Light therapy improves diurnal blood pressure control in night shift workers via reduction of catecholamines: the EuRhythDia study

Abstract

Supplemental Digital Content is available in the text Objectives: Night shift work is associated with high rates of hypertension and cardiometabolic disease, which are linked to disrupted circadian rhythms. We hypothesized that timed light therapy might improve disrupted circadian rhythms and stabilize diurnal control of blood pressure and glucose in night shift workers. Methods: We randomized 24 rotating night shift workers (mean age, 36\u200a±\u200a13\u200ayears, 7 men) who had spent a median of 6\u200ayears on rotating night shifts (median, six night shifts per month) to 12\u200aweeks of light therapy or no intervention and compared them with 12 daytime workers (37\u200a±\u200a11\u200ayears, 6 men). We measured oral glucose tolerance (OGTT), 24-h blood pressure and arterial stiffness, and the circadian profiles of melatonin, cortisol, metanephrine and nor-metanephrine at baseline, after 12\u200aweeks of intervention, and 12\u200aweeks after the end of intervention. Results: At baseline, fewer night shift workers showed dipper status as compared with daytime workers (29 vs. 58%; P\u200a<\u200a0.001). After 12\u200aweeks of light therapy, there was a highly significant increase in the proportion of dippers (to 58%; P\u200a<\u200a0.0001). We also observed a significant decrease in serum glucose during OGTT in the light therapy group (−22%; P\u200a<\u200a0.05) with no change in serum insulin. Whilst circadian profiles of melatonin and cortisol were unchanged, plasma metanephrine and nor-metanephrine levels were significantly reduced in the light therapy group (P\u200a<\u200a0.01). Conclusion: Timed light therapy improves diurnal blood pressure control and glucose tolerance in rotating night shift workers. This effect is unrelated to melatonin and cortisol but is paralleled by reduced catecholamine levels.