Trabalho noturno: efeitos imunofisiológicos da restrição do sono e do desalinhamento circadiano

Abstract

Can the immunophysiological effects of sleep restriction and circadian misalignment associated with night work be detrimental to the health of night workers? The aim of this study is to describe the immunophysiological mechanisms by which sleep restriction and circadian misalignment can cause damage to the health of night workers. The present study consists of a bibliographical review, covering scientific papers written in English and published in periodicals, predominantly in the last 5 (five) years and peer-reviewed. Due to its relevance to the study and the absence of similar publications of interest, some articles published over five years ago were also included in this period. The articles were searched in the years 2016 and 2017 in Portal Capes, through the internet, covering the Google Academics and Pubmed databases. The main terms used in the research were the following: mechanisms sleep wakefulness, sleep functions, neurotransmitters sleep wakefulness, sleep circadian; melatonin circadian; melatonin oxidative stress; sleep melatonin cancer; melatonin immunity; adenosine sleep; orexin hypocretin; circadian immunity; sleep immunity; sleep inflammation; sleep circadian stress; sleep cognitive function; sleep circadian metabolism; sleep circadian obesity; sleep circadian glucose; sleep restriction cardiovascular; sleep circadian hypertension; shift work immunity; shift work stress; shift work cognitive function; shift work cancer; shift work obesity; shift work metabolism; shift work cardiovascular. We selected articles describing sleep, wake and circadian cycles mechanisms, as well as the relationship of sleep with immunophysiological processes, as well as those that present significant results regarding the damaging effects of sleep restriction and circadian misalignment on individuals' health. We excluded articles with non-significant results and articles dealing in a secondary way. After reading the summaries of the 92 articles initially selected, 31 were discarded and the 61 remaining articles were used as references in the present study. The body of this work was divided into three parts. The first part presents an overview of the physiological mechanisms of wakefulness and sleep, its stages, its possible functions and its means of regulation. The second part covers research on the impact of sleep restriction and circadian misalignment on the immune system and the possible associated pathologies. The third part is the approach of the effects of night work on sleep restriction and circadian misalignment and its possible damages to health. In this study, the generic name of "night work" was used to cover the work regime performed totally or partially during the night shift, either permanently, that is, the worker will work in fixed shift, covering all night hours or part Or in the form of a relay, a system in which companies periodically exchange their employees' shifts, alternating their schedules between night and day. In English, the term shift work is used, which literally means "shift work" and can cover the work performed in all these forms, but not all articles researched clarify the exact working hours, On the other hand, that at least part of this work is performed at night in order to induce acute or chronic sleep restriction or chronic circadian misalignment.