Effects of work organization on the occurrence and resolution of sleep disturbances among night shift workers: a longitudinal observational study

AbstractThis study aimed to investigate the association between work organization and the trajectories of insomnia patterns among night shift workers in a hospital. The health examination data of hospital workers, recorded from January 2014 to December 2018, were collected; 6765 records of 2615 night shift workers were included. Insomnia was defined as a score of ≥ 15 on the Insomnia Severity Index (ISI). Participants were categorized into five groups according to insomnia patterns derived from the analysis of their ISI scores. Work organization and socio-demographic characteristics were also investigated. Generalized estimating equation models and linear mixed models were constructed to analyze the longitudinal data. Of the total participants, 53.0% reported insomnia at least once during the follow-up period. The lack of nap opportunities and work-time control was associated with the occurrence of insomnia, whereas more than 5 years of shift work experience was related to the resolution of insomnia. All work-related factors were significantly related to insomnia risk; however, the effects were not significant in the sustained insomnia group. Although sleep problems are inevitable in night shift workers, well-designed work schedules and better work organization can help reduce the occurrence of insomnia among them.

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Sleep Disturbances in Individuals Quarantined Due to SARS-CoV-2 Pandemic in Poland: A Mixed Methods Design Study

Global Advances in Health and Medicine ◽

10.1177/21649561211020707 ◽

2021 ◽

Vol 10 ◽

pp. 216495612110207

Author(s):

Sabina Krupa ◽

Witt Paweł ◽

Wioletta Mędrzycka-Dąbrowska ◽

Agnieszka Lintowska ◽

Dorota Ozga

Keyword(s):

Mixed Methods ◽

Sleep Disturbances ◽

Acute Stress ◽

Sleep Problems ◽

Severity Index ◽

Structured Interview ◽

Mixed Methods Design ◽

Design Study ◽

Insomnia Severity Index ◽

Insomnia Severity

Objectives The study aimed to assess sleep disturbances in patients subjected to home quarantine due to suspected SARS-CoV-2 infection. The study used a mixed methods design study as a research methodology. Methods A semi-structured interview and the scale for Insomnia Severity Index (ISI) were used to achieve the aim of the study. The survey was conducted from 16 to 20 April 2020 and 1 to 2 September 2020 in Poland, at the during of SARS-CoV-2 epidemic in this country. The data were coded and cross-processed. The (COREQ) checklist was followed. Results Interviews with patients and a thorough analysis of recordings revealed commonly used phrases in the following categories: “anxiety”, “ Am I going crazy?”, “Sleep problems”. 10 out of 11 respondents reported sleep disorders of varying severity according to the Insomnia Severity Index scale. Patients presented a fear related to the return to society and normal functioning after quarantine. Additionally, some study participants voiced concerns related to their mental health; some cases of hallucinations were reported. Conclusions Further global population studies should be conducted to analyse this phenomenon. Acute Stress Disorder should be understood as a threat to life and health of an isolated society in quarantine. Further research in this area should be promoted and the need for global guidelines for the entire population should be developed.

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Impacts of shift work: A study in textile companies in Portugal

International Journal of Occupational and Environmental Safety ◽

10.24840/2184-0954_001.001_0007 ◽

2017 ◽

Vol 1 (1) ◽

pp. 69-78

Author(s):

I. S. Silva ◽

J. Keating ◽

D. Costa

Keyword(s):

Shift Work ◽

Social Life ◽

Sleep Disturbances ◽

Night Shift ◽

The Other ◽

Work Schedules ◽

Textile Workers ◽

Shift Workers ◽

Work Shifts ◽

Morning Shift

Shift work, especially if it involves night work and/or weekend work, may represent disadvantages for workers and their families at the level of family, social life, and health. The present study evaluates the impacts of three work shifts (morning, afternoon and night) on sleep, family and social life as well as satisfaction with work schedules. In total, 373 Portuguese textile workers participated in this study; all were men. The results indicated that night shift workers had greater sleep disturbances and less satisfaction with their work schedules. On the other hand, morning shift workers were most satisfied with family and social life in association with their work schedules. Based on the results, implications of the practice have been reflected.

