Circadian rhythms in bed rest: monitoring core body temperature via heat-flux approach is superior to skin surface temperature
Open accessAbstract
Continuous recordings of core body temperature (CBT) are a well-established approach in describing circadian rhythms. Given the discomfort of invasive CBT measurement techniques, the use of skin temperature recordings has been proposed as a surrogate. More recently, we proposed a heat-flux approach (the so-called Double Sensor) for monitoring CBT. Studies investigating the reliability of the heat-flux approach over a 24-hour period, as well as comparisons with skin temperature recordings, are however lacking. The first aim of the study was therefore to compare rectal, skin, and heat-flux temperature recordings for monitoring circadian rhythm. In addition, to assess the optimal placement of sensor probes, we also investigated the effect of different anatomical measurement sites, i.e. sensor probes positioned at the forehead vs. the sternum. Data were collected as part of the Berlin BedRest study (BBR2-2) under controlled, standardized, and thermoneutral conditions. 24-hours temperature data of seven healthy males were collected after 50 days of -6° head-down tilt bed-rest. Mean Pearson correlation coefficients indicated a high association between rectal and forehead temperature recordings (r > 0.80 for skin and Double Sensor). In contrast, only a poor to moderate relationship was observed for sensors positioned at the sternum (r = -0.02 and r = 0.52 for skin and Double Sensor, respectively). Cross-correlation analyses further confirmed the feasibility of the forehead as a preferred monitoring site. The phase difference between forehead Double Sensor and rectal recordings was not statistically different from zero (p = 0.313), and was significantly smaller than the phase difference between forehead skin and rectal temperatures (p = 0.016). These findings were substantiated by cosinor analyses, revealing significant differences for mesor, amplitude, and acrophase between rectal and forehead skin temperature recordings, but not between forehead Double Sensor and rectal temperature measurements. Finally, Bland-Altman analysis indicated narrower limits of agreement for rhythm parameters between rectal and Double Sensor measurements compared to between rectal and skin recordings, irrespective of the measurement site (i.e. forehead, sternum). Based on these data we conclude that (1) Double Sensor recordings are significantly superior to skin temperature measurements for non-invasively assessing the circadian rhythm of rectal temperature, and (2) temperature rhythms from the sternum are less reliable than from the forehead. We suggest that forehead Double Sensor recordings may provide a surrogate for rectal temperature in circadian rhythm research, where constant routine protocols are applied. Future studies will be needed to assess the sensor's ecological validity outside the laboratory under changing environmental and physiological conditions.
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The double heat-flux sensor technology has been successfully tested during hypothermia, bedrest, and exercise on Earth and in space.
“The double heat-flux sensor technology has been successfully tested during hypothermia, bedrest, and exercise on Earth and in space [44–48].”
The Tcore heat-flux sensor is a validated device.
“a validated heat-flux sensor (Tcore, Dräger, Germany), connected to a miniaturized data logger (HFUM, KORA Industrie Elektronik, Germany) [44–48]”
The Double Sensor provides a reliable and valid estimate of core body temperature.
“This approach has been tested in various space analogs and clinical settings and has been found to provide a reliable and valid estimate of CBT20–23.”
From Increased core body temperature in astronauts during long-duration space missions (2017) · cites this paper as [22]
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ResultA COMPARISON OF SOME DIFFERENT METHODS FOR PURIFYING CORE TEMPERATURE DATA FROM HUMANS
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BackgroundThe 2nd Berlin BedRest Study: protocol and implementation.
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Dilemmas in Measurement of Human Body Temperature
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Background"Demasking" the Temperature Rhythm after Simulated Time Zone Transitions
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MethodThoracic surface temperature rhythms as circadian biomarkers for cancer chronotherapy
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BackgroundResultDeep Body Thermometry during General Anesthesia
Muravchick, S. (1983) · Anesthesiology · doi:10.1097/00000542-198303000-00014 · Cited by 34 · cited 1× · see citing works
“…and validity of heat-flux approaches recorded under varying environmental conditions (Gunga et al., 2008; Teunissen et al., 2011), as well as in different clinical settings (Kimberger et al., 2009; Muravchick, 1983; Opatz et al., 2013; Sakuragi et al., 1993; Xu et al., 2013; Zeiner et al., 2010).”
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“Finally, agreement of circadian rhythm parameters between the methods was evaluated by Bland–Altmanmethod (Bland & Altman, 1986), facilitating the comparison with related previous works (Edwards et al., 2002; Thomas et al., 2004).”
