Effects of Circadian Rhythm Phase Alteration on Physiological and Psychological Variables

536 Pages·2009·33.13 MB·English

Irk:
NASA Technical Memorandum 81277
Effects of Circadian Rhythm Phase
Alteration on Physiological and
Psychological Variables:',
Implications to Pilot Performance
(including a partially annotated
bibliography)
(DIASA—TN-81277) EFFECTS OF CikCADIAN RHYTHM 981-2472U
FdASE ALYERATION ON PHYSIOLOGICAL AND
PSYCHOLOGICAL YAkIABLkS: INFLICATIONS TO
PILOT PEBFURSANCE (INCLUDING A PARTIALLY Dnclas
ANNUTATED BIBLIOGlikedl) (UASA) 537 p 63/52 24935
March 1981
A&SA

9
National Aeronautics and
Space Administration
1 NASA Technical Memorandum 81277
i
i
t
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Ell of Circadian Rhythm Phase
Alteration on Physiological and
Psychological Variables:
Implications to Pilot Performance
(inc ludaing annotated

partially
bibliography)
Daniel C. Holley, Department of Biological Sciences,
San Jose State University, San Jose, California
Charles M. Winget
Charles M. DeRoshia, Ames Research Center, Moffett Field, California
Michele P. Heinold, Dale M. Edger, Norman E. Kinney,
Susan E. Langston, Carol L. Markley and Jill A. Anthony,
San Jose State University, San Jose, California
NASA
c
w
National Aeronautics and
Space Administration
t Ames Reesara Center
Moffett Field, California 94035
j
TABLE OF CONTENTS
Page
PMACE . . as . . . to . . . . . . . . . . . . . . . . . . . . . . . . v
T 1
SUl4IM. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I. INTRODUCTION . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
II. PERFORMANCE . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
A. Introduction . . . . . . . . . 7
7
B. Fatigue . . . . . . .
C. Performance Rhytbms 01 mory and Immediate Process Tasks) 9
*0
D. Sleep and Performance . . . . . . . . . . . . . . . . . 10
1. Total sleep deprivation . . . . . . . . . . . . . . 11
2. Partial sleep deprivation . . . . . . . . . . . . . 11
3. REM sleep . . . . . . . . . . . . . . . . . . . . . 12
4. Naps . .......................... 12
5. Conclusions . . . . . . . . . . . . . . 13
E. Other Factors and Performance 13
1. Drugs and hypoglycemia 13
2. Physiology and performance . . . . . . . 14
F. Environmental Factors and Performance . . . . . . . . . . . . 14
G. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . 14
H. Selected Bibliography on Performance . . . . . . . . . . . . . 15
III. PHASE-SHIFT . . . . . . . . . . . . . . . . . . . . . . . . . 16
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . 0 16
B. Effects of Sleep Disturbances on Performance . . . . . . . . . 17
C. Effects of Transmeridian Flight on Circadian Rhythms 19
D. Factors Influencing Rate of Re-entrainment after
Phase-Shift of the Zeitgeber . . . . . . . . . . . . 20
E. Effects of Phase-Shift on Health . . . . . . . . . . . 22
F. Interpretation of Phase-Shift Data . . . . . . . . . . 23
G. Selected Bibliography on Phase-Shift . . . . . . . . . 24
IV* SHIFT-WORK . . . . . . . . . . . . . . . . . . . . . . . . 26
A. Introduction . . . . . . . . . . . . . . . . . . . . . 26
B. Shift Work and Physiological Rhythms . . . . . . . . . 27
C. Effects on Health . . . . . . . . . . . . . . . . . . 28
1. General symptoms . . . . . . . . . . . . . . . . . 28
2. Disturbances of "normal" diurnal sleep-wake cycle . . . . 28
3. Emotional and behavioral correlates . . . . . . . . . . . 29
4. Complications of predisposed medical conditions . . . . . 30
5. Chronic shift-work and overall health and longevity . . . 30
D. Effects of Shift-Work on Performance and Productivity . . .... 31
E. Shift-Work and Accidents 32
F. Psycho-Social Aspects 32
G. Conclusions . . . . . . . 34
S. Selected Bibliography on Shift-Work . . . . . . . . . . . . . 34
iii
PRECEDING PAGE BLANK IM FXM
Page
V. INTERNAL DESYNCHRONIZATION . . . . . . . . . . . . . . . . . . . . 35
