Precision Circadian Medicine for Shift Workers in the Digital Era - Project Summary/Abstract All essential 24-hr operations (e.g., first responders, hospital services) rely on nightshift workers who forgo nocturnal sleep for work. These essential services are available to us because of the 20% of the workforce who work nightshifts; however, they are provided little to no support in managing inverted sleep-work schedule, putting them at elevated risk for Shift Work Disorder (SWD). Because industries that rely on nightshift workers are often safety-sensitive, the consequences of impaired performance can be catastrophic (eg, Three Mile Island nuclear reactor meltdown, the American Airlines Flight 1420 crash, and the Exxon Valdez oil spill). Given this landscape, there is an urgent need for precision circadian medicine solutions. With support from multiple NIH awards, Dr. Cheng has laid the requisite foundation for vertical advancement in precision circadian medicine for SWD. For example, he pioneered the validation and creation of the first open-source, free, and widely accessible tool to track circadian rhythms in nightshift workers using wearable technology (ie, a free web portal). Furthermore, his work has also led to the understanding that a unitary focus on circadian misalignment for SWD may be overly reductionistic. This proposal seeks to enable the scaling-up of precision circadian medicine for nightshift workers by 1) leveraging digital health technologies (eg, consumer-based wearables), and 2) transforming the etiological framework of SWD from a unidimensional to a multi-level construct informed by a socioecological lens. In collaboration with a team of national leaders in sleep and circadian rhythms, Dr. Cheng will break ground in new directions of research. Potential directions include 1) examining the use of consumer-based wearable technology for precision circadian medicine, 2) establish the appropriate dose of light for a therapeutic response and remission in SWD, 3) improving the accuracy of circadian rhythms tracking with personalized parameters, 4) mechanistic evaluation of a multilevel etiological framework for SWD treatment, and 5) establish mechanistic targets for prevention of SWD. Additionally, the proposal also seeks to advance workforce development in precision circadian medicine by expanding training programs for undergraduates, doctoral students, and postdoctoral fellows. As a clinical psychologist with expertise in sleep and circadian physiology, Dr. Cheng is ideally positioned to lead this program of research to move the field of precision circadian medicine forward. He has demonstrated productivity in this area; his portfolio of work is well-cited, with a mean relative citation ratio of 2.88, which is higher than the 90% percentile of all scientific publications (NIH Office of Portfolio Analysis: iCite Tool). The proposed work would also advance five of objectives in the NHLBI Strategic Vision, and stands to significantly advance precision sleep medicine for this population, ultimately impacting outcomes related to occupational health, performance, safety, and public health.
