beginning of residency ( p = 0.008) than women. Poor diet was observed for both genders, including the low intake of vegetables and fruits and the high intake of sweets, saturated fat, cholesterol, and caffeine. The PSQI global scores indicated significant differences between genders (5.9 vs. 7.5 for women and men, respectively; p = 0.01). Women had significantly higher mean high-density lipoprotein cholesterol (HDL-C; p < 0.005), hs-CRP ( p = 0.04), and cortisol ( p = 0.009) values than men. The elevated prevalence of hypertriglyceridemia and abnormal values of low-density lipoprotein cholesterol (LDL-C; >100 mg/dL) were observed in most individuals. Higher than recommended hs-CRP levels were observed in 66% of the examined resident physicians. Based on current recommendations, a high prevalence of low sleep quality and excessive daytime sleepiness was identified. These observations indicate the need to monitor health status and develop actions to reassess the workload of medical residency and the need for permission to perform extra night shifts for medical residents to avoid worsening health problems in these individuals. [ABSTRACT FROM AUTHOR]

Shiftwork is often associated with metabolic diseases, and in the past few years, several cytokines have been postulated to contribute to various diseases, including insulin resistance. The aim of this study was to compare the concentrations of adiponectin, tumor necrosis factor-α (TNF-α), and interleukin-6 (IL-6) in samples of young adult men exposed to a fixed (i) night shift (n = 9), working from 22:00 to 06:00 h; (ii) early morning shift (n = 6), working from 06:00 to 14:00 h; and (iii) day shift (n = 7), working from 08:00 to 17:00 h. The fixed night-shift and early-morning-shift samples were considered collectively as a shiftworker group given their work times. Blood samples were collected during the regular working day at 4-h intervals over the course of 24 h, thus totaling six samples. Morphological and physical activity parameters did not differ between the three groups. Total energy intake was lowest on the early morning shifts ( p < .03). Both shiftworker groups ingested a significantly higher percentage of fat ( p < .003) and a lower percentage of carbohydrate ( p < .0005) than the day group. The early morning group had a lower mean 24-h level of adiponectin than the other two groups ( p = .016), and both the early morning and night groups exhibited higher mean 24-h levels of TNF-α than the day group ( p = .0001). The 24-h mean levels of IL-6 did not differ significantly between the groups ( p = .147). None of the groups exhibited a significant circadian effect on adiponectin ( p = .829), TNF-α ( p = .779), or IL-6 ( p = .979) levels. These results indicate that individuals who are enrolled in shiftwork are susceptible to alterations in the secretion of cytokines that are involved in insulin resistance and cardiovascular disease, both of which are known to affect this population. (Author correspondence: ) [ABSTRACT FROM AUTHOR]

