Russell Foster: Could we cure jet lag?

In this episode of Titans of science, body clock guru Russell Foster chats about the discovery of the body clock's mechanisms, as well as what can happen if you upset your body's balance...

Chris - Let's turn to teenagers for a minute because I'm the proud parents of a couple of them. So I know all about this. I'm an authority. I think you've been there. Now they really do try and sleep all day. I wish I could still do that. Now what's the difference between them and me? And is this true, that teenagers do perform worse in the morning and therefore should we give them an extra few hours in bed, we probably get a better set of teenagers for it?

Russell - Well, yes and no. And really this brings us to the topic of chronotype, whether you're a morning person, evening person, or somewhere in between. About 10% of the population are extreme morning types. 65% of us are in the middle and 25% tend to be on the owl spectrum. But this changes as we age. There are three important factors that contribute to our chronotype. One is age. So from about the age of 10, there's a tendency to want to go to bed later and later. And this peaks in our late teens, early twenties. And then there's a slow move to a more morning chronotype. So the bottom line is, when you're in your late fifties, early sixties, you're getting up about two hours earlier than you did when you were in your late teens, early twenties. So there's a very significant effect there. So one is age. And that is almost certainly linked to the changing levels of the sex steroids, the steroids that underpin puberty. The second factor is genetics. So we talked about those clock genes and subtle changes in those clock genes can predispose you to be a morning type or an evening type. So there's a couple of factors you can't do much about, which is your genetics and your state of puberty and how old you are. But the third factor is what's so interesting. And of course I'm a light bore. And it's the impact of light on the clock. Morning light advances the clock. You get up earlier and go to bed earlier. Whereas dusk light delays the clock. You go to bed later and you get up later. And we did a wonderful study a few years ago on university students around the world showing that the later the chronotype, the less morning light they got, which would make them get up early, but they got lots of late afternoon, early evening light, which would delay the clock. So one thing that we do have some control over is our light exposure. So if you are a late type, if you're a teenager, it's brutal. But what you need to do is you set the alarm and then you get outside, you sit near a window or you sit in front of a light box to make sure you get that morning photon shower to advance the clock. So yes, teenagers are delayed biologically, but it's made worse if you don't get light at the right time.

Chris - I heard that you are trying to rope in our political system as guinea pigs now. Is this true? Because you're interested in studying how they work, how our legal and political representatives work.

Russell - Well, I've had the privilege of working with an organisation Liminal Space to deliver educational information to night shift workers. Now I think what's so fascinating about night shift work is that it's a genie that we can't put back in its bottle. It's here to stay. And so what we've got to do is be aware of the problems associated with night shift work, but think about ways in which we can mitigate some of the issues we've talked about. Poor physical and mental health. And so why don't we have higher frequency health checks in that vulnerable group to try and detect the problems before they become chronic? We know higher levels of obesity, diabetes 2, metabolic abnormalities in night shift workers. So why aren't we providing that sector with appropriate food? What we've got available to that group is fast food, high fat, high sugar. And it's amazing to me that with a food industry that is so vibrant in the UK, we haven't come up with high protein, low fat, nutritious, pleasing to eat snacks for night shift workers during the night shift. We've got to produce educational materials for our night shift workers to not only let them know of some of the problems, but also the people they share their lives with. The divorce rate in some sectors of night shift workers is six times higher than day shift workers. We've got to let their partners know that this person hasn't turned into a monster, but this is an inevitable consequence of driving one's biology outside of its normal range. And then finally, because these pathologies develop over time, maybe we should do the studies, and we don't have the studies yet, to limit night shift work to three to four years and then hopefully wind back some of the long-term health issues. So you cycle out of night shift work onto day shift work, and you stabilise biology and then you could potentially go back to night shift work. Now the economic formula for that is tricky because people don't invariably do night shift work because they want to, it's because they get paid a higher rate. So there are issues that we need to resolve. So this is a really important sector. And Lord Tom Watson has been really a fantastic advocate of trying to improve the health status of our night shift workers. And so we suggested to him that we institute a sleep health questionnaire for our members of the House of Lords and the House of Commons coupled with a mood and stress questionnaire. So hopefully that'll be instituted in the new Parliament in the coming months and we'll do it at the beginning of the parliament and then towards the end of the parliament. So, this has a serious aspect. I think it would be very interesting to find out how tired our decision makers are and how their ability to function is being affected by long hours and disrupted hours. But also I think it'll raise public awareness to this really important problem and start an informed public debate about what we should be doing in terms of our night shift workers, their health. And just because we can invade the night, should we always? Clearly our frontline staff, police, firemen, hospital workers, yep, they're going to be needed and we need to find interventions for them. But do we really always need to run our society on a 24/7 basis in view of the problems? I'm not sure that we do. And it's a debate that we need to have.

Chris - Short of changing how the world works. And that's a big ask, isn't it, because you've got eight and a half billion people on earth and many economies run very differently and are less sympathetic actually to the way we tend to run our country. Although it's hard to believe it sometimes. Are there any things we can do perhaps with drugs or pharmacologically? Because there are people, of course, who take drugs, caffeine being the obvious one to wake us all up. Is there anything we can do to help with this body clock resetting or to make us all healthier and combat some of these desynchronisation that are happening that make us less healthy?

Russell - The first line of attack has to be sort of behavioural change and behavioural modification. But what's so exciting for me is that the curiosity driven research that has led us to understand how light interacts with a molecular pathway has identified drugs which can fool the clock that it sees light. Why do we want those drugs? Well, if you have no eyes, if you're profoundly blind, then you're drifting through time constantly. And so where we are, we've done all the preclinical work, we know we've got a drug that can fool the clock that it's seen light. We know that it's safe in humans. And our big hope is that we can then introduce this into individuals, into clinical trials and then use those drugs to stabilise sleep weight patterns in the profoundly blind, but also in other groups where you have massive circadian rhythm disruption. So for example, in schizophrenia and neurodevelopmental conditions. So I'm very excited that this curiosity driven research could translate to really new and powerful ways in which we could regulate the circadian rhythms across multiple conditions and across the health spectrum.

Chris - And cure jet lag?

Russell - <laugh>. Well, that isn't our primary aim, but you know, that's what these drugs will do. They will shift the clock. And so yes, as a cure for jet lag, they could be incredibly effective, far better than anything else we've got because they activate the pathway that light activates.