I urval från Stockholms universitets publikationsdatabas

• Considerations on how to light the night-shift

  2021. Arne Lowden, Göran Kecklund. Lighting Research and Technology 53 (5), 437-452

  Artikel

  Electric lighting has decreased dependence on natural light to illuminate the workplace. Humans are genetically predisposed to be day-oriented (diurnal) and depend on daylight to regulate circadian rhythms. Shift work will force workers to sleep and work at non-biological times, inducing circadian disruption with implications for workers' safety and health. The scientific literature may be used in practice in shift work settings to improve safety, performance and health in the workplace by reducing circadian misalignment. Alertness profiles at work and degree of melatonin suppression may indicate degree of circadian disruption among workers. However, when considering lighting solutions at night, there are several factors that need consideration. Light measures based on biological effectiveness should be used rather than room illuminance giving better predictions of performance and long-term health among workers. Also, large individual differences in light sensitivity and preferences suggest not only to rely on common lighting alone but also to implement complementary individual lighting solutions at work. Lighting advice should consider shift scheduling characteristics such as speed of turnover and shift timing to guide decisions of preferred circadian phase influence. Lighting should also include the flexibility to be fit for morning, afternoon and evening work.

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• Does Work after Retirement Matter? Sleep Features among Workers in the Brazilian Longitudinal Study of Adult Health

  2021. Arne Lowden (et al.). International Journal of Environmental Research and Public Health 18 (8)

  Artikel

  A growing number of people keep working after retirement, a phenomenon known as bridge employment. Sleep features, which are related to morbidity and mortality outcomes, are expected to be influenced by bridge employment or permanent retirement. The objective of this study was to analyze sleep duration and quality of bridge employees and permanent retirees compared to nonretired, i.e., active workers, from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Participants (second wave of ELSA-Brasil, 2012-2014) comprised permanently retired (n = 2348), career bridge workers (n = 694), bridge workers in a different place (n = 760), and active workers (n = 6271). The associations of all studied retirement schemes and self-reported sleep quality and duration were estimated through logistic and linear regression analysis. Workers from all studied retirement schemes showed better sleep patterns than active workers. In comparison to active workers, bridge workers who had changed workplace also showed a reduced chance of difficulty falling asleep and too-early awakenings, which were not found among career bridge workers. Bridge employment and permanent retirement were associated with a reduced chance of reporting sleep deficit. Bridge work at a different place rather than staying at the same workplace seems to be favorable for sleep. Further study is needed to explain mechanisms.

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• Eating Behavior (Duration, Content, and Timing) Among Workers Living under Different Levels of Urbanization

  2020. Natalia M. Tiuganji (et al.). Nutrients 12 (2)

  Artikel

  Urbanization has contributed to extended wakefulness, which may in turn be associated with eating over a longer period. Here, we present a field study conducted in four groups with different work hours and places of living in order to investigate eating behavior (duration, content, and timing). Anthropometric measures were taken from the participants (rural (n = 22); town (n = 19); city-day workers (n = 11); city-night workers (n = 14)). In addition, a sociodemographic questionnaire was self-answered and 24-h food recalls were applied for three days. The 24-h food recalls revealed that fat intake varied according to the groups, with the highest consumption by the city-day workers. By contrast, city-day workers had the lowest intake of carbohydrate, whereas the rural group had the highest. In general, all groups had some degree of inadequacy in food consumption. Eating duration was negatively correlated with total energy intake, fat, and protein consumption in the rural and town groups. There was a positive correlation between body mass index and eating duration in both city groups. The rural group had the earliest start time of eating, and this was associated with a lower body mass index. This study suggested that food content and timing, as well as eating duration, differed according to place of living, which in turn may be linked to lifestyle.

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• The effect of urbanization on sleep, sleep/wake routine, and metabolic health of residents in the Amazon region of Brazil

  2020. Andressa J. Martins (et al.). Chronobiology International 37 (9-10), 1335-1343

  Artikel

  Studying communities with different levels of urbanization may further the understanding of risk factors underlying metabolic diseases. The present study is unique by comprising detailed assessment of sleep and activity, biological rhythms, and metabolic factors of men from the same geographical location and place of birth that reside in different, rural vs. town, stages of urbanization. Sleep patterns, activity, and metabolic indicators in two groups (rural, n = 22 and town/urban, n = 20) of men residing in an Amazonian community (Xapuri, Acre, Brazil) were compared. Sociodemographic, anthropometric, and metabolic variables - fasting glucose, insulin resistance, triglycerides, total HDL cholesterol, LDL cholesterol, and VLDL cholesterol - were assessed. Sleep patterns, light exposure, and physical activity levels were additionally assessed by actigraphy, plus daily activities were recorded in diaries for 10 days. Town/urban dwellers were found to have significantly higher body weight, fasting glucose, insulin levels, and insulin resistance than rural dwellers, whereas triglycerides levels were similar. Town/Urban dwellers had shorter sleep duration (p< .01) and later sleep onset and offset times (p= .01). Our findings show an association between stage of urbanization and presence of risk factors for metabolic disorders, such as overweight, insulin resistance, increased glucose levels, short sleep duration, and less natural light exposure during work times.

