@article{pmid41289768,

title = {Altered sleep EEG spectral dynamics across the menstrual cycle in premenstrual dysphoric disorder},

author = {Christophe Moderie and Philippe Boudreau and Rafael Pérez Medina Carballo and Diane B Boivin},

doi = {10.1016/j.sleep.2025.108679},

issn = {1878-5506},

year  = {2026},

date = {2026-02-01},

journal = {Sleep Med},

volume = {138},

pages = {108679},

abstract = {INTRODUCTION: Premenstrual Dysphoric Disorder (PMDD) is frequently associated with luteal-phase (LP) insomnia. Although the mechanisms underlying insomnia remain unclear, prior evidence suggests paradoxically increased N3 sleep in PMDD across the menstrual cycle. This study investigated potential alterations in sleep microarchitecture in women with PMDD.nnMETHODS: Six women diagnosed with PMDD (32.0 ± 5.7years), along with five healthy controls (30.4 ± 8.2 years) completed polysomnographic sleep recordings (PSGs) every third night throughout one menstrual cycle. EEG spectral analysis (C3-A2) was performed on NREM sleep using Fast Fourier Transform with a 4-s Hamming window and 50 % overlap, and a sleep spindle detector was used. Within-group changes were reported relative to the follicular phase (set at 100 %), and between-group differences relative to controls (set at 100 %), with 95 % confidence intervals for significance. Mixed-model ANOVA was used for spindles parameters. Correlations examined the relationships among EEG frequency bands, core body temperature (Tcore), urinary 6-sulfatoxymelatonin (aMT6), and self-reported mood and sleep quality.nnRESULTS: Relative to their FP, the PMDD group showed decreased theta and increased spindle frequency activity (SFA) in the LP. Between-group comparisons indicated higher SFA (∼60 %) and spindle density in PMDD across both phases, as well as lower slow wave activity (SWA; ∼40 %). Moreover, SWA correlated with aMT6 and subjective sleep quality, while elevated SFA was associated with Tcore and mood symptoms.nnCONCLUSIONS: This study revealed alterations in sleep microarchitecture in PMDD, particularly regarding spindle activity and SWA. The previously observed increase in N3 sleep may reflect a compensatory mechanism in response to disrupted homeostatic processes, warranting further investigation into targeted interventions for insomnia in PMDD.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38665057,

title = {Dampened circadian amplitude of EEG power in women after menopause},

author = {Rafael Pérez-Medina-Carballo and Anastasi Kosmadopoulos and Christophe Moderie and Philippe Boudreau and Manon Robert and Diane B Boivin},

doi = {10.1111/jsr.14219},

issn = {1365-2869},

year  = {2025},

date = {2025-08-01},

journal = {J Sleep Res},

volume = {34},

number = {4},

pages = {e14219},

abstract = {Postmenopausal women are at high risk of developing sleep-wake disturbances. We previously reported dampened circadian rhythms of melatonin, alertness and sleep in postmenopausal compared with young women. The present study aims to further explore electroencephalography power spectral changes in the sleep of postmenopausal women. Eight healthy postmenopausal women were compared with 12 healthy, naturally ovulating, young women in their mid-follicular phase. Participants followed a regular 8-hr sleep schedule for ≥ 2 weeks prior to laboratory entry. The laboratory visit included an 8-hr baseline sleep period followed by an ultradian sleep-wake cycle procedure, consisting of alternating 1-hr wake periods and nap opportunities. Electroencephalography power spectral analysis was performed on non-rapid eye movement sleep obtained over a 48-hr period. The baseline nocturnal sleep of postmenopausal women comprised lower power within delta and sigma, and higher power within alpha bands compared with that of younger women. During nighttime naps of the ultradian sleep-wake cycle procedure, lower power within delta and sigma, and higher power within beta bands were observed in postmenopausal women. During the ultradian sleep-wake cycle procedure, postmenopausal women presented lower power of delta, theta and sigma (14-15 Hz), undetectable rhythms of delta and theta, and a dampened or undetectable rhythm of sigma (12-15 Hz) power compared with younger women. Our results support the hypothesis of a dampened circadian variation of sleep microstructure in healthy-sleeping postmenopausal women. Circadian changes with aging are potential mechanisms for increased susceptibility to develop sleep disturbances; however, further research is needed to clarify their clinical implications and contribution to insomnia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39935825,

title = {Pathophysiological Models of Hypersomnolence Associated With Depression},

