scholarly journals The Effect of Massage on the Cardiac Autonomic Nervous System and Markers of Inflammation in Night Shift Workers: a Pilot Randomized Crossover Trial

2020 ◽  
pp. 6-17
Author(s):  
Mir Sohail Fazeli, MD, PhD ◽  
Mir-Masoud Pourrahmat, BSc ◽  
Golshan Massah, MD ◽  
Kelsey Lee, BSc ◽  
Pascal M. Lavoie, MD, PhD ◽  
...  
Keyword(s):  
Blood Pressure ◽  
High Frequency ◽  
Inflammatory Markers ◽  
Primary Outcome ◽  
Night Shift ◽  
Medical Residents ◽  
Markers Of Inflammation ◽  
Significant Difference ◽  
Massage Intervention ◽  
Night Shifts

Background: Shift work is a necessary part of many industries; however, it can have detrimental effects on health over time. Purpose: This study investigated the effect of a massage intervention on the cardiac autonomic activity and blood inflammatory markers of healthy medical residents working night shifts. Setting: This trial was conducted at British Columbia Children’s and Women’s Hospital between February 2014 and June 2016. Participants: Included participants were generally healthy medical residents and were working rotating night shifts on a regular basis. Research Design: This was a randomized, controlled, crossover, open-label trial (NCT02247089). Interventions: Participants received either a 30-min massage intervention or reading control after consecutive periods of night shift. Main Outcome Measures: The primary outcome was high frequency, a proxy for the cardiac parasympathetic activity, measured via heart rate variability. Secondary outcomes included other heart rate variability measures, blood markers of inflammation, and blood pressure. Results: Twelve participants were recruited (nine female) with median age of 28 years. There was no significant difference between the massage intervention and the reading control for the primary outcome, (median relative change between pre- and postmassage [interquartile range]: 62% [-1 to 150], pre- and postreading: 14% [-10 to 51], p = .16). Similarly, there was no difference with respect to blood inflammatory markers and blood pressure. Median high frequency significantly increased between pre- and postmassage (185 vs. 358 ms2, p = .04). Conclusion: This pilot study found no statistically significant difference between the massage intervention and the reading control; however, we did observe a significant increase in median high frequency from before massage to after massage, indicative of increased parasympathetic activity. This study may help inform planning of larger trials evaluating massage interventions on the activity of the autonomic nervous system and managing shift work stress.

Abstract TMP56: Prediction of Primary Stroke: A Secondary Analysis of the SPRINT Trial

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Adam H de Havenon ◽  
Eric Goldstein ◽  
Stephanie Lyden ◽  
Jennifer Majersik
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Blood Pressure Control ◽  
Primary Outcome ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Blood Pressure Reduction ◽  
Pressure Control ◽  
Significant Difference ◽  
History Of

Background: The Systolic Blood Pressure Intervention Trial enrolled patients aged 50 or older with at least one cardiovascular disease risk factor, but free of prior symptomatic stroke. Patients were assigned to two blood pressure reduction goals (<140 versus 120 mm Hg). There was not a significant difference in the rate of stroke, making this an ideal cohort to refine risk prediction of primary stroke, which is understudied in patients with adequate blood pressure control and a rigorously adjudicated outcome of stroke. Methods: The primary outcome is ischemic stroke. We fit Cox models to the primary outcome and evaluated all baseline demographic variables to determine which would be most predictive of stroke, which we then used to create a prediction score. Results: We included 9,361 patients with a mean (SD) age of 67.9 (9.4) years and 171 (1.8%) patients met the primary outcome of stroke. For our prediction model, we gave one point each for history of TIA, atrial fibrillation, congestive heart failure, or diabetes. Patients with 2 or more points were collapsed, making three possible scores of 0, 1, and 2, which had rates of stroke of 1.5% (117/8042), 3.2% (30/933), and 6.2% (24/386) (p<0.001). Compared to a score of 0, the hazard ratios for stroke of score 1 and 2 were 2.3 (95% CI, 1.6-3.5) and 4.6 (95% CI, 2.9-7.1) (both p<0.001) (Figure 1). Conclusion: A simple scoring system can improve prediction of ischemic stroke from 1.8% to 6.2% in patients with no prior history of stroke and excellent blood pressure control. This information could be used to improve patient selection for clinical trials or for identifying patients for more aggressive primary prevention strategies.

