scholarly journals Differences in Daytime Activity Levels and Daytime Sleep Between Night and Day Duty: An Observational Study in Italian Orthopedic Nurses

2021 ◽  
Vol 12 ◽  
Author(s):  
Eliana Roveda ◽  
Lucia Castelli ◽  
Letizia Galasso ◽  
Antonino Mulè ◽  
Emiliano Cè ◽  
...  
Keyword(s):  
Night Shift ◽  
Rest Period ◽  
Activity Levels ◽  
Shift Workers ◽  
Daytime Sleep ◽  
Daytime Activity ◽  
Rest Periods ◽  
Sleep Debt ◽  
Sleep Parameters ◽  
Night And Day

Working nonstandard work schedules is often associated with increased sedentary behavior and risk of sleep disorders. Night shift workers are prone to accumulating sleep debt, which they recover by sleeping during the day. The effect on daytime activity levels is unknown. The present study aims to objectively assess whether daytime sleep could affect daytime activity levels of shift worker nurses, resulting in an accumulation of their activity debt differently between working and rest periods. The study population (N = 37; mean age 41.7 ± 9.1 years) was composed of orthopedic nurses working on a rotating schedule, including either a night shift (NS) or only day/afternoon shift (DS). Actigraph monitoring lasted both on the working and the rest period. For the NS nurses, the working period recorded higher daytime activity levels than the rest period, while daytime sleep during the working and rest periods was similar. Conversely, DS nurses showed higher daytime activity levels and shorter daytime sleep during the working period. NS nurses were less active than DS nurses during the working period, probably because NS tended to have a longer daytime sleep. During the rest period, daytime activity levels for both groups were decreased. For NS nurses, sleep recorded the better sleep parameters during the rest period, while sleep parameters did not show significant differences between the working and the rest periods in DS. During the working period, NS nurses slept worse than the DS nurses. Both groups tended to accumulate a debt in daytime activity levels during the rest period. While daytime sleep may be an excellent way to counteract sleep debt and increase sleep duration over 24 h period, on the other hand, it makes nurses less active.

scholarly journals Chronotype-specific Sleep in Two Versus Four Consecutive Shifts

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.

scholarly journals Effects of Light on Daytime Sleep in 12 Hours Night Shift Workers: A Field Study

2019 ◽  
Vol 16 (1) ◽  
pp. 26-35
Author(s):  
Su Jung Choi ◽  
Hea Ree Park ◽  
Eun Yeon Joo
Keyword(s):  
Field Study ◽  
Night Shift ◽  
Shift Workers ◽  
Daytime Sleep

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

SLEEP ◽  
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)

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

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.

scholarly journals Objective Food Intake in Night and Day Shift Workers: A Laboratory Study

2018 ◽  
Vol 1 (1) ◽  
pp. 42-49 ◽  
Author(s):  
Yichi Chen ◽  
Shaza Lauren ◽  
Bernard P. Chang ◽  
Ari Shechter
Keyword(s):  
Food Intake ◽  
Sleep Duration ◽  
Shift Work ◽  
Test Meal ◽  
Food Choice ◽  
Night Shift ◽  
Overweight And Obesity ◽  
Shift Workers ◽  
Sleep Episode ◽  
Night And Day

Night shift work is associated with risk of overweight and obesity. In night shift workers, short sleep duration combined with circadian misalignment may contribute to altered food intake regulation, favoring positive energy balance and weight gain. Prior work investigating food intake in shift workers has suffered methodologically due to reliance on subjective self-report for dietary assessment. No study has yet been done to examine the impact of night shift work on food intake in real-life shift workers using objective measures. Female day (n = 12) and night (n = 12) shift workers from a hospital setting participated in a laboratory-based objective food intake assessment. Participants entered the laboratory in the fasted state after awakening from the sleep episode following a final work shift, and underwent an ad libitum 14-item test meal buffet to objectively quantify food choice/intake. Sleep duration (measured via wrist-accelerometry) during the sleep episode before laboratory assessment was significantly longer in day vs. night workers (373.9 ± 127.5 vs. 260.6 ± 102.9 min, p = 0.03). No significant group difference was observed in calories consumed during the test meal (943.08 ± 469.55 vs. 878.58 ± 442.68 kcal, p = 0.74). When expressed as percent of energy consumed, day workers had higher protein consumption vs. night workers (16.03 ± 5.69 vs. 11.82 ± 4.05%; p = 0.05). To our knowledge, this is the first laboratory-based behavioral assessment of food choice/intake in actual night and day shift workers. Although not studied here, work by others has linked protein intake to satiety. This may be a potential pathway placing shift workers at risk for overweight and obesity.

scholarly journals Effects of Shift Work in a Sample of Italian Nurses: Analysis of Rest-Activity Circadian Rhythm

2021 ◽  
Vol 18 (16) ◽  
pp. 8378
Author(s):  
Letizia Galasso ◽  
Antonino Mulè ◽  
Lucia Castelli ◽  
Emiliano Cè ◽  
Vincenzo Condemi ◽  
...  
Keyword(s):  
Circadian Rhythm ◽  
Shift Work ◽  
Night Shift ◽  
Rest Period ◽  
Working Hours ◽  
Normal Weight ◽  
Activity Levels ◽  
Lower Amplitude ◽  
Study Population ◽  
Rest Activity

