![]() Susceptibility to desynchronization of circadian autonomic and cardiopulmonary processes may influence one’s ability to adapt to shift work. These observations emphasize the importance of circadian processes in cardiovascular pathology. Adverse cardiovascular events, including myocardial infarction, sudden cardiac death, pulmonary embolism, and ischemic or hemorrhagic stroke, all exhibit a circadian pattern of risk, with a greater likelihood of occurrence in the early morning relative to night (Takeda and Maemura 2016 Manfredini et al. Under normal circumstances, average heart rate increases in the morning after awakening, reaches a peak between 10 h, then gradually declines later in the day, maintaining a low level during the night relative to daytime (Takeda and Maemura 2016 Portaluppi et al. The ANS interacts closely with the cardiopulmonary system, and the activity of both systems exhibit distinct circadian patterns that are readily quantified via monitoring of blood pressure or heart rate (Takeda and Maemura 2016 Portaluppi et al. 2016).Ī normally functioning cardiovascular system depends on a homeostatic balance between the sympathetic and parasympathetic components of the autonomic nervous system (ANS). These perturbations occur in conjunction with neuroendocrine and lipid dysregulation, hypertension, and other cardiometabolic disturbances that are observed among shift workers (Reutrakul and Knutson 2015 Proper et al. Shift work and its accompanying disruption of circadian rhythms and sleep act as stressors that can activate the sympathetic nervous system, increase allostatic load, and stimulate inflammatory cytokine secretion (Caruso 2014 Vogel et al. Understanding how to ameliorate the pathophysiological perturbations induced by shift work is essential for implementation of effective strategies for safety and disease prevention. About 20–30% of US employees work some type of irregular shift, and the work includes high-consequence occupations, including: health care, transportation, public safety, and emergency response (McMenamin 2007 Yong et al. Shift work is an essential component of modern clinical workplaces, and it has been associated with assorted maladies, including: sleep disruption, fatigue, cognitive impairment, accidents, injuries, depression, metabolic and gastrointestinal disturbances, and increased risks for diabetes, cardiovascular disease, and cancer (Reutrakul and Knutson 2015 Videnovic and Zee 2015 IARC 2010 Faraut et al. ![]() The HRV coherence ratio may serve as a novel indicator of HRV dysregulation among shift workers. The results suggest a pattern of autonomic dysregulation among night workers during their sleep period relative to those working day shifts. ![]() To the authors knowledge, this study was the first to quantify patterns of the HRV coherence ratio among shiftworkers in a non-experimental (work/home) setting. The HRV coherence patterns were similar to high frequency HRV power among nurses on the same shift. Day nurses exhibited an increase in hourly mean HRV coherence ratios during their sleep period, suggesting a circadian pattern of cardiorespiratory phase coupling, whereas night nurses had no increase in HRV coherence ratios during their sleep period. Symptoms and psychomotor vigilance were assessed at the end of the ambient HRV monitoring period, and no differences between shifts were observed. Continuous ambulatory HRV monitoring was performed among night nurses (n = 11), and a comparison group of permanent day nurses (n = 7), over a 36-h period coinciding with the last two 12-h shifts of each participant’s work week. This study used ambient heart rate monitoring among health care workers to determine whether a novel measure of heart rate variability (HRV), as well as sleep disturbances, fatigue, or cognitive performance differed among non-rotating night shift nurses relative to those working permanent day shifts.
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