Chronotherapy

Researchers Discover How Coffee Affects the Circadian Rhythm

Coffee is an American obsession. While many people enjoy this energizing beverage, many of us also view it as a bad habit, even if a minor one. However, a new chronobiology study on coffee and the circadian rhythm has found that moderate amounts of coffee affect the circadian rhythm in positive ways, and may be especially good when it comes to regulating your sleep-wake cycle.

How Coffee Affects the Circadian Rhythm: Turning Back the Clock

Many of the studies looking at the effects of caffeine on the circadian rhythm have been performed on lab animals rather than humans. Recently, researchers decided to definitively nail down exactly how caffeine affects the circadian rhythm by studying the effects of this stimulant on both live humans and human cells in-vitro.

In a human study, four groups of people were subjected to one of four treatments shortly before going to bed. The first group was exposed to bright light and given a double-espresso strength dose of caffeine. The second group was exposed to dim light and given a double-espresso dose of caffeine. The two other groups were both exposed to bright or dim light but were given a placebo pill. The result? Not only did the caffeine keep participants awake at night, but it completely shifted their circadian rhythm so they produced sleep hormones and fell asleep an average of 40 minutes later—nearly half the magnitude of delay caused by bright light. In short, coffee appears to delay the circadian clock by about 40 minutes, about half as long as does exposure to bright light.

When human cells in Petri dishes were treated with caffeine, the same effect was observed. Researchers found that coffee affects the circadian rhythm in human cells in-vitro by activating adenosine receptors, which are important regulators of internal clocks. In effect, the clocks were held back.

Of Mice and Metabolism: Caffeine and Metabolic Markers

This is not the first study that has found coffee can have powerful effects on internal clocks and metabolism. In prior research, mice were exposed to caffeine. Half of the mice were allowed to eat whenever they wanted while half had restricted feeding times. It was shown that caffeine restricted the gene expression and thus production of inflammatory factors and metabolic markers associated with cancer in the intestines of both groups. In the group allowed to eat freely, it also restricted these factors in the liver. Interestingly, coffee affects the circadian rhythm of different cells in different ways.

A Cure for Jet Lag?

What does this mean for human health? First, caffeine may be used in the future to modify the activity of circadian clocks. This could help in the treatment of jet lag, non-24 hour circadian rhythm disorders and several other sleep disorders. However, caffeine alone appears to have less effect on the liver and possibly other organs with their own internal clock mechanisms. In essence, we may be able to use our new knowledge about how caffeine affects the circadian rhythm to cure jet lag in the brain, but jet lag in the liver will remain an issue. In other words, some organs will still remain in their own time zone.

This research also has potential consequences for people who enjoy a cup of coffee after dinner or otherwise take in caffeine at night. By doing so, you may be delaying your internal clocks and interfering with sleep more than previously believed. Even if you can easily fall asleep after a cup of coffee, your internal clocks have still been altered. A substance that is beneficial to people trying to reset internal clocks may not be beneficial to others.

Because caffeinated beverages are so popular in the United States, it is important to understand how coffee affects the circadian rhythm and other aspects of health. It appears that caffeine can be extremely beneficial in people who need to modify their internal clocks slightly, but that it could have unwanted effects in others who drink it before bed. In short, if you are looking for a warm beverage to enjoy after dinner, unless you’re trying to adjust your circadian rhythms, you may want to reach for the herbal tea.

Discovered: Magnesium Keeps Your Body Clocks Running on Time

Apr 20 by Ewcopywriting Leave a Comment

Although we often associate vitamin deficiencies with past eras, they are a modern epidemic as well. While most people today generally get enough vitamins in their diet to prevent serious diseases such as rickets and scurvy, many still live with sub-clinical levels that aren’t sufficient for optimal cellular function. This can lead to vague symptoms such as fatigue, malaise and sleep disturbances. New research has discovered that magnesium, a mineral in which many people are deficient, may be especially important for preventing sleep disorders and maintaining a healthy circadian rhythm.

Magnesium: A Foundational Element of Life

Like many essential minerals and vitamins, magnesium plays a variety of roles in the human body. It is a cofactor in more than 300 biochemical reactions, with more yet to be discovered. When we lack this important mineral, even with a small deficiency, we have an increased risk of cardiovascular disease as well as symptoms that include memory loss, insomnia and muscle cramps. The link between magnesium and sleep disturbances has been of special interest to researchers because the exact mechanism behind this connection was previously unknown.

