Sleep and Circadian Rhythm Disruption in Social Jetlag and Mental Illness - Progress in Molecular Biology and Translational Science - page 333

Table 11.1 The impact of sleep and circadian rhythms disruption (SCRD) arising from
social jetlag and shift work are summarized here and illustrate the severe health
consequences of working against biological time (for full references, see Pritchett
et al. 14 )
Emotional responses Cognitive responses Somatic responses

￿ Exhaustion
￿ Increased irritability
￿ Mood fluctuations
￿ Anxiety
￿ Depressed mood
￿ Frustration
￿ Anger
￿ Increased impulsivity
￿ Decreased motor
skills
￿ Increased
stimulant use
￿ Increased
sedative use
￿ Alcohol use/misuse

￿ Reduced concentration
￿ Reduced performance
￿ Reduced attention
￿ Decreased memory
￿ Reduced recall of
events
￿ Reduced multitasking
￿ Reduced decision
making
￿ Reduced creativity
￿ Reduced productivity
￿ Reduced socialization
￿ Reduced
communication

￿ Drowsiness
￿ Microsleeps
￿ Unintended sleep
￿ Bodily sensations
of pain
￿ Bodily sensations
of cold
￿ Cardiovascular disease
￿ Risk of cancer
￿ Metabolic
abnormalities
￿ Weight gain
￿ Risk of diabetes II
￿ Reduced immunity
￿ Disorders of the HPA

Associations between SCRD and poor health (this table) have long been a concern for shift workers, who
suffer from the most extreme form of social jetlag. Shift-work schedules have been simulated in carefully
controlled laboratory studies and result in the impairments to both cognitive and metabolic systems listed
here. Subjects develop, for example, imbalanced glucose regulation resembling metabolic syndrome or
type II diabetes. 15

work times are not compatible with circadian sleep times. 17 Finally, being
forced to live against ones circadian clock has metabolic consequences.
Many studies have reported that short sleep duration is associated with an
increased body mass index (BMI; for review, see Ref. 18 ) , and more recent
studies have shown that social jetlag also contributes, over and above sleep
duration, to BMI. 2 With every hour of social jetlag, the probability of being
overweight or obese increases by 30%.

3. SCRD AND PSYCHOSES
SCRD is a common comorbidity in numerous psychiatric disorders. 1
The greatest focus has been on mood disorders, especially unipolar and sea-
sonal affective subtypes, yet SCRD is also prominent in the more severe,
psychotic disorders such as schizophrenia. 19-21 The relationship between
schizophrenia and abnormal sleep was first described in the late nineteenth
century by the German psychiatrist Emil Kraepelin. 22 Today, SCRD is