The quest of circadian medicine to make the most of our body clock

His observations have resonated with circadian scientists who are struggling to move forward in their own institutions. “John has been able to raise awareness about discussion,” said Elizabeth Clarman, a professor of neurology at Harvard Medical School, who works in the sleep division at Massachusetts General Hospital. Frank Shearer, director of the medical chronobiology program at Brigham and Women’s Hospital, was also impressed. “We are trying to improve the health of the most at-risk, we have a responsibility to take care of them, and yet, they are in an environment that is not conducive to sleep,” he told hospital patients. “I think his work is beautiful. He is making great progress in this area. ”

Although PNAS data revealed that when hospitals dispense drugs are probably more effective than medical money, it has not been able to show whether it harms patients at that time. If it is not, why change it? Hogenesch’s team and colleagues at other hospitals are now analyzing electronic medical records to see how well they affect certain generic drugs. This is harder to hear, because the data that hospitals collect is primarily for billing, not for research, and does not always specify when patients receive services and medications. If patients’ electronic medical records – blood drawings, vaccines, urine and other sampling procedures – are timed, it can greatly improve our understanding, G notes. “Your vaccination record does not say when you received it.” But it should be “so easy,” he added. “It’s all electronic.”

Any data collected from medical records will still be observational, but the more information you have from different sources, the more persuasive it can be. In the meantime, researchers can look at multiple small studies collectively called metanalysis to create larger and more representative samples. Last year, to help with the case that medications can have a big impact over time, Hogenesh and colleagues published as a preprint, before peer review, a metanalysis of previous clinical trials that included daytime topics that included 48 pharmacological or surgical treatments. Unexpectedly, low-dose aspirin, which millions of people take every day to prevent cardiovascular disease and does not come with guidelines on when to take it, proved to be the most time-sensitive: in eight out of 10 studies it was given in the evening as opposed to in the morning. If effective.

Personalized circadian medicine The future may be. The time of our clock varies individually, set by the sun, the light of the house, the genetic predisposition, our behavior, our age, by each other. Scientists are still scrambling to come up with a quick and easy way to tell where your organs are. But for now, you don’t need perfect precision to improve the coordination and strength of your biological rhythm. Circadian researchers generally recommend getting as much sunlight as possible during your day, especially when you wake up, dimming the light before bed and darkening your bedroom. (Parking in America at standard time, not in broad daylight, will help you get it done.) Front-load your calories at the beginning of the day. Above all, try to keep your schedule comparable throughout the week, including weekends. “There’s room to think about overall health optimization – improving mood, improving overall health,” Helen Burgess, a professor of psychiatry and co-director of the Slip and Circadian Research Laboratory at the University of Michigan, told me. “We are all getting old. Many of us feel like we are fading, ”he added. “Can I do small things to feel good?”

Circadian drugs can increase our well-being in other words, but most of us should not expect that it will change our lives anytime soon. Although there are exceptions to that rule whose abnormal situation may later point to a larger application. As Hoganesh told me, “You will learn from the case of the edge.”

Shortly after he arrived in Cincinnati, a Boston colleague forwarded him an email from the parents of teenage Jack Grosseclos with Smith-Kingsmore Syndrome, a very rare condition caused by mutations in a single gene that causes pain and convulsions, developmental delays, and autism. The nature of harm. In their letter, Mike and Kristen Grosseclos explain that Jack is taking a drug to stop the gene. It improved many of her symptoms, but her sleep took on a bizarre pattern. For more than a week, he slept no more than an hour or two and instead moved at a constant pace. (His parents congratulated him on a Fitbit he bought to track his activity.) Then, seven to 10 days, he slept 14 hours. “After 10 days of little sleep, his body began to break down,” they wrote. “He became limp and restless, breaking into eczema.” Jack’s doctors were shocked. In hopes of creating an explanation, Grosecloses included a bar graph of Jack’s sleep cycle and a picture of him in their email. “He was looking bad,” Mike told me. Kristen added, “We thought a visual aid could help.”

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