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . 35
B. internal Desynchronization . . . . . . . . . . . . . . . . . . 35
1. Real internal desynchronization . . . . . . . . . . . . . 35
2. Apparent internal desynchronization . . . . . . . . . . . 36
3. Electromagnetic fields and internal desynchronosis . . . . 37
C. Transient States of Internal Desynchronization . . . . . . . . 37
1. Internal dissociation . . . . . . . . . . . . . . . . 37
2. Internal rhythmic dissociation and conflicting
temporal information . . . . . . . . . . . . . . . . 38
3. Internal dissociation during re-entrainment by partition . 39
4. Special forms of internal dissociation . . . . . . . . . . 39
D. Internal Desynchronization and Sleep Disturbances . . . . . . 40
1. Specific sleep problems . . . . . . . . . . . . . . 41
2. Approaches to reordering temp.ora•lr elationahips of
circadian rhythms . . . . . . . . . . . . . . . . . . . . 41
E. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . . 42
F. Selected Bibliography on Internal Desynchronization 42
VI. CHRONOTHERAPY 43
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . 43
B. Zeitgebers . . . . . . . . . . . . . . . . . . . . . . . . . . 44
1. Social.• . . . . . . . . . . . . . . . . . . . . . . 44
2. Sleep and light-dark cycles . . . . . . . . . . . . . . . 44
3. Meal time . . . . . . . . . . . . . . . . . . . . . . . . 46
C. Re-entrainment Following Phase-Shift of Zeitgebers . . . . . . 48
D. Chronotherapy . . . . . . . . . . . . . . . . . . . . . . 49
1. Chronobiotics . . . . . . . . . . . . . . . . . . . . . . 51
2. Relaxation techniques . . . . . . . . . . . . . . . . . . 51
E. Conclusions . . . . . . . . . . . . . . . . . . . . . . . . 52
F. Selected Bibliography on Chronotherapy . . . . . . . . . . . . 53
VII. THE BIORHYT K THEORY . . . . . . . . . . . . . . . . . . . . . . . 54
A. Introduction . . . . . . . . . . . . . . . . . . . . . . . 54
B. Historical Development of the Theory . . . . . . . . . . . . . 54
C. Wilhelm Fliess' Theory . . . . . . . . . . . . . . . . . . . . 55
D. Scientific Evidence for Biorhythm Theory 56
E. Biorhythm Theory and Singular Events . 57
F. Biorhythm and Longitudinal Studies . . . . . . . . . . . . . . 59
G. Neobiorhythm . . . . . . . . . . . . . . . . . . . . . . . 61
H. Selected Bibliography on Biorhythm Theory . . . . . . . . . . 64
I. Selected Bibliography on Infradian Rhythms . . . . . . . . . . 64
VIII. CONCLUSIONS . . . . . . . . . . . . . . . . . . . . . . . . . . . 64
IX. ANNOTATED BIBLIOGRAPHY . . . . . . . . . . . . . . . . . . . . . . 67
s
IV
PREFACE
This report is the preliminary effort of the NASA Joint Research Inter-
change entitled "Effects of Circadian Rhythm Phase Alteration on Physiological
and Psychological Variables: Implications to Pilot Performance" (NCA2-OR675-
005) conducted under the direction of Dr. Daniel C. Holley, Department of
Biological Sciences, San Jose State University, San Jose, California. The
review narrative was compiled by several individuals. The united time for
carrying out this project (June 1, 1980 to July 15, 1980) precluded integra-•
I
tive editing of the review sections to effect a cocoon style. As with any
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project of large scope and limited time, many people made special contributions
without which we could not have completed this effort. We acknowledge the
excellent support of the library staff of San Jose State University (Mrs. King
} Wah Moberg and Mrs. Kathleen Taylor). We are also appreciative of the superb
technical assistance of Mrs. Bridget Falkenstein, Mr. Curt Zingheim, Mrs. Dora
McCollister, and Ms. Rosemary Burnett. We thankfully acknowledge Dr. Leon
Rosenblatt, Walnut Creek, California, for reviewing the manuscript and pro-
viding constructive criticism.
