O4A.4 The relationship between shift work and sleep disturbance in hospital workers

IntroductionMany hospital workers suffer from sleep disturbance due to shift work. The best way to mitigate the problem would be reducing night shift. However, that is commonly impossible in reality. Thus, we aimed to examine the factors associated with sleep disturbance and suggest better-rotating schedules for hospital workers.MethodsWe used sleep questionnaires asking sleep disturbance including sleep onset and maintenance problems for measuring health outcomes. Also, We obtained a duty schedule of the workers for assessing exposure. We examined the effect of the pattern of shift schedule and amount of night shifts on sleep disturbance.ResultsA total of 590 workers participated in this study. Female (95%) 3-rotating shift (92%) workers dominated. For workshift pattern, two consecutive night shifts increased the risk of sleep maintenance problem significantly. For the amount of night shift, two or more night shifts per week increased the risk of sleep onset problem significantly.ConclusionOur results suggest that avoding consecutive night shifts and restricting night shift to one time per week would be helpful to prevent sleep disturbance in hospital workers.

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Differential effects of light at night and shift rotation pattern on the circadian system in night workers.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.1556 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 1556-1556

Author(s):

Pedram Razavi ◽

Eva S Schernhammer ◽

Keyword(s):

Shift Work ◽

Night Shift ◽

Circadian System ◽

Activity Level ◽

Melatonin Level ◽

Consecutive Night ◽

Light At Night ◽

Night Shift Work ◽

Single Night ◽

Night Shifts

1556 Background: Light at night as in shift work suppresses nocturnal secretion of melatonin, a pineal hormone with oncostatic properties. Several studies have associated night shift work with higher risk of cancer, leading WHO in 2007 to classify rotating night shift work as “probably carcinogenic”. We conducted one of the most comprehensive studies, to date, to evaluate the effects of light and night shift work on melatonin measurements in the field. Methods: Study participants were 130 active nurses (84 current rotating night shift workers and 46 day shift workers) participating in NHS2. Each nurse wore a head-mounted light- and accelerometer for a 3-day study period, during which each spontaneous urine was collected for repeated urinary 6-sulfatoxymelatonin (melatonin) measurements. In addition, nurses were asked to fill out paper questionnaires and diaries. We used mixed models to evaluate the influence of light, activity and night shift work on urinary melatonin level adjusting, for age, lifestyle, and occupational history. We log-transformed main variables and report geometric means (GM [standard deviation]). Results: Greater levels of light were associated with lower melatonin (P < 0.0001), independent of activity level. An increase in light intensity from 10 to 100 lux was associated with a 12% decrease in geometric mean of melatonin level; however, this inverse association was only significant at night (Ptrend = 0.01). At night, each hour increase in exposure to ≥ 20 lux light lowered melatonin level by 5.7% (Ptrend < 0.0001). A single night shift affected the circadian system by lowering melatonin peak by 22% (day shift: GM = 17.57 [2.73]; night shift: GM = 13.64 [2.54]) and induced a phase shift (PS) of 0.9 hours, -changes that reset to normal by the next day. Two consecutive night shifts had a similar effect as a single shift. However, the effect was worse after three consecutive night shifts (GM = 10.11 [2.77]; PS = 2.2 hours). Conclusions: We found significant inverse associations of intensity and duration of exposure to light at night with urinary melatonin, independent of activity level. Three consecutive night shifts affected the circadian system more strongly than two consecutive, or a single night shift.

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0006 The Role of Stress in Sleep in Night Shift Workers: Going Beyond Circadian Misalignment

SLEEP ◽

10.1093/sleep/zsaa056.005 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A2-A3

Author(s):

E Schaap ◽

C Sagong ◽

A S Cuamatzi Castelan ◽

J Sayed ◽

T Roth ◽

...

