Decreased DNA Repair Links Shift Work and Increased Cancer Risk

MedicalResearch.com Interview with:
Parveen Bhatti, PhD
Associate Member
Fred Hutchinson Cancer Research Center

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Evidence in humans for an association between shift work and cancer has been mixed. This may be due to difficulties in accurately assessing long-term exposures to shift work in studies of cancer risk. We took a different approach that circumvented these difficulties. Rather than look at cancer risk directly, we measured, among actively employed shift workers, a marker of DNA damage that has been linked to cancer.

When repaired by cellular machinery, this particular marker is excreted in urine where it can be measured. We found that, compared to sleeping at night during their night off, shift workers had lower urinary levels of the DNA damage marker during their night work. This effect appears to be driven by reductions in circulating melatonin levels among shift workers during night work relative to night sleep. Given that melatonin has been shown to enhance repair of DNA damage, our results suggest that, during night work, shift workers have reduced ability to repair DNA damage resulting in lower levels being excreted in their urine. Because of this, shift workers likely have higher levels of DNA damage remaining in their cells, which can lead to mutations and cause cancer.

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If High School Students Are Naturally Owls, Shouldn’t School Start Later?

MedicalResearch.com Interview with:
Dr. Dorothee Fischer
Department of Environmental Health
Harvard T.H. Chan School of Public Health, Boston, Massachusetts
Center for Injury Epidemiology, Liberty Mutual Research Institute for Safety
Hopkinton, Massachusetts,

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Chronotypes are a result of how the circadian clock embeds itself into the 24h light-dark cycle, producing earlier and later individuals (“larks and owls”) with regards to rhythms in physiology, cognition and behavior, including sleep.

It can be beneficial for health and safety to sync forced wake times (work, school) with individual chronotypes, thereby reducing the misalignment between sleep, circadian rhythms and external demands.

To better inform potential interventions such as tailored work schedules, more information is needed about the prevalence of different chronotypes and how chronotype differs by age and sex.

To the best of our knowledge, this is the first large-scale and nationally representative study of chronotypes in the US.
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SIMPONI ARIA (golimumab) Improved Sleep and Pain in Ankylosing Spondylitis Trial

MedicalResearch.com Interview with:

Atul A. Deodhar, MD, MRCP, FACP, FACR Professor of Medicine Medical Director, Rheumatology Clinics Medical Director, Immunology Infusion Center Oregon Health & Science University 

Dr. Deodhar

Atul A. Deodhar, MD, MRCP, FACP, FACR
Professor of Medicine
Medical Director, Rheumatology Clinics
Medical Director, Immunology Infusion Center
Oregon Health & Science University 

MedicalResearch.com: What is the background for this study?

Response: The GO-ALIVE study (CNTO148AKS3001) is a multicenter, randomized, double-blind, placebo-controlled study of golimumab, an anti-TNFα monoclonal antibody, administered intravenously (IV), in adult patients with active ankylosing spondylitis (AS). The primary objective is to evaluate the efficacy of golimumab 2 mg/kg in patients with active AS by assessing the reduction in signs and symptoms of AS. The secondary objectives include assessing efficacy related to improving physical function, range of motion, health-related quality of life, and other health outcomes.

A total of 208 patients who had a diagnosis of definite  ankylosing spondylitis (per modified New York criteria) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) ≥4, total back pain visual analogue scale (VAS) ≥4, and CRP ≥0.3 mg/dL were randomized.  Patients were treated with IV golimumab (n=105) at Weeks 0, 4, and every 8 weeks through Week 52 or placebo (n=103) at Weeks 0, 4, and 12, with crossover to IV golimumab at Week 16 and through Week 52.