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v
EFFECTS OF CIRCADIAN RHYTHM PHASE ALTERATION ON PHYSIOLOGICAL AND
PSYCHOLOGICAL VARIABLES: IMPLICATIONS TO PILOT PERFORMANCE
(Including a partially annotated bibliography)
Daniel C. Holley, Ph.D.
San Jose State University
Charles M. Winget, Ph.D., and Charles W. DeRoshia, M.A.
Ames Research Center
Michele P. Heinold, Dale M. Edgar, Norman E. Kinney, Susan E. Langston,
Carol L. Markley, and Jill A. Anthony
San Jose State University
SUMMARY
Selected recently published literature (1972 to 1980) was reviewed deal-
ing with the physiologic and psychologic effects of altered circadian rhythm
phase relationships in higher vertebrates. Major emphasis was placed on the
effects of environmental synchronizers upon circadian rhythmic stability in
man and the deleterious alterations in performance and well-being which result
from changes in this stability. The review (66 pp) includes a partially
annotated bibliography consisting of 2084 references relevant to pilot perfor-
mance and circadian phase alteration. Review categories include: 1) human
performance, with primary emphasis on the effects of sleep loss or disturbance
and fatigue; 2) phase shift, in which ground based light/dark cycle alteration
and transmeridian flight studies are discussed; 3) shiftwork; 4) internal
desynchronization, which includes the effects of constant environments, isola-
tion or other environmental factors on rhythmic stability, and the effects of
rhythm disturbances on sleep and psychopathology; 5) chronotherapy, the appli-
cation of methods to ameliorate desynchronosis symptomatology; and 6) bio-
rhythm theory, in which a critical analysis is male of the birthdate based
biorhythm method for predicting aviation accident susceptibility. There is a
need for more integrative investigation in realistic operational environments
to evaluate the effects of chronic time zone travel upon health and perfor-
mance. Further work is necessary on the evaluation of chronotherapeutic mea-
sures and the development of appropriate educational programs for pilots based
upon present knowledge of the influence of sleep and circadian rhythm distur-
bances upon performance.
I. INTRODUCTION
This annotated bibliography has been compiled to provide a data base of
material in the scientific literature on which to address the following ques-
tions: 1) What, if any, are the pertinent issues of importance to the
aeronautical cossunity regarding circadian decyuchronosis; and 2) Can these
issues be resolved by current research techniques?
We have included a review of selected recently publisher) literature deal-
ing with the physiological and psychological effects of altered circadian
rhythm phase relationships in higher vertebrate species, with major emphasis
on the effects of alteration in environmental synchronizers upon circadian
rhythmic stability in man, and the deleterious changes in performance and
well-being which result from changes in such stability.
The report includes an annotated bibliography of materials relevant to
pilot performance and circadian phase alterations and a series of review
articles, each of which covers a major research area within the topic. A
selected bibliography of citations (included within the master bibliography)
pertaining to each review area can be found at the and of each section.
NASA previously funded a review of the literature dealing with factors in
the aviation environment and their effects on performance (Boljan, J. R.,
L. S. Rosenblatt, N. W. Hetherington, J. L. Lyman, S. F. Flaim, G. T. Dale,
and D. C. Holley, Human Performance in the Aviation Environment, NASA Contract
No. NAS2-6657, 1972). This report included a review of circadian rhythm
desynchronization in relation to performance. It concluded that rhythm desyn-
chronization often results in a wide variety of physiological and psychologi-
cal abnormalities resulting in the desynchronosis syndrome, which can have
debilitating effects on individual performance.
