Randomized placebo-controlled field study of the effects of bright light and melatonin in adaptation to night work

Bjorvatn, Bjørn; Stangenes, Kristine Marie; Øyane, Nicolas; Forberg, Knut; Löwden, Arne; Holsten, Fred; Åkerstedt, Torbjörn

doi:10.5271/sjweh.1129

Cited by 71 publications

(94 citation statements)

References 46 publications

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“…However, of the included interventions that reported on sleepiness, findings were aligned with sleep quality and quantity results (23,24,33,36,42,53,60,64). One exception was a study of Modafinil, which significantly reduced sleepiness during the commute home from a night shift but had no effects on sleep (63).…”

Section: Discussionmentioning

confidence: 99%

“…For example, sleep outcomes reported using actigraphy or polysomnography (PSG), compared to sleep diaries, logs or questionnaires, more frequently found improvements in sleep. Of the five studies reporting both subjective and objective measures, two showed improvements only in objective measures (37,60) two showed improvements only in subjective measures (24,64), while one showed improvements in both (40). While logs or questionnaires may have lacked adequate sensitivity to detect sleep pattern changes, actigraphy or PSG were limited by technical issues or poor compliance.…”

Section: Discussionmentioning

confidence: 99%

“…Wearing blue-blocking goggles while commuting improved total sleep time (34) and sleep efficiency (35) in two studies. The two remaining studies found no significant effect of bright light on sleep parameters (24,29).…”

Section: Controlled Light Exposurementioning

confidence: 99%

“…Eight pharmacological interventions met inclusion criteria (24,(61)(62)(63)(64)(65)(66)(67) (table 6). Mean study quality score was 18.1 (range: 11-24).…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

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Health-related interventions among night shift workers: a critical review of the literature

Neil-Sztramko¹,

Pahwa²,

Demers³

et al. 2014

Scand J Work Environ Health

120

124

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The following articles refer to this text: 2014;40 (6) 543Review Scand J Work Environ Health. 2014:40(6):543-556. doi:10.5271/sjweh.3445 Health-related interventions among night shift workers: a critical review of the literature Objectives Associations between shift work and chronic disease have been observed, but relatively little is known about how to mitigate these adverse health effects. This critical review aimed to (i) synthesize interventions that have been implemented among shift workers to reduce the chronic health effects of shift work and (ii) provide an overall evaluation of study quality.Methods MeSH terms and keywords were created and used to conduct a rigorous search of MEDLINE, CINAHL, and EMBASE for studies published on or before 13 August 2012. Study quality was assessed using a checklist adapted from Downs & Black.Results Of the 5053 articles retrieved, 44 met the inclusion and exclusion criteria. Over 2354 male and female rotating and permanent night shift workers were included, mostly from the manufacturing, healthcare, and public safety industries. Studies were grouped into four intervention types: (i) shift schedule; (ii) controlled light exposure; (iii) behavioral; and, (iv) pharmacological. Results generally support the benefits of fast-forward rotating shifts; simultaneous use of timed bright light and light-blocking glasses; and physical activity, healthy diet, and health promotion. Mixed results were observed for hypnotics. Study quality varied and numerous deficiencies were identified.Conclusions Except for hypnotics, several types of interventions reviewed had positive overall effects on chronic disease outcomes. There was substantial heterogeneity among studies with respect to study sample, interventions, and outcomes. There is a need for further high-quality, workplace-based prevention research conducted among shift workers.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Controlled Light Exposurementioning

confidence: 99%

“…Eight pharmacological interventions met inclusion criteria (24,(61)(62)(63)(64)(65)(66)(67) (table 6). Mean study quality score was 18.1 (range: 11-24).…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

See 2 more Smart Citations

Health-related interventions among night shift workers: a critical review of the literature

