† Disorders classified as TSRDs in the Diagnostic and Statistical Manual of Mental (DSM-5) include posttraumatic stress disorder (PTSD), acute (ASD), adjustment disorders (ADs), among others.§ Unpaid adult caregiver status was self-reported.The definition an unpaid for adults a person who had provided care to relative or friend aged ≥18 years help them take themselves at any time last 3 months.Examples included helping with personal needs, household chores, health tasks, managing person's...

To determine whether the onset of myocardial infarction occurs randomly throughout day, we analyzed time pain in 2999 patients admitted with infarction. A marked circadian rhythm frequency was detected, a peak from 6 a.m. to noon (P<0.01). In 703 patients, first elevation plasma creatine kinase MB (CK-MB) level could be used objectively. CK-MB—estimated timing confirmed existence rhythm, threefold increase at (9 a.m.) as compared trough (11 p.m.) periods. The not detected receiving...

Although sleep deprivation has been shown to impair neurobehavioral performance, few studies have measured its effects on medical errors.

Regulation of circadian period in humans was thought to differ from that other species, with the activity rhythm reported range 13 65 hours (median 25.2 hours) and body temperature average 25 adulthood, shorten age. However, those observations were based on studies exposed light levels sufficient confound estimation. Precise estimation periods endogenous rhythms melatonin, core temperature, cortisol healthy young older individuals living carefully controlled lighting conditions has now...

Temporary disruptions in routine and nonemergency medical care access delivery have been observed during periods of considerable community transmission SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (1). However, delay or avoidance might increase morbidity mortality risk associated with treatable preventable health conditions contribute to reported excess deaths directly indirectly related COVID-19 (2). To assess urgent emergency because concerns about COVID-19, a...

The role of the endogenous circadian pacemaker in timing sleep-wake cycle and regulation internal structure sleep, including REM EEG slow-wave (0.75-4.5 Hz) sleep spindle activity (12.75-15.0 was investigated. Eight men lived an environment free time cues for 33-36 d were scheduled to a 28 hr rest-activity so that episodes (9.33 each) occurred at all phases variations wakefulness preceding minimized. crest robust rhythm which observed throughout episode, positioned shortly after minimum core...

1 Ocular exposure to early morning room light can significantly advance the timing of human circadian pacemaker. The resetting response such has a non-linear relationship illuminance. dose-response pacemaker late evening dim moderate intensity not been well established. 2 Twenty-three healthy young male and female volunteers took part in 9 day protocol which single experimental exposure6.5 h duration was given biological night. effects on endogenous phase melatonin rhythm acute plasma...

Significance The use of light-emitting electronic devices for reading, communication, and entertainment has greatly increased recently. We found that the these before bedtime prolongs time it takes to fall asleep, delays circadian clock, suppresses levels sleep-promoting hormone melatonin, reduces amount timing REM sleep, alertness following morning. Use immediately also increases at time, which may lead users delay home. Overall, we portable biological effects perpetuate sleep deficiency...

The circadian pacemaker is differentially sensitive to the resetting effects of retinal light exposure, depending upon phase at which exposure occurs. Previously reported human response curves (PRCs) single bright exposures have employed small sample sizes, and were often based on relatively imprecise estimates resetting. In present study, 21 healthy, entrained subjects underwent pre- post-stimulus constant routines (CRs) in dim (approximately 2-7 lx) with maintained wakefulness a...

The response of the human circadian pacemaker to light was measured in 45 resetting trials. Each trial consisted an initial endogenous phase assessment, a three-cycle stimulus which included 5 hours bright per cycle, and final assessment. induced strong (type 0) resetting, with responses highly dependent on exposure. magnitude direction shifts were modulated by timing exposure ordinary room light, previously thought be undetectable pacemaker. data indicate that sensitivity is far greater...

Long work hours and shifts of an extended duration (> or =24 hours) remain a hallmark medical education in the United States. Yet their effect on health safety has not been evaluated with use validated measures.We conducted prospective nationwide, Web-based survey which 2737 residents first postgraduate year (interns) completed 17,003 monthly reports that provided detailed information about hours, duration, documented motor vehicle crashes, near-miss incidents, incidents involving...