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Continuous Release REMfresh® Mimics Natural Melatonin Release

MedicalResearch.com Interview with:

David C. Brodner, M.D</strong>. Founder and Principle Physician, The Center for Sinus, Allergy, and Sleep Wellness Double Board-Certified in Otolaryngology (Head and Neck Surgery) and Sleep Medicine Assistant Clinical Professor, Florida Atlantic University College of Medicine Medical Director, Good Samaritan Hospital Sleep Laboratory Senior Medical Advisor, Physician’s Seal, LLC®

Dr. Brodner

David C. Brodner, M.D.
Founder and Principle Physician, The Center for Sinus, Allergy, and Sleep Wellness
Double Board-Certified in Otolaryngology (Head and Neck Surgery) and Sleep Medicine
Assistant Clinical Professor
Florida Atlantic University College of Medicine
Medical Director, Good Samaritan Hospital Sleep Laboratory
Senior Medical Advisor, Physician’s Seal, LLC®

MedicalResearch.com: What is the background for this study?

Response: Chronic sleep and wakefulness disorders affect an estimated 50 to 70 million Americans, and long-term sleep deprivation has been associated with negative health consequences, including an increased risk of diabetes, hypertension, heart attack, stroke, obesity and depression.

Sleep/wake cycles are regulated by melatonin, levels of which normally begin to rise in the mid- to late evening and remain high for the majority of the night. Levels begin to decline towards early morning, as the body’s wake cycle in triggered. Melatonin levels typically decline with age, with a significant decrease after age 40.

And as people age, their bodies may no longer produce enough melatonin to ensure adequate sleep. In addition to difficulties falling asleep, sleep in older populations can include fragmented and sustained sleep problems. Melatonin supplementation has been shown to promote and maintain sleep in older populations.

In this study, we compared the pharmacokinetics (PK) profile of REMfresh®, a continuous release and absorption melatonin (CRA-melatonin), with that of a leading immediate-release melatonin (IR-melatonin) formulation.

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Blood Pressure Variability May Trigger Stroke, Especially During Sleep

MedicalResearch.com Interview with:

Shyam Prabhakaran, MD, MS</strong> Department of Neurology Feinberg School of Medicine Northwestern University Chicago, IL

Dr. Prabhakaran

Shyam Prabhakaran, MD, MS
Department of Neurology
Feinberg School of Medicine
Northwestern University
Chicago, IL

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Wake-up stroke, or stroke onset during sleep, accounts for one-quarter of stroke presentations. Yet, there are few studies exploring mechanisms or triggers of onset during sleep. We explored whether blood pressure variability which is known to have circadian patterns could trigger wake-up stroke. We found that in the first 24 hours after stroke, those with wake-up stroke had greater blood pressure variability than non-wake up stroke patients.

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Cycles of Poor Sleep Then Crashing Leads To Loss of Creativity

MedicalResearch.com Interview with:

Michael K. Scullin, Ph.D. Assistant Professor of Psychology and Neuroscience Director, Sleep Neuroscience and Cognition Laboratory Baylor University Waco, TX 76798

Dr. Scullin

Michael K. Scullin, Ph.D.
Assistant Professor of Psychology and Neuroscience
Director, Sleep Neuroscience and Cognition Laboratory
Baylor University
Waco, TX 76798

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: In studio-based courses (e.g., design, architecture, art), students have a large project due at the end of the semester that requires creativity and attention to detail. Anecdotally, they will work long hours without sleep to finish the project.

The problem is that cutting back on sleep may actually be impeding their ability to execute the project successfully.

We used wristband actigraphy (a device that detects movement and light) to monitor sleep for one week in 28 interior design students—many of whom had a final project due. At the beginning and end of the week, the participants completed tests of attention and creativity.

We found that students slept less than contemporary recommendations (7 to 9 hours; Associated Professional Sleep Societies) on approximately half of the nights, and shorter sleep was associated with declining attention and creativity scores across the week. The more thought provoking result was that many individuals showed inter-night variability in how long they slept (e.g., going from 4 hours to 11 hours to 5 hours to 8 hours, etc.). Inter-night variability in sleep duration was an even stronger predictor than total sleep time in how creativity scores changed across the week.