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• Effects of evening exposure to electromagnetic fields emitted by 3G mobile phones on health and night sleep EEG architecture

  2019. Arne Lowden (et al.). Journal of Sleep Research 28 (4)

  Artikel

  Studies on sleep after exposure to radiofrequency electromagnetic fields have shown mixed results. We investigated the effects of double-blind radiofrequency exposure to 1,930-1,990 MHz, UMTS 3G signalling standard, time-averaged 10 g specific absorption rate of 1.6 W kg(-1) on self-evaluated sleepiness and objective electroencephalogram architecture during sleep. Eighteen subjects aged 18-19 years underwent 3.0 hr of controlled exposure on two consecutive days 19:45-23:00 hours (including 15-min break); active or sham prior to sleep, followed by full-night 7.5 hr polysomnographic recordings in a sleep laboratory. In a cross-over design, the procedure was repeated a week later with the second condition. The results for sleep electroencephalogram architecture showed no change after radiofrequency exposure in sleep stages compared with sham, but power spectrum analyses showed a reduction of activity within the slow spindle range (11.0-12.75 Hz). No differences were found for self-evaluated health symptoms, performance on the Stroop colour word test during exposure or for sleep quality. These results confirm previous findings that radiofrequency post-exposure in the evening has very little influence on electroencephalogram architecture but possible on spindle range activity.

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• Reduced melatonin synthesis in pregnant night workers

  2019. P. A. Nehme (et al.). Medical Hypotheses 132

  Artikel

  Several novel animal studies have shown that intrauterine metabolic programming can be modified in the event of reduced melatonin synthesis during pregnancy, leading to glucose intolerance and insulin resistance in the offspring. It is therefore postulated that female night workers when pregnant may expose the offspring to unwanted health threats. This may be explained by the fact that melatonin is essential for regulating energy metabolism and can influence reproductive activity. Moreover, the circadian misalignment caused by shift work affects fertility and the fetus, increasing the risk of miscarriage, premature birth and low birth weight, phenomena observed in night workers. Thus, we hypothesize that light-induced melatonin suppression as a result of night work may alter intrauterine metabolic programming in pregnant women, potentially leading to metabolic disorders in their offspring.

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• Working Time Society consensus statements

  2019. Arne Lowden (et al.). Industrial Health 57 (2), 213-227

  Artikel

  Interventions and strategies to improve health through the management of circadian (re) adaptation have been explored in the field, and in both human and animal laboratory manipulations of shiftwork. As part of an initiative by the Working Time Society (WTS) and International Committee on Occupational Health (ICOH), this review summarises the literature on the management of circadian (re) adaption using bright light treatment. Recommendations to maximise circadian adaptation are summarised for practitioners based on a variety of shiftwork schedules. In slowly rotating night shift schedules bright light appears most suitable when used in connection with the first three night shifts. These interventions are improved when combined with orange glasses (to block blue-green light exposure) for the commute home. Non-shifting strategies involve a lower dosage of light at night and promoting natural daylight exposure during the day (also recommended for day shifts) in acordance with the phase and amplitude response curves to light in humans.

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• Delayed Sleep in Winter Related to Natural Daylight Exposure among Arctic Day Workers

  2018. Arne Lowden (et al.).

  Artikel

  Natural daylight exposures in arctic regions vary substantially across seasons. Negative consequences have been observed in self-reports of sleep and daytime functions during the winter but have rarely been studied in detail. The focus of the present study set out to investigate sleep seasonality among indoor workers using objective and subjective measures. Sleep seasonality among daytime office workers (n = 32) in Kiruna (Sweden, 67.86° N, 20.23° E) was studied by comparing the same group of workers in a winter and summer week, including work and days off at the weekend, using actigraphs (motion loggers) and subjective ratings of alertness and mood. Actigraph analyses showed delayed sleep onset of 39 min in winter compared to the corresponding summer week (p < 0.0001) and shorter weekly sleep duration by 12 min (p = 0.0154). A delay of mid-sleep was present in winter at workdays (25 min, p < 0.0001) and more strongly delayed during days off (46 min, p < 0.0001). Sleepiness levels were higher in winter compared to summer (p < 0.05). Increased morning light exposure was associated with earlier mid-sleep (p < 0.001), while increased evening light exposure was associated with delay (p < 0.01). This study confirms earlier work that suggests that lack of natural daylight delays the sleep/wake cycle in a group of indoor workers, despite having access to electric lighting. Photic stimuli resulted in a general advanced sleep/wake rhythm during summer and increased alertness levels.

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• Sleep Quality After Modified Uvulopalatopharyngoplasty

  2018. Joar Sundman (et al.). Sleep 41 (1)

  Artikel

  Study Objectives: To investigate whether uvulopalatopharyngoplasty (UPPP) improves sleep quality in patients with Obstructive Sleep Apnea (OSA) using the Functional Outcomes of Sleep Questionnaire (FOSQ) and the Karolinska Sleep Questionnaire (KSQ).

  Methods: Randomized controlled trial used to compare modified UPPP, with controls at baseline and after six months. The controls received delayed surgery and a six-month postoperative follow-up. All operated patients were offered a 24-month follow-up. At each follow-up, patients underwent polysomnography and vigilance testing and completed questionnaires. Nine scales were evaluated: five subscales and the total score in the FOSQ and three subscales in the KSQ.

  Results: Sixty-five patients, mean 42.3 years (SD 11.5), Friedman stage I and II, BMI <36 kg/m 2, moderate to severe OSA, were randomized to intervention (n = 32) or control (n = 33). In the FOSQ and in the KSQ, the mean rate of missing values was 6.2% (range 0-19%) and 20.5% (3-38%), respectively. In 8 of 9 scales, significant differences were observed between the groups in favor of UPPP. There were significant correlations between results from the questionnaires and objective measures from polysomnography and the vigilance test. At the six and 24-month postoperative follow-ups, 8 of 9 scales were significantly improved compared to baseline.

  Conclusions: In selected patients with OSA, subjective sleep quality was significantly improved six months after UPPP compared to controls, with stable improvements 24 months postoperatively. The correlations between subjective and objective outcomes, and the long-term stability suggest a beneficial effect from surgery, although a placebo effect cannot be excluded.

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