author = {Christophe Moderie and Diane B Boivin},

doi = {10.1016/j.bpsgos.2024.100445},

issn = {2667-1743},

year  = {2025},

date = {2025-03-01},

journal = {Biol Psychiatry Glob Open Sci},

volume = {5},

number = {2},

pages = {100445},

abstract = {Up to 25% of patients with depression experience hypersomnolence (e.g., excessive daytime sleepiness, hypersomnia, and/or sleep inertia), which is associated with treatment resistance, overall poorer outcomes, and safety concerns while driving. Hypersomnolence can result from various sleep/neurological disorders or side effects from medication but is often medically unexplained in depression. In this review, we aimed to summarize the different pathophysiological models of hypersomnolence in depression to discuss their impact on nosology and to foster the development of better tailored diagnostics and treatments. We identified several potential mechanisms underlying hypersomnolence including a daytime hypoactivity of dopaminergic and noradrenergic systems, nighttime GABA (gamma-aminobutyric acid) hypoactivation, hypoperfusion, and hypoconnectivity in the medial prefrontal cortex, as well as a longer circadian period and light hyposensitivity. In some patients with depression, nighttime hyperarousal can fragment sleep and result in a complaint of excessive daytime sleepiness, thus mimicking hypersomnolence. Others might adopt maladaptive behaviors such as spending excessive time in bed, a term coined clinophilia. Objective markers of hypersomnolence, such as ambulatory ad libitum polysomnography may facilitate distinguishing between conditions that mimic hypersomnolence. Our review identified several clinical targets for hypersomnolence in depression. Low-sodium oxybate, which is approved for idiopathic hypersomnia, needs additional study in patients with depression. Neuromodulation that targets prefrontal cortex anomalies should be systematically explored, while tailored light therapy protocols may mitigate light hyposensitivity. Additionally, cognitive behavioral therapy for hypersomnolence is being developed as a nonpharmacological adjunct to these treatments.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39423674,

title = {Diagnosing and treating hypersomnolence in depression},

author = {Christophe Moderie and Diane B Boivin},

doi = {10.1016/j.sleep.2024.10.008},

issn = {1878-5506},

year  = {2024},

date = {2024-12-01},

journal = {Sleep Med},

volume = {124},

pages = {462--470},

abstract = {Hypersomnolence, a broad presentation encompassing excessive daytime sleepiness, hypersomnia and sleep inertia, affects around 25 % of patients with a major depressive disorder. Yet, hypersomnolence is often overlook in clinical settings - which can prevent remission of the mood disorder in addition to significantly interfering with quality of life. Clinical guidelines are lacking to support clinicians in the diagnosis and treatment of hypersomnolence in depression. Pharmacological treatment with selective serotonin reuptake inhibitors is insufficient and noradrenaline and dopamine reuptake inhibitors or similar molecules are generally indicated. Low-sodium oxybate was recently approved for Idiopathic Hypersomnia, but studies are needed to assess its efficacy in patients with comorbid depression. In parallel, cognitive behavioral therapy for hypersomnia is being developed as adjunct non-pharmacological treatment. Light therapy might also be beneficial in these populations. This narrative review aims at proposing a diagnostic approach reconciliating psychiatry and sleep medicine nosologies, as well as offering a multimodal treatment algorithm for hypersomnolence in depression.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid38695643,

title = {A shot in the dark: the impact of online visibility on the search for an effective sleep app},

author = {Niamh Power and Diane B Boivin and Michel Perreault},

doi = {10.5664/jcsm.11202},

issn = {1550-9397},

year  = {2024},

date = {2024-08-01},

journal = {J Clin Sleep Med},

volume = {20},

number = {8},

pages = {1379--1386},

abstract = {STUDY OBJECTIVES: Dictated by consumer ratings and concealed algorithms, high levels of online visibility are granted to certain sleep apps on mainstream modes of app selection. Yet, it remains unclear to what extent these highly visible apps are evidence-based. The objectives of this review were to identify and describe the apps with the greatest online visibility when searching for a sleep app and to assess the claimed and actual research associated with them.nnMETHODS: A keyword search was conducted in Google Play and Google search. Titles of the most visible apps were retrieved. App descriptions were examined to identify research claims made about app effectiveness on sleep and other health-related outcomes. A follow-up search on PubMed and Google Scholar was conducted to verify claims.nnRESULTS: The keyword search identified 53 highly visible apps. Examination of app store descriptions found that no reference to research was made for the majority of apps (n = 45, 84.9%). Published research studies were available for just 3 apps, with most studies evaluating app impact on non sleep-related outcomes. There was some evidence to attesting to the effectiveness of 2 apps in improving sleep.nnCONCLUSIONS: This review demonstrates how, when carrying out a typical search for a sleep app, information about the evidence base for the majority of highly visible apps is not available. Results highlight the need for the improvement of mainstream modes of app selection in terms of better consumer-app specificity and increased transparency regarding the access to information about the evidence base for apps.nnCITATION: Power N, Boivin DB, Perreault M. A shot in the dark: the impact of online visibility on the search for an effective sleep app. . 2024;20(8):1379-1386.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid39001096,