Keyword(s):

Sleep Disturbance ◽

Sleep Duration ◽

Shift Work ◽

Night Shift ◽

Sleep Onset ◽

Shift Workers ◽

Circadian Misalignment ◽

Circadian Phase ◽

Falling Asleep ◽

Dim Light

Abstract Introduction Despite a growing need for nighttime work, few studies have characterized the causes of sleep disturbance in night shift workers beyond circadian misalignment. Recent research suggest that high sleep reactivity to stress (a predisposition for sleep disturbance due to stress) may also lead to sleep difficulties in shift workers. This study investigated if sleep reactivity is an independent predictor of daytime sleep disturbances after controlling for circadian phase. Methods Night shift workers (N= 48) completed an 8 hour polysomnography (PSG) during the daytime following a night shift (9am - 4pm). Circadian phase was measured using melatonin assays of saliva samples collected over 24 hours under dim light (<10 lux; Dim Light Melatonin Onset [DLMO]). Sleep reactivity was measured using the Ford Insomnia Response to Stress Test (FIRST). Linear regressions were conducted with PSG sleep parameters as outcome variables: difficulty falling asleep (Sleep Onset Latency [SOL] and Latency to Persistent Sleep [LPS]), difficulty staying asleep (Wake After Sleep Onset [WASO]), and sleep duration (Total Sleep Time [TST]). FIRST was tested as a predictor controlling for DLMO. Results After controlling for circadian phase, higher FIRST scores was associated with more difficulty staying asleep (WASO: t[45]=4.059, p<0.001) and shorter sleep duration (TST: t[45] = -4.403, p<0.0001), but not predictive of difficulty falling asleep (SOL: p>0.05). However, higher FIRST scores did predict a longer latency to persistent sleep (LPS: t[45]=2.272, p<0.05). Conclusion These results suggest that sleep reactivity to stress and circadian misalignment are independent processes that are both associated with disrupted daytime sleep in night shift workers. Given that night shift work can also cause psychosocial stress, treatments focused on circadian misalignment alone may not be sufficient. Our study highlights the need to consider sleep reactivity in the clinical management of shift work disorder. Support Support for this study was provided to PC by NHLBI (K23HL138166).

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Chronotype-specific Sleep in Two Versus Four Consecutive Shifts

Journal of Biological Rhythms ◽

10.1177/07487304211006073 ◽

2021 ◽

pp. 074873042110060

Author(s):

Dorothee Fischer ◽

Till Roenneberg ◽

Céline Vetter

Keyword(s):

Night Shift ◽

Sleep Diary ◽

Sequence Length ◽

Consecutive Night ◽

Shift Workers ◽

Subject Field ◽

Sleep Diaries ◽

Social Jetlag ◽

Sleep Debt ◽

Night Shifts

The study aimed to explore chronotype-specific effects of two versus four consecutive morning or night shifts on sleep-wake behavior. Sleep debt and social jetlag (a behavioral proxy of circadian misalignment) were estimated from sleep diary data collected for 5 weeks in a within-subject field study of 30 rotating night shift workers (29.9 ± 7.3 years, 60% female). Mixed models were used to examine whether effects of shift sequence length on sleep are dependent on chronotype, testing the interaction between sequence length (two vs. four) and chronotype (determined from sleep diaries). Analyses of two versus four morning shifts showed no significant interaction effects with chronotype. In contrast, increasing the number of night shifts from two to four increased sleep debt in early chronotypes, but decreased sleep debt in late types, with no change in intermediate ones. In early types, the higher sleep debt was due to accumulated sleep loss over four night shifts. In late types, sleep duration did not increase over the course of four night shifts, so that adaptation is unlikely to explain the observed lower sleep debt. Late types instead had increased sleep debt after two night shifts, which was carried over from two preceding morning shifts in this schedule. Including naps did not change the findings. Social jetlag was unaffected by the number of consecutive night shifts. Our results suggest that consecutive night shifts should be limited in early types. For other chronotypes, working four night shifts might be a beneficial alternative to working two morning and two night shifts. Studies should record shift sequences in rotating schedules.

