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Grünberger T, Höhn C, Schabus M, Pletzer BA, Laireiter AR. Comparison of Tailored Versus Standard Group Cognitive Behavioral Therapy for Shift Worker Insomnia: A Randomized Controlled Trial. Clocks Sleep 2025; 7:24. [PMID: 40407630 PMCID: PMC12101211 DOI: 10.3390/clockssleep7020024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2025] [Revised: 04/02/2025] [Accepted: 05/06/2025] [Indexed: 05/26/2025] Open
Abstract
Shift workers are at increased risk of insomnia. The standard treatment (cognitive behavioral therapy for insomnia) poses significant challenges for this demographic due to irregular work and sleep schedules. New approaches are still considered insufficient due to high attrition or insufficient effectiveness. Our preliminary study identified sleep-relevant state and trait factors (see secondary outcomes) for incorporation into an innovative manual that addresses sleep in an implicit manner. The objective was to reduce the focus on insomnia and to replace regularity-based interventions. With a sample of 55 insomniacs (67.74% male, mean age 41.62 years), standard and customized treatments were compared using pre-treatment, post-treatment, and three-month follow-up measurements (RCT, self-assessment data). Our linear mixed models revealed the main significant effects of the measurement point for the primary (insomnia severity, sleep quality, sleep onset latency, total sleep time, daytime sleepiness) and the secondary outcomes (selection: anxiety/depression, dysfunctional beliefs, arousal, emotional stability, concern). No main effects of the condition or interaction effects were identified. Non-inferiority and equivalence tests demonstrated that the customized treatment is equivalent to standard therapy, which is a favorable outcome in light of the implicit approach. Consequently, this innovative approach warrants further exploration, incorporating the present results.
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Grants
- none Therapiezentrum und Ambulanz, Prof. Dr. Anton-Rupert Laireiter, department of psychology, University of Salzburg, Getreidegasse 21, 5020 Salzburg, Austria
- none Förderverein zur wissenschaftlichen Forschung an der Paris Lodron Universität Salzburg, Churfürststraße 1, 5020 Salzburg, Austria;
- none Doktoratskolleg Universtität Salzburg, Christopher Höhn, Manuel Schabus;
- none Doctoral College 'Imaging the Mind' of the Austrian Science Fund
- none Paris Lodron University of Salzburg Publication Fund
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Affiliation(s)
| | | | - Manuel Schabus
- Department of Psychology, Paris-Lodron-University Salzburg, A-5020 Salzburg, Austria; (T.G.); (C.H.); (B.A.P.); (A.-R.L.)
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Brückner HA, Ell J, Kalon L, Strahler J, Ducki A, Riemann D, Buntrock C, Spiegelhalder K, Lehr D. Effectiveness of digital cognitive behavioral therapy for insomnia in nurses with shift work sleep disorder: Results of a randomized controlled trial. Int J Nurs Stud 2025; 169:105112. [PMID: 40403587 DOI: 10.1016/j.ijnurstu.2025.105112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2024] [Revised: 04/29/2025] [Accepted: 05/01/2025] [Indexed: 05/24/2025]
Abstract
BACKGROUND Shift work is associated with many adverse effects on health and, in particular, affects sleep. In nurses, one of the most common forms of insomnia is shift work sleep disorder. Traditional face-to-face cognitive behavioral therapy for insomnia is often impractical for shift-working nurses due to irregular work schedules. Digital therapy presents a promising alternative to provide nurses with access to cognitive behavioral therapy for insomnia. OBJECTIVE To investigate the effectiveness of the digital SleepCare intervention for reducing insomnia in nurses being affected by shift work sleep disorder. DESIGN Randomized controlled trial. PARTICIPANTS 74 nurses affected by shift work sleep disorder. METHODS In a two-armed randomized controlled trial, SleepCare was compared to shift work-specific psychoeducation published digitally by the German Sleep Society. The diagnosis of shift work sleep disorder was established through a clinical interview. The primary outcome was insomnia severity as measured by the Insomnia Severity Index at baseline before randomization, at 8 weeks, and 3 months after randomization. Further indicators of mental health and long-term hair cortisol concentration were evaluated as secondary endpoints. RESULTS Intention-to-treat analysis of covariance showed a greater reduction in insomnia severity in the intervention group versus psychoeducation, at both post-intervention (d = 1.11[0.7-1.6]) and follow-up (d = 0.97 [0.5-1.4]), corresponding to between-group differences of 5.0 and 5.3 points on the Insomnia Severity Index, respectively. 