title = {Derivative Method to Detect Sleep and Awake States through Heart Rate Variability Analysis Using Machine Learning Algorithms},

author = {Fabrice Vaussenat and Abhiroop Bhattacharya and Philippe Boudreau and Diane B Boivin and Ghyslain Gagnon and Sylvain G Cloutier},

doi = {10.3390/s24134317},

issn = {1424-8220},

year  = {2024},

date = {2024-07-01},

journal = {Sensors (Basel)},

volume = {24},

number = {13},

abstract = {Sleep disorders can have harmful consequences in both the short and long term. They can lead to attention deficits, as well as cardiac, neurological and behavioral repercussions. One of the most widely used methods for assessing sleep disorders is polysomnography (PSG). A major challenge associated with this method is all the cables needed to connect the recording devices, making the examination more intrusive and usually requiring a clinical environment. This can have potential consequences on the test results and their accuracy. One simple way to assess the state of the central nervous system (CNS), a well-known indicator of sleep disorder, could be the use of a portable medical device. With this in mind, we implemented a simple model using both the RR interval (RRI) and its second derivative to accurately predict the awake and napping states of a subject using a feature classification model. For training and validation, we used a database providing measurements from nine healthy young adults (six men and three women), in which heart rate variability (HRV) associated with light-on, light-off, sleep onset and sleep offset events. Results show that using a 30 min RRI time series window suffices for this lightweight model to accurately predict whether the patient was awake or napping.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37750410,

title = {Circadian Adaptation of Melatonin and Cortisol in Police Officers Working Rotating Shifts},

author = {Anastasi Kosmadopoulos and Philippe Boudreau and Laura Kervezee and Diane B Boivin},

doi = {10.1177/07487304231196280},

issn = {1552-4531},

year  = {2024},

date = {2024-02-01},

journal = {J Biol Rhythms},

volume = {39},

number = {1},

pages = {49--67},

abstract = {Misalignment of behavior and circadian rhythms due to night work can impair sleep and waking function. While both simulated and field-based studies suggest that circadian adaptation to a nocturnal schedule is slow, the rates of adaptation in real-world shift-work conditions are still largely unknown. The aim of this study was to evaluate the extent of adaptation of 24-h rhythms with 6-sulfatoxymelatonin (aMT6s) and cortisol in police officers working rotating shifts, with a special attention to night shifts. A total of 76 police officers (20 women; aged 32 ± 5.4 years, mean ± SD) from the province of Quebec, Canada, participated in a field study during their 28- or 35-day work cycle. Urine samples were collected for ~32 h before a series of day, evening, and night shifts to assess circadian phase. Before day, evening, and night shifts, 60%-89% of officers were adapted to a day schedule based on aMT6 rhythms, and 71%-78% were adapted based on cortisol rhythms. To further quantify the rate of circadian adaptation to night shifts, initial and final phases were determined in a subset of 37 officers with suitable rhythms for both hormones before and after 3-8 consecutive shifts (median = 7). Data were analyzed with circular and linear mixed-effects models. After night shifts, 30% and 24% of officers were adapted to a night-oriented schedule for aMT6s and cortisol, respectively. Significantly larger phase-delay shifts (aMT6s: -7.3 ± 0.9 h; cortisol: -6.3 ± 0.8 h) were observed in police officers who adapted to night shifts than in non-adapted officers (aMT6s: 0.8 ± 0.9 h; cortisol: 0.2 ± 1.1 h). Consistent with prior research, our results from both urinary aMT6s and cortisol midpoints indicate that a large proportion of police officers remained in a state of circadian misalignment following a series of night shifts in dim-light working environments.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37914633,

title = {Interindividual variability in coherence between self-reported alertness and performance in shift workers},