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Evaluation of habitual sleep and factors influencing it in patients awaiting acute or planned abdominal surgery

Gastrointestinal Nursing ◽

10.12968/gasn.2021.19.8.28 ◽

2021 ◽

Vol 19 (8) ◽

pp. 28-34

Author(s):

Marian Christin Petersen ◽

Ismail Gögenur

Keyword(s):

Abdominal Surgery ◽

Epworth Sleepiness Scale ◽

Sleep Disturbances ◽

Sleep Problems ◽

Negative Impact ◽

Severity Index ◽

Study Cohort ◽

Insomnia Severity Index ◽

Female Sex ◽

Insomnia Severity

Background and aims: This study aimed to clarify the incidence and severity of habitual sleep disturbances in patients undergoing surgery. Methods: A survey was conducted to collect data in a cohort of patients awaiting abdominal surgery. The Insomnia Severity Index score was used as primary measurement, while the Epworth Sleepiness Scale and Pittsburgh Sleep Quality Index scores were used as secondary measurements. Findings: Overall, 119 patients were included in the analysis. The habitual sleep in the study cohort revealed high incidence of sleep difficulties and insomnia. Female sex and incidence of anxiety and depression were significantly related to all three scores, while age and employment were associated with Epworth Sleepiness Scale and Insomnia Severity Index scores, respectively. Conclusions: Female sex, experiencing depression or anxiety had severe negative impact on sleep in patients scheduled for elective or planned surgery. The prevalence of sleep problems in patients should be considered for optimising sleep to improve rehabilitation and reduce stress associated with surgery.

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Association between night-shift work, sleep quality and metabolic syndrome

Occupational and Environmental Medicine ◽

10.1136/oemed-2018-105104 ◽

2018 ◽

Vol 75 (10) ◽

pp. 716-723 ◽

Cited By ~ 20

Author(s):

Yin Cheng Lim ◽

Victor C W Hoe ◽

Azlan Darus ◽

Nirmala Bhoo-Pathy

Keyword(s):

Metabolic Syndrome ◽

Sleep Quality ◽

Shift Work ◽

Sleep Disturbances ◽

Night Shift ◽

Future Research ◽

Global Score ◽

Early Screening ◽

Shift Workers ◽

Night Shift Work

ObjectivesOccupational factors, particularly night-shift work, are attracting growing interest as a possible determinant of metabolic syndrome (MetS). This study aimed to determine the association between night-shift work and MetS, and assess whether sleep quality is a mediating factor.MethodsA cross-sectional study was conducted among Malaysian manufacturing workers, aged 40–65 years old. They completed a self-administered questionnaire on sociodemographics, lifestyle and family history, and the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Waist circumference, blood pressure, fasting blood sugar, triglycerides and high-density lipoprotein levels were measured. Baron and Kenny’s method, Sobel test and multiple mediation models with bootstrapping were used to determine whether the PSQI global score or its components mediated the association between night-shift work and MetS.ResultsOf the 494 participants, 177 (36%) worked night shift and 51% were men. The prevalence of MetS was 37%. Night-shift work was independently associated with a twofold increase in the risk of MetS (adjusted OR: 1.92, 95% CI 1.24 to 2.97). However, the association between night-shift work and MetS did not appear to be modified by sex. Night-shift workers also reported significantly poorer sleep quality, longer sleep latency, shorter sleep duration, sleep disturbances and daytime dysfunction. Robust mediation analysis nonetheless showed that neither PSQI global score nor its components mediated the association between night-shift work and MetS.ConclusionEarly screening and management of MetS and the development of programmes to improve sleep quality should be carried out among night-shift workers. Future research should investigate other modifiable mediators linking night-shift work and MetS.

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0007 Daytime Sleep in Night Shift Workers: Quantifying the Role of Circadian Misalignment

SLEEP ◽

10.1093/sleep/zsaa056.006 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A3-A3

Author(s):

E Mann ◽

C Sagong ◽

A Cuamatzi Castelan ◽

M Singh ◽

T Roth ◽

...

Keyword(s):