61. Can Melatonin Improve Adaptation To Night Shift? A Pilot Study Using an Urban EMS System

1996 ◽  
Vol 11 (S2) ◽  
pp. S34-S34
Author(s):  
Michael Tremea ◽  
Mark James ◽  
Jeffrey Jones ◽  
Jon Krohmer
Keyword(s):  
Job Performance ◽  
Night Shift ◽  
Biological Clock ◽  
Consecutive Night ◽  
Sleep Diaries ◽  
Visual Analog Scales ◽  
Significant Difference ◽  
Clinical Benefits ◽  
Double Blinded ◽  
Night Shifts

Purpose: To determine whether melatonin (N-acetyl-5-methoxytryptamine) is effective in helping prehospital personnel working consecutive night shifts reset their biological clock and minimize circadian rhythm disruption.Methods: A double-blinded, randomized, cross-over study was performed using 12 paramedic volunteers. Paramedics were working a span of consecutive night (2300-0700) shifts and received either a melatonin capsule (6 mg) or placebo to be taken prior to each of the consecutive day sleeps. Each participants completed a total of four spans of consecutive night shifts (2-melatonin, 2-placebo). Collected data included daily sleep diaries, quantification of alcohol/caffeine consumed, and possible drug side-effects. Assessment of job performance, mood and alertness were measured every day using 10-cm visual analog scales (VAS).Results: Analysis of sleep diaries demonstrated no significant difference (p >0.05) between the two treatments in respect to mean sleep latency (melatonin = 15.4 min. vs. placebo = 14.6 min), mean sleep duration (melatonin = 6.7 hrs. vs. placebo = 6.9 hrs), or subjectively rated sleep quality (melatonin = 5.8 VAS vs placebo = 5.6 VAS). Similarly, no significant benefits were noted between the mean VAS scores for daily job performance, mood and alertness. Adverse effects were rare, one patient taking melatonin reported a prolonged sedative effect.Conclusion: Despite widespread belief in the benefits of melatonin as a hypnotic agent, no clinical benefits were noted in terms of daytime sleep or job performance in paramedics working consecutive night shifts.

Abstract 14384: Light Therapy Improves Circadian Blood Pressure Control and Glucose Homeostasis in Rotating Night Shift Workers via Mechanisms Independent of Melatonin

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Juliane Hannemann ◽  
Anika Laing ◽  
Benita Middleton ◽  
Jonathan Cridland ◽  
Bart Staels ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Circadian Rhythms ◽  
Glucose Tolerance ◽  
Shift Work ◽  
Therapy Group ◽  
Night Shift ◽  
Light Therapy ◽  
Pressure Control ◽  
Shift Workers ◽  
Night Shifts

