Scheduled evening sleep and enhanced lighting improve adaptation to night shift work in older adults

Aug 28, 2016Occupational and environmental medicine

Evening sleep timing and brighter light help older adults adjust to night shift work

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Abstract

Circadian-based treatment increased sleep duration to 6-7 hours in older adults during night shifts.

Alertness and sustained attention decreased on the first night shift for both treatment and control groups.
The treatment group showed improvements in alertness and attention by the second and third night shifts, unlike the control group.
Circadian timing advanced by 169.3±16.1 minutes in the treatment group, while the control group did not experience a shift.
Sleep duration remained stable at 6-7 hours for the treatment group after night shifts, contrasting with the control group's shorter duration of 3-5 hours.

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OBJECTIVES: We tested whether a sleep and circadian-based treatment shown to improve circadian adaptation to night shifts and attenuate negative effects on alertness, performance and sleep in young adults would also be effective in older adults.

METHODS: We assessed subjective alertness, sustained attention (psychomotor vigilance task, PVT), sleep duration (actigraphy) and circadian timing (salivary dim-light melatonin onset, DLMO) in 18 older adults (57.2±3.8 years; mean±SD) in a simulated shift work protocol. 4 day shifts were followed by 3 night shifts in the laboratory. Participants slept at home and were randomised to either the treatment group (scheduled evening sleep and enhanced lighting during the latter half of night shifts) or control group (ad-lib sleep and typical lighting during night shifts).

RESULTS: Compared with day shifts, alertness and sustained attention declined on the first night shift in both groups, and was worse in the latter half of the night shifts. Alertness and attention improved on nights 2 and 3 for the treatment group but remained lower for the control group. Sleep duration in the treatment group remained similar to baseline (6-7 hours) following night shifts, but was shorter (3-5 hours) following night shifts in the control group. Treatment group circadian timing advanced by 169.3±16.1 min (mean±SEM) but did not shift (-9.7±9.9 min) in the control group.

CONCLUSIONS: The combined treatment of scheduled evening sleep and enhanced lighting increased sleep duration and partially aligned circadian phase with sleep and work timing, resulting in improved night shift alertness and performance.

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Scheduled evening sleep and enhanced lighting improve adaptation to night shift work in older adults

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