author = {Diane B Boivin and Philippe Boudreau},

doi = {10.1016/j.sleh.2023.09.005},

issn = {2352-7226},

year  = {2024},

date = {2024-02-01},

journal = {Sleep Health},

volume = {10},

number = {1S},

pages = {S63--S66},

abstract = {OBJECTIVES: Evidence indicates that self-reported measures of alertness do not always reflect performance impairments. The present study aims to explore whether subjective and objective measures of vigilance vary in the same direction in individuals working nights.nnMETHODS: A total of 76 police officers participated to a month-long observational study. They worked either a 2 or 3-shift system during which they self-reported alertness and completed a psychomotor vigilance task several times a day.nnRESULTS: A reduction in alertness and reaction speed was observed with time awake. At the group level, changes in alertness and reaction speed with time awake were positively correlated during night shifts only. In 63.6% of the officers, changes were coherent between both variables. The other officers reported that their alertness dropped (25.5%) or improved (10.9%) whereas their performance changed in the opposite direction.nnCONCLUSION: Significant interindividual variability exists in self-appraisal vigilance impairment due to night shift work.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36346168,

title = {The Effect of Night Shifts on 24-h Rhythms in the Urinary Metabolome of Police Officers on a Rotating Work Schedule},

author = {Laura Kervezee and Anna Koshy and Nicolas Cermakian and Diane B Boivin},

doi = {10.1177/07487304221132088},

issn = {1552-4531},

year  = {2023},

date = {2023-02-01},

journal = {J Biol Rhythms},

volume = {38},

number = {1},

pages = {64--76},

abstract = {Shift workers face an increased risk of metabolic health problems, but the direct metabolic response to working nights is not fully understood. The aim of this study was to investigate the effect of night shifts on the 24-h urinary metabolome of shift workers. Eleven police officers working rotating shifts completed two 24-h laboratory visits that took place before and after they worked 7 consecutive nights. Sleep and meals were scheduled on a day schedule in the first visit and then on a night schedule (i.e., sleep and meals shifted by approximately 12 h) in the second visit. Targeted metabolomic analysis was performed on urine samples collected throughout these laboratory visits. Differential rhythmicity analysis was used to compare 24-h rhythms in urinary metabolites in both conditions. Our results show that on the day schedule, 24-h rhythms are present in the urinary levels of the majority of metabolites, but that this is significantly reduced on the night schedule, partly due to loss of organic acid rhythmicity. Furthermore, misalignment of 24-h metabolite rhythms with the shifted behavioral cycles in the night schedule was observed in more than half of the metabolites that were rhythmic in both conditions (all acylcarnitines). These results show that working nights alters the daily rhythms of the urinary metabolome in rotating shift workers, with the most notable impact observed for acylcarnitines and organic acids, 2 metabolite classes involved in mitochondrial function. Further research is warranted to study how these changes relate to the increased metabolic risks associated with shift work.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid36420995,

title = {The circadian variation of sleep and alertness of postmenopausal women},

author = {Rafael Pérez-Medina-Carballo and Anastasi Kosmadopoulos and Philippe Boudreau and Manon Robert and Claire-Dominique Walker and Diane B Boivin},

doi = {10.1093/sleep/zsac272},

issn = {1550-9109},

year  = {2023},

date = {2023-02-01},

journal = {Sleep},

volume = {46},

number = {2},

abstract = {STUDY OBJECTIVES: Several factors may contribute to the high prevalence of sleep disturbances occurring in postmenopausal women. However, the contribution of the circadian timing system to their sleep disturbances remains unclear. In the present study, we aim to understand the impact of circadian factors on changes of sleep and alertness occurring after menopause.nnMETHODS: Eight healthy postmenopausal women and 12 healthy young women in their mid-follicular phase participated in an ultradian sleep-wake cycle procedure (USW). This protocol consisted of alternating 60-min wake periods and nap opportunities for ≥ 48 h in controlled laboratory conditions. Core body temperature (CBT), salivary melatonin, self-reported alertness, and polysomnographically recorded sleep were measured across this procedure.nnRESULTS: In both groups, all measures displayed a circadian variation throughout the USW procedure. Compared to young women, postmenopausal women presented lower CBT values, more stage N1 and N2 sleep, and number of arousals. They also showed a reduced amplitude of the circadian variation of melatonin, total sleep time (TST), sleep onset latency (SOL), stage N3 sleep, and alertness levels. Postmenopausal women fell asleep faster and slept more during the biological day and presented higher alertness levels during the biological night than young women.nnCONCLUSION: These results support the hypothesis of a weakened circadian signal promoting sleep and wakefulness in older women. Aging processes including hormonal changes may be main contributors to the increased sleep-wake disturbances after menopause.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid37193267,

title = {Exploratory study of the effects of sex and hormonal contraceptives on alertness, fatigue, and sleepiness of police officers on rotating shifts},

