中国临床心理学杂志

倒班相关睡眠障碍与倒班耐受性

作者：周雅范方

分类号：R395.6

出版年,卷(期):页码：2016,24(6):1126-1131

摘要：

长期倒班易引起生物节律紊乱，导致倒班相关睡眠障碍（SWSD）与其他心身问题。而倒班耐受性存在个体差异，受到节律类型、人格特质、社会支持等心理社会因素影响。同时，节律调节涉及体内激素、神经生化、节律基因表达等的作用，因此SWSD与倒班耐受的个体差异也有生物及遗传基础。目前针对我国倒班人群的研究相当有限。未来可采取前瞻性队列研究和病例对照研究设计，借助流行病学调查、表观遗传分析、神经影像、神经化学波谱定量等方法技术手段，研究我国SWSD的流行病学特征和变化转归轨迹，探索SWSD的心理社会层面影响因素以及可能的遗传易感性与神经生化层面的内表型，并在此基础上甄别倒班耐受的预测指标，开发有助提升倒班耐受、降低SWSD风险的干预方案。

Exposure to long-term shift work may cause a misalignment between one's behavioral timing of sleep/wake and endogenous circadian timing, thereby increasing the risk for shift work sleep disorder(SWSD) and imposing adverse impacts on one's physical and mental health. As evidenced by studies in Western countries, large individual variation exists in people's tolerance to shift work. Research on the psychosocial, biological and genetic mechanisms underlying the individual variation in shift work tolerance is warranted. However, there is a dearth of studies on SWSD and shift work tolerance among Chinese workers. Future work adopting prospective cohort design or nested case-control design is needed, to investigate epidemiological characteristics, developmental trajectories and relevant psychosocial risk factors of SWSD among Chinese workers. Epigenetic analysis, magnetic resonance imaging/spectroscopy and other advanced techniques should also be utilized to explore genetic mechanisms, gene-environment interactions and potential neurobiological endophenotypes implicated in the SWSD susceptibility. Effort should also be made to develop prevention and intervention programs for enhancing shift work tolerance and relieving the risk of SWSD.

基金项目：

国家自然科学基金项目（31671165）；中国博士后科学基金第9批特别资助项目（2016T90790）；广东省委宣传部打造“理论粤军”2014年度重点课题（WT1424）