Shift work can lead to circadian desynchronization due to temporary misalignment between working hours and physiological and behavioral functioning, resulting in compromised health, insomnia, worsening of sleep quality, reduced ability to work during waking hours, and increased cardiovascular risk. We evaluated the effects of shift work on the rest-activity circadian rhythm (RAR) and health status of Italian orthopaedic nurses. The study population was 59 nurses: 44 worked the night shift and 15 worked the day shift. All carried out continuous 5-day actigraphic monitoring to assess RAR, including both the working and the rest period. The rhythmometric analysis showed that, during the working period, the night shift nurses had a significantly lower amplitude than the day shift nurses (p < 0.001), and the acrophase was significantly different between the two groups (p < 0.01). When we stratified the two groups by median body mass index (<25 kg/m2 normal weight and ≥25 kg/m2 overweight), during the working period, we noted a significantly lower amplitude for both the normal weight and the overweight nurses who worked the night shift (p < 0.01 and p < 0.001, normal weight and overweight respectively). The current findings suggest the need for further study of the relationship between activity levels and shift work.

Sleep Quality in Nurses

2012 ◽  
Vol 15 (3) ◽  
pp. 273-279 ◽  
Author(s):  
Shu-Fen Niu ◽  
Hsin Chu ◽  
Min-Huey Chung ◽  
Chun-Chieh Lin ◽  
Yu-Shiun Chang ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Medical Center ◽  
Night Shift ◽  
Sleep Time ◽  
Shift Workers ◽  
Sleep Diaries ◽  
Shift Group ◽  
Sleep Parameters ◽  
The Difference ◽  
Night Shifts

The study investigated the number of days off nurses working night shifts need to recover their sleep quality to the level of daytime workers during their days off. This study included 30 day-shift nurses and 32 night-shift nurses. It was conducted as a randomized clinical trial in the medical and surgical wards of a medical center in northern Taiwan in May and June 2010 using sleep diaries and sleep parameters collected by actigraphy on different workdays and days off. On workdays, the night-shift group had significantly less total sleep time (TST) on Day 5 and significantly lower sleep efficiency (SE) on Day 3 than the day-shift group. TSTs of the two groups on days off were higher than those on workdays. On the 4th consecutive day off, higher TST, a decrease in WASO, and an increase in SE suggests that the night-shift group had recovered their sleep quality to the level of the day-shift group on their days off. The SE of the night-shift group exceeded that of the day-shift group after the 4th consecutive day off, though the difference was not statistically significant in the present study. Based on these data, it is recommended that night-shift workers arrange a period of at least 4 days off after 5 consecutive night shifts and at least 5 days off if the staff who have previously worked night shifts are being assigned a set of different shifts.

299 Limited Time for Sleep in Night Shift Workers is associated with Risk of Insomnia and Shift Work Disorder

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A119-A120
Author(s):  
Heidi Lammers-van der Holst ◽  
Yuan Zhang ◽  
Laura Barger ◽  
John Wise ◽  
Audra Murphy ◽  
...  
Keyword(s):  
Shift Work ◽  
Night Shift ◽  
Free Time ◽  
Shift Workers ◽  
Severe Problem ◽  
Work Activities ◽  
Daytime Sleep ◽  
Shift Work Disorder ◽  
Recovery Sleep ◽  
Insomnia Severity

Abstract Introduction Sleep deficiency is a severe problem faced by night shift workers. Approximately one-third of night workers report insomnia during daytime sleep and excessive sleepiness during nighttime work; when severe, these symptoms characterize shift work disorder (SWD). Difficulty sustaining 7 to 9 hours of sleep during the daytime is partly due to a circadian drive for wakefulness. Not much is known, however, about how non-work activities contribute to the inability to obtain recovery sleep. We sought to explore how much time night workers are able to allocate for daytime sleep, and how this relates to insomnia-like symptoms and the likelihood of developing SWD. Methods Night shift workers (n=452, 19–69 years old, 54% men) from various occupations who worked at least four night shifts per month completed an online survey. This included questions related to shift duration, hours per workday of non-optional non-work activities, self-rated sleep need, the Insomnia Severity Index (ISI) and a validated 4-item SWD screening questionnaire. For each participant, we calculated the duration of work plus non-optional activities and compared the remaining available time for sleep to their self-described sleep need. Non-parametric Chi-square analyses and Pearson correlations were conducted. Results On average, shift duration was 8.9±1.6 hours, non-optional activities were 3.6±2.9 hours, and sleep need was 7.6±1.6 hours, leaving 15% of shift workers with insufficient free time to obtain the amount of sleep they needed. The percentage of workers at high risk for SWD was significantly greater among those who did not have enough free time for sleep compared to those whose schedules allowed sufficient sleep time (72% vs. 42%; χ2=20.2, p&lt;0.0001). We also found that shift workers with insufficient free time for sleep reported higher insomnia severity (r2=-0.20, p&lt;0.0001). Conclusion About 15% of night workers have non-optional activities outside work that limit their time to obtain sufficient sleep, and this contributes to greater insomnia-like symptoms and increased risk for SWD. Future research should focus on understanding what these non-optional activities are and whether they differ between night and day workers. These insights will enable personalized countermeasures to maximize the sleep and health of shift workers. Support (if any) Supported by US NIH grant R01-AG044416.