author = {Diane B Boivin and Gabriela M Caetano and Laura Kervezee and Fernando Gonzales-Aste and Philippe Boudreau},

doi = {10.1093/sleepadvances/zpac049},

issn = {2632-5012},

year  = {2023},

date = {2023-01-01},

journal = {Sleep Adv},

volume = {4},

number = {1},

pages = {zpac049},

abstract = {STUDY OBJECTIVES: This exploratory study assessed the impact of sex and hormonal contraceptives (HC) use on the homeostatic and diurnal variation of alertness, fatigue, sleepiness, psychomotor performance, and sleep behavior in police officers working rotating shifts.nnMETHODS: A total of 56 men and 20 women (6 using, 11 not using, and 3 with unknown use of HC) participated in an observational study throughout a month-long work cycle. Participants wore an actigraph, filled out a sleep and work log, answered questionnaires (Samn-Perelli, KSS, Visual Analogue Scales), and completed 5-min Psychomotor Vigilance Tasks (PVT) according to an ecological momentary assessment approach. Linear mixed-effects models were used to analyze the effects of group (men, women, and HC use), time awake, and time of day on the dependent variables.nnRESULTS: Self-reported parameters and performance significantly varied with time awake and time of day. Women were more fatigued and sleepier than men, when considering both time awake and time of day. Compared to men, women using HC were more fatigued, less alert, and sleepier. Women had less attention lapses than men after 7 and 17 h awake, although no main effect of HC was detected.nnCONCLUSIONS: Women tended to rate themselves as more fatigued than men, especially when using HC. Surprisingly, psychomotor performances of women were sometimes better than those of men. This exploratory study indicates that sex and HC are important factors to consider in occupational medicine.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid35773789,

title = {Sleep of Healthcare Workers During the COVID-19 Pandemic and the Role of Atypical Work Schedules: A Scoping Review},

author = {Niamh Power and Michel Perreault and Manuela Ferrari and Philippe Boudreau and Diane B Boivin},

doi = {10.1177/07487304221103376},

issn = {1552-4531},

year  = {2022},

date = {2022-08-01},

journal = {J Biol Rhythms},

volume = {37},

number = {4},

pages = {358--384},

abstract = {The COVID-19 pandemic has negatively impacted the well-being of healthcare workers (HCWs). HCWs are highly exposed to shift work and their work schedules have been subject to increasing unpredictability since the start of the pandemic. This review aims to: (1) map the studies providing information about factors associated with sleep characteristics in HCWs working in the context of the COVID-19 pandemic during the first and second waves and (2) examine the state of the evidence base in terms of the availability of information on the influence of atypical work schedules. A literature search was performed in PubMed. Studies containing information about factors (demographic; psychological; occupational; COVID-19-specific; work schedule; lifestyle; medical; or other) associated with various sleep characteristics among HCWs working in the context of the COVID-19 pandemic were included. Particular attention was paid to the availability of information on the role of atypical work schedules on HCW sleep. Fifty-seven articles met the inclusion criteria. Most studies were reports of quantitative cross-sectional surveys using self-report measures. Associations between female sex, frontline HCW status, psychological factors, and poorer sleep were observed. Six studies included a measure of shift work in their analyses, 5 of which reported an association between shift work status and sleep. A wide range of factors were investigated, with female sex, frontline HCW status, and psychological factors repeatedly demonstrating associations with poorer sleep. Sleep was predominantly measured in terms of self-reported sleep quality or insomnia symptoms. Few studies investigated the influence of atypical work schedules on HCW sleep in the context of the COVID-19 pandemic. Research on this topic is lacking in terms of reliable and consistent measurements of sleep outcomes, longitudinal data, and knowledge about the influence of covariates such atypical work schedules, comorbidity, and medical history on HCW sleep.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34756484,

title = {How effective are Fatigue Risk Management Systems (FRMS)? A review},

author = {Madeline Sprajcer and Matthew J W Thomas and Charli Sargent and Meagan E Crowther and Diane B Boivin and Imelda S Wong and Alison Smiley and Drew Dawson},