The annotated bibliography in the present report includes all available
literature since the time of the Beljan report (1972 to present). A few
selected publications from the period prior to 1972 which were omitted from
the Beljan report have been included in order to complete the literature
review. Methods of retri al included:
lu
1. Computerized literature search of several data bases (Medlars, Recon,
Dialog).
2. Direct search of literature indexes (Biological ibstracts, Bioresearch
Index, Index Madicus, Excerpts, Medic&, International Aerospace Abstracts (IAA),
Scientific and Technical Aerospace Reports (STAR), Science Citation Index,
Psychological Abstracts, Reader's Guide to Periodical Literature).
3. Direct search of abstracting services covering foreign literature
(Library of Congress Science & Technology (S & T) Alert items and USSR Life
Sciences Digest).
4. Direct search of lists of literature currently in print (Bowker's
Books in Print, British Books in Print, Canadian Books in Print, Medical Books
and Serials in Print).
5. Cross reference of many of the bibliographies in published articles
retrieved.
2
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An attempt was made to obtain as many references as possible relevant to
performance and circadian rhythm desynchronization within the time period of
the consortium (June 1, 1980 to July 15, 1980) and any omissions should be
considered unintentional. The annotations to the citations are either: 1) the
author's abstract or summary; 2) an abstract from an indexing system or com-
puter search; or 3) an abstract made by one of our group. A total of approxi-
mately 2000 references was obtained, including approximately 85Z relating to
humans. M to non-human primate, and 1OX to animal studies. The non-human
primate and animal references represent a select group of papers which were
Included in this report since they deal with important experimental studies of
circadian rhythm desynchronization, rephasal dynamics and mechanisms, con-
ducted under carefully controlled laboratory conditions to an extent which is
usually not possible for human research. Some of these studies could not have
been performed on human subjects.
A significant finding of this project was the tremendous increase in the
sleep literature since the Beljan report in 1972. The role of sleep and the
significance of the sleep-wake cycle in physiology and psychology cannot be
overestimated. This subject is treated in several sections of this report
since it is key to the discussion of many of the topic categories.
The literature obtained for this report was divided into six major
categories:
Performance
This category includes those papers relevant to the topic of performance
which do not fall into the categories of shift work, phase shift, internal
desynchronization or chronotherapy. This discussion, therefore, focuses on
variables which adversely affect performance, primarily those factors which
affatt human performance in the aviation environment. Primary attention has
been directed to the effects of sleep loss or disturbance and fatigue. Other
variables affecting performance such as motivation, arousal, hypoglycemia and
drugs are also discussed. This category is important to the topic of perfor-
sance and circadian rhythm desynchronization since the relative effect on
pilot performance of circadian rhythm desynchronosis-induced performance
deterioration will be a function of the existing level of performance deterior-
ation resulting from the effects of one or more of the variables discussed in
this section.
Phase-Shift
This category includes studies involving rhythm desynchronization result-
ing from altered rhythm synchronizer phases (light-dark cycles, social inter-
action and meal timing). Primary emphasis will be placed upon the effects of
transmeridian flight upon circadian rhythm desynchronization and reodaptation,
performance and physical and psychological well-being. This category will also
include discussion of ground-based experimental studies on circadian rhythm
phase-shifts, inverted schedules, unusual work-rest schedules, and rhythm
3
desynchronization. which have implications to pilot performance on transmeri-
than routes.
Shift Work
This category includes papers involving circadian phase-shifts in the work
environment, i.e.. the effects of various kinds of rotating work shift sched-
ules or night work on rhythm stability and their effects upon performance and
well-being. This topic is important in that rhythm desynchronization result-
ing from shift-work is often manifested by performance deterioration and health
problems and therefore has implications to pilot and air traffic controller
performance. The effect of circadian desynchronization upon homeostatic
regulation of physiological processes and subsequent long term effects upon
health and longevity is discussed.