Neil-Sztramko¹,

Pahwa²,

Demers³

et al. 2014

Scand J Work Environ Health

120

124

View full text Add to dashboard Cite

show abstract

“…The data are consistent with the notion that current artificial light sources are suboptimal for supporting melanopsin-based nonvisual effects of light because wavelengths targeting this photoreceptive system are not well represented. Traditionally, the effects of light on performance and sleepiness have been investigated at night or in nightshift settings (31)(32)(33)(34) because it is in such settings that the circadian system is the most sensitive to light. The current data, obtained in a field study, add to the growing evidence that light can enhance positive mood and performance during the daytime.…”

Section: Discussionmentioning

confidence: 99%

Blue-enriched white light in the workplace improves self-reported alertness, performance and sleep quality

Viola¹,

James²,

Schlangen³

et al. 2008

Scand J Work Environ Health

459

352

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Pharmacological interventions for sleepiness and sleep disturbances caused by shift work

Liira

Verbeek

Costa

et al. 2014

Cochrane Database of Systematic Reviews

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BACKGROUND: Shift work results in sleep-wake disturbances, which cause sleepiness during night shifts and reduce sleep length and quality in daytime sleep after the night shift. In its serious form it is also called shift work sleep disorder. Various pharmacological products are used to ameliorate symptoms of sleepiness or poor sleep length and quality. OBJECTIVES: To evaluate the effects of pharmacological interventions to reduce sleepiness or to improve alertness at work and decrease sleep disturbances whilst off work, or both, in workers undertaking shift work. METHODS: Search methods: We searched CENTRAL, MEDLINE, EMBASE, PubMed and PsycINFO up to 20 September 2013 and ClinicalTrials.gov up to July 2013. We also screened reference lists of included trials and relevant reviews. Selection criteria: We included all eligible randomised controlled trials (RCTs), including cross-over RCTs, of pharmacological products among workers who were engaged in shift work (including night shifts) in their present jobs and who may or may not have had sleep problems. Primary outcomes were sleep length and sleep quality while off work, alertness and sleepiness, or fatigue at work. Data collection and analysis: Two authors independently selected studies, extracted data and assessed risk of bias in included trials. We performed meta-analyses where appropriate. MAIN RESULTS: We included 15 randomised placebo-controlled trials with 718 participants. Nine trials evaluated the effect of melatonin and two the effect of hypnotics for improving sleep problems. One trial assessed the effect of modafinil, two of armodafinil and one examined caffeine plus naps to decrease sleepiness or to increase alertness. Melatonin (1 to 10 mg) after the night shift may increase sleep length during daytime sleep (mean difference, MD, 24 minutes, 95% confidence interval, CI, 9.8 to 38.9; seven trials, 263 participants, low quality evidence) and night-time sleep (MD 17 minutes, 95% CI 3.71 to 30.22; three trials, 234 participants, low quality evidence) compared to placebo. We did not find a dose-response effect. Melatonin may lead to similar sleep latency times as placebo (MD 0.37minutes, 95% CI-1.55 to 2.29; five trials, 74 participants, low quality evidence). Hypnotic medication, zopiclone, did not result in significantly longer daytime sleep length compared to placebo in one low quality trial and we could not use the data from the study on lormetazepam. Armodafinil taken before the night shift probably reduces sleepiness by one point on the Karolinska Sleepiness Scale (KSS) (MD-0.99, 95% CI-1.32 to-0.67; range 1 to 10; two trials, 572 participants, moderate quality evidence) and increases alertness by 50 ms in a simple reaction time test (MD-50.0, 95% CI-85.5 to-15.5) at three months' follow-up in shift work sleep disorder patients. Modafinil probably has similar effects on sleepiness (KSS) (MD-0.90, 95% CI-1.45 to-0.35; one trial, 183 participants, moderate quality evidence) and alertness in the psychomotor

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Randomized placebo-controlled field study of the effects of bright light and melatonin in adaptation to night work

Cited by 71 publications

References 46 publications

Health-related interventions among night shift workers: a critical review of the literature

Health-related interventions among night shift workers: a critical review of the literature

Blue-enriched white light in the workplace improves self-reported alertness, performance and sleep quality

Pharmacological interventions for sleepiness and sleep disturbances caused by shift work

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