Introduction: Night shift work is associated with high rates of hypertension, heart disease, and metabolic syndrome. These cardiometabolic diseases have been linked to the disruption of circadian rhythms in night shift workers. Rotating night shift work is increasingly common in the working population worldwide. Hypothesis: We hypothesized that light therapy might help to normalize disrupted circadian rhythms and stabilize diurnal control of blood pressure and glucose tolerance in rotating night shift workers. Methods: We randomized 24 rotating night shift workers (mean age, 36±13 years, 7 males) who had spent a median of 6 years on rotating night shifts with a median of 6 night shifts/month to 12 weeks of light therapy (light during first half of each night shift and in the morning of off-work days) or no intervention and compared them with 12 daytime workers (37±11 years, 6 males). We measured oral glucose tolerance (OGTT), 24h blood pressure and arterial stiffness, and the circadian profiles of melatonin, cortisol, metanephrine and normetanephrine at baseline, after 12 weeks of intervention, and 12 weeks after the end of intervention. Results: At baseline, fewer night shift workers showed dipper status of blood pressure as compared to daytime workers (21% vs. 55%; p<0.001). After 12 weeks of light therapy, there was a highly significant increase in the proportion of dippers (to 42%; p<0.0001). We also observed a significant decrease in serum glucose during OGTT in the light therapy group (-22%; p<0.05), with no change in serum insulin. Whilst circadian profiles of melatonin and cortisol were unchanged, there was a significant reduction in nighttime plasma metanephrine and normetanephrine levels in the light therapy group (p<0.01). Conclusions: Chronotherapeutic light therapy significantly improves diurnal blood pressure control and glucose tolerance in rotating night shift workers. This effect is unrelated to mechanisms traditionally linked to the circadian clock like melatonin and cortisol, but it is paralleled by reduced catecholamine levels. Our data suggest that chronotherapeutic light therapy may improve the adjustment to atypical working hours in rotating night shift workers, thereby reducing stress and improving cardiometabolic function.

scholarly journals Napping on the night shift and its impact on blood pressure and heart rate variability among emergency medical services workers: study protocol for a randomized crossover trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
P. Daniel Patterson ◽  
Leonard S. Weiss ◽  
Matthew D. Weaver ◽  
David D. Salcido ◽  
Samantha E. Opitz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Emergency Medical Services ◽  
Shift Work ◽  
Crossover Trial ◽  
Night Shift ◽  
Shift Workers ◽  
Randomized Crossover Trial ◽  
Night Shifts

Abstract Background There is an emerging body of evidence that links exposure to shift work to cardiovascular disease (CVD). The risk of coronary events, such as myocardial infarction, is greater among night shift workers compared to day workers. There is reason to believe that repeated exposure to shift work, especially night shift work, creates alterations in normal circadian patterns of blood pressure (BP) and heart rate variability (HRV) and that these alterations contribute to increased risk of CVD. Recent data suggest that allowing shift workers to nap during night shifts may help to normalize BP and HRV patterns and, over time, reduce the risk of CVD. The risk of CVD related to shift work is elevated for emergency medical services (EMS) shift workers due in part to long-duration shifts, frequent use of night shifts, and a high prevalence of multiple jobs. Methods We will use a randomized crossover trial study design with three study conditions. The targeted population is comprised of EMS clinician shift workers, and our goal enrollment is 35 total participants with an estimated 10 of the 35 enrolled not completing the study protocol or classified as lost to attrition. All three conditions will involve continuous monitoring over 72 h and will begin with a 36-h at-home period, followed by 24 total hours in the lab (including a 12-h simulated night shift), ending with 12 h at home. The key difference between the three conditions is the intra-shift nap. Condition 1 will involve a simulated 12-h night shift with total sleep deprivation. Condition 2 will involve a simulated 12-h night shift and a 30-min nap opportunity. Condition 3 will involve a simulated 12-h night shift with a 2-h nap opportunity. Our primary outcomes of interest include blunted BP dipping and reduced HRV as measured by the standard deviation of the inter-beat intervals of normal sinus beats. Non-dipping status will be defined as sleep hours BP dip of less than 10%. Discussion Our study will address two indicators of cardiovascular health and determine if shorter or longer duration naps during night shifts have a clinically meaningful impact. Trial registration ClinicalTrials.gov NCT04469803. Registered on 9 July 2020

scholarly journals Occupational Fatigue Based on Work Shift Among Medical Workers at Harjono S Hospital

2019 ◽  
Vol 10 (3) ◽  
pp. 199-206
Author(s):  
Dian Afif Arifah ◽  
Yuli Dwi Andarini ◽  
Rindang Dianita
Keyword(s):  
Night Shift ◽  
Sampling Technique ◽  
Simple Random Sampling ◽  
Sleep Cycle ◽  
Shift Workers ◽  
Work Shift ◽  
Fatigue Score ◽  
Significant Difference ◽  
Occupational Fatigue ◽  
Night Shifts

