We are studying how light and behaviors like eating affect the body clock. The body clock controls your daily cycles of sleep, hormones, and performance. We hope that this research will contribute to the development of recommendations for healthy light exposure and eating schedules and guide treatment strategies for circadian rhythm disruption, for example in shift workers.
This study involves up to a 3-week screening process prior to a 7-8 day inpatient stay at Brigham and Women's Hospital. During the 3-week screening process, you will keep a consistent 8-h sleep schedule, including wearing an activity monitor and completing daily sleep logs and call-ins. For up to 11 days, you will record what you eat and will be given food to eat for 3 days before your inpatient study. The inpatient period of the study will consist of 7-8 days of living in our lab. If you would like to learn more, please download our study description below!
We will be studying healthy men and women who are/have:
• Ages 18-35 years old
• No history of medical, psychiatric, or sleep disorders/conditions
• Free from medication (contraception OK)
Participants can receive up to $3,500.
If you would like to participate, please complete the survey below.
Thank you!
First name:
* must provide value
Last name:
* must provide value
Male
Female
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Do you have a Social Security Number?
(This is for study payment purposes; you do not need to provide it at this time).
* must provide value
Yes
No
Where did you hear about the study?
Craigslist BWH Website Partners Clinical Trials Website Harvard DSM Website Facebook Poster/ Flyer MBTA Other
Any personal or identifying information asked during
this screen will need to be stored in the Division of
Sleep Medicine Database. Do you give us your
permission to enter information in our Database?
* must provide value
Yes
No
Before booking your first appointment, you will need to be associated with the research study on the
Partners Electronic Medical Records Database. During this process we will gain access to a summary of your past medical record within Partners. Do you give your consent for this to occur?
* must provide value
Yes
No
If you are found ineligible, or are uninterested in this particular study, would you like to be informed about other studies in the future?
* must provide value
Yes
No
Phone Number
* must provide value
Email Address
* must provide value
State
* must provide value
Do you have an emergency contact?
* must provide value
Yes
No
Current Occupation
* must provide value
Employed Unemployed Student
Date of Birth
* must provide value
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Inches
* must provide value
Weight (lbs)
* must provide value
Which is your dominant hand?
* must provide value
Right
Left
(i.e. which hand do you use to write, etc.)
Have you ever participated in a Research Study before?
* must provide value
Yes
No
Was it a BWH Sleep Study?
* must provide value
Yes
No
What type of study did you participate in? Please explain. Use as much detail possible.
Yes
No
When was the study?
(month, year)
Yes
No
Was it a BWH Sleep Study?
Yes
No
What type of study did you participate in?
Yes
No
When was the study?
(month, year)
Yes
No
Was it a BWH Sleep Study?
Yes
No
What type of study did you participate in?
Yes
No
When was the study?
(month, year)
Did you formerly or do you currently smoke cigarettes?
* must provide value
Yes
No
Which one of the two are you?
* must provide value
Former smoker
Current smoker
When did you quit smoking?
* must provide value
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How many per day?
* must provide value
0 (less than one every day) 1 2 3 4 5 6 7 8 +
Do you currently use any chewing tobacco, cigars, or nicotine patches?
* must provide value
Yes
No
Do you have any problems with your sleep?
* must provide value
Yes
No
What kind? Please describe.
Typical Bedtime
(WEEKDAYS)
* must provide value
Before 8:00pm 08:15pm 08:30pm 08:45pm 09:00pm 09:15pm 09:30pm 09:45pm 10:00pm 10:15pm 10:30pm 10:45pm 11:00pm 11:15pm 11:30pm 11;45pm 12:00am 12:15am 12:30am 12:45am 01:00am 01:15am 01:30am 01:45am 02:15am 02:30am 02:45am 03:00am After 3am Bedtime varies greatly- no "typical" or "average" time
Typical Waketime
(WEEKDAY)
* must provide value
Before 05:00am 05:00am 05:15am 05:30am 05:45am 06:00am 06:15am 06:30am 06:45am 07:00am 07:15am 07:30am 07:45am 08:00am 08:15am 08:30am 08:45am 09:00am 09:15am 09:30am 09:45am 10:00am 10:15am 10:30am 10:45am 11:00am 11:15am 11:30am 11:45am 12:00pm After 12:00pm Waketime varies greatly- no "typical" or "average" waketime
Typical Bedtime
(WEEKENDS)
* must provide value
Before 8:00pm 08:15pm 08:30pm 08:45pm 09:00pm 09:15pm 09:30pm 09:45pm 10:00pm 10:15pm 10:30pm 10:45pm 11:00pm 11:15pm 11:30pm 11;45pm 12:00am 12:15am 12:30am 12:45am 01:00am 01:15am 01:30am 01:45am 02:00am 02:15am 02:30am 02:45am 03:00am After 3am Bedtime varies greatly- no "typical" or "average" time
Typical Waketime
(WEEKENDS)
* must provide value
Before 05:00am 05:00am 05:15am 05:30am 05:45am 06:00am 06:15am 06:30am 06:45am 07:00am 07:15am 07:30am 07:45am 08:00am 08:15am 08:30am 08:45am 09:00am 09:15am 09:30am 09:45am 10:00am 10:15am 10:30am 10:45am 11:00am 11:15am 11:30am 11:45am 12:00pm After 12:00pm Waketime varies greatly- no "typical" or "average" waketime
Would you be able to keep a regular 7-hour sleeping schedule?
* must provide value
Yes
No
Target Bedtime
* must provide value
Now H:M
Target Waketime
* must provide value
Now H:M
Do you have any medical illnesses or problems?