Magnesium and the Circadian Rhythm

A new study of magnesium and the circadian rhythm has found that this mineral is one of the chief players in our cells’ internal clocks. Magnesium levels in our cells oscillate, or rhythmically increase and decrease, throughout the day in a predictable pattern. The level of magnesium in a cell determines when the cell will be in high metabolic activity or in a period of rest and repair. When researchers adjusted magnesium levels in cells, the activity rate changed accordingly. These findings shed light on how magnesium deficiency may relate to sleep disorders and offers a possibly promising treatment for those who suffer from insomnia.

People who have low levels of magnesium in their diet, even levels that are not low enough to cause more serious symptoms, may not have enough magnesium to support optimal metabolism and a healthy circadian rhythm. This is especially concerning because the Western diet does not include a high amount of fruits, vegetables, soy, whole grains and other magnesium-rich foods. Knowledge of the link between magnesium and the circadian rhythm may encourage people to eat a more nutritious diet or supplement with magnesium, especially if they wish to sleep better.

Good Nutrition: The New Wonder Drug

Doctors and scientists are just beginning to discover the connections between good nutrition, good sleep and whole-body health. The link between magnesium and the circadian rhythm is one of many connections between essential nutrition and a healthy internal clock. The unique timing of fluctuations in magnesium levels in cells suggests that this mineral may be best used in a chronotherapeutic way. In other words, there may be optimal times during the day for people to take a magnesium supplement or eat foods rich in this nutrient. For example, choosing a bedtime snack that is high in magnesium may help people who struggle with insomnia to sleep better. Magnesium is already being used as an adjunct therapy for delirium, a disease that is deeply entwined with circadian rhythm disruption.

Understanding the way that different nutrients interact with the circadian rhythm can help researchers to develop more effective treatments for common ailments such as insomnia. This knowledge can also help when it comes to chronotherapy, the science of timing medications and therapies so they will be present during the time in the cell cycle when they can best be used. New medical discoveries in the field of chronobiology can help improve lives by allowing doctors to treat diseases in safer and more effective ways, in sync with the body’s natural rhythms.

Chronotherapy Offers New Hope for Rheumatoid Arthritis

Mar 02 by Ewcopywriting Leave a Comment

Rheumatoid arthritis is a debilitating autoimmune disease that can lead to joint pain and a host of other health issues. As with many autoimmune diseases, patients often have to try many therapies before finding one that works. Unfortunately, some never get total relief of debilitating symptoms. However, a new paper on chronotherapy and rheumatoid arthritis suggests that carefully timing medications may lead to more relief of symptoms as well as fewer side effects.

The Circadian Rhythm of Autoimmune Disease

The immune system runs on a distinctive circadian rhythm, as well as seasonal and other rhythms, so it is no surprise that autoimmune disease does so as well. Immune system tends to peak while we are sleeping, allowing the body to detect and repair inflammation when it can be quickly repaired. Glucocorticoids, which suppress immune activity, as well as performing many other essential tasks, peak early in the day. There are also many other hormones that affect the immune system and show a 24-hour cycle.

Because of the circadian rhythm involved in immune activities, it is no surprise that many autoimmune diseases show a 24-hour cycle. In rheumatoid arthritis, also known as RA, pain and stiffness in joints are worse in the morning, usually immediately upon waking. This timing of symptoms is so predictable that it is used to differentiate RA from other joint diseases in diagnosis.

A Day with RA

People with rheumatoid arthritis develop inflamed nodules on their joints that can make movement painful. Over time, these nodules can degrade healthy joints so that they don’t function well. In general, people with rheumatoid arthritis wake with joint pain, swelling, and stiffness. This is likely to due to an increase in IL-6, an important immune mediator of inflammation. The glucocorticoid peak in the morning gradually decreases symptoms, which are generally manageable throughout the day.

The intense morning pain associated with rheumatoid arthritis begins early enough in the morning that it can interfere with sleep, leaving people who have this disease fatigued. While people with RA are more likely to use pain medication in the morning, other medications such as immune suppressants generally are not given at any particular time. A new paper suggests that this may be a mistake.

Chronotherapy and Rheumatoid Arthritis

How can chronotherapy be used to help rheumatoid arthritis and other autoimmune diseases? Researchers suggest that taking a delayed release glucocorticoid at night that prevents the immune system from reaching as high of a nighttime peak, may alleviate much of the morning stiffness and other symptoms. People with RA commonly take glucocorticoids but often do so in the morning. Levels are often too low at night to have a large effect at the time when they are most needed.

