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Relevance of Flammer Syndrome to the “Sleep-Wake” Rhythm: Possible Mechanisms, Risks and Preventive Strategies

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Flammer Syndrome

Abstract

Sleep and chronobiology have decisive effects on human health and disease status. Chronobiology is relatively recently recognised as a prominent scientific area, particularly as in 2017 three American researchers received the Nobel Prize for their discoveries on molecular mechanisms behind the internal clocks and biological rhythms that govern human lifes. Genetic make-up responsible for the self-sustaining clockwork inside the cell regulating fundamental functions such as behaviour, hormone levels, sleep, body temperature and metabolism has been discovered. Research data demonstrate that sleep is connected to cell regeneration, detoxification of the body, memory consolidation, and psychological recovery. Consequently, being in a state of sleep deficit can be dangerous; short sleep duration correlates with increased risk of cardiovascular and metabolic diseases, and untreated insomnia can lead to severe depression. Many people think that if they sleep less, they can work more. But the truth is that self-induced short sleep leads to impaired work ability. Car accidents, work accidents, as well as impaired concentration - all may result from the sleep deprivation. Pathomechanisms of severe neurological disorders have been demonstrated as being connected to impaired sleep patterns. Noteworthy, highly increased mortality, due to accidents generally, car accidents in particular, sleep disorders, depression and neurodegenerative impairments have been recorded specifically for individuals with low BMI (see the introductory chapter “Flammer Syndrome in the Global Context – The “U-Shape” of Health Risks”).

This chapter highlights mechanisms of the sleep patterns alteration characteristic for the FS affected individuals, discusses a potential link between the long-term consequences and increased risks of exemplified pathologies and provides expert recommendation for effective PPPM strategies applied to sleep medicine.

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Abbreviations

PVD:

primary vascular dysregulation

TDCE:

thermal discomfort from cold extremities

DLMO:

Dim Light Onset Melatonin

SCN:

suprachiasmatic nucleus

NTG:

normal tension Glaucoma

BMI:

body mass index

FS:

Flammer Syndrome

References

  1. Flammer J, Pache M, Resink T (2001) Vasospasm, its role in the pathogenesis of diseases with particular reference to the eye. Prog Retin Eye Res 20(3):319–349

    Article  CAS  PubMed  Google Scholar 

  2. Teuchner B, Orgül S, Ulmer H, Haufschild T, Flammer J (2004) Reduced thirst in patients with a vasospastic syndrome. Acta Ophthalmol Scand 82(6):738–740

    Article  PubMed  Google Scholar 

  3. Flammer J, Konieczka K (2017) The discovery of the Flammer syndrome. A historical and personal perspective. EPMA J 8(2):75–97

    Article  PubMed  PubMed Central  Google Scholar 

  4. Flammer J, Mozaffarieh M (2007) What is the present pathogenetic concept of glaucomatous optic neuropathy? Surv Ophthalmol 52(Suppl 2):162–173

    Article  Google Scholar 

  5. Pache M, Kräuchi K, Cajochen C, Wirz-Justice A, Dubler B, Flammer J, Kaiser HJ (2001) Cold feet and prolonged sleep-onset latency in vasospastic syndrome. Lancet 358(9276):125–126

    Article  CAS  PubMed  Google Scholar 

  6. Vollenweider S, Wirz-Justice A, Flammer J, Orgül S, Kräuchi K (2008) Chronobiological characterization of women with primary vasospastic syndrome. Body heat loss capacity in relation to sleep initiation and phase of entrainment. Am J Physiol Regul Integr Comp Physiol 294(2):R630–R638

    Article  CAS  PubMed  Google Scholar 

  7. Golubnitschaja O (2017) Feeling cold and other underestimated symptoms in breast cancer: anecdotes or individual profiles for advanced patient stratification? EPMA J 8(1):17–22. https://doi.org/10.1007/s13167-017-0086-6

    Article  PubMed  PubMed Central  Google Scholar 

  8. Bubnov R, Polivka J Jr, Zubor P, Koniczka K, Golubnitschaja O (2017) “Pre-metastatic niches” in breast cancer: are they created by or prior to the tumour onset? “Flammer Syndrome” relevance to address the question. EPMA J 8(2):141–157. https://doi.org/10.1007/s13167-017-0092-8

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kräuchi K, Gasio Vollenweider S, Arb M, Dubler B, Orgül S et al (2008) Cold extremities and difficulties initiating sleep. Evidence of co-morbidity from a random sample of a Swiss urban population. J Sleep Res 17(4):420–426

    Article  PubMed  Google Scholar 

  10. Ohayon MM (2002) Epidemiology of insomnia. What we know and what we still need to learn. Sleep Med Rev 6(2):97–111

    Article  PubMed  Google Scholar 

  11. American Psychiatric Association (2013) Sleep-wake disorders. In: Diagnostic and statistical manual of mental disorders. DSM-5, 5th edn. Author, Washington, DC

    Chapter  Google Scholar 

  12. Riemann D, Spiegelhalder K, Feige B, Voderholzer U, Berger M, Perlis M, Nissen C (2010) The hyperarousal model of insomnia. A review of the concept and its evidence. Sleep Med Rev 14(1):19–31