作者简介：

参考文献：

1 Wright KP, Jr., Bogan RK, Wyatt JK. Shift work and the assessment and management of shift work disorder(SWD). Sleep Medicine Reviews, 2013, 17:41-54
2 Ayas NT, Barger LK, Cade BE, et al. Extended work duration and the risk of self-reported percutaneous injuries in interns. JAMA, 2006, 296:1055-1062
3 Folkard S, Tucker P. Shift work, safety and productivity. Occupational Medicine, 2003, 53:95-101
4 Culpepper L. The social and economic burden of shift-work disorder. Journal of Family Practice, 2010, 59:S3-S11
5 Drake CL, Roehrs T, Richardson G, et al. Shift work sleep disorder:prevalence and consequences beyond that of symptomatic day workers. Sleep, 2004, 27:1453-1462
6 Garbarino S, De Carli F, Nobili L, et al. Sleepiness and sleep disorders in shift workers:a study on a group of Italian police officers. Sleep, 2002, 25:642-647
7 Härmä M, Tenkane L, Sjöblom T, et al. Combined effects of shift work and life-style on the prevalence of insomnia, sleep deprivation and daytime sleepiness. Scandinavian Journal of Work, Environment & Health, 1998, 24:300-307
8 Vogel M, Braungardt T, Meyer W, Schneider W. The effects of shift work on physical and mental health. Journal of Neural Transmission, 2012, 119:1121-1132
9 孙玲玲,倪伟慧,章美华. 倒班护士睡眠质量与自我效能的相关性研究. 中国老年保健医学,2014,12:119-120
10 杨玲,赵明,王勇,等. 倒班军人睡眠质量与心理健康的相关性研究. 临床军医杂志,2011,39:1003-1005
11 赵广跃,宋国萍. 睡眠剥夺对值班医生情绪的影响. 中国临床心理学杂志,2005,13(1):68-69
12 Guo Y, Rong Y, Huang X, et al. Shift work and the relationship with metabolic syndrome in Chinese aged workers. PloS One, 2015, 10:e0120632
13 Wang P, Ren FM, Lin Y, et al. Night-shift work, sleep duration, daytime napping, and breast cancer risk. Sleep Medicine, 2015, 16:462-468
14 Li W, Ray RM, Thomas DB, et al. Shift work and breast cancer among women textile workers in Shanghai, China. Cancer Causes & Control, 2015, 26:143-150
15 Reinberg A, Vieux N, Andlauer P, Smolensky M. Tolerance to shift work:A chronobiological approach. Advances in Biological Psychiatry, 1983, 11:35-47
16 Reinberg A, Ashkenazi I. Internal desynchronization of circadian rhythms and tolerance to shift work. Chronobiology International, 2009, 25:625-643
17 Seo Y-j, Matsumoto K, Park Y-m, et al. The Relationship between Sleep and Shift System, Age and Chronotype in Shift Workers. Biological Rhythm Research, 2000, 31:559-579
18 Saksvik-Lehouillier I, Bjorvatn B, Hetland H, et al. Personality factors predicting changes in shift work tolerance:A longitudinal study among nurses working rotating shifts. Work & Stress, 2012, 26:143-160
19 Saksvik IB, Bjorvatn B, Hetland H, et al. Individual differences in tolerance to shift work-A systematic review. Sleep Medicine Reviews, 2011, 15:221-235
20 Wolffe AP, Matzke MA. Epigenetics:Regulation through repression. Science, 1999, 286:481-486
21 McEwen BS, Karatsoreos IN. Sleep deprivation and circadian disruption:Stress, allostasis, and allostatic load. Sleep Medicine Clinics, 2015, 10:1-10
22 Wright KP, Jr., Drake AL, Frey DJ, et al. Influence of sleep deprivation and circadian misalignment on cortisol, inflammatory markers, and cytokine balance. Brain, Behavior, and Immunity, 2015, 47:24-34
23 Davies SK, Ang JE, Revell VL, Holmes B, Mann A, Robertson FP, et al. Effect of sleep deprivation on the human metabolome. Proceedings of the National Academy of Sciences of the United States of America, 2014, 111:10761-10766
24 Gumenyuk V, Roth T, Drake CL. Circadian phase, sleepiness, and light exposure assessment in night workers with and without shift work disorder. Chronobiology International, 2012, 29:928-936
25 Bhatti P, Mirick DK, Davis S. Racial differences in the association between night shift work and melatonin levels among women. American Journal of Epidemiology, 2013, 177:388-393
26 Cedernaes J, Osler ME, Voisin S, et al. Acute sleep loss induces tissue-specific epigenetic and transcriptional alterations to circadian clock genes in men. Journal of Clinical Endocrinology and Metabolism, 2015, 100:E1255-E1261
27 Archer SN, Laing EE, Moller-Levet CS, et al. Mistimed sleep disrupts circadian regulation of the human transcriptome. Proceedings of the National Academy of Sciences of the United States of America, 2014, 111:E682-E691
28 Zarbl H, Kipen H, Fang M, et al. Evaluation of circadian gene expression changes in human peripheral blood cells as biomarkers of circadian disruption in shift workers:application to studies of breast and prostate cancer chemoprevention. Sleep Medicine, 2013, 14:e28-e29
29 Bracci M, Manzella N, Copertaro A, et al. Rotating-shift nurses after a day off:Peripheral clock gene expression, urinary melatonin, and serum 17-beta-estradiol levels. Scandinavian Journal of Work, Environment & Health, 2014, 40:295-304
30 Guilding C, Piggins HD. Challenging the omnipotence of the suprachiasmatic timekeeper:are circadian oscillators present throughout the mammalian brain? European Journal of Neuroscience, 2007, 25:3195-3216
31 Abrahamson EE, Moore RY. Suprachiasmatic nucleus in the mouse:retinal innervation, intrinsic organization and efferent projections. Brain Research, 2001, 916:172-191
32 Smith VM, Sterniczuk R, Phillips CI, Antle MC. Altered photic and non-photic phase shifts in 5-HT(1A) receptor knockout mice. Neuroscience, 2008, 157:513-523
33 Choi HJ, Lee CJ, Schroeder A, et al. Excitatory actions of GABA in the suprachiasmatic nucleus. Journal of Neuroscience, 2008, 28:5450-5459
34 Hut RA, Van der Zee EA. The cholinergic system, circadian rhythmicity, and time memory. Behavioural Brain Research, 2011, 221:466-480
35 McGaugh JL. Memory-a century of consolidation. Science, 2000, 287:248-251
36 赵正卿,李雁鹏,赵菲,赵忠新. 神经肽S:睡眠-觉醒相关新型神经肽. 中国现代神经疾病杂志,2013,13:372-376
37 Colwell CS. Linking neural activity and molecular oscillations in the SCN. Nature Reviews Neuroscience, 2011, 12:553-569
38 Samann PG, Tully C, Spoormaker VI, Wetter TC, Holsboer F, Wehrle R, et al. Increased sleep pressure reduces resting state functional connectivity. Magma, 2010, 23:375-389
39 Volkow ND, Tomasi D, Wang GJ, Telang F, Fowler JS, Logan J, et al. Evidence that sleep deprivation downregulates dopamine D2R in ventral striatum in the human brain. Journal of Neuroscience, 2012, 32:6711-6717
40 Nofzinger EA, Buysse DJ, Germain A, et al. Functional neuroimaging evidence for hyperarousal in insomnia. American Journal of Psychiatry, 2004, 161:2126-2128
41 Plante DT, Jensen JE, Schoerning L, Winkelman JW. Reduced gamma-aminobutyric acid in occipital and anterior cingulate cortices in primary insomnia:a link to major depressive disorder? Neuropsychopharmacology, 2012, 37:1548-1557
42 Thorpy MJ. Managing the patient with shift-work disorder. Journal of Family Practice, 2010, 59:S24-S31
43 Barger LK, Wright KPJ, Hughes RJ, Czeisler CA. Daily exercise facilitates phase delays of circadian melatonin rhythm in very dim light. American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 2004, 286:R1077-R1084
44 Paz A, Berry EM. Effect of meal composition on alertness and performance of hospital night-shift workers. Annals of Nutrition and Metabolism, 1997, 41:291-298
45 Liira J, Verbeek J, Ruotsalainen J. Pharmacological interventions for sleepiness and sleep disturbances caused by shift work. JAMA, 2015, 313:961-962
46 郎莹,蒋晓江,马国重,等. 光照疗法对轮班睡眠时相障碍患者昼夜节律恢复作用的疗效观察. 中国临床神经科学, 2013,21:284-288
47 Welsh DK, Takahashi JS, Kay SA. Suprachiasmatic nucleus:cell autonomy and network properties. Annual Review of Physiology, 2010, 72:551-577

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