56 % completed at least five of the six sessions and results indicated larger effects for these intervention completers with d = 1.49 and d = 1.28, respectively. Statistically significant effects were observed for sleep-related, but not other mental health indicators, for example, stress and depression. Reduced hair cortisol levels were observed post-intervention in the SleepCare group (V = 82, p = .008; Δ = -1.8 pg/mg, 44 % reduction from baseline). CONCLUSIONS SleepCare was effective in reducing insomnia symptoms to a clinically meaningful extent and is one of the first digitally delivered programs to adapt cognitive behavioral therapy for insomnia with specific exercises to address nurses' needs for shift work. The development of effective strategies to promote treatment adherence seems necessary, as substantially larger effects were observed for intervention completers. REGISTRATION German Clinical Trials Register - DRKS; DRKS00027411 (https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00027411). Registration date: March 9, 2022. Start of recruitment: May 13, 2022.
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Affiliation(s)
- Hanna A Brückner
- Institute of Sustainability Psychology, Department of Health Psychology and Applied Biological Psychology, Leuphana University, Lüneburg, Germany.
| | - Johanna Ell
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lina Kalon
- Institute of Sustainability Psychology, Department of Health Psychology and Applied Biological Psychology, Leuphana University, Lüneburg, Germany
| | - Jana Strahler
- Department of Sport and Sport Science, Sport Psychology, Albert Ludwig University Freiburg, Freiburg, Germany
| | - Antje Ducki
- Department of Economic and Social Sciences, Berliner Hochschule für Technik, Berlin, Germany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Claudia Buntrock
- Institute of Social Medicine and Health Systems Research, Faculty of Medicine, Otto von Guericke University Magdeburg, Magdeburg, Germany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Dirk Lehr
- Institute of Sustainability Psychology, Department of Health Psychology and Applied Biological Psychology, Leuphana University, Lüneburg, Germany
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Khemakhem R, Kammoun N, Fehri S, Gargouri R, Bader S, Abid N, Boudaoura NK, Elghoul J, Kallel N, Moussa N, Kwas H, Msaad S, Kammoun S. Sleep disorders among Tunisian night-shift workers: a cross-sectional study. Sleep Breath 2025; 29:172. [PMID: 40293573 DOI: 10.1007/s11325-025-03335-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2025] [Revised: 04/15/2025] [Accepted: 04/18/2025] [Indexed: 04/30/2025]
Abstract
PURPOSE Night shift work is common today and disrupts circadian rhythms, leading to health concerns. This study examines the impact of night shifts on sleep quality among Tunisian workers, determines the prevalence of sleep disorders, and identifies factors associated with poor sleep quality. METHODOLOGY This cross-sectional study employed an online questionnaire to assess sleep disorders among night workers aged 18 and older. Key measures included sleep quality, daytime alertness, mood, and subjective well-being, assessed with validated Arabic versions of the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), Epworth Sleepiness Scale (ESS), Patient Health Questionnaire-9 (PHQ-9), and WHO-Five Well-Being Index (WHO-5). RESULTS A study of 503 Tunisian night shift workers aged 25 to 64 revealed significant sleep disturbances. Poor sleep quality (PSQI score > 5) was found in 59.4%, while 13.7% reported insomnia (ISI score > 15). Severe insomnia, excessive daytime sleepiness, severe depression, and poor well-being were present in 2%, 32.6%, 4%, and 58.3%, respectively. Factors linked to poor sleep quality included BMI, active smoking, fatty meals, hypnotic use, nasal obstruction, sinusitis, gastrointestinal disorders, and well-being scores. CONCLUSION The findings of this study highlight the significant impact of night shift work on sleep quality and overall well-being among Tunisian workers. To mitigate these effects, practical interventions are essential, including promoting shift work schedules, improving workplace wellness programs, encouraging healthier lifestyle choices, and providing access to mental health support. Future research should investigate the relationship between shift work, sleep, and mental health while finding ways to mitigate these effects.
