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The endogenous circadian system worsens asthma at night independent of sleep and other daily behavioral or environmental cycles

Overview of attention for article published in Proceedings of the National Academy of Sciences of the United States of America, September 2021
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  • In the top 5% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (99th percentile)
  • High Attention Score compared to outputs of the same age and source (92nd percentile)

Mentioned by

news
29 news outlets
blogs
1 blog
twitter
57 X users
facebook
1 Facebook page

Citations

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28 Dimensions

Readers on

mendeley
44 Mendeley
Title
The endogenous circadian system worsens asthma at night independent of sleep and other daily behavioral or environmental cycles
Published in
Proceedings of the National Academy of Sciences of the United States of America, September 2021
DOI 10.1073/pnas.2018486118
Pubmed ID
Authors

Frank A J L Scheer, Michael F Hilton, Heather L Evoniuk, Sally A Shiels, Atul Malhotra, Rena Sugarbaker, R Timothy Ayers, Elliot Israel, Anthony F Massaro, Steven A Shea

Abstract

Asthma often worsens at night. To determine if the endogenous circadian system contributes to the nocturnal worsening of asthma, independent of sleep and other behavioral and environmental day/night cycles, we studied patients with asthma (without steroid use) over 3 wk in an ambulatory setting (with combined circadian, environmental, and behavioral effects) and across the circadian cycle in two complementary laboratory protocols performed in dim light, which separated circadian from environmental and behavioral effects: 1) a 38-h "constant routine," with continuous wakefulness, constant posture, 2-hourly isocaloric snacks, and 2) a 196-h "forced desynchrony" incorporating seven identical recurring 28-h sleep/wake cycles with all behaviors evenly scheduled across the circadian cycle. Indices of pulmonary function varied across the day in the ambulatory setting, and both laboratory protocols revealed significant circadian rhythms, with lowest function during the biological night, around 4:00 AM, uncovering a nocturnal exacerbation of asthma usually unnoticed or hidden by the presence of sleep. We also discovered a circadian rhythm in symptom-based rescue bronchodilator use (β2-adrenergic agonist inhaler) whereby inhaler use was four times more likely during the circadian night than day. There were additive influences on asthma from the circadian system plus sleep and other behavioral or environmental effects. Individuals with the lowest average pulmonary function tended to have the largest daily circadian variations and the largest behavioral cycle effects on asthma. When sleep was modeled to occur at night, the summed circadian, behavioral/environmental cycle effects almost perfectly matched the ambulatory data. Thus, the circadian system contributes to the common nocturnal worsening of asthma, implying that internal biological time should be considered for optimal therapy.

X Demographics

X Demographics

The data shown below were collected from the profiles of 57 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 44 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 44 100%

Demographic breakdown

Readers by professional status Count As %
Student > Ph. D. Student 7 16%
Researcher 6 14%
Student > Doctoral Student 3 7%
Student > Bachelor 3 7%
Student > Master 3 7%
Other 5 11%
Unknown 17 39%
Readers by discipline Count As %
Biochemistry, Genetics and Molecular Biology 7 16%
Medicine and Dentistry 5 11%
Nursing and Health Professions 4 9%
Neuroscience 3 7%
Unspecified 2 5%
Other 4 9%
Unknown 19 43%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 248. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 March 2024.
All research outputs
#151,386
of 25,587,485 outputs
Outputs from Proceedings of the National Academy of Sciences of the United States of America
#3,007
of 103,380 outputs
Outputs of similar age
#4,177
of 434,591 outputs
Outputs of similar age from Proceedings of the National Academy of Sciences of the United States of America
#74
of 1,002 outputs
Altmetric has tracked 25,587,485 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 103,380 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 39.5. This one has done particularly well, scoring higher than 97% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 434,591 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 1,002 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 92% of its contemporaries.