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Biomedical subjects

Gerard A Kerkhof

Publications and source records attributed to Gerard A Kerkhof.

10 recordsLinked to original sources

Are individuals' nighttime sleep characteristics prior to shift-work exposure predictive for parameters of daytime sleep after commencing shift work?

This study aimed to examine prospectively whether individual nighttime sleep characteristics at baseline (prior to shift-work exposure) are related to parameters of daytime sleep after commencing shift work. A longitudinal field study was carried out with novice police officers of the Dutch Police Force. A total of 26 subjects were examined at baseline before they entered shift work and re-examined during follow-up sessions after four and twelve months of shift-work exposure. Wrist actigraphy and sleep diaries were used to study nocturnal sleep at baseline and daytime sleep after night shifts during follow-up sessions. As outcome variables, estimated total sleep time, sleep efficiency, and subjective sleep quality were analyzed. Daytime total sleep time showed a 66 min decline during the first year of shift-work exposure. Systematic inter-individual differences were observed for daytime total sleep time and subjective sleep quality (explaining 53% and 38% of the variance, respectively), suggesting potential predictability of these sleep parameters. Although no predictors were found for daytime total sleep time, the subjective quality of nighttime sleep before the onset of shift work predicted 40% of the variance in the subjective quality of daytime sleep after commencing shift work. Follow-up studies may reveal whether the subjective quality of baseline nighttime sleep also predicts long-term overall tolerance for shift work.

Adult↗

Vital working hour schemes: The dynamic balance between various interests.

"Balancing Interests", the theme of the 17th International Symposium on Shift Work and Working Time held in Hoofddorp, The Netherlands (September 2005), refers to the ambition to reach an optimal balance between the various aspects of shift work. Economic, ergonomic, physical, and psychosocial factors all interact in determining the impact of shift work at the individual, organizational, and societal level. It is the challenge of this multidisciplinary field of research to model all relevant factors in such a way that it will allow us to optimize the dynamic trade-off between the yield and the risk of shift work. The organizers of the 17th International Symposium and the co-editors of these proceedings are convinced that the high quality of the contributions will bring us closer to this ultimate goal.

Chronobiology Phenomena↗

Chronic insomnia and performance in a 24-h constant routine study.

Insomniacs report daytime functioning problems, but studies of neurobehavioral functioning in insomniacs have shown little objective evidence of impairment. In addition, very little is known about the influence of the circadian clock on performance in chronic insomniacs. In the present study, we investigated whether chronic insomnia is associated with an overall performance deficit, and what the effect is of circadian rhythmicity, under strictly controlled laboratory conditions. A 24-h experiment was carried out under constant routine conditions. Psychomotor performance, body temperature, and subjective functioning of 11 insomniacs and 13 healthy subjects were assessed. The insomniacs showed significant overall performance impairments in vigilance, working memory, and motor control. In addition, body temperature, performance and subjective functioning showed a circadian pattern similar to healthy subjects, with trough values in the late night/early morning and peak values in the early evening. Self-reported functioning among the insomniacs indicated mood disturbances, concentration problems, elevated fatigue and elevated sleepiness. The results indicated that chronic insomnia is associated with a substantial lowering of the 24-h level of performance and subjective functioning, irrespective of the type of task and/or the particular parameter, and without differential effects of circadian rhythmicity. Apparently, chronic insomnia has a negative impact upon performance as measured under strictly controlled, unmasked conditions.

Adult↗

Physiologic indexes in chronic insomnia during a constant routine: evidence for general hyperarousal?

