Date of Award

2018

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

Keywords

circadian rhythm; circadian misalignment; chronotype; social jet lag; shift-work; delayed sleep phase; advance sleep phase; irregular sleep; sleep deprivation; non-24-hour; free running; phase angle

Abstract

The circadian system is important in all living organisms because it generates a 24-hour rhythm for physiological and behavioral processes enabling anticipation and adaptation to daily changes in the environment. The prevalence of cardiometabolic diseases, which are linked to lifestyle choices, has been rising at an alarming rate. Modernization and globalization are two of many factors to blame for lifestyle changes resulting in circadian disruption. The purpose of this literature review is to explore circadian misalignment with regards to its mechanism and impact on cardiometabolic health and to determine possible interventional measures. The primary focus is on lifestyle change, particularly sleep, as an interventional measure for circadian misalignment. Studies were included if they included a cardiometabolic disease risk factor studied in the context of circadian alignment/misalignment or sleep duration/architecture. The data indicates that circadian misalignment and sleep deprivation impede cardiovascular function and cause a decrease in glucose tolerance and insulin sensitivity; however, restoring circadian rhythmicity and correcting for sleep deprivation improves several health indices including glucose tolerance, insulin sensitivity, blood pressure, and cardiac remodeling.

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