Sleep Duration ◽

Sleep Disturbances ◽

Night Shift ◽

Sleep Onset ◽

Sleep Onset Latency ◽

Shift Workers ◽

Circadian Misalignment ◽

Daytime Sleep ◽

Falling Asleep ◽

Dim Light

Abstract Introduction Circadian misalignment is commonly cited as a culprit of daytime sleep disturbances in night shift workers; however, the specific impact and magnitude that circadian misalignment has on daytime sleep has not been well-characterized in larger samples of night shift workers. Methods Participants included fixed-night shift workers (n=52, ages 18–50) who completed an 8-hour daytime polysomnography (PSG) in the lab following a night shift. Measures of sleep disturbances included: difficulty falling asleep (sleep onset latency [SOL], latency to persistent sleep [LPS]), difficulty staying asleep (sleep efficiency [SE], wake after sleep onset [WASO]), and sleep duration (total sleep time [TST]). Melatonin samples were collected hourly for 24 hours under dim light (<10 lux) and used to determine dim light melatonin offset (DLMOff). Circadian misalignment (CM) was calculated as the time difference between bedtime and DLMOff (higher values represented sleeping after DLMOff), and correlated with PSG sleep variables. Results CM was significantly associated with difficulty staying asleep (WASO: r=0.48, p<0.001; SE: r=-0.45, p<0.001), and sleep duration (TST: r=-0.38, p<0.01). Specifically, every 3 hours of CM on average added 19.2 minutes of WASO and reduced TST by 15 minutes. In contrast, CM was not significantly correlated with sleep onset difficulties (SOL: r=-0.27; LPS: r=-0.02). Conclusion These data suggest that circadian misalignment in shift workers may be a better predictor of difficulties staying asleep and sleep duration during the day relative to difficulties falling asleep. Because longer work hours (10–12 hours) are common in night shift worker, it may be that sleep initiation difficulties associated with circadian misalignment is masked by elevated fatigue or an increased homeostatic drive from prolonged wakefulness. These results may help guide decisions about the magnitude of phase shifts required (e.g., with light therapy) for the desired improvement in daytime sleep. Support Support for this study was provided to PC by the NHLBI (K23HL138166)

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Night shift work and the risk of metabolic syndrome: Findings from an 8-year hospital cohort

PLoS ONE ◽

10.1371/journal.pone.0261349 ◽

2021 ◽

Vol 16 (12) ◽

pp. e0261349

Author(s):

Wan-Ju Cheng ◽

Chiu-Shong Liu ◽

Kai-Chieh Hu ◽

Yu-Fang Cheng ◽

Kati Karhula ◽

...

Keyword(s):

Metabolic Syndrome ◽

Shift Work ◽

Night Shift ◽

Working Time ◽

Health Examination ◽

Long Term Effects ◽

Time Data ◽

Shift Workers ◽

Night Shift Work ◽

Night Shifts

Objectives Studies concerning the risk of metabolic syndrome associated with night work have shown inconsistent findings, due to imprecise working time data and cross-sectional design. We used register-based daily working time data to examine the risk of incident metabolic syndrome associated with night shift work. Methods Working time data collected between 2010 and 2018 of 5775 Taiwanese hospital workers were used to identify night shift workers and to calculate the number of night shifts. Metabolic syndrome was identified by annual occupational health examination results, which were linked to the working time data. Logistic regression models and generalized estimating equations were used to examine the association between night shift work and metabolic syndrome and the 5 components of metabolic syndrome. Results Night shift work is associated with a higher risk of developing metabolic syndrome (adjusted OR = 1.36, 95% CI = 1.04 to 1.78) and high waist circumference (adjusted OR = 1.27, 95% CI = 1.07 to 1.78) compared to day work. Among night shift workers, increased number of night shifts was associated with high blood pressure (adjusted OR = 1.15, 95% CI = 1.01 to 1.31). Conclusions Night shift work is associated with metabolic risk factors. Long-term effects of circadian rhythm disruption on metabolic disturbances needs to be further studied.

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Individuell variasjon i utskillelse av 6-sulfatoksymelatonin og døgnrytmetype analysert hos skiftarbeidere

Norsk Epidemiologi ◽

10.5324/nje.v9i1.440 ◽

2009 ◽

Vol 9 (1) ◽

Author(s):

Tore Tynes ◽

Bjarte Haugsdal ◽

Magnar Kleiven ◽

Arnfinn Tønnessen

Keyword(s):

