Table 2.

The impact of chronic sleep and circadian rhythm disruption (SCRD) upon human emotional responses, cognition, physiology and health. Such associations have long been a concern for shift workers, who suffer from extreme forms of SCRD. Citations: fluctuations in mood [72–75], depression and psychosis [76–79], anxiety, irritability, loss of empathy, frustration [80–82], risk-taking and impulsivity [83–86], negative salience [87], stimulant, sedative and alcohol abuse [88–92], illegal drug use [93]; impaired cognitive performance and the ability to multi-task [94–96], memory, attention and concentration [97–100], communication and decision-making [90,101–104], creativity and productivity [105–108], motor performance [96,109], dissociation/detachment [110,111]; day time sleepiness, micro-sleeps, unintended sleep [112–115], altered stress response [116,117], altered sensory thresholds [118–120], impaired immunity and infection [121,122], cancer [123–125], metabolic abnormalities and diabetes II [63,126–129], cardiovascular disease [129–131].

emotional	cognitive	physiology and health
increased	impaired	increased risk
fluctuations in mood	cognitive performance	day time sleepiness
irritability	ability to multi-task	micro-sleeps
anxiety	memory	cardiovascular disease
loss of empathy	attention	altered stress response
frustration	concentration	altered sensory thresholds
risk-taking and impulsivity	communication	infection, lowered immunity
negative salience	decision-making	cancer
stimulant use (caffeine)	creativity and productivity	metabolic abnormalities
sedative use (alcohol)	motor performance	diabetes II
illegal drug use	dissociation/detachment	depression and psychosis