doi = {10.1016/j.aap.2021.106398},

issn = {1879-2057},

year  = {2022},

date = {2022-02-01},

journal = {Accid Anal Prev},

volume = {165},

pages = {106398},

abstract = {OBJECTIVE: Fatigue Risk Management Systems (FRMS) are a data-driven set of management practices for identifying and managing fatigue-related safety risks. This approach also considers sleep and work time, and is based on ongoing risk assessment and monitoring. This narrative review addresses the effectiveness of FRMS, as well as barriers and enablers in the implementation of FRMS. Furthermore, this review draws on the literature to provide evidence-based policy guidance regarding FRMS implementation.nnMETHODS: Seven databases were drawn on to identify relevant peer-reviewed literature. Relevant grey literature was also reviewed based on the authors' experience in the area. In total, 2129 records were screened based on the search strategy, with 231 included in the final review.nnRESULTS: Few studies provide an evidence-base for the effectiveness of FRMS as a whole. However, FRMS components (e.g., bio-mathematical models, self-report measures, performance monitoring) have improved key safety and fatigue metrics. This suggests FRMS as a whole are likely to have positive safety outcomes. Key enablers of successful implementation of FRMS include organisational and worker commitment, workplace culture, and training.nnCONCLUSIONS: While FRMS are likely to be effective, in organisations where safety cultures are insufficiently mature and resources are less available, these systems may be challenging to implement successfully. We propose regulatory bodies consider a hybrid model of FRMS, where organisations could choose to align with tight hours of work (compliance) controls. Alternatively, where organisational flexibility is desired, a risk-based approach to fatigue management could be implemented.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34969316,

title = {Disturbance of the Circadian System in Shift Work and Its Health Impact},

author = {Diane B Boivin and Philippe Boudreau and Anastasi Kosmadopoulos},

doi = {10.1177/07487304211064218},

issn = {1552-4531},

year  = {2022},

date = {2022-02-01},

journal = {J Biol Rhythms},

volume = {37},

number = {1},

pages = {3--28},

abstract = {The various non-standard schedules required of shift workers force abrupt changes in the timing of sleep and light-dark exposure. These changes result in disturbances of the endogenous circadian system and its misalignment with the environment. Simulated night-shift experiments and field-based studies with shift workers both indicate that the circadian system is resistant to adaptation from a day- to a night-oriented schedule, as determined by a lack of substantial phase shifts over multiple days in centrally controlled rhythms, such as those of melatonin and cortisol. There is evidence that disruption of the circadian system caused by night-shift work results not only in a misalignment between the circadian system and the external light-dark cycle, but also in a state of internal desynchronization between various levels of the circadian system. This is the case between rhythms controlled by the central circadian pacemaker and clock genes expression in tissues such as peripheral blood mononuclear cells, hair follicle cells, and oral mucosa cells. The disruptive effects of atypical work schedules extend beyond the expression profile of canonical circadian clock genes and affects other transcripts of the human genome. In general, after several days of living at night, most rhythmic transcripts in the human genome remain adjusted to a day-oriented schedule, with dampened group amplitudes. In contrast to circadian clock genes and rhythmic transcripts, metabolomics studies revealed that most metabolites shift by several hours when working nights, thus leading to their misalignment with the circadian system. Altogether, these circadian and sleep-wake disturbances emphasize the all-encompassing impact of night-shift work, and can contribute to the increased risk of various medical conditions. Here, we review the latest scientific evidence regarding the effects of atypical work schedules on the circadian system, sleep and alertness of shift-working populations, and discuss their potential clinical impacts.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34240212,

title = {Effects of exogenous melatonin on sleep and circadian rhythms in women with premenstrual dysphoric disorder},

author = {Christophe Moderie and Philippe Boudreau and Ari Shechter and Paul Lespérance and Diane B Boivin},

doi = {10.1093/sleep/zsab171},

issn = {1550-9109},

year  = {2021},

date = {2021-12-01},

journal = {Sleep},

volume = {44},

number = {12},

abstract = {We previously found normal polysomnographic (PSG) sleep efficiency, increased slow-wave sleep (SWS), and a blunted melatonin secretion in women with premenstrual dysphoric disorder (PMDD) compared to controls. Here, we investigated the effects of exogenous melatonin in five patients previously studied. They took 2 mg of slow-release melatonin 1 h before bedtime during their luteal phase (LP) for three menstrual cycles. At baseline, patients spent every third night throughout one menstrual cycle sleeping in the laboratory. Measures included morning urinary 6-sulfatoxymelatonin (aMt6), PSG sleep, nocturnal core body temperature (CBT), visual analog scale for mood (VAS-Mood), Prospective Record of the Impact and Severity of Menstrual Symptoms (PRISM), and ovarian plasma hormones. Participants also underwent two 24-hour intensive physiological monitoring (during the follicular phase and LP) in time-isolation/constant conditions to determine 24-hour plasma melatonin and CBT rhythms. The same measures were repeated during their third menstrual cycle of melatonin administration. In the intervention condition compared to baseline, we found increased urinary aMt6 (p < 0.001), reduced objective sleep onset latency (p = 0.01), reduced SWS (p < 0.001), and increased Stage 2 sleep (p < 0.001). Increased urinary aMt6 was correlated with reduced SWS (r = -0.51, p < 0.001). Circadian parameters derived from 24-hour plasma melatonin and CBT did not differ between conditions, except for an increased melatonin mesor in the intervention condition (p = 0.01). Ovarian hormones were comparable between the conditions (p ≥ 0.28). Symptoms improved in the intervention condition, as measured by the VAS-Mood (p = 0.02) and the PRISM (p < 0.001). These findings support a role for disturbed melatonergic system in PMDD that can be partially corrected by exogenous melatonin.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid34666885,