Internal Desynchronization
This category includes all studies involving circadian rhythm desynchroni-
zation or rhythm instability which do not fall under the categories of shift-
work or phase-shift. It includes the effects of constant environments (e.g..
continuous light or darkness) and isolation on rhythmicity, the effects of
rhythm disturbance on sleep and psychopathology, and the effects of other
environmental agents (electromagnetic fields. hypokinesis. space flight) on
the maintenance of circadian rhythmic stability. This section provides a
basic experimental background into the nature of circadian rhythmic desynchro-
nization by examining studies of circadian pacemaker or coupled oscillating
mechanisms. This topic is important in providing an experimental background
for understanding the mechanisms involved in circadian rhythm desynchroniza-
tion and their relationship to the kinds of sleep disturbances and deteriora-
tion in well-being commonly observed in humans who have become rhythmically
desynchL^nized following transmeridian flight.
Chronotherapy
This section specifically deals with methods or suggestions for amelior-
ating or counteracting the effects of rhythm desgnchronization. Included is
a discussion of experimental approaches to the facilitation of readaptation
following phase-shifts or transmeridian flights by effecting alterations in
circadian rhythmicity (chronotherapy). These treatments include synchronizer
control (e.g.. light-dark cycles, saal timing, social interaction effects) and
chironobioCics (drugs affecting circadian oscillatory mechanisms). In addition.
methods or recommendations for alleviation of desynchronosis symptomatology
have been included (sedative drugs, preadaptation, relaxation techniques.
etc.). These treatments are discussed with respect to their relative effec-
tiveness in treating desynchronosis and their suitability for future resear6i.
4
Tbs Biorhythm Theory
I
A separate section will provide a critical analysts of the so-called
"biorhythm theory." which postulates that 23, 28. and 33 day cycles have sit-
f
! nificant influences upon performance levels and that aviation accident occur-
s rencea significantly above chance levels occur on days upon which these cycles
cross the transition from high to low phases (critical days). The theory's
many proponents, including soma from the scientific community, have reported
that a statistically significant number of aviation accidents occur on bio-
rhythm critical days, that airlines have employed safety awareness programs
using biorhythm charting to achLew substantial reductions in accidents and
I
that certain airlines already use, or should use, biorhythm charting for work
scheduling and safety meetings.
f Although the scientific community has characterized the theory as fraudu-
lent or invalid, the theory enjoys considerable popularity and it was deemed
Important to include in this report a critical analysis of the theory because
of the theory's implications for pilot performance and aviation safety. based
upon these reputed cyclical phenomena. This review will show that the origi-
nal theory is mathematically and theoretically unsound, that studies in sup-
port of the theory mostly reflect improper methodology, lack of documentation.
faulty interpretation of results and that the theory's predictions are Contra-
s dieted by the entire literature on inrcadian biological rhythm research.
For the purpose of this report it is necessary to define terminology
related to circadian rhythm synchronization, desynchronization and transmerid-
ian flight.
• An environmental agent is termed a synchronizer (entraining r.gent,
Zeitgeber) if it is capable of forcing another cycle to assume its fre-
quency with a characteristic phase relationship. Examples of synchro-
nizers are light-dark cycles, social interaction and restricted meal
times.
• Circadian rhythms are said to be desynchronized from antraicm ent or
synchronization when two or more previously arnchronized rhythmic vari-
ables cease to exhibit the same frequency or phase relationship to the
synchronizer. 722
• Rhythm desynchronization from an environmental cycle is termed external
desynchronization.
• If external desynchronization results in the continuance of periodicity
with a natural frequency at least slightly different from the period of
any known environmental factor. the resultant circadian rhythms are
termed "free-runnins." Free-running often occurs in constant condi-
tions (constant light or darkness in a controlled isolated environment).
Interns?, desynchronization refers to desynchronization of two or more
rhythmic variables from each other. manifested by the appearance of a
previously absent difference in frequency or a change in the timing of
rhythmic phase positions with respect to each other.
S
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