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Disturbances of Autonomic Regulation of Cardiovascular System at Different Working Regimes with Night Shifts

Kardiologiia ◽

10.18087/cardio.2020.9.n1134 ◽

2020 ◽

Vol 60 (9) ◽

pp. 62-67

Author(s):

Yu. A. Merkulov ◽

A. A. Pyatkov ◽

S. G. Gorokhova ◽

D. M. Merkulova ◽

O. Yu. Atkov

Keyword(s):

Shift Work ◽

Spectral Characteristics ◽

Night Shift ◽

Autonomic Regulation ◽

Total Power ◽

Orthostatic Test ◽

Heart Rhythm Variability ◽

Shift Workers ◽

Rotating Shift Work ◽

Night Shifts

Aim To study temporal and spectral characteristics of heart rhythm variability (HRV) in night shift workers.Materials and methods Along with traditional risk factors, conditions of labor contribute to development of cardiovascular morbidity, including night shift work, which can be associated with disorders of the autonomic regulation detected by analysis of HRV. This study included 100 healthy men. 74 of them were engaged in shift work, including 53 men with rotating shift work, 21 men with fixed night shifts, and 26 men with day-time work. HRV was analyzed by data of 5-min electrocardiogram recording (background recording and orthostatic test).Results Night-shift workers had decreases in total power of regulation (ТР, SDNN) and in the parasympathetic branch (HF, pNN50). Rotating night-shift workers displayed significant decreases in SDNN and pNN50 and pronounced changes in the VLF / LF / HF ratio in the orthostatic test.Conclusion In work with night shifts, the type of autonomic regulation differs from the “standard” functioning of the autonomic nervous system (ANS). This study showed different effects of night work regimens on HRV indexes. With the rotating shift work, the ANS dysregulation was more profound and was evident by a significant decrease in the ANS total tone and parasympathetic activity (SDNN, pNN50) compared to night shifts with fixed working hours. The excessive weakening of the parasympathetic component in the passive orthostatic test can be considered as an early marker for ANS maladaptation.

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Daytime Sleep Disturbance in Night Shift Work and the Role of PERIOD3

Journal of Clinical Sleep Medicine ◽

10.5664/jcsm.6984 ◽

2018 ◽

Vol 14 (03) ◽

pp. 393-400 ◽

Cited By ~ 3

Author(s):

Philip Cheng ◽

Gabriel Tallent ◽

Helen J. Burgess ◽

Kieulinh Michelle Tran ◽

Thomas Roth ◽

...

Keyword(s):

Sleep Disturbance ◽

Shift Work ◽

Night Shift ◽

Night Shift Work ◽

Daytime Sleep

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61. Can Melatonin Improve Adaptation To Night Shift? A Pilot Study Using an Urban EMS System

Prehospital and Disaster Medicine ◽

10.1017/s1049023x0004574x ◽

1996 ◽

Vol 11 (S2) ◽

pp. S34-S34

Author(s):

Michael Tremea ◽

Mark James ◽

Jeffrey Jones ◽

Jon Krohmer

Keyword(s):

Job Performance ◽

Night Shift ◽

Biological Clock ◽

Consecutive Night ◽

Sleep Diaries ◽

Visual Analog Scales ◽

Significant Difference ◽

Clinical Benefits ◽

Double Blinded ◽

Night Shifts

Purpose: To determine whether melatonin (N-acetyl-5-methoxytryptamine) is effective in helping prehospital personnel working consecutive night shifts reset their biological clock and minimize circadian rhythm disruption.Methods: A double-blinded, randomized, cross-over study was performed using 12 paramedic volunteers. Paramedics were working a span of consecutive night (2300-0700) shifts and received either a melatonin capsule (6 mg) or placebo to be taken prior to each of the consecutive day sleeps. Each participants completed a total of four spans of consecutive night shifts (2-melatonin, 2-placebo). Collected data included daily sleep diaries, quantification of alcohol/caffeine consumed, and possible drug side-effects. Assessment of job performance, mood and alertness were measured every day using 10-cm visual analog scales (VAS).Results: Analysis of sleep diaries demonstrated no significant difference (p >0.05) between the two treatments in respect to mean sleep latency (melatonin = 15.4 min. vs. placebo = 14.6 min), mean sleep duration (melatonin = 6.7 hrs. vs. placebo = 6.9 hrs), or subjectively rated sleep quality (melatonin = 5.8 VAS vs placebo = 5.6 VAS). Similarly, no significant benefits were noted between the mean VAS scores for daily job performance, mood and alertness. Adverse effects were rare, one patient taking melatonin reported a prolonged sedative effect.Conclusion: Despite widespread belief in the benefits of melatonin as a hypnotic agent, no clinical benefits were noted in terms of daytime sleep or job performance in paramedics working consecutive night shifts.