Night Shift ◽

Potential Effect ◽

English Summary ◽

Font Size ◽

Related Factors ◽

Shift Workers ◽

Future Studies ◽

Work Related ◽

Hormone Balance ◽

Individual Variations

SAMMENDRAGI denne studien har vi undersøkt om det finnes noen sammenheng mellom målte verdier av urinmetabolitten6-sulfatoxymelatonin (aMT6s) tatt ut i porsjoner gjennom døgnet og selvrapportert døgnrytme hos engruppe norske skiftarbeidere. Studien omfatter 19 arbeidstakere ved to produksjonsenheter ved HydroPorsgrunn, magnesiumfabrikken og fullgjødselfabrikk 3. Etter å ha deltatt i en studie der urinprøver blesamlet inn, svarte de involverte senere på et spørreskjema om søvn og døgnrytme. Resultatene indikerer ategenrapporterte B-type mennesker har en tendens til høyere midlere timeutskillelse av aMT6s analysert pådøgnbasis første døgn med nattskift, og en signifikant høyere nattutskillelse (8 timer) i et kontrolldøgnhjemme. I fremtidige studier av melatoninsekresjon og utskillelse av metabolitt i urin, kan det være avinteresse samtidig å samle inn spørreskjemabaserte opplysninger om døgnrytmetype og utfyllende opplysningerom søvn og søvnmønster i relasjon til eksponeringer som skiftarbeid og andre arbeidsmiljøfaktorersom kan ha effekt på hormonbalansen.Tynes T, Haugsdal B, Tønnessen A, Kleiven M. Individual variations in excretion of6-sulfatoxymelatonin in morning and evening type Norwegian shift workers.Nor J Epidemiol ENGLISH SUMMARYThe aim of this study was to evaluate whether there is an association between measured values of the urinemetabolite 6-sulfatoxymelatonin (aMT6s) in samples collected at selected intervals and self-reported diurnalrhythm in a group of Norwegian shift workers. The study included 19 workers at two production unitsat Hydro Porsgrunn, the magnesium factory and fertiliser factory 3. After submitting the urine samplesused for the study, subjects filled in a questionnaire on sleep and diurnal rhythm at a later date. The resultsindicate that self-reported evening type subjects have a tendency towards a higher mean hourly aMT6ssecretionfirst day on night shift, and a significantly higher night secretion (8 hours) analysed for a controlday at home. In future studies on secretion of melatonin and its metabolite in urine, the collection ofquestionnaire-based information on diurnal type, sleep and sleep pattern in relation to exposures like shiftwork, and other work-related factors with potential effect on hormone balance might be of interest.1999; 9 (1): 33-38.

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Workability, quality of life and cardiovascular risk markers in aging nightshift workers: a pilot study

Wiener klinische Wochenschrift ◽

10.1007/s00508-021-01928-6 ◽

2021 ◽

Author(s):

Galateja Jordakieva ◽

Lovro Markovic ◽

Walter Rinner ◽

Isabel Santonja ◽

Seungjune Lee ◽

...

Keyword(s):

Quality Of Life ◽

Pilot Study ◽

Sleep Problems ◽

Night Shift ◽

World Health ◽

Risk Markers ◽

Cvd Risk ◽

Shift Workers ◽

Night And Day

Summary Background In aging healthcare professionals, multiple stressors such as night work may affect life and work satisfaction and risk for chronic diseases (e.g. cardiovascular disease [CVD]). In this pilot study we compared workability, quality of life (QoL), and CVD risk markers between night shift and day workers. Methods We included 70 hospital employees (mean age 52 ± 4 years, 91.4% female): 32 rotating night shift workers (> 3 nights/month) and 38 permanent day workers. In addition to sociodemographic, lifestyle, and sleep characteristics, we assessed i) workability index (WAI), ii) QoL (World Health Organization Quality of Life [WHOQOL-Bref]) and iii) CVD risk markers, i.e. carotid ultrasound measurements, and biomarkers (NTproBNP, CRP, IL‑6, LDL, ferritin, copper, zinc, and selenium). WAI, QoL, and CVD risk markers were compared between night and day workers. In a subgroup of participants (N = 38) with complete data, we used quantile regression analysis to estimate age and multivariate adjusted differences in biomarker levels. Results We found no differences in the domains of QoL (physical health, psychological, social relationships, and environment) and WAI scores between night and day workers. Night shift workers were less likely to report excellent workability than day workers, although differences were not statistically significant. Night shift workers reported more sleep problems (73.1% vs. 55.6%) and tended to have lower zinc levels and higher inflammatory markers (CRP, IL‑6, ferritin), but differences were not significant after adjusting for potential confounders. Conclusions Workability, QoL and CVD markers did not significantly differ between rotating night shift and day workers in this small pilot study. Sleep problems and inflammatory marker levels carry implications for occupational health.

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Adverse effects of shift work at a biscuits manufacturer

10.51415/10321/2588 ◽

2017 ◽

Author(s):

◽

Philisiwe Kenlly Mhlongo

Keyword(s):