Shiftwork has been associated with a higher propensity for the development of metabolic disorders and obesity. The aim of the study was to investigate concentrations of glucose, cortisol, and insulin among fixed night workers (n = 9), fixed early morning workers (n = 6), and day workers (n = 7). Food intake was recorded for 7 days using a diary. Blood samples were collected every 4 h over the course of 24 h, yielding six samples. Total carbohydrate intake was lowest ( p < .0005), whereas fat ( p = .03) and protein ( p < .0005) were highest on the early morning shifts. Early morning workers also had overall elevated cortisol levels relative to the other two groups. Cortisol levels appeared to be more influenced by time since waking prior to the shift than by time-of-day. Cortisol was highest for the early morning group than the day group 12 h after waking, and both the early morning and night groups had higher levels than the day group 16 h after waking ( p < .05 in all cases). In contrast, the homesostatsis model assessment of insulin resistance (HOMA-IR) appeared to be more influenced by time-of-day than by time since waking prior to the shift. The early morning group had higher levels of HOMA-IR at 08:00 h than the other groups ( p < .05). In conclusion, the early morning group had the highest overall concentrations of cortisol and tended to have higher levels of HOMA-IR, indicating that more attention should be given to these workers. Moreover, all three groups showed pronounced cortisol levels on awakening, suggesting that they may have adjusted to their awaking time. (Author: ) [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine whether aerobic plus resistance training (AT + RT) is more effective than aerobic training (AT) at reducing inflammatory markers and cardiovascular risk in obese adolescents. A total of 139 obese adolescents were enrolled, aged 15–19 years, body mass index (BMI) ≥ 95th percentile and participated in 1 year of interdisciplinary intervention. They were randomised into two groups: AT (n = 55), AT + RT (n = 61). Blood samples were collected to analyse glycaemia, insulin, the lipid profile, leptin and adiponectin concentrations. Insulin resistance was measured by homeostasis model assessment of insulin resistance index (HOMA-IR). The AT + RT group showed better results with regard to decreased body fat mass, low-density lipoprotein concentration (LDL-c) levels, subcutaneous and visceral fat and increased body lean mass. Indeed, a reduction of hyperleptinaemia and an increase in adiponectin concentrations, promoting an improvement in the leptin/adiponectin ratio, was observed. Important clinical parameters were improved in both types of exercise; however, AT + RT was more effective in improving the visceral adiposity, metabolic profile and inflammatory markers than AT alone, suggesting clinical applications for the control of intra-abdominal obesity and cardiovascular risk in the paediatric population. [ABSTRACT FROM AUTHOR]

The literature widely recognizes that shift workers have more health complaints than the general population. The objective of this study was to describe the prevalence of sleep complaints and verify the polysomnographic (PSG) variables of shift workers in two Brazilian nuclear power plants. We carried out a subjective evaluation with a sleep questionnaire. Based on these results, the interviewees that reported sleep-related complaints were referred for polysomnographic evaluation. Of the 327 volunteers initially evaluated by the sleep questionnaire, 113 (35%) reported sleep complaints; they were significantly older, had higher body mass index (BMI), and worked more years on shifts than those without sleep complaints. Of these 113, 90 met criteria for various sleep disorders: 30 (9%) showed obstructive sleep apnea (OSA), 18 (5.5%) showed limb movement, and 42 (13%) evidenced both sleep problems and had a significantly higher proportion of sleep stage 1 and arousals compared with the 23 shift workers that had no indices of sleep problems. The present study found that 90 (27.5%) of the evaluated participants met the PSG criteria of some type of clinical sleep disorder. This high proportion should be investigated for associations with other aspects of work, such as working hours, working schedule, years performing shift work, and access to health services. Due to the strong association between sleep disorders and the incidence of fatigue and sleepiness, the evaluation of the sleep patterns and complaints of shift workers is essential and should be considered to be one of the basic strategies of industry to prevent accidents. [ABSTRACT FROM AUTHOR]

Truck drivers are more likely to suffer severe injury and death due to certain truck driving characteristics. Identifying and preventing factors associated with accidents in this population is important to minimize damage and improve road safety. Excessive daytime sleepiness is a major public health problem, leading to impaired cognitive function, reduced alertness, and increased risk of motor vehicle crashes. The aim of this cross‐sectional study was to determine the prevalence and predictors of hypersomnolence (defined as an Epworth Sleepiness Scale score greater than 10) among truck drivers. Three hundred male truck drivers were studied. Quality of sleep was assessed by the Pittsburgh Sleep Quality Index, and the association between demographic, clinical, and occupational data with excessive sleepiness was analyzed. The mean daily sleep duration was 5.6±1.3 h, and poor quality of sleep was found in 46.3% of the individuals. Hypersomnolence was found in 46% of the drivers and was associated with younger age, snoring, and working >10 h without rest. A positive correlation between hypersomnolence and previous accidents was detected (p=0.005). These results show that sleep deprivation and hypersomnolence are frequent among truck drivers. The treatment of sleep‐disordered breathing and the implementation of educational programs, particularly targeting younger drivers and promoting increased awareness of the deleterious effects of sleep loss and work overload, may help to reduce hypersomnolence and accidents among truck drivers. [ABSTRACT FROM AUTHOR]