ResultAreas, R., Duarte, L. L., & Menna-Barreto, L. S. (2006) · Biological Rhythm Research · doi:10.1080/09291010600869752 · Cited by 29 · cited 1× · see citing works
“We found a wide range for phases of SKste, a finding which is well in line with results from thoracic skin temperatures in field studies (Areas et al., 2006; Bogh et al., 1994; Roche et al., 2014; Scully et al., 2011; Thomas et al., 2004).”
ResultTemporal and spatial dispersion of human body temperature during deep hypothermia
Opatz, O., Trippel, T., Lochner, A., Werner, A., Stahn, A., Steinach, M., Lenk, J., Kuppe, H., & Gunga, H. C. (2013) · British Journal of Anaesthesia · doi:10.1093/bja/aet217 · Cited by 22 · cited 2× · see citing works
“For measuring CBT from the skin surface, the Double Sensor technology was employed (Gunga et al., 2008; Gunga et al., 2009; Opatz et al., 2013).”
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“We found a wide range for phases of SKste, a finding which is well in line with results from thoracic skin temperatures in field studies (Areas et al., 2006; Bogh et al., 1994; Roche et al., 2014; Scully et al., 2011; Thomas et al., 2004).”
ResultHenriksson, E., & Lamia, K. A. (2015) · Journal of Biological Rhythms · doi:10.1177/0748730415581234 · Cited by 21 · cited 1× · see citing works
“…but are not limited to, the distribution of subcutaneous fat, molecular clocks inside peripheral and subcutaneous fat tissues (Albrecht, 2012; Henriksson & Lamia, 2015; Zvonic et al., 2006), and passive blood flow elevation by vasoconstriction of arteriovenousanastomoses in distal regions…”
DEEP BODY TEMPERATURE DURING THE WARMING PHASE OF CARDIOPULMONARY BYPASS
Sakuragi, T., Mukai, M., & Dan, K. (1993) · British Journal of Anaesthesia · doi:10.1093/bja/71.4.583 · Cited by 12 · see citing works
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“This was confirmed by the shape of rectal temperature, very close to a sinusoid (Waterhouse et al., 2005; Waterhouse et al., 2000), and by the forehead skin temperature, which follows the rhythm of rectal temperature (Kräuchi & Wirz-Justice, 1994; Park & Waterhouse, 2013).”
BackgroundMethodMonitoring of Body Core Temperature in Humans
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BackgroundKern und Schale im Wärmehaushalt des Menschen
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- Authors
- Mendt, S., Maggioni, M. A., Nordine, M., Steinach, M., Opatz, O., Belavý, D., Felsenberg, D., Koch, J., Shang, P., Gunga, H.-C., & Stahn, A.
- Affiliations
- Charité – Universitätsmedizin Berlin (DE)
- University of Milan (IT)
- Deakin University (AU)
- Dräger (Germany) (DE)
- Northwestern Polytechnical University (CN)
- Corresponding author
- Mendt, Stefan
- ORCID
- Venue
- Chronobiology International
- Publisher
- Informa UK Limited
- Published
- 2016-10-11
- Volume
- 34
- Issue
- 5
- Pages
- 666-676
- ISSN
- 0742-0528 (ISSN-L)
- 1525-6073
- OpenAlex
- W2530650101
- Cited by
- 60
- References
- 49
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 11 · 2023: 6 · 2022: 7 · 2021: 8 · 2020: 6 · 2019: 6 · 2018: 3 · 2017: 5
- FWCI
- 2.97
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Licence
- cc-by
- Locations
- Chronobiology International (publishedVersion)
- PubMed (publishedVersion)
- Figshare (submittedVersion, cc-by)
- Funders
- Deutsches Zentrum für Luft- und Raumfahrt (50WB0720, 50WB1030, 50WB1330)
- European Space Agency (14431/02/NL/SH2)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Health Sciences › Medicine › Physiology › Thermoregulation and physiological responses
- Health Sciences › Medicine › Physiology › Spaceflight effects on biology
- Keywords
- circadian rhythm, core body temperature, skin surface temperature, rectal temperature, head-down bed rest, sensor placement, non-invasive temperature monitoring, cosinor analysis, phase difference, measurement agreement, microgravity experiments, spaceflight countermeasures, shift work
- MeSH terms
- Bed Rest, Body Temperature Regulation, Circadian Rhythm, Humans, Monitoring, Physiologic, Skin Temperature, Thermography
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