Health Outcomes ◽

Shift Work ◽

Work Experience ◽

Night Shift ◽

First Aid ◽

Limited Time ◽

Shift Workers ◽

Domestic Activities ◽

Lost Time ◽

Minor Injuries

Shift work is a necessity for many organizations. Reasons for shift work are mainly to ensure continuous and optimized operations. Many studies on shift workers have concluded that it can lead to adverse physiological, social and psychological health effects. This study examines challenges associated with working shifts at a biscuits manufacturing factory. Results should be able to assist the employer in implementing effective interventions directed at limiting the negative effects of shift work on employees. This is a convergent parallel design multi method stud among 152 shift workers in a biscuits manufacturer located in Durban, KwaZulu Natal. An abbreviated and modified form of the validated SSI questionnaire was used (Barton et al. 1995). The questionnaire contained a battery of items designed to examine the relationship of health and personal adjustment to shift work. Owing to the exploratory nature of the study, a focus group methodology was also used and this allowed for in-depth qualitative research which catered for a more comprehensive understanding of the current shift work issues. A retrospective review of injury records of employees who sustained occupational injuries between 2012 and 2013 was also conducted. The sample comprised of 85 (56%) males and 63 (42%) females. Logistic regression was used to estimate the association between shift work and the likelihood of sleep disturbance, poor health outcomes and limited time for social and domestic activities, adjusting for age, sex, partner working, years working night shift, marital status, job class and years employed. Odds ratio (OR) for reported sleep disturbance was slightly higher among women (OR=1.65; 95% CI = 0.25; 10.84; p < 0.05) compared to males, but this was not statistically significant. Longer shift work experience (i.e.11-20 years) was significantly associated with better health status (OR=0.18; 95%CI = 0.06; 0.46; p < 0.05). Shift work experience (11 to 20 years) was also found to be significantly associated with limited time for both social (OR = 0.10; 95%CI = 0.03; 0.30) and domestic activities (OR= 0.25; 95% CI = 0.11; 0.57; p < 0.05) (Table 4). Age had no effect on social and domestic activities, but those 40 years and above were more likely to have limited time for social and domestic activities (OR = 3.06; 95%CI =0.60; 15.60 and OR= 2.5; 95%CI=0.47; 13.06). Those with more shift work experience seemed to have more time for social and domestic activities compared to those with less than 10 years experience. Findings from the FGD’s revealed that most participants (91%) did not get sufficient sleep time after night shift; this was mainly because of the chores they had to do after getting home form night shift and disturbances from the household and neighbours. The average time spent sleeping by majority of participants after night shift was 5 hours. Swollen feet, gastric, sleep disorders, indigestion and headaches were some common complaints experienced by shift workers in this study. About 27% of participants reported to have been injured at work before. These incidents were reported to be related to drowsiness and fatigue. The company’s incident records showed a total of 160 injuires between 2012 and 2013, of which 38 occurred during night shift. In 2012, the company recorded 65 injuries which included 51 first aid (FA) injuries, 6 minor injuries (MI) and 8 lost time (LT) injuries, as categorized by the company. 2013 had the highest number of incidents, with 95 total injuries, averaging to 7.9 injuries annually. There were 84 first aid incidents recorded for year 2013, 9 minor injuries and only 2 lost time injuries. Twenty three percent (15, n=65) incidents occurred during night shift in year 2012, of which 11% (7, n=65) were females. The number of night shift incidents slightly increased to 24% (23, n=95) in 2013 and females accounted for 9.40%. The records showed that majority of injuries happened between 17h00 and 21h00 at night. Results of this study provides evidence that shift work impacts negatively on the lives of the employees and can lead to adverse health outcomes such as poor dietary intake, headaches and swollen feet to mention but a few.

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The Effect of Special Medical Examination for Night Shift Workers and Follow-Up Management Against Hypertension

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16050719 ◽

2019 ◽

Vol 16 (5) ◽

pp. 719 ◽

Cited By ~ 1

Author(s):

Won Choi ◽

Ji-Won Lee ◽

Jae Lee ◽

Kyeong Kim ◽

Jun-Pyo Myong ◽

...

Keyword(s):

Screening Program ◽

Night Shift ◽

Medical Examination ◽

Hazardous Substances ◽

Medical Institute ◽

Health Examination ◽

Full Time ◽

Hypertension Status ◽

Shift Workers

Background: Special health examination is a screening program introduced in 1973 in Korea to examine health problems of workers who are regularly exposed to 177 hazardous substances and physical environments specified by the Occupational Safety and Health Act. Shiftwork was added as a risk factor in 2013. The purpose of this study was to analyze changes of hypertension status after a special medical examination and subsequent follow-up management. Methods: We used the data based on the special medical examination outcomes for night shift workers, performed at seven different health examination centers under the Korea Medical Institute (KMI) between 2014 and 2016. Workers who received special medical examinations for two consecutive years (2014–2015 and 2015–2016) were selected. A final study population of 2070 was evaluated. Results: Compared with the first-year examination, 1503 subjects (72.6%) received hypertension medication or showed improvement in blood pressure in their second-year examination. Older age (≥40s), women, larger workplaces (≥300 full-time workers), long-term workers (≥12 years), improvement in smoking habits, improvements for diabetes or dyslipidemia, normal or reduced BMI, and normal waist circumference were associated with proper management of hypertension. Conclusions: An appropriate follow-up management program should be developed to provide health management for night shift workers that need to focus on the factors identified in this study.

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