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Rotating night shift work, exposure to light at night, and glomerular filtration rate: baseline results from a Chinese occupational cohort

10.21203/rs.3.rs-19446/v1 ◽

2020 ◽

Author(s):

Shengkui Zhang ◽

Yongbin Wang ◽

Zhende Wang ◽

Han Wang ◽

Chao Xue ◽

...

Keyword(s):

Glomerular Filtration Rate ◽

Glomerular Filtration ◽

Shift Work ◽

Filtration Rate ◽

Night Shift ◽

Cumulative Number ◽

Ambient Light ◽

Light At Night ◽

Night Shift Work ◽

Night Shifts

Abstract Background The misalignment between the circadian clock and behavioral cycles has been implicated in pathogenesis of many diseases. However, whether the kidneys are also more prone to disease in the circumstances of chronic circadian rhythms disruption due to night shift work and light at night (LAN) is unclear. The main purpose of this study is to examine the association between rotating night shift work, exposure to light at night, and glomerular filtration rate among steelworkers in north China. Methods A total of 6869 participants, aged 22 to 60 years, were included in this study. Multivariable logistic regression was used to examine the association between night shift work, the brightness of bedroom ambient light at night (LAN), and estimated glomerular filtration rate (eGFR) with adjustment for potential confounders. The relationship between duration of night shift work (continuous), cumulative number of night shifts (continuous), and eGFR were also examined using restricted cubic spline models. Results Long duration of night shift work (≥29 years) had elevated odds of decreased eGFR (OR, 1.39, 95% CI 1.10–1.75) compared with day work after adjustment for potential confounders. Negative associations between duration of night shift work, cumulative number of night shifts, and eGFR (mL/min/1.73 m 2 ) were observed in RCS models. No significant associations were observed among the different brightness of bedroom ambient light levels: middle level (OR, 0.90, 95% CI 0.77–1.05), lightest level (OR, 0.94, 95% CI 0.75–1.17), and decreased eGFR compared with the darkest level. Conclusion The increased duration of night shift work and cumulative number of night shifts among night shift workers, but not the brightness of bedroom ambient LAN, are associated with a slight decline of renal function among steelworkers.

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Poor Sleep Quality in Nurses Working or Having Worked Night Shifts: A Cross-Sectional Study

Frontiers in Neuroscience ◽

10.3389/fnins.2021.638973 ◽

2021 ◽

Vol 15 ◽

Author(s):

Qiao Huang ◽

Chong Tian ◽

Xian-Tao Zeng

Keyword(s):

Sleep Quality ◽

Clinical Care ◽

Night Shift ◽

Cross Sectional Study ◽

Poor Sleep ◽

Consecutive Night ◽

Sectional Study ◽

Poor Sleep Quality ◽

Cross Sectional ◽

Night Shifts

Night shifts are part of clinical care. It is unclear whether poor sleep quality of nurses working both consecutive night shifts and day shifts after quitting night shifts is common. In this cross-sectional study, Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality as study outcome. Univariable and multivariable linear and logistic regressions were performed to compare PSQI score and prevalence of poor sleep quality between 512 nurses currently working consecutive night shifts and 174 nurses having worked night shifts in the past. The prevalence of poor sleep quality was 62.11% in nurses working consecutive night shifts and 55.75% in nurses having worked night shifts before. In multivariable regressions with adjustment for potential confounders, compared with nurses working consecutive night shifts, nurses having worked past night shifts reported decreased PSQI score [mean difference: −0.82 (95% CI: −1.27 to −0.38, p < 0.001)] and lower poor sleep quality [odds ratio (OR): 0.49 (95% CI: 0.29 to 0.80, p = 0.005)]. In nurses working consecutive night shifts, a rising curve that plateaued at the end was observed between years of consecutive night shifts and PSQI score, p = 0.004. To explore the change in PSQI score after quitting night shift, we constructed a hypothetical prospective cohort from the cross-sectional data. Here, 98 pairs of nurses with consecutive and past night shifts were matched for the number of night shift years, religion, marital status, living condition, hypertension, and hyperlipidemia. In each pair, a hypothetical change in PSQI score was calculated between the two types of nurses and hypothetical years after quitting night shifts was obtained from the matched nurse with past night shifts. A U-shaped curve between change in PSQI and years after quitting night shifts was observed, p = 0.007. The rising curve and U-shaped curve together formed an S-shaped curve, which mapped the change in sleep quality. These results based on the hypothetical cohort constructed from cross-sectional data suggested the presence of persistent poor sleep quality in night shift nurses. Also, we support early and continuous sleep hygiene education and reflection for an optimal strategy for when to cease working night shifts with regard to sleep-related problems.