Working at day (morning and afternoon shift) is normal working times according to human physiological conditions, but working at night would impact to the sleep cycle and regulation of human homeostasis. Various studies have found that working at night causing conditions that can interfere the ability to adapt both biologically and socially. Workers on the night shift also have a higher risk of injury or accidents due to work fatigue. This stydy aims to determine the fatigue score between night and non-noght shift workers at Dr Harjono S Hospital, Ponorogo. Data Collected in August 2019 and involved 80 medical workers as respondents who were randomly selected using simple random sampling technique. Data were obtained through direct observation and interviews to respondents. Fatigue was measured in numerical score with Fatigue Assesment Scale (FAS) Instrument. Work shift variables (WS) are divided into : non-night shift (morning, noon) and night shift (morning, noon, night). To find out the differences in physical conditions of workers in each shift, the Heart Rate (HR) of the night shift workers measured in the end of three shifts (morning : 07-14.00; Afternoon : 14.00-21.00; and night :21.00-07.00). Using independent T-test analysis, there was a significant difference in Fatigue Level of workers with night shifts and non-night shifts (p < 0.000). Workers with the night shift has 29.0 of Fatigue Levels or 21 % greather than workers with non-nigh shift (Fatigue Level : 24.2). Result shows that working at night increasing level of fatigue by 21 % than working at day. Workers on the night shift have the highest HR at the end of the shift (86.311 bpm) while workers at noon shift have the lowest HR (85.2). Keywords: Occupational fatigue, work shift, medical workers

scholarly journals Clonidine for the Treatment of Agitation After Dexmedetomidine Discontinuation in Pediatric Patients: A Retrospective Cohort Study

2021 ◽  
Vol 26 (8) ◽  
pp. 821-827
Author(s):  
Thao L. Nguyen ◽  
Weng Man Lam ◽  
Hillary Orr ◽  
Brian Gulbis ◽  
Riza Mauricio ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cohort Study ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Primary Outcome ◽  
Pediatric Patients ◽  
Group Versus ◽  
Significant Difference ◽  
Scoring Tool ◽  
Dexmedetomidine Infusion

OBJECTIVE Dexmedetomidine has become a widely used drug in PICUs for sedation. We aim to determine the effects of clonidine on pediatric patients after dexmedetomidine use. METHODS This was a retrospective cohort study that evaluated all pediatric patients admitted to a tertiary PICU who received dexmedetomidine infusion for &gt;48 hours. Outcomes in patients exposed to clonidine (CLON) were compared with those of patients who were not exposed (NoCLON). RESULTS A total of 216 patients were included in this study (43 CLON and 173 NoCLON). The primary outcome, agitation, was less in the CLON cohort (9.3%) than in the NoCLON cohort (9.3% versus 29.5%, respectively; p &lt; 0.01). Hospital LOS was longer in the CLON group (59 versus 20 days, p &lt; 0.01), as was PICU LOS (37.4 versus 11.1 days, p &lt; 0.01). There was no significant difference in the occurrence of increased heart rate or blood pressure between the 2 cohorts. Patients exposed to concurrent midazolam and opioid infusions had higher incidence of agitation when they did not receive clonidine (CLON 8% versus NoCLON 37%, OR 0.15; 95% CI, 0.05–0.51; p &lt; 0.01). In contrast, there was no difference in the incidence of agitation for the CLON group versus the NoCLON group when dexmedetomidine was administered alone (25% versus 19%, OR 1.4; p = 0.99). CONCLUSIONS Our study confirms the importance and effectiveness of clonidine to treat agitation after dexmedetomidine discontinuation. A validated withdrawal scoring tool can help better define dexmedetomidine withdrawal in pediatric patients.