* must provide value
Yes
No
Unsure (requires explanation below)
Please explain.
* must provide value
Do you have a regular menstrual cycle? (Bleeding once per month)
* must provide value
Yes
No
Unsure
What was the date (month/day/year) of your most recent menses? (i.e., first day you observe red blood)
If you are unable to recall the exact date, please provide an approximate one.
* must provide value
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What was the date of your previous menses? (prior to the most recent one you listed above)
If you are unable to recall the exact date, please provide an approximate one.
* must provide value
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Average length of cycle?
* must provide value
The number of days between two SEPARATE periods NOT the number of days spent bleeding during one period.
Have you ever taken birth control?
* must provide value
Yes
No
What type of birth control is/was it?
* must provide value
Please explain your other form of birth control:
* must provide value
When did you start taking it?
* must provide value
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When did you stop taking it? Or are you currently still taking it?
* must provide value
Is/was it tricyclic?
* must provide value
Yes
No
Unsure
Are you currently using any medications, inhalers, patches, or hormone replacements (other than what you may have reported above)?
* must provide value
Yes
No
Are you currently using any medications, inhalers, patches, or hormone replacements?
* must provide value
Yes
No
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Yes
No
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Yes
No
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Oral Retin-A
* must provide value
Yes
No
Unsure
Accutane
* must provide value
Yes
No
Unsure
Tetracycline
* must provide value
Yes
No
Unsure
What type?
(check all that apply)
How long ago did you take it?
Have you traveled outside of the Eastern Time Zone within the past 3 months?
* must provide value
Yes
No
City, State -or- City, Country
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Yes
No
City, State -or- City, Country
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Do you have any plans to travel in the next few months?
* must provide value
Yes
No
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Have you ever worked or do you currently work the night shift?
* must provide value
Yes
No
Night shift work is defined as working anytime during the hours of 1:00am and 06:00am. Anything in the last 3 years should be explained in detail.
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Are you still working nights?
* must provide value
Yes
No
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How many nights per week?
Which of the following do you have?
* must provide value
Heart Disease
Heart Murmur
Both (Heart Disease & Murmur)
When did it develop? What is the severity?
* must provide value
What kind of lung disease?
* must provide value
When did it develop? What is the severity?
* must provide value
What kind of kidney disease?
* must provide value
When did it develop? What is the severity?
* must provide value
What sort of visual or hearing impairment? If you wear glasses or contact lenses, how much are you able to see without them?
* must provide value
Please explain the eye injury.
* must provide value
What kind of stomach or intestine disease?
* must provide value
When did it develop? what is the severity?
* must provide value
What kind of neurological disease?
* must provide value
When did it develop? What is the severity?
* must provide value
What type of surgery? When was the procedure? Were you under anesthesia?
* must provide value
Please indicate what type of anesthesia you were under and when.
* must provide value
What type of thyroid disease?
* must provide value
When did it develop? What is the severity?
* must provide value
When were you diagnosed with high blood pressure? What is the severity?
* must provide value
What type of diabetes do you have? When were you diagnosed with diabetes?
What type of hepatitis do you have? When were you diagnosed with this?
* must provide value
Which types of hepatitis are you vaccinated for? When did you get your vaccination(s)?
Are you still asthmatic? What type of asthma inhaler do you use?
* must provide value
What sort of psychiatric care have you received? When? Were you diagnosed with anything? Were you given any medications? Please explain.
* must provide value
Which family member(s) have/had a mental illness or disease? Which illness/disease?
* must provide value
Please explain the accident or head injury. Did you lose consciousness? For how long?
* must provide value
Aside from the above questions, is there anything else that you would like us to know in order for us to help determine your eligibility?
* must provide value
How many times per week do you typically drink alcohol?
* must provide value
0 1 2 3 4 5 6 7+
How many drinks per time?
* must provide value
0 (I never consume alcohol)
1-2
3-4
5-6
7+
What kind? (example: Beer, Hard Liquor, etc.)
Antihistamines (medications for allergies)
* must provide value
Never A few times per year Monthly Weekly Daily
Sedatives (anti-anxiety agents such as Valium)
* must provide value
Never A few times per year Monthly Weekly Daily
Please specify what medication.
Please specify how often.
When was the most recent time?
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Yes
No
Aspirin, Tylenol, other pain relievers
* must provide value
Never A few times a year Monthly Weekly Daily
Please specify how often.
Antacids
* must provide value
Never A few times per year Monthly Weekly Daily
How often? Please explain.
Health Food Supplements/Remedies (melatonin, herbal ecstasy, ginseng)
* must provide value
Never A few times per year Monthly Weekly Daily
Please specify which supplement or product you take.
How often do you take this supplement?
When was the last time you took the supplement?
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Yes
No
When was the most recent time you used marijuana?
* must provide value
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When was the most recent time you used cocaine?
* must provide value
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When was the most recent time you used amphetamines?
* must provide value
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What type?
* must provide value
Were/are they prescribed to you?
* must provide value
Yes
No
When was the most recent time you used ecstasy?
* must provide value
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When was the most recent time you used sleeping pills?
* must provide value
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What type of sleeping pills?
* must provide value
Were/are they prescribed to you?
Yes
No
When was the most recent time you used LSD or mushrooms?
* must provide value
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When was the most recent time you used steroids?
* must provide value
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Are you able to stop during, and 3 weeks prior to, the study?
This includes all drugs, medicines, alcohol, caffeine, nicotine products, chocolate, herbal remedies, etc.
* must provide value
Yes
No