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Designing Light for Night Shift Workers: Application of Nonvisual Lighting Design Principles in an Industrial Production Line

Applied Sciences ◽

10.3390/app112210896 ◽

2021 ◽

Vol 11 (22) ◽

pp. 10896

Author(s):

Johannes Zauner ◽

Herbert Plischke

Keyword(s):

Shift Work ◽

Industrial Production ◽

Night Shift ◽

Stimulus Range ◽

Automation System ◽

Shift Workers ◽

Health And Wellbeing ◽

Rotating Shift Work ◽

Lighting Simulation ◽

Night Shifts

Chronodisruption deteriorates the health and wellbeing of shift workers. Artificial light at night and the lack of light during the day are major contributors to chronodisruption and need to be optimized in shift work scenarios. Here, we present one solution for a lighting and automation system in an industrial production workplace. The setting is a rapidly rotating shift work environment with morning, evening, and night shifts. We describe a procedure to specify the new lighting through a software-agnostic nonvisual lighting simulation for artificial and daylighting scenarios. Through this process, a new luminaire is created, called Drosa, that allows for a large melanopic stimulus range between 412 and 73 lx melanopic equivalent daylight (D65) illuminance vertically at eye level, while maintaining a neutral white illuminance at task level between 1250 and 900 lx, respectively. This is possible through a combination of glare-free spotlights with adjustable areal wing lights. An individually programmed automation system controls the light dosage and timing during the day and night. The work is relevant for other shift work scenarios, where the presented example and the discussed rationale behind the automation might provide insights. The work is further relevant for other lighting scenarios beyond industrial shift work, as the nonvisual lighting simulation process can be adapted to any context.

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Relationship between Night shift work, Eating Habits and BMI among Nurses in Lebanon

10.21203/rs.2.16152/v3 ◽

2020 ◽

Author(s):

Zeinab Samhat ◽

Randa Attieh ◽

Yonna Sacre

Keyword(s):

Shift Work ◽

Dietary Habits ◽

Eating Habits ◽

Night Shift ◽

Cumulative Number ◽

Anthropometric Measures ◽

Cross Sectional ◽

Night Shift Work ◽

Validated Questionnaire ◽

Night Shifts

Abstract Background: The objective of this cross-sectional study was to evaluate the relationships between night shift work, eating habits and body mass index (BMI) among Lebanese nurses. Methods: A total of 307 nurses were randomly selected from five hospitals located in Beirut. Data about demographic and professional characteristics, anthropometric measures, dietary habits and intakes were collected through a validated questionnaire. To study the relationship between night shift work, eating habits and BMI, chi-square test, t-test and logistic regressions were used.Results: The majority of nurses (78. 2%) had irregular meals timing with a significant decrease in the number of complete meals consumed during the day and an increase in the number of snacks consumed during night (p<0. 05). The most consumed snacks during night shifts were sweets and potato chips. The findings highlighted that BMI and waist circumference significantly increased with the number of years of work (r=0.175; p<0.05) and the cumulative number of night shifts hours over the entire work history (r=0.135/p< 0. 05). Conclusion: Night shift work is positively associated with abnormal eating patterns and BMI among Lebanese nurses. However the increase in BMI is not related to eating habits.

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