scholarly journals Effects of Swedish Massage Therapy on Blood Pressure, Heart Rate, and Inflammatory Markers in Hypertensive Women

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Izreen Supa’at ◽  
Zaiton Zakaria ◽  
Oteh Maskon ◽  
Amilia Aminuddin ◽  
Nor Anita Megat Mohd Nordin
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Adhesion Molecules ◽  
Inflammatory Markers ◽  
Massage Therapy ◽  
Whole Body ◽  
Control Group ◽  
Relaxation Effects ◽  
Significant Difference ◽  
Massage Group

Swedish Massage Therapy (SMT) is known for its therapeutic relaxation effects. Hypertension is associated with stress and elevated endothelial inflammatory markers. This randomized control trial measured the effects of whole body SMT (massage group) or resting (control group) an hour weekly for four weeks on hypertensive women. Blood pressure (BP) and heart rate (HR) were measured before and after each intervention and endothelial inflammatory markers: vascular endothelial adhesion molecules 1 (VCAM-1) and intracellular adhesion molecules 1 (ICAM-1) were measured at baseline and after the last intervention. Massage group (n=8) showed significant systolic BP (SBP) reduction of 12 mmHg (P=0.01) and diastolic BP (DBP) reduction of 5 mmHg (P=0.01) after four sessions with no significant difference between groups. Reductions in HR were also seen in massage group after sessions 1, 3, and 4 with significant difference between groups. VCAM-1 showed significant reduction after four sessions: the massage group showed reduction of 998.05 ng/mL (P=0.03) and the control group of 375.70 ng/mL (P=0.01) with no significant differences between groups. There were no changes in ICAM-1. In conclusion, SMT or resting an hour weekly has effects on reducing BP, HR, and VCAM-1 in hypertensive women.

scholarly journals Precision Nutrition Assessment of Risk for Metabolic Syndrome in Active Duty Service Members

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 943-943
Author(s):  
Mary McCarthy ◽  
Evelyn Elshaw ◽  
Barbara Szekely ◽  
Zachary Colburn ◽  
Laurel Gillette ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Metabolic Syndrome ◽  
Weight Loss ◽  
Blood Glucose ◽  
Waist Circumference ◽  
Behavior Change ◽  
Primary Outcome ◽  
Control Group ◽  
Nutrition Counseling ◽  
Significant Difference

Abstract Objectives Precision nutrition leverages the specificity of molecular and phenotypic differences in personalizing diet and lifestyle interventions.Objective for this phase of the study: 1) examine the effectiveness of gene-based nutrition counseling on behavior change measured by weight, body mass index (BMI), blood glucose, lipids, 25-hydroxyvitamin (OH) D, %body fat (BF), waist circumference, and blood pressure. Methods In this prospective multisite RCT, a baseline genomic profile from 70 diet-responsive genes/80 variants, is augmented by biomarkers specific to metabolic syndrome (MetS) risk for each subject. Treatment group (TG) receives gene-based nutrition counseling for six weekly sessions; Control group (CG) receives evidence-based nutrition content in pamphlets directed at preventing metabolic syndrome. A digital app provides real-time health data capture with continuous feedback and is validated by in-person interviews. Primary outcome is weight loss at 12 weeks. Results Army NW cohort has enrolled 90 subjects to date; 49 are assigned to the TG. Sample demographics: males (70%), mean age 32 yrs, 58% married, 75% Caucasian, non-Hispanic, and 78% report some college education. In females, mean BMI 28.3, %BF 34.2, waist circumference 32.2 in; males mean BMI 30.1, %BF 29, waist circumference 40 in. For MetS components, 27/90 subjects show no abnormal components yet 41/90 have 2 or 3 alterations. Elevations noted as follows: fasting blood glucose in 47%, blood pressure in 38%, and waist circumference in 30%. High variant presence is noteworthy for genes with a role in obesity and hypertension. In 71% of subjects baseline 25(OH) D ≤ 30 ng/mL. Preliminary results for primary outcome of weight loss at 12 weeks reveal no change in TG (n = 21), an average loss of 5 lbs in CG (n = 21) within groups, and a significant difference between groups; TG 197.4 (39.3) vs CG 192.6 (40.3), p &lt; .001. Conclusions Digital health integration, along with genomic data and family history, can reveal early signals of risk in a young, generally healthy, military population. Health promotion efforts must drive behavior change at both the individual and population level. Funding Sources The TriService Nursing Research Program