Objective: Critically ill patients require high-intensity care and may be at especially high risk of iatrogenic injury because they are severely ill. We sought to study the incidence nature adverse events serious errors in critical setting. Design: conducted a prospective 1-year observational study. Incidents were collected with use multifaceted approach including direct continuous observation. Two physicians independently assessed incident type, severity, preventability as well...

Two- to threefold variations in sleep length were observed 12 subjects living on self-selected schedules an environment free of time cues. The duration polygraphically recorded episodes was highly correlated with the circadian phase body temperature rhythm at bedtime and not prior wakefulness. Furthermore, rate REM (rapid eye movement) accumulation, latency, selection, self-rated alertness assessments also rhythm.

Epidemiological studies link short sleep duration and circadian disruption with higher risk of metabolic syndrome diabetes. We tested the hypotheses that prolonged restriction concurrent disruption, as can occur in people performing shift work, impairs glucose regulation metabolism. Healthy adults spent >5 weeks under controlled laboratory conditions which they experienced an initial baseline segment optimal sleep, 3 (5.6 hours per 24 hours) combined (recurring 28-hour "days"), followed by 9...

Knowledge of the physiological effects extended (24 hours or more) work shifts in postgraduate medical training is limited. We aimed to quantify hours, sleep, and attentional failures among first-year residents (postgraduate year 1) during a traditional rotation schedule that included an intervention limited scheduled 16 fewer consecutive hours.

Human circadian rhythms were once thought to be insensitive light, with synchronization the 24-hour day accomplished either through social contacts or sleep-wake schedule. Yet demonstration of an intensity-dependent neuroendocrine response bright light has led renewed consideration as a possible synchronizer human pacemaker. In laboratory study, output pacemaker elderly woman was monitored before and after exposure 4 hours for seven consecutive evenings, control study in ordinary room while...

The endogenous circadian oscillator in mammals, situated the suprachiasmatic nuclei, receives environmental photic input from specialized subsets of photoreceptive retinal ganglion cells. human pacemaker is exquisitely sensitive to ocular light exposure, even some people who are otherwise totally blind. magnitude resetting response white depends on timing, intensity, duration, number and pattern exposures. We report here that humans, as measured by pineal melatonin rhythm, also wavelength...

Complete blindness generally results in the loss of synchronization circadian rhythms to 24-hour day and recurrent insomnia. However, some blind patients maintain entrainment. We undertook this study determine whether patients' eyes convey sufficient photic information entrain hypothalamic pacemaker suppress melatonin secretion, despite an apparently complete visual function.

To assess the wavelength-dependent sensitivity of acute effects ocular light exposure on alertness, performance, waking electroencephalogram (EEG), and cortisol.A between-subjects design was employed to compare 460-nm or 555-nm for 6.5 hours during biological night.Intensive Physiological Monitoring Unit, Brigham Women's Hospital, Boston, MA.Sixteen healthy adults (8 women; mean age +/- SD = 23.3 2.4 years).Subjects were exposed equal photon densities (2.8 x 10(13) photons cm(-2) s(-1))...

Circadian and sleep/wake dependent processes underlying variations in subjective alertness cognitive performance were assessed a constant routine protocol which the cycle was uncoupled from output of endogenous circadian pacemaker. In latter protocol, contribution process to separated by folding data at either period or body temperature rhythm. This analysis revealed that prior wakefulness within range 0-18 h significantly reduced rhythm core paralleled performance. During first 16 coincided...

Working at night results in a misalignment between the sleep-wake cycle and output of hypothalamic pacemaker that regulates circadian rhythms certain physiologic behavioral variables. We evaluated whether such maladaptation to nighttime work could be prevented effectively by treatment regimen exposure bright light during darkness day. assessed functioning five control studies order assess extent adaptation eight normal young men week work. In studies, on sixth consecutive sedentary ordinary...