title: Complete or partial circadian re-entrainment improves performance, alertness, and mood during night-shift work.
abstract: OBJECTIVE
  To assess performance, alertness, and mood during the night shift and subsequent daytime sleep in relation to the degree of re-alignment (re-entrainment) of circadian rhythms with a night-work, day-sleep schedule.
  
  
  METHODS
  Subjects spent 5 consecutive night shifts (11:00 pm-7:00 am) in the lab and slept at home in darkened bedrooms (8:30 am-3:30 pm). Subjects were categorized by the degree of re-entrainment attained after the 5 night shifts. Completely re-entrained: temperature minimum in the second half of daytime sleep; partially re-entrained: temperature minimum in the first half of daytime sleep; not re-entrained: temperature minimum did not delay enough to reach daytime sleep.
  
  
  METHODS
  See above.
  
  
  METHODS
  Young healthy adults (n = 67) who were not shift workers.
  
  
  METHODS
  Included bright light during the night shifts, sunglasses worn outside, a fixed dark daytime sleep episode, and melatonin. The effects of various combinations of these interventions on circadian re-entrainment were previously reported. Here we report how the degree of re-entrainment affected daytime sleep and measures collected during the night shift.
  
  
  RESULTS
  Salivary melatonin was collected every 30 minutes in dim light (<20 lux) before and after the night shifts to determine the dim light melatonin onset, and the temperature minimum was estimated by adding a constant (7 hours) to the dim light melatonin onset. Subjects kept sleep logs, which were verified by actigraphy. The Neurobehavioral Assessment Battery was completed several times during each night shift. Baseline sleep schedules and circadian phase differed among the 3 re-entrainment groups, with later times resulting in more re-entrainment. The Neurobehavioral Assessment Battery showed that performance, sleepiness, and mood were better in the groups that re-entrained compared to the group that did not re-entrain, but there were no significant differences between the partial and complete re-entrainment groups. Subjects slept almost all of the allotted 7 hours during the day, and duration did not significantly differ among the re-entrainment groups.
  
  
  CONCLUSIONS
  In young people, complete re-entrainment to the night-shift day-sleep schedule is not necessary to produce substantial benefits in neurobehavioral measures; partial re-entrainment (delaying the temperature minimum into the beginning of daytime sleep) is sufficient. The group that did not re-entrain shows that a reasonable amount of daytime sleep is not enough to produce good neurobehavioral performance during the night shift. Therefore, some re-alignment of circadian rhythms is recommended.
authors.affiliation: Biological Rhythms Research Laboratory, Rush University Medical Center, Chicago, IL 60612, USA.
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: Crowley
authors.forename: Clara
authors.initials: C
authors.lastname: Lee
authors.forename: Christine Y
authors.initials: CY
authors.lastname: Tseng
authors.forename: Louis F
authors.initials: LF
authors.lastname: Fogg
authors.forename: Charmane I
authors.initials: CI
authors.lastname: Eastman
mesh_terms: D000293:Adolescent; D000328:Adult; D001143:Arousal / Q000502:physiology*; D001831:Body Temperature / Q000502:physiology; D002940:Circadian Rhythm / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology; D005260:Female; D006801:Humans; D008027:Light; D008297:Male; D008550:Melatonin / Q000032:analysis; D008569:Memory Disorders / Q000175:diagnosis / Q000453:epidemiology; D011939:Mental Recall; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology*; D009483:Neuropsychological Tests; D011597:Psychomotor Performance; D012463:Saliva / Q000737:chemistry; D012720:Severity of Illness Index; D020178:Sleep Disorders, Circadian Rhythm / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D013997:Time Factors
chemical_list: D008550:Melatonin