STUDY OBJECTIVES: It has been hypothesized that general hyperarousal, present during both sleep and wakefulness, may underlie chronic insomnia. The present study explored, under strictly controlled conditions, whether chronic insomnia is associated with altered physiologic markers of arousal, both in absolute levels and in terms of circadian rhythmicity, relative to controls. DESIGN: A 24-hour constant-routine protocol was implemented to assess physiologic measures. SETTING: The study was conducted in an isolated, temperature- and light-controlled, sound-attenuated sleep laboratory. PARTICIPANTS: Eleven subjects with clinically diagnosed chronic insomnia were compared with 13 healthy matched controls. INTERVENTIONS: The subjects underwent physiologic parameter recordings and cognitive performance testing during 24 hours of total sleep deprivation under strictly controlled circumstances. MEASUREMENTS AND RESULTS: Cardiovascular parameters, free cortisol, and body temperature were subjected to mixed-model analysis of variance and mixed-model harmonic regression. Overall, no differences were found in either the absolute level or the circadian parameters (amplitude, phase) of these variables between the insomniacs and the control subjects. CONCLUSIONS: Although physiologic indexes of arousal were slightly elevated in the insomnia group relative to the controls, the differences between the groups were not statistically significant. This could have been due to a lack of statistical power or could reflect the actual absence of arousal in our sample of chronic insomniacs. Systematic interindividual level differences overwhelmed any differences between the 2 groups, making it unlikely that general hyperarousal was a critical underlying factor in our sample. Earlier findings of hyperarousal in insomnia during studies that allowed sleep may have been specifically related to the sleep state.

Adult↗

Circadian variation in base rate measures of cardiac autonomic activity.

To investigate the role of the circadian pacemaker in autonomic modulation of base rate cardiac activity, 29 healthy subjects participated in a constant routine protocol. They were randomly divided into two groups in order to manipulate prior wakefulness. Group 1 started at 0900 hours immediately after a monitored sleep period, while group 2 started 12 h later. Measures of interbeat intervals (IBIs), respiratory sinus arrhythmia (RSA, an estimate of parasympathetic activity), pre-ejection period (PEP, an estimate of sympathetic activity), and core body temperature (CBT) were recorded continuously. Multilevel regression analyses (across-subjects) revealed significant 24- and/or 12-h sinusoidal circadian variation for CBT, IBI, and RSA, but not for PEP. Subject-specific 24+12 h sinusoidal fits demonstrated a convergence of phase distribution for IBI and RSA of group 1 similar to CBT, while PEP showed a relatively large (i.e. random) distribution of phase. In group 2, all cardiac measures showed large distributions of phase. Unexpected results in the cardiac measures were found in group 2, probably caused by group differences in prior activation. Also, effects of sleep deprivation were observed for IBI and RSA in group 2. Consequently, all cardiac measures revealed significant sinusoidal x group interactions, a result not shown in CBT. These findings were interpreted as an indication for circadian endogenous parasympathetic modulation of cardiac activity that is mainly confounded by prior wakefulness that extends 24 h, while the sympathetic modulation is relatively uncoupled from the endogenous circadian drive and mainly influenced by prior activation.

Adult↗

Circadian variation in cardiac autonomic activity: reactivity measurements to different types of stressors.

The role of endogenous circadian rhythmicity in autonomic cardiac reactivity to different stressors was investigated. A constant routine protocol was used with repeated exposure to a dual task and a cold pressor test. The 29 subjects were randomly divided into two groups in order to manipulate prior wakefulness. Group 1 started at 09:00 h immediately after a monitored sleep period, whereas group 2 started 12 h later. Measures of interbeat intervals (IBI), respiratory sinus arrythmia (RSA, a measure of parasympathetic activity), pre-ejection period (PEP, a measure of sympathetic activity), as well as core body temperature (CBT) were recorded continuously. Multilevel regression analyses (across-subjects) revealed significant (mainly 24 h) sinusoidal circadian variation in the response to both stressors for IBI and RSA, but not for PEP. Individual 24 + 12 h cosine fits demonstrated a relatively large interindividual variation of the phases of the IBI and RSA rhythms, as compared to that of the CBT rhythm. Sinusoidal by group interactions were found for IBI and PEP, but not for RSA. These findings were interpreted as an indication for endogenous circadian and exogenous parasympathetic (vagal) modulation of cardiac reactivity, while sympathetic reactivity is relatively unaffected by the endogenous circadian drive and mainly influenced by exogenous factors.