title = {Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society},

author = {Indira Gurubhagavatula and Laura K Barger and Christopher M Barnes and Mathias Basner and Diane B Boivin and Drew Dawson and Christopher L Drake and Erin E Flynn-Evans and Vincent Mysliwiec and P Daniel Patterson and Kathryn J Reid and Charles Samuels and Nita Lewis Shattuck and Uzma Kazmi and Gerard Carandang and Jonathan L Heald and Hans P A Van Dongen},

doi = {10.5664/jcsm.9512},

issn = {1550-9397},

year  = {2021},

date = {2021-11-01},

journal = {J Clin Sleep Med},

volume = {17},

number = {11},

pages = {2283--2306},

abstract = {Risks associated with fatigue that accumulates during work shifts have historically been managed through working time arrangements that specify fixed maximum durations of work shifts and minimum durations of time off. By themselves, such arrangements are not sufficient to curb risks to performance, safety, and health caused by misalignment between work schedules and the biological regulation of waking alertness and sleep. Science-based approaches for determining shift duration and mitigating associated risks, while addressing operational needs, require: (1) a recognition of the factors contributing to fatigue and fatigue-related risks; (2) an understanding of evidence-based countermeasures that may reduce fatigue and/or fatigue-related risks; and (3) an informed approach to selecting workplace-specific strategies for managing work hours. We propose a series of guiding principles to assist stakeholders with designing a shift duration decision-making process that effectively balances the need to meet operational demands with the need to manage fatigue-related risks.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33538307,

title = {The relationship between chronotype and sleep behavior during rotating shift work: a field study},

author = {Laura Kervezee and Fernando Gonzales-Aste and Phillipe Boudreau and Diane B Boivin},

doi = {10.1093/sleep/zsaa225},

issn = {1550-9109},

year  = {2021},

date = {2021-04-01},

journal = {Sleep},

volume = {44},

number = {4},

abstract = {Shift work, an essential part of our 24/7 society, inevitably leads to displacement of the habitual sleep period and thereby to misalignment of the internal circadian timing system with the rest-activity cycle and the environment. How interindividual differences in circadian organization affect sleep duration and timing during rotating shift work is not fully understood. The objective of this study was to assess the effect of chronotype, shift type, and their interaction on actigraphy-based sleep behavior in 74 police officers (20 women and 54 men; age [mean ± SD]: 32.1 ± 5.4 years) involved in rotating shift work throughout a 28- to 35-day work cycle consisting of morning, evening, and night shifts. Using linear mixed modeling, we found that chronotype was associated with sleep duration depending on the shift type: increasing morningness was correlated with longer sleep duration during series of consecutive morning shifts, while increasing eveningness was correlated with longer sleep duration during series of evening shifts. During series of night shifts, increasing eveningness was associated with a longer duration of the main sleep episode, but this relationship was attenuated and no longer significant when naps were taken into account due to increased napping in morning chronotypes during series of night shifts. Providing a detailed within-subject characterization of sleep behavior across a complete work cycle consisting of morning, evening, and night shifts, this study advances the understanding of the relationship between chronotype and sleep in rotating shift workers and supports the implementation of work schedules that take into account chronobiological principles.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid33284434,

title = {The Assessment of Circadian Rhythms Within the Immune System},

author = {Chloé C Nobis and Marc Cuesta and Jean-François Daudelin and Geneviève Dubeau Laramée and Diane B Boivin and Nathalie Labrecque and Nicolas Cermakian},