This approach may also be helpful with methotrexate, monoclonal antibodies and other medications used to treat RA. These drugs target very specific cellular processes. Taking them when they are most likely to have an impact could mean a more effective treatment, as well as lower dosing and fewer side effects.

New and sophisticated drugs are coming out every day for autoimmune diseases such as rheumatoid arthritis, offering hope to people who desperately need answers. Understanding the circadian and seasonal rhythms of autoimmune diseases will lead to more effective treatments, which ultimately means more quality of life for those who desperately seek it.

Take Your Blood Pressure Medication Before Bed for Best Results

Jan 22 by Ewcopywriting Leave a Comment

A new study finds blood pressure medication may be more effective and even prevent death due to cardiovascular disease when taken at night.

Treating hypertension, or high blood pressure, is a challenge for many health care workers. While there are many medications available, it can be difficult to find the right combinations and doses that will keep blood pressure under control with minimum side effects. A new study suggests that the time when people take their blood pressure medication may be an important factor in hypertension control.

What Causes Hypertension?

There are several causes of hypertension. As people age, many develop atherosclerosis, or hardening of their blood vessels. This keeps their vessels from stretching to accommodate changes in blood volume, which leads to higher pressure in the circulatory system. Second, many people also develop lipid deposits in their arteries as they age, which further constricts their blood vessels and raises pressure.

One last and highly-treatable factor in blood pressure is the Renin-Angiotensin-Aldosterone System, or RAAS. This system releases hormones that control the excretion of fluids and electrolytes. Retaining fluid and electrolytes as a result of abnormal activity in the RAAS is a major cause of hypertension. For this reason, this system is the target of the most commonly-used classes of blood pressure medication, including ACE inhibitors and angiotensin receptor blockers (ARBs).

The Timing of Blood Pressure

The RAAS is tightly-timed and runs on a circadian rhythm, which means that hypertension also has a distinct 24-hour cycle. In a healthy person, blood pressure rises shortly before waking as the RAAS goes into high gear. It reaches a peak around noon and then slowly falls until bedtime. It reaches an all-time low when people finally fall into deep sleep.

However, in people with hypertension, especially hypertension that doesn’t respond to medication, blood pressure fails to fall at night. People with higher nighttime blood pressure, called non-dippers, are more likely to suffer heart attacks and strokes, especially late at night and in the early morning.

Can Timing Blood Pressure Medication Help?

In a recent chronobiology study, people with hypertension were followed for more than five years. Some took their blood pressure medication in the morning, which is typical, while others took it before bed.

The people who took their blood pressure medication at night had lower blood pressure. In addition, they had one-third the amount of heart attacks and strokes. This is not the only study suggesting that taking blood pressure medication at night has health benefits. Another recent study found that people who take their medication at night have a lower risk of developing diabetes, a common complication in hypertensive people.

Chronopharmacology and Health Care

Chronopharmacology, a sub-discipline of chronobiology, is one of the fastest growing fields in medicine. New studies are published almost every week suggesting that when we take medication can have a huge effect on treatment, side effects and even death rates. Circadian rhythms dictate almost every cell process, including how we use and metabolize medications.

One in three adults, or about 70 million Americans, suffer from hypertension. Of these people, only about half have their condition under control. These new studies on chronopharmacology and blood pressure medication offer hope that people may find better control of a difficult-to-treat disease and lead longer, healthier lives.

Need Sleep? Drink “Night Milk”

Jan 20 by Ewcopywriting Leave a Comment

Can’t seem to fall asleep? New research suggests that a glass of “night milk” may be as effective as common sedatives in promoting sleep.

Next time you have trouble falling or staying asleep, reach for a glass of night milk instead of into your medicine cabinet. To clarify, this beverage isn’t called night milk because you drink it before bedtime; it’s actually cow’s milk that is harvested from the cow in the evening hours. If you’re like the majority of people learning about this new concept, you’re probably wondering why the time the cow is milked makes a difference.

Thanks to a study performed by a Korean research team we have the answers.

The Science Behind Night Milk

Recently, a new animal study that was published in the Journal of Medicinal Food determined that before bed, a mother’s milk takes on an enhanced chemical structure with elevated levels of tryptophan and melatonin.