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Affiliation(s)
- Rim Khemakhem
- Department of Respiratory and Sleep Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia.
| | - Nesrine Kammoun
- Tunisian Occupational Health and Safety Institute, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Sirine Fehri
- Department of Respiratory and Sleep Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Rahma Gargouri
- Department of Respiratory and Sleep Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Saeb Bader
- Department of Respiratory and Sleep Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Narjes Abid
- Department of Pneumology, Mohamed Taher Maamouri University Hospital of Nabeul, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - Nadia Keskes Boudaoura
- Department of Pneumology, Taher Sfar University Hospital of Mahdia, Faculty of Medicine of Monastir, University of Monastir, Monastir, Tunisia
| | - Jamel Elghoul
- Department of Pneumology, Habib Bourguiba University Hospital of Medenine, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Nesrine Kallel
- Department of Respiratory and Sleep Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Nedia Moussa
- Department of Respiratory and Sleep Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Hamida Kwas
- Pulmonology, University of Sfax, Faculty of Medicine of Sfax, University Hospital of Gabès, Gabès, Tunisia
| | - Sameh Msaad
- Department of Respiratory and Sleep Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
| | - Samy Kammoun
- Department of Respiratory and Sleep Medicine, Hedi Chaker University Hospital of Sfax, Faculty of Medicine of Sfax, University of Sfax, Sfax, Tunisia
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Duske J, D'Souza N, Mayer D, Dieterich DC, Fendt M. Orexinergic modulation of chronic jet lag-induced deficits in mouse cognitive flexibility. Neuropsychopharmacology 2025; 50:762-771. [PMID: 39478089 PMCID: PMC11914050 DOI: 10.1038/s41386-024-02017-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2024] [Revised: 10/16/2024] [Accepted: 10/18/2024] [Indexed: 03/19/2025]
Abstract
Cognitive flexibility and working memory are important executive functions mediated by the prefrontal cortex and can be impaired by circadian rhythm disturbances such as chronic jet lag (CJL) or shift work. In the present study, we used mice to investigate whether (1) simulated CJL impairs cognitive flexibility, (2) the orexin system is involved in such impairment, and (3) nasal administration of orexin A is able to reverse CJL-induced deficits in cognitive flexibility and working memory. Mice were exposed to either standard light-dark conditions or simulated CJL consisting of series of advance time shifts. Experiment (1) investigated the effects of a mild CJL protocol on cognitive flexibility using the attentional set shifting task. Experiment (2) used a stronger CJL protocol and examined CJL effects on the orexin system utilizing c-Fos and orexin immunohistochemistry. Experiment (3) tested whether nasal orexin application can rescue CJL-induced deficits in cognitive flexibility and working memory, the latter by measuring spontaneous alternation in the Y-maze. The present data show that CJL (1) impairs cognitive flexibility and (2) reduces the activity of orexin neurons in the lateral hypothalamus. (3) Nasal administration of orexin A rescued CJL-induced deficits in working memory and cognitive flexibility. These findings suggest that executive function impairments by circadian rhythm disturbances such as CJL are caused by dysregulation of orexinergic input to the prefrontal cortex. Compensation of decreased orexinergic input by nasal administration of orexin A could be a potential therapy for CJL- or shift work-induced human deficits in executive functions.
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Affiliation(s)
- Julius Duske
- Institute for Pharmacology and Toxicology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
| | - Nicole D'Souza
- Institute for Pharmacology and Toxicology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
- Institute of Neurophysiology, Goethe University, Frankfurt, Germany
| | - Dana Mayer
- Institute for Pharmacology and Toxicology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
| | - Daniela C Dieterich
- Institute for Pharmacology and Toxicology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany
- Center of Behavioural Brain Sciences, Otto-von-Guericke University, Magdeburg, Germany
| | - Markus Fendt
- Institute for Pharmacology and Toxicology, Medical Faculty, Otto-von-Guericke University, Magdeburg, Germany.
- Center of Behavioural Brain Sciences, Otto-von-Guericke University, Magdeburg, Germany.
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Nilsson T, Lashari A, Gustavsson P, Härmä M, Bigert C, Bodin T, Maclachlan L, Norberg AL, Brulin E. Night and shift work and incidence of physician-diagnosed sleep disorders in nursing staff: A prospective cohort study. Int J Nurs Stud 2025; 164:105017. [PMID: 39929033 DOI: 10.1016/j.ijnurstu.2025.105017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Revised: 01/27/2025] [Accepted: 01/30/2025] [Indexed: 02/12/2025]
Abstract
BACKGROUND Epidemiological studies provide evidence for an association between shift work and sleep problems but often lack precise exposure and outcome data. OBJECTIVE To investigate the risk of first-time physician-diagnosed sleep disorder in nursing staff using register-based data of shift work and health outcomes. DESIGN A prospective cohort study with a 4.5-year follow-up. PARTICIPANTS 25,639 healthcare employees (nurses including midwives, nursing assistants, and related care professions) employed for at least six months between 2012 and 2016 by Region Stockholm were included. METHODS Information on hour-by-hour and day-by-day working hours was obtained from a computerised employee register. Physician-diagnosed sleep disorders (N = 326) were obtained from an outpatient register from January 2013 to June 2017. Discrete time proportional hazards models were used to estimate hazard ratios (HR) adjusting for age, sex, country of birth and profession. RESULTS An increased risk of physician-diagnosed sleep disorder was seen among those who, during the preceding six months, only or frequently (>66 times) worked night shifts compared to those who did not work nights (HR 1.70, 95 % CI 1.17-2.43 and HR 1.77, 95 % CI 1.21-2.50 respectively). The associations were supported by a dose-response pattern (p = 0.0006). Among those who work night shifts, the risk associated with 9-12 times of three or more consecutive nights was of borderline statistical significance (HR 1.66, 95 % CI 0.98-2.81). Frequently (>39 times the last six months) having quick returns from night shifts (<28 h) showed an almost 2-fold increased risk of physician-diagnosed sleep disorder compared to those who had few (<8 times in the last six months) quick returns from night shifts (HR 1.89, 95 % CI 1.05-3.52). Quick returns from afternoon shifts in non-night workers (<11 h) did not significantly increase the risk of physician-diagnosed sleep disorder. CONCLUSION The results indicate that intensive night shift work, especially frequent and consecutive night shifts, is associated with an increased risk of physician-diagnosed sleep disorder in nursing staff. This study raises awareness of the need to acknowledge objective in addition to subjective health outcomes in relation to shift work.
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Affiliation(s)
- Tove Nilsson
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
| | - Abid Lashari
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Per Gustavsson
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Mikko Härmä
- Work ability and Work careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Carolina Bigert
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Theo Bodin
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Laura Maclachlan
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Annika Lindahl Norberg
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden; Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden
| | - Emma Brulin
- Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden
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DI Milia L, Bjorvatn B. The relationship between shift work, sleep, and work hours on wellbeing. INDUSTRIAL HEALTH 2025; 63:148-155. [PMID: 39155078 PMCID: PMC11995149 DOI: 10.2486/indhealth.2024-0088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 08/01/2024] [Indexed: 08/20/2024]
Abstract
We investigated the role of sleep and work hours on wellbeing among day- and shift workers. We tested a mediation-moderation hypothesis proposing that; 1) sleep would mediate the association between the work schedule and the impact of sleep/sleepiness on wellbeing; 2) work hours would moderate the link between work schedule and sleep. We made random phone calls to 1,162 participants and identified 172-d and 130 shift workers that worked ≥35 h/week. The work schedule had a positive indirect effect on the impact of sleep/sleepiness via sleep duration (β=0.0511, SE=0.0309, [0.0008, 0.3219]. The relationship between shift work and sleep duration was negative (β=-0.35, SE=0.14, p<0.01), and sleep duration was negatively associated with a greater impact of sleep/sleepiness on wellbeing (β=-0.15, SE=0.06, p<0.02). The path between the work schedule and sleep duration was moderated by work hours; fewer work hours resulted in shift workers reporting a greater impact of sleep/sleepiness on wellbeing. The results support the mediation-moderation hypothesis. Work hours and sleep duration are key characteristics in work schedule design.
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Affiliation(s)
- Lee DI Milia
- School of Business and Law, Central Queensland University, Australia
| | - Bjorn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Norway
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Kohl IS, Garcez A, da Silva JC, de Arruda HC, Canuto R, Paniz VMV, Olinto MTA. Association Between Shift Work and Vitamin D Levels in Brazilian Female Workers. Nutrients 2025; 17:1201. [PMID: 40218959 PMCID: PMC11990299 DOI: 10.3390/nu17071201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2025] [Revised: 03/09/2025] [Accepted: 03/17/2025] [Indexed: 04/14/2025] Open
Abstract
Objectives: Vitamin D plays a crucial role in maintaining bone and muscle health and is associated with various health conditions. Risk factors for reduced vitamin D levels include occupation. The aim of this study was to explore the association between shift work and vitamin D levels among female workers. Methods: This cross-sectional study was conducted among 304 women from an industrial group located in southern Brazil. Vitamin D deficiency was defined as serum 25(OH)D levels < 20 ng/mL, and deficiency/insufficiency was defined as serum levels < 30 ng/mL. Work shift data were collected through interviews using the start and end times of work shifts, classified as "day shift" (6:00 AM ≤ hh:hh < 10:00 PM) and "night shift" (10:00 PM ≤ hh:hh < 6:00 AM), respectively. The association between vitamin D deficiency and shift work was expressed as prevalence ratio (PR), using Poisson regression adjusted for confounding variables. Results: The prevalence of vitamin D deficiency was 36.5% (95% CI: 31.1-41.9), while the prevalence of insufficiency was 75.7% (95% CI: 70.8-80.5). After adjustment, a significant association was found, with 65% and 17% higher probabilities of having vitamin D deficiency (PR = 1.65; 95% CI: 1.23-2.22; p = 0.001) and vitamin D deficiency/insufficiency (PR = 1.17; 95% CI: 1.02-1.35; p = 0.030) among nightshift workers compared with dayshift workers. Conclusions: The findings of this study indicate a high prevalence of hypovitaminosis D among Brazilian female fixed-shift workers as well as a higher probability of vitamin D deficiency and deficiency/insufficiency among nightshift workers compared with dayshift workers.
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Affiliation(s)
- Ingrid Stähler Kohl
- Pos-Graduate Program in Medical Sciences: Endocrinology, Faculty of Medicine, Federal University of Rio Grande do Sul State, UFRGS, Porto Alegre CEP 90035-002, RS, Brazil; (I.S.K.); (A.G.)
| | - Anderson Garcez
- Pos-Graduate Program in Medical Sciences: Endocrinology, Faculty of Medicine, Federal University of Rio Grande do Sul State, UFRGS, Porto Alegre CEP 90035-002, RS, Brazil; (I.S.K.); (A.G.)
- Post-Graduate Program in Food, Nutrition and Health, Faculty of Medicine, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre CEP 90035-002, RS, Brazil
| | - Janaína Cristina da Silva
- Post-Graduate Program in Collective Health, University of Vale do Rio dos Sinos, Unisinos, São Leopoldo CEP 93022-750, RS, Brazil
| | - Harrison Canabarro de Arruda
- Post-Graduate Program in Food, Nutrition and Health, Faculty of Medicine, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre CEP 90035-002, RS, Brazil
| | - Raquel Canuto
- Post-Graduate Program in Food, Nutrition and Health, Faculty of Medicine, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre CEP 90035-002, RS, Brazil
- Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre CEP 90035-903, RS, Brazil
| | - Vera Maria Vieira Paniz
- Post-Graduate Program in Collective Health, University of Vale do Rio dos Sinos, Unisinos, São Leopoldo CEP 93022-750, RS, Brazil
| | - Maria Teresa Anselmo Olinto
- Pos-Graduate Program in Medical Sciences: Endocrinology, Faculty of Medicine, Federal University of Rio Grande do Sul State, UFRGS, Porto Alegre CEP 90035-002, RS, Brazil; (I.S.K.); (A.G.)
- Post-Graduate Program in Food, Nutrition and Health, Faculty of Medicine, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre CEP 90035-002, RS, Brazil
- Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, UFRGS, Porto Alegre CEP 90035-903, RS, Brazil
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Degenfellner J, Strohmaier S, Zebrowska M, Saksvik-Lehouillier I, Schernhammer E. Identifying Risk and Protective Factors for Shift Work Sleep Disorder: Insights from UK Biobank Night Shift Workers. Clocks Sleep 2025; 7:14. [PMID: 40136851 PMCID: PMC11941026 DOI: 10.3390/clockssleep7010014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2024] [Revised: 02/25/2025] [Accepted: 02/27/2025] [Indexed: 03/27/2025] Open
Abstract
Shift Work Sleep Disorder (SWSD) is a significant and highly prevalent condition affecting up to 48% of individuals with irregular work schedules. The diagnostic criteria for SWSD include persistent insomnia or sleepiness in relation to shift work, not attributable to other disorders or external factors. To explore risk factors of SWSD, we conducted a cross-sectional analysis among 10,787 night shift workers in the UK Biobank. To determine correlates of SWSD using multivariable-adjusted logistic regression models, a preselection of potential risk factors was made on the basis of previous literature. Self-identifying as 'Asian or Asian British' or 'Black or Black British' (compared to being 'White'), male sex, and high scores on sociability, warmth and diligence were associated with lower odds for SWSD. We did not find significant associations of chronotype, frequency of alcohol intake, smoking, and time employed in current job with SWSD. These findings underscore the need for targeted interventions and workplace policies to mitigate the adverse effects of SWSD. Future research should aim to explore the mechanisms behind these associations and develop strategies to enhance shift work tolerance among night shift workers.
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Affiliation(s)
- Jürgen Degenfellner
- Department of Epidemiology, Center of Public Health, Medical University of Vienna, 1090 Vienna, Austria; (J.D.)
- Institute of Physiotherapy, ZHAW School of Health Sciences, Katharina-Sulzer-Platz 9, 8400 Winterthur, Switzerland
| | - Susanne Strohmaier
- Department of Epidemiology, Center of Public Health, Medical University of Vienna, 1090 Vienna, Austria; (J.D.)
| | - Magdalena Zebrowska
- Department of Epidemiology, Center of Public Health, Medical University of Vienna, 1090 Vienna, Austria; (J.D.)
| | | | - Eva Schernhammer
- Department of Epidemiology, Center of Public Health, Medical University of Vienna, 1090 Vienna, Austria; (J.D.)
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Gu K, Chen H, Shi H, Hua C. Global prevalence of excessive daytime sleepiness among nurses: A systematic review and meta-analysis. Int Nurs Rev 2025; 72:e13087. [PMID: 39726100 DOI: 10.1111/inr.13087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2024] [Accepted: 11/28/2024] [Indexed: 12/28/2024]
Abstract
BACKGROUND Nurses face significant risks of excessive daytime sleepiness (EDS), which adversely affects workplace safety and productivity. Yet, the extent of EDS in this workforce remains inadequately characterized. AIM The aims of this systematic review were to assess the pooled prevalence of EDS among nurses. METHODOLOGY We systematically searched PubMed, Embase, Scopus, and ISI Web of Science for observational studies reporting the prevalence of EDS, as measured by the Epworth Sleepiness Scale (ESS), from database inception to May 1, 2024, with no language restrictions. Study quality was evaluated using JBI's critical appraisal tool. Pooled estimates were calculated through random-effects meta-analysis, with subgroup and meta-regression analyses assessing associations between EDS prevalence and study-level factors. Linear regression modeling was used to assess time trends. This study was registered with PROSPERO (CRD42024535109). RESULTS We included 36 unique studies encompassing 2677 nurses from 20 countries. EDS occurred in 14.0%-55.6% of nurses. The results of the meta-analysis showed a pooled prevalence of EDS of 32.2% (95% confidence interval [CI]: 28.5-36.1; I2 = 92.6). Prevalence estimate did not vary substantially in terms of study-level data (i.e., region, country income, pre/post covid era, hospital type, proportion of female nurse, average nursing experience, or proportion of married nurses). The prevalence of EDS in nurses has remained unchanged over time. CONCLUSIONS This meta-analysis identifies a high global prevalence of EDS among nurses, affecting nearly one-third of this workforce. The findings underscore the urgent need for targeted interventions to mitigate EDS across diverse geographic and economic contexts. IMPLICATION FOR NURSING AND NURSING POLICY This study highlights the pervasive issue of EDS among nurses worldwide, necessitating comprehensive strategies to address this challenge across all regions, income levels, hospital settings, and demographic groups.
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Affiliation(s)
- Kaini Gu
- Ningbo Medical Center Li Huili Hospital, Ningbo, China
| | - Huigang Chen
- Nursing College, Zhangjiakou University, Zhangjiakou, China
| | - Hong Shi
- Second Department of Outpatients, PLA Joint Logistic Support Force 908 Hospital, Nanchang, China
| | - Cui Hua
- Tangshan Fengnan District Traditional Chinese Medicine Hospital, Tangshan, China
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Prados G, Mendoza-Vinces Á, Holguín M, Cambil-Martín J, Fernández-Puerta L. Factors Associated with Workplace Injuries Among Shift Work Nurses: A Cross-Sectional Study in an Ecuadorian Sample. NURSING REPORTS 2025; 15:44. [PMID: 39997780 PMCID: PMC11858646 DOI: 10.3390/nursrep15020044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2024] [Revised: 01/20/2025] [Accepted: 01/24/2025] [Indexed: 02/26/2025] Open
Abstract
Background/Objectives: Shift work schedules and mental and physical workloads affect the sleep homeostasis of nurses, increasing the risk of occupational injuries. This study aimed to investigate the relationship between sleep disturbances caused by shift schedules and the occurrence of needlestick and sharps injuries (NSIs) among nurses, considering significant worker and occupational factors. Methods: A total of 348 nurses from five hospitals of Santiago de Guayaquil, Ecuador, participated in this cross-sectional survey. Data on sociodemographic and occupational characteristics, work schedules, and NSI incidents during the previous six months were collected. Emotional status, sleepiness, and insomnia symptoms were assessed using validated questionnaires. Additionally, nurses with night shifts (fixed or rotating) were specifically assessed to estimate the relationship between NSIs and insomnia or sleepiness symptoms related to these types of shift work using logistic regression analyses. Results: Nurses whose schedule included night shifts showed a higher prevalence of NSIs than those with other shifts (33.2% vs. 29.0%; p < 0.05). High levels of depression, anxiety, and stress were associated with having had an NSI in the previous six months. Logistic regression showed that female sex (adjusted odds ratio, aOR 4.62, 95% CI: 1.65-12.97), less experience in the current clinical setting (aOR 3.12, 95% CI: 1.46-6.57), the use of psychotropic drugs (aOR 4.46, 95% CI: 1.51-13.17), and insomnia and sleepiness symptoms due to shift work (aOR 2.61, 95% CI: 1.15-5.91) increased NSI risk among nurses with night shifts. Conclusions: There is an acute need to explore the complex relationship between sleep troubles linked to shift work schedules, occupational factors, and the risk of occupational injuries and propose preventive strategies for enhancing nurses' sleep health and workplace safety.
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Affiliation(s)
- Germán Prados
- Department of Nursing, School of Health Sciences, University of Granada, 18071 Granada, Spain; (G.P.); (J.C.-M.)
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, 18071 Granada, Spain
| | - Ángela Mendoza-Vinces
- Department of Nursing, Faculty of Health Sciences, School of Medicine, Catholic University of Santiago de Guayaquil, Avenida Carlos Julio Arosemena, km 1.5, Guayaquil 090615, Ecuador;
| | - Martha Holguín
- Department of Nursing, Faculty of Health Sciences, School of Medicine, Catholic University of Santiago de Guayaquil, Avenida Carlos Julio Arosemena, km 1.5, Guayaquil 090615, Ecuador;
| | - Jacobo Cambil-Martín
- Department of Nursing, School of Health Sciences, University of Granada, 18071 Granada, Spain; (G.P.); (J.C.-M.)
| | - Laura Fernández-Puerta
- Valencia Clinic University