scholarly journals Effects of a Snack on Performance and Errors During a Simulated 16-h Night Shift: a Pilot Study

2021 ◽  
Author(s):  
Sanae Oriyama ◽  
Kotomi Yamashita
Keyword(s):  
Heart Rate ◽  
High Frequency ◽  
Night Shift ◽  
High Frequency Power ◽  
Shift Workers ◽  
Psychomotor Vigilance Test ◽  
Vigilance Test ◽  
Psychomotor Vigilance ◽  
Frequency Power ◽  
Night Shifts

Abstract Background: Night shift workers might not eat due to their busy schedules during the night shift. However, diet may not only satisfy hunger, but also affect performance and errors.The aim of this study was to clarify the effect of a snack on performance and errors during 2-day, 16-h simulated night shifts. Methods: A randomized repeated-measure crossover study was performed to investigate subjective and cognitive performance in 15 healthy female adults (mean age, 21.7 years) after they consumed a snack (352 kcal) during a simulated night shift (16:00 to 09:00). The participants were kept awake from wake up in the morning to the next day at 09:00. Subjects were tested for performance on the Uchida-Kraepelin test, as well as for subjective feeling, body temperature, psychomotor vigilance test, and heart rate variability, before and after they consumed the snack. One day before the experiment, all participants wore an actigraphy monitoring device to determine their sleep state. Results: There was no difference between the snack condition and the skipping condition in sleep states the day before the experiment. On the day of the experiment, between 16:00 and 09:00, subjective sleepiness, fatigue, and body temperature were not different between the two conditions. Subjects showed a significant improvement in performance on the Uchida-Kraepelin test and total errors on the psychomotor vigilance test, the primary outcome measure, when they consumed a snack compared with the skipping condition. In addition, the snack condition was associated with decreased high-frequency power, decreased low-frequency power/high-frequency power ratio, and increased heart rate, in the vagally mediated heart rate variability indices, which may reflect a higher ability to modulate cognitive and behavioral processes. Conclusions: These results suggest that providing a snack to shift workers during night shifts might improve work safety and efficiency.Trial registration: This study was registered with the University Hospital Medical Information Network-Clinical Trials Registry (UMIN-CRT registry ID: UMIN 000034345).

scholarly journals Napping on the Night Shift and Impact on Blood Pressure and HRV among EMS Workers

2021 ◽  
Author(s):  
Ektha Parchuri ◽  
James Paule
Keyword(s):  
Blood Pressure ◽  
Shift Work ◽  
Night Shift ◽  
Shift Workers ◽  
Frequent Use ◽  
Long Duration ◽  
High Prevalence ◽  
Circadian Patterns ◽  
Night Shifts ◽  
Over Time

Recent evidence linking exposure toshift work to cardiovascular disease (CVD) as well as incidence of myocardial infarction seems to be greater among night shift workers compared to day workers. Repeated exposure tonight shift work causes disruptions in normal circadian patterns of blood pressure (BP) and heart rate variability (HRV), which cause anincreased risk of CVD. Recent data suggest that allowing shift workers to nap during night shifts may help to normalize BP and HRV patterns and, over time, reduce the risk of CVD. The risk of CVD related to shift work is elevated for emergency medical services (EMS) shift workers due in part to long-duration shifts, frequent use of night shifts, and a high prevalence of multiple jobs. Therefore, the effect of SBP and HRV in EMS night shift workers is analyzed through stimulated night work and it's effect on CVD is characterized.

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