Adolescent↗

24-hour assessment of performance on a palmtop computer: validating a self-constructed test battery.

A test battery was constructed on a palmtop computer for ambulatory purposes. This study explored whether the test battery could assess circadian rhythmicity underconstant routine conditions. Performance, body temperature, and subjective sleepiness of 12 healthy subjects were measured. The test battery consisted of a sleepiness questionnaire and three performance tests: a vigilance detection test, a working memory test, and a choice-reaction time test. The subjects were divided into early-start and late-start groups and were subjected to the constant-routine protocol. All tests showed a trough in performance in the early morning around 07:00h and a peak in the evening between 21:00 and 23:00h. In addition, an afternoon decrement in performance was observed between 15:00 and 17:00h. On average, the circadian (peak-to-trough) variation of the performance variables amounted to 16.9% +/- 1.7 SEM of the maximum across subjects. The late starters showed a larger impairment in performance during the morning than the early starters. This could be attributed to prior wakefulness. The characteristics of the performance rhythms found in this study replicate findings in several other studies carried out under constant routine conditions. In conclusion, the present test battery appeared to be a good tool for future assessment of performance under natural conditions.

Adolescent↗

Circadian variation in cortisol reactivity to an acute stressor.

To investigate the role of the circadian pacemaker in cortisol reactivity to a cold pressor challenge, 26 diurnally subjects participated in a constant-routine protocol and were divided into two groups. Group 1 started immediately after a monitored sleep period at 09:00 h, while group 2 started 12 h later. After 2 h of adaptation, a cold pressor test was presented every 3 h. The cortisol response was assessed by means of saliva samples that were taken before and after the test. The pretest samples were considered to be base-rate measures and base-rate values as subtracted from post-test values were considered as reactivity measures. Both measures showed distinct Time-of-Day variations (respectively: F(7,168) = 16.92, p < 0.001, epsilon = 0.383; and F(7,175) = 8.01, p < 0.001, epsilon = 0.523). These findings are interpreted as evidence for the existence of an endogenous circadian periodicity underlying the sensitivity of the hypothalamus-pituitary-adrenal (HPA)-axis to acute stress.

Adolescent↗

Melatonin improves health status and sleep in children with idiopathic chronic sleep-onset insomnia: a randomized placebo-controlled trial.

OBJECTIVE: To investigate the effect of melatonin treatment on health status and sleep in children with idiopathic sleep-onset insomnia. METHOD: A randomized, double-blind, placebo-controlled trial was conducted in a Dutch sleep center, involving 62 children, 6 to 12 years of age, who suffered more than 1 year from idiopathic chronic sleep-onset insomnia. Patients received either 5 mg melatonin or placebo at 7 pm. The study consisted of a 1-week baseline period, followed by a 4-week treatment. Health status was measured with the RAND General Health Rating Index (RAND-GHRI) and Functional Status II (FS-II) questionnaires. Lights-off time, sleep onset, and wake-up time were recorded in a diary, and endogenous dim light melatonin onset was measured in saliva. RESULTS: The total scores of the RAND-GHRI and FS-II improved significantly more during melatonin treatment compared to placebo. The magnitude of change was much higher in the melatonin group than in the placebo group, with standardized response means for the RAND-GHRI of 0.69 versus 0.07 and for the FS-II of 1.61 versus 0.64. Melatonin treatment also significantly advanced sleep onset by 57 minutes, sleep offset by 9 minutes, and melatonin onset by 82 minutes, and decreased sleep latency by 17 minutes. Lights-off time and total sleep time did not change. CONCLUSIONS: Melatonin improves health status and advances the sleep-wake rhythm in children with idiopathic chronic sleep-onset insomnia.

Antioxidants↗