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Sleep Difficulties Linked to Survival Among Women With Breast Cancer

MedicalResearch.com Interview with:

Claudia Trudel-Fitzgerald Ph.D. FRQS Postdoctoral research fellow & Clinical psychologist (OPQ) Department of Social and Behavioral Sciences Harvard T.H. Chan School of Public Health Boston, MA 02115

Dr. Trudel-Fitzgerald

Claudia Trudel-Fitzgerald Ph.D. 
FRQS Postdoctoral research fellow & Clinical psychologist (OPQ)
Department of Social and Behavioral Sciences
Harvard T.H. Chan School of Public Health
Boston, MA 02115

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: There is very limited research on the association between sleep characteristics and survival among individuals with cancer. However, this is an important question, especially among breast cancer patients because sleep disturbances are frequently reported by these women. Preliminary studies have suggested that sleep duration is related to mortality. The novel findings of our research indicate that not only sleep duration, but also changes in sleep duration before versus after diagnosis, as well as regular difficulties to fall or stay asleep, may also be associated with mortality among women with breast cancer over a period of up to 30 years.

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Insomnia Linked to Increased Risk of Stroke and Heart Attack

MedicalResearch.com Interview with:
Qiao He

Master’s degree student
China Medical University
Shenyang, China

MedicalResearch.com: What is the background for this study?

Response: Sleep is an important factor for biological recovery functions, but in modern society, more and more people have complained having sleep problems like insomnia, one of the main sleep disorders. It is reported that approximately one-third of the German general population has been suffering from insomnia symptoms. In decades, many researchers have found associations between insomnia and bad health outcomes. Insomnia seems to be a big health issue. However, the results from previous studies regarding the association of insomnia and cardiovascular or cerebrovascular events were inconsistent. Therefore, we conducted this study.
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LGBTQ+ Patients Have Poor Sleep Compared to Heterosexuals

MedicalResearch.com Interview with:

Jen-Hao Chen PhD Assistant Professor Department of Health Sciences and School of Public Affairs University of Missouri - Columbia

Dr. Jen-Hao Chen

Jen-Hao Chen PhD
Assistant Professor
Department of Health Sciences and School of Public Affairs
University of Missouri – Columbia

MedicalResearch.com: What is the background for this study?

Response: It has been well known that sexual minority adults in the US have worse health as compared with heterosexual peers. Queer folks are found to have poorer physical, mental and behavioral health outcomes because of their marginalized status and social environments. But we know very little about prevalence of sleep problems in the population of sexual minorities compared to heterosexual people. Do sexual minorities lose sleep? Do they wake up more often during the night? Do they sleep less? This study aims to address this important gap in the LGBT health literature. Using recent nationally representative data, we exam whether sexual minority adults have greater odds of having short sleep duration and poor sleep quality. In addition, we also investigate sexual minorities’ sleep in the context of gender and race/ethnicity  Continue reading

Adaptive Servo-Ventilation Therapy Has Variable Effects in Heart Failure Patients

MedicalResearch.com Interview with:

Christopher M. O’Connor, MD FACC  CEO and Executive Director,  Inova Heart & Vascular Institute IHVI Administration Falls Church, Virginia 22042

Dr. Christopher O’Connor

Christopher M. O’Connor, MD FACC 
CEO and Executive Director,
Inova Heart & Vascular Institute
IHVI Administration
Falls Church, Virginia 22042

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Sleep apnea is a very common comorbidity of patients with heart failure (both reduced ejection fraction and preserved ejection fraction). Early evidence from observational and small studies suggested that treating sleep apnea with adaptive servo-ventilation (ASV) therapy may improve patient outcomes. There is minimal clinical evidence about identifying and treating sleep apnea in those who’ve been hospitalized with acute decompensated heart failure. The CAT-HF study was designed to help address this, with the primary endpoint being cardiovascular outcomes measured as a Global Rank Score that included survival free from cardiovascular hospitalization and change in functional capacity as measured by the six-minute walk distance. It was also planned to expand on the SERVE-HF study that was investigating the use of ASV therapy to treat central sleep apnea (CSA) in chronic stable heart failure patients with reduced ejection fraction patients (HFrEF).

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