doi = {10.1007/978-1-0716-0381-9_3},

issn = {1940-6029},

year  = {2021},

date = {2021-01-01},

journal = {Methods Mol Biol},

volume = {2130},

pages = {29--51},

abstract = {In recent years, circadian rhythms have been observed in many aspects of the immune system, both for the innate immunity (the first line of defense against pathogens) and the adaptive immunity (a more specific set of responses, which lead to immune memory). Here, to illustrate principles to be taken into account when working on circadian rhythms in immunology experiments, two protocols will be presented. The first one aims to analyze immune parameters in blood sampled from human subjects at different times over the day: counts of different cell types among the peripheral blood mononuclear cells and cytokine secretion by monocytes and T cells after ex vivo stimulation. The second protocol describes how to follow the response of CD8 T cells after immunization of mice with antigen presenting cells loaded with a peptide antigen. These two protocols are optimized for circadian experiments, and outcome measures are mainly based on flow cytometry, which allows analysis of different parameters in the same cells.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid32260404,

title = {Effects of Shift Work on the Eating Behavior of Police Officers on Patrol},

author = {Anastasi Kosmadopoulos and Laura Kervezee and Philippe Boudreau and Fernando Gonzales-Aste and Nina Vujovic and Frank A J L Scheer and Diane B Boivin},

doi = {10.3390/nu12040999},

issn = {2072-6643},

year  = {2020},

date = {2020-04-01},

journal = {Nutrients},

volume = {12},

number = {4},

abstract = {Recent studies indicate that the timing of food intake can significantly affect metabolism and weight management. Workers operating at atypical times of the 24-h day are at risk of disturbed feeding patterns. Given the increased risk of weight gain, obesity and metabolic syndrome in shift working populations, further research is required to understand whether their eating behavior could contribute to these increased metabolic risks. The objective of this study was to characterize the dietary patterns of police officers across different types of shifts in their natural environments. Thirty-one police officers (six women; aged 32.1 ± 5.4 years, mean ± SD) from the province of Quebec, Canada, participated in a 28- to 35-day study, comprising 9- to 12-h morning, evening, and night shifts alternating with rest days. Sleep and work patterns were recorded with actigraphy and diaries. For at least 24 h during each type of work day and rest day, participants logged nutrient intake by timestamped photographs on smartphones. Macronutrient composition and caloric content were estimated by registered dieticians using the Nutrition Data System for Research database. Data were analyzed with linear mixed effects models and circular ANOVA. More calories were consumed relative to individual metabolic requirements on rest days than both evening- and night-shift days ( = 0.001), largely sourced from increased fat ( = 0.004) and carbohydrate (trend,  = 0.064) intake. Regardless, the proportions of calories from carbohydrates, fat, and protein did not differ significantly between days. More calories were consumed during the night, between 2300 h and 0600 h, on night-shift days than any other days ( < 0.001). Caloric intake occurred significantly later for night-shift days (2308 h ± 0114 h, circular mean ± SD) than for rest days (1525 h ± 0029 h;  < 0.01) and was dispersed across a longer eating window (13.9 h ± 3.1 h vs. 11.3 h ± 1.8 h, mean ± SD). As macronutrient proportions were similar and caloric intake was lower, the finding of later meals times on night-shift days versus rest days is consistent with emerging hypotheses that implicate the biological timing of food intake-rather than its quantity or composition-as the differentiating dietary factor in shift worker health.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{pmid30357975,

title = {Metabolic and cardiovascular consequences of shift work: The role of circadian disruption and sleep disturbances},

author = {Laura Kervezee and Anastasi Kosmadopoulos and Diane B Boivin},

doi = {10.1111/ejn.14216},

issn = {1460-9568},

year  = {2020},

date = {2020-01-01},

journal = {Eur J Neurosci},

volume = {51},

number = {1},

pages = {396--412},

abstract = {Shift work, defined as work occurring outside typical daytime working hours, is associated with an increased risk of various non-communicable diseases, including diabetes and cardiovascular disease. Disruption of the internal circadian timing system and concomitant sleep disturbances is thought to play a critical role in the development of these health problems. Indeed, controlled laboratory studies have shown that short-term circadian misalignment and sleep restriction independently impair physiological processes, including insulin sensitivity, energy expenditure, immune function, blood pressure and cardiac modulation by the autonomous nervous system. If allowed to persist, these acute effects may lead to the development of cardiometabolic diseases in the long term. Here, we discuss the evidence for the contributions of circadian disruption and associated sleep disturbances to the risk of metabolic and cardiovascular health problems in shift workers. Improving the understanding of the physiological mechanisms affected by circadian misalignment and sleep disturbance will contribute to the development and implementation of strategies that prevent or mitigate the cardiometabolic impact of shift work.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}