Authors of the study from Sahmyook University in Seoul, South Korea concluded from this finding that night milk may be a promising natural remedy for anxiety and sleep disturbances.

Can Night Milk Improve Sleep and Reduce Anxiety?

To test this theory, milk from cows was collected at various times during the day and night. The milk was then put into powder form and fed to groups of mice.

Evaluation of the milk’s effect on both groups revealed that the mice fed night milk were notably less active than the mice that received milk from cows who were milked during the day.

Surprisingly, the mice who were less active were more apt to explore open spaces. Researchers interpreted their attempt to explore as being reflective of reduced anxiety, with effects comparable to the effects of diazepam, a common sedative used to treat anxiety.

The night milk was found to contain nearly 10 times more melatonin and 24 percent more tryptophan than daytime milk.

However, the effects have yet to be tested on people, though many people have been drinking milk or taking melatonin to successfully fall asleep for years.

New Theory, or Just First of Its Kind Research?

While this is new research, it is not a new concept. A German company patented “nocturnal milk” and produced a powder from milk that had been collected from cows between the hours of 2 a.m. and 4 a.m.

The effectiveness of nocturnal milk can be vouched for by happy consumers like Maike Schnittger, who was able to get through a troublesome period of anxiety by taking the powder that helped her fall asleep within half an hour. She also stated that she fell into a deep sleep and felt really awake the next morning.

Carl Bazil, director of the Epilepsy and Sleep Division of the neurology department at Columbia University, was a little skeptical about the night milk concept. However, he stated that the theory behind it is correct, as melatonin and tryptophan have proven sedative properties and milk is also known to help people fall asleep.

The Effects of Melatonin and Tryptophan on Sleep

Wondering just how the tryptophan- and melatonin-rich milk might work? Studies dating all the way back to the 1970s have suggested that taking between one and 15 grams of tryptophan at bedtime can help people fall asleep. Even smaller doses, as little as 250 milligrams, were found to provide people with increased sleep quality by lengthening the amount of time they spent in the deepest stage of sleep.

Normal sleep is produced by two main biomolecules: the hormone melatonin and the neurotransmitter serotonin. Both of these are made naturally in the body from tryptophan, making tryptophan a valuable supplement for those seeking a better quality of sleep.

Scientists reviewed 15 studies of sleep in healthy adults and noted that the administration of melatonin significantly reduced the amount of time needed to fall asleep, boosted the percentage of time that people were actually asleep while in bed and increased their total sleep duration. This is due to the active role melatonin has in the sleep-wake cycle.

So, does this research warrant replacing conventional sleep aids with a glass of night milk? For some, maybe, if they have access to night milk. Although this is excellent research and a great first step in providing a natural solution for two very common conditions, i.e. anxiety and sleep disturbances, we anticipate that a human study is most likely imminent.

Chronotherapy: Harmonizing Disease Treatment with Internal Body Clocks

Jan 15 by Ewcopywriting Leave a Comment

Do you suffer from a chronic medical condition? If so, this review of the advancements in chronotherapy may prepare you to better advocate for your healthcare.

For generations, people have been saying that timing is everything. In recent years, breakthroughs in healthcare have brought a whole new meaning to this old saying that affects not only our daily routines, but most importantly, our overall health.

Chronotherapy and the Circadian Rhythm

Although not a new concept, the use of chronotherapy is steadily expanding. Chronotherapy, a subset of chronobiology, is the science of delivering medications and therapies in harmony with the circadian rhythms of the body and of certain diseases. Today, various treatments continue to be administered to coincide with our body’s internal clocks for optimal outcomes.

Circadian rhythms control fluctuations in the chemistry of our body hourly, daily and seasonally. Endogenous in nature, the circadian rhythm is influenced by signals within our environment including light, temperature and food intake. These signals tailor the circadian rhythm into a predictable 24-hour pattern.

Disease-Specific Circadian Rhythms

Just as every person’s body has its own circadian rhythms, so do certain diseases. Extensive research shows that the diseases that follow patterns of circadian rhythm can have improved outcomes, as treatment with chronotherapy can positively influence the manner in which they are managed.

Having knowledge of the circadian rhythms of specific diseases allows healthcare providers to utilize chronotherapy for better treatment outcomes, as drugs can be administered during time periods that will provide the best symptom management.

The extensive research on circadian rhythms and chronotherapy has revealed a great deal of information that is beneficial to the management and treatment of certain diseases. The findings specific to arthritis, bronchial asthma and cardiovascular disorders will be explored.

Arthritis

Both rheumatoid arthritis (RA) and osteoarthritis follow their own circadian rhythm. The Journal of Global Trends in Pharmaceutical Sciences reveals a study that suggests chronotherapy for all types of arthritis using non-steroidal anti-inflammatory drugs (NSAIDs) should be timed to ensure the highest drug levels in the blood coincide with an individual’s peak pain levels.

People who suffer from RA are more likely to experience joint pain and finger swelling during the morning hours. Those with osteoarthritis have less pain during the morning compared to the rest of the day. Many arthritis sufferers rely on NSAIDs for pain relief, but because they can have bothersome side effects, the timing of administration is not only important for their effectiveness, but in reducing the risk of side effects as well.

As symptoms of RA are worse in the morning, the administration of long-acting NSAIDs such as ketoprofen, indomethacin and flubiprofen at bedtime provides the maximum therapeutic effect and minimizes their side effects.

Certain mechanisms of RA, including higher cortisol levels during the day and pro-inflammatory conditions during the night related to elevated levels of prolactin and melatonin, have led researchers to believe that a practical approach to managing this debilitating disease would be the chronotherapeutic use of corticosteroids to increase their efficacy and reduce the risk of adverse events.

One scientific report references a study performed by Buttgereit and co-workers, which highlights the clinical relevance of the chronotherapeutic use of glucocorticoid therapy in low doses for RA suppression, as morning stiffness can be effectively reduced by an evening dose of a modified-release prednisone tablet.

Bronchial Asthma

Compared to other diseases, asthma has more circadian variations. While studying the circadian rhythm associated with asthma, researchers determined the lung function of even healthy individuals dips during the early morning hours; a phenomenon that’s more pronounced in those with asthma. The decrease in lung function can be significant, between 25 to 50 percent.

Also, airway resistance in asthmatic individuals increases progressively during the night, leading to frequent awakenings and sleep disturbances. According to the Journal of Global Trends in Pharmaceutical Sciences, the risk of having an asthma attack is 100-fold greater during the night than during daytime hours.

Upon reviewing data from several clinical studies, researches introduced a proposed chronotherapeutic approach to the management of nocturnal asthma, which is as follows:

In the morning – Use of a long-acting beta agonist, such as salmeterol (serevent). Studies found that asthma patients who were administered salmeterol in the AM had a significantly-reduced percentage of night awakenings and their lung function was significantly increased.
At 3 p.m. – Use of an oral corticosteroid.
Between 6-7 p.m. – Use of sustained-release theophylline. Researchers advise that an individual’s period of wakefulness should be considered with this chronotherapeutic approach, as the pharmacokinetics of theophylline can be altered in those that work the night shift.
At bedtime – Use of a leukotriene modifier, such as montelukast (singulair).

Cardiovascular Disorders

Several functions of the cardiovascular system follow a circadian rhythm, including heart rate, blood pressure, platelet aggregation, blood flow and cardiac output.

Upon waking in the morning, heart rate and blood pressure are high with a rise in systolic blood pressure by 20-25 mmHg and diastolic blood pressure by 10-15mmHg. This hypertensive state in the morning is a physiological condition described as the morning surge.

Several trials have been conducted exploring the chronotherapy of hypertension, which has established that changing the time of a treatment, rather than the combination of the treatment, may be a better approach to controlling blood pressure. Their reasoning is related to findings that blood pressure is reported to be highest in the mid-morning, progressively falling throughout the day with the lowest blood pressure to be noted at 3 a.m.

In the morning, the release of cortisol and catecholamine is high. There is also an increase in platelet aggregation. For these reasons, more myocardial infarctions are believed to occur in the morning, with 34 percent taking place between the hours of 6 a.m. and 12 noon.

Other Disorders Governed by Circadian Rhythms

There are other significant medical conditions that follow circadian rhythms as well. Treatment with chronotherapy is expanding. However, not all healthcare providers are on board with this concept yet. The purpose of this article is by no means to provide medical advice, but people who have poorly-managed medical conditions should be aware that additional treatment methods may be available so they can better advocate for their healthcare.

Other significant medical conditions that follow circadian rhythms include:

Glaucoma
Innate immunity
Diabetes
Epilepsy
Gastric ulcers
HIV/AIDS
Pain
Cancer
Allergic rhinitis