Paul Kelley 

Why we must listen to the ticking of our body clock

Ignoring the body’s natural rhythms can affect our physical and mental wellbeing and even the outcome of surgery, writes neuroscientist Paul Kelley
  
  

Surgeons performing open heart surgery in modern operation room.
‘Heart surgery appears to be safer in the afternoon.’ Photograph: Thierry Dosogne/Getty Images

Our bodies have many clocks that control sleep, health and performance. If we do things at the wrong times, there can be dangerous consequences. This year’s Nobel prize was awarded to the three scientists who discovered the key genes in circadian (24-hour) body clocks. Their discovery enabled other scientists to discover the thousands of circadian times that control our health, our genes and even when we should have treatments: it can make the difference between life and death.

Major heart surgery is common, but fraught with dangers. The most significant is the magnitude and duration of interrupting and restarting the body’s oxygenated blood supply. On Friday a study was published on the complications arising from morning and afternoon heart surgery. The time of surgery made a significant difference: 54 (out of 298) patients who had surgery in the morning experienced complications (18% of all patients) compared to 28 (of 298) patients who had surgery in the afternoon (9%). Heart surgery appears to be safer in the afternoon.

On the same day, Science published a report on genetic medicine in the world’s largest genomic medicine project. A patient called Atkinson told her story: she received a call from GenomeFIRST and was told she had a genetic mutation linked to Long QT syndrome that can cause fatal disruption to heart timing. Atkinson was stunned. Her mother had died young and unexpectedly, so Atkinson had her three children tested. Her two sons had the Long QT mutation: aged nine and 12, these sporty boys were most at risk in adolescence and during intense exercise. Atkinson has no doubts about genetic medicine: it found her Long QT mutation in time. “I’m not burying one of my kids,” she said.

The heart has an exceptionally strong circadian timing system, as is well-known to those in elite sports. According to sports experts, 17:00 (5pm) is the time of greatest cardiovascular efficiency and muscle strength. The heart’s circadian strength in the late afternoon may help explain better heart surgery outcomes at that time of day, and suggests the times that Atkinson’s sons should avoid intense exercise.

Living to our circadian times boosts health; when we do not live to these times we have increased health risks. Greater disease risks arising from circadian disruption have been identified in the brain, pancreas and stress systems. Metabolic studies have found disruption in sleep, liver, gut and metabolic systems. These are only some of the consequences of not living to our body’s circadian clocks.

The links between mental health problems and our circadian clocks are perhaps the strongest of all. Depression is closely associated with chronic sleep disorders. Indeed, changes in our circadian patterns are often the first symptom in many other mental illnesses.

What prevents us from living our lives to circadian times? There are many answers: working hours, social commitments, using technologies late into the night, 24/7 lifestyles.

Using our bodies’ clocks to improve our lives starts by making sure we know our own body’s circadian times: when we should wake, how long we sleep and when we’re at your best. There are many quizzes to help: try the BBC body clock quiz. Then decide what is preventing you from living to these circadian times.

Probably the biggest barrier to being in synchrony is work and commuting times. English and European laws protect our right to ask for working hours that better suit our circadian times, health and performance. If it helps, 10am is a good estimate of a starting time that would better suit most workers.

Is good sleep important? When Sainsbury’s commissioned a national survey on living well it found that “better sleep is the biggest single contributor to living better”. Its NatCen research also created a short quiz that enables us to compare our living well scores with national results. This research found that people in Britain felt a good night’s sleep was as important to them as quadrupling their disposable income.

Living to our body’s circadian clocks will boost our heath, mood and performance. It will do the same for our families too, even teenagers or those at university. It’s time to wake up to the possibilities.

• Paul Kelley is a neuroscientist

 

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