scholarly journals Social jetlag and sleep debts are altered in different rosters of night shift work

PLoS ONE ◽  
2022 ◽  
Vol 17 (1) ◽  
pp. e0262049
Author(s):  
Swaantje Casjens ◽  
Frank Brenscheidt ◽  
Anita Tisch ◽  
Beate Beermann ◽  
Thomas Brüning ◽  
...  
Keyword(s):  
Sleep Quality ◽  
Sleep Deprivation ◽  
Sleep Duration ◽  
Shift Work ◽  
Night Shift ◽  
Shift Workers ◽  
Social Jetlag ◽  
Sleep Debt ◽  
The Impact ◽  
Night Shifts

Background Night and shift work are suspected to cause various adverse effects on health and sleep. Sleep deprivation through shift work is assumed to be compensated on free days. So far it is not clear how different shift systems and shift lengths affect sleep structure on work and free days. Especially working night shifts disrupts the circadian rhythm but also extended working hours (12h) might affect sleep characteristics. Hitherto, the magnitude of sleep debt, social jetlag, and Locomotor Inactivity During Sleep (LIDS) in different shift systems is unknown. Methods Here, we investigated the impact of five different shift rosters on sleep in 129 industrial workers from Germany. Permanent night work with multiple shift systems with and without night shifts and with different shift lengths were compared. Wrist-activity was monitored over 28 days revealing sleep on- and offsets as well as LIDS as proxy for sleep quality. Overall, 3,865 sleep bouts comprising 22,310 hours of sleep were examined. Results The mean daily age-adjusted sleep duration (including naps) was 6:43h and did not differ between shift workers of different rosters. However, sleep duration on workdays was particularly low in rotational shift systems with 12h-shifts (5:00h), while overall sleep debt was highest. Shift workers showed a median absolute social jetlag of 3:03h, which differed considerably between shift types and rosters (p<0.0001). Permanent night workers had the highest social jetlag (5:08h) and latest mid-sleeps on workdays and free days. Sleep quality was reduced in permanent night shift workers compared with shift workers in other rosters and differed between daytime and nighttime sleep. Conclusions Shift work leads to partial sleep deprivation, which particularly affects workers in 12h-shifts and permanent night shifts. Working these shifts resulted in higher sleep debts and larger absolute social jetlag whereas sleep quality was especially reduced in permanent night shift workers compared with shift workers of other rosters.

scholarly journals 0781 Impact Of Suvorexant On Total Daytime Sleep Hours In Shift Workers: A Randomized, Double-blind, Placebo-controlled Clinical Field Trial

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A297-A297
Author(s):  
J M Zeitzer ◽  
D S Joyce ◽  
A L Sterkel ◽  
Y L Quevedo ◽  
B Hernandez ◽  
...  
Keyword(s):  
Field Study ◽  
Total Sleep Time ◽  
Night Shift ◽  
Sleep Time ◽  
Placebo Condition ◽  
Double Blind ◽  
Shift Workers ◽  
Daytime Sleep ◽  
Therapeutic Mechanism ◽  
Lack Of Sleep

Abstract Introduction Many shift workers have an inability to sleep during the daytime following a night shift not due to insomnia or lack of sleep pressure, but because a circadian signal promoting wakefulness is hampering their ability to maintain sleep. We have previously hypothesized that the neuropeptide hypocretin-1 is, in part, responsible for the physiologic expression of this circadian wake signal. As such, it was our intent to determine whether a pharmacologic blockade of hypocretin would enable shift workers to obtain more daytime sleep. Methods Nineteen shift workers took part in a placebo-controlled, double-blind field study of suvorexant. Following two weeks of baseline, participants received 10 mg suvorexant/placebo for one week and were titrated upward to 20 mg suvorexant/placebo for an additional two weeks. Subjective (diaries) and objective (actigraphy) sleep were monitored throughout. No restrictions were placed on participants’ schedules. Results Both subjective and objective measures of total sleep time significantly improved in the active vs. the placebo condition, increasing by 2.08 ± 0.47 hours (diary) or 1.04 ± 0.53 hours (actigraphy) by the end of the 10 mg condition, and increasing by 2.97 ± 0.56 hours (diary) or 2.16 ± 0.75 hours (actigraphy) by the end of the 20 mg condition. Physician ratings of change in the severity of symptoms similarly improved in the active group. There were no adverse events reported in the active condition. Conclusion Robust changes in total sleep time were observed after administration of suvorexant, a dual-hypocretin antagonist, prior to daytime sleep in a field study of shift workers. The very large changes in total sleep time, coupled with the permissive nature of the therapeutic mechanism (i.e., suppressing wake rather than inducing sleep) indicate that this could be a viable and important therapy for shift workers. Support Merck Sharpe and Dohme investigator-initiated study #53236

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