    Article  PubMed  Google Scholar 

  13. Scholze A, Burkert A, Mardanzai K, Suvd-Erdene S, Hausberg M, Zidek W, Tepel M (2007) Increased arterial vascular tone during the night in patients with essential hypertension. J Hum Hypertens 21(1):60–67

    Article  CAS  PubMed  Google Scholar 

  14. Moore RY, Danchenko RL (2009) Paraventricular–subparaventricular hypothalamic lesions selectively affect circadian function. Chronobiol Int 19(2):345–360

    Article  Google Scholar 

  15. Gompper B, Bromundt V, Orgül S, Flammer J, Kräuchi K (2010) Phase relationship between skin temperature and sleep-wake rhythms in women with vascular dysregulation and controls under real-life conditions. Chronobiol Int 27(9–10):1778–1796

    Article  PubMed  Google Scholar 

  16. Anders D, Vollenweider S, Cann J, Hofstetter M, Flammer J, Orgül S, Kräuchi K (2010) Heart-rate variability in women during 40-hour prolonged wakefulness. Chronobiol Int 27(8):1609–1628

    Article  PubMed  Google Scholar 

  17. Kräuchi K, Cajochen C, Wirz-Justice A (2004) Waking up properly. Is there a role of thermoregulation in sleep inertia? J Sleep Res 13(2):121–127

    Article  PubMed  Google Scholar 

  18. Kräuchi K, Knoblauch V, Wirz-Justice A, Cajochen C (2006) Challenging the sleep homeostat does not influence the thermoregulatory system in men. Evidence from a nap vs. sleep-deprivation study. Am J Physiol Regul Integr Comp Physiol 290(4):1052–1061

    Article  Google Scholar 

  19. Cajochen C, Münch M, Kobialka S, Kräuchi K, Steiner R, Oelhafen P et al (2005) High sensitivity of human melatonin, alertness, thermoregulation, and heart rate to short wavelength light. J Clin Endocrinol Metab 90(3):1311–1316

    Article  CAS  PubMed  Google Scholar 

  20. Ju YS, Ooms SJ, Sutphen C et al (2017) Slow wave sleep disruption increases cerebrospinal fluid amyloid-β levels. Brain 140(8):2104–2111

    Article  PubMed  PubMed Central  Google Scholar 

  21. Bhaskaran K, Dos-Santos-Silva I, Leon DA, Douglas IJ, Smeeth L (2018) Association of BMI with overall and cause-specific mortality: a population-based cohort study of 3·6 million adults in the UK. Lancet Diabetes Endocrinol 6(12):944–953. https://doi.org/10.1016/S2213-8587(18)30288-2

    Article  PubMed  PubMed Central  Google Scholar 

  22. Juda M, Vetter C, Roenneberg T (2013) Chronotype modulates sleep duration, sleep quality, and social jet lag in shift-workers. J Biol Rhythm 28(2):141–151

    Article  Google Scholar 

  23. Richter K, Acker J, Kamcev N, Bajraktarov S, Piehl A, Niklewski G (2011) Recommendations for the prevention of breast cancer in shift workers. EPMA J 2:351–356

    Article  PubMed  PubMed Central  Google Scholar 

  24. Richter K, Niklewski G (2012) Health promotion and prevention in companies – economic aspects and prevention strategies for shift work sleep disorders. In: Costigliola V (ed) Advances in predictive, preventive and personalised medicine. Healthcare overview. New perspectives, vol 1. Springer, Dordrecht, pp 423–467

    Google Scholar 

  25. Richter K, Niklewski G (2013) Book review: chronotherapeutics for affective disorders. A clinician’s manual for light and wake therapy. In: Wirz-Justice A, Benedetti F, Terman M (eds) S.Karger AG, Basel, 124 pages. ISBN:978-3-318-02090-8.2014. Acta Neuropsychiatrica 26:193–194

    Google Scholar 

  26. Schlack R, Hapke U, Maske U, Busch MA, Cohrs S (2013) Häufigkeit und Verteilung von Schlafproblemen und Insomnie in der deutschen Erwachsenenbevölkerung – Ergebnisse der Studie zur Gesundheit Erwachsener in Deutschland (DEGS1). Bundesgesundheitsblatt 56(5/6):740–748

    Article  CAS  Google Scholar 

  27. Spielman AJ, Glovinsky P (1991) The varied nature of insomnia. In: Hauri PJ (ed) Case studies in insomnia. Plenum Press, New York

    Google Scholar 

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Richter, K., Peter, L., Miloseva, L., Hillemacher, T., Niklewski, G., Golubnitschaja, O. (2019). Relevance of Flammer Syndrome to the “Sleep-Wake” Rhythm: Possible Mechanisms, Risks and Preventive Strategies. In: Golubnitschaja, O. (eds) Flammer Syndrome. Advances in Predictive, Preventive and Personalised Medicine, vol 11. Springer, Cham. https://doi.org/10.1007/978-3-030-13550-8_8

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  • DOI: https://doi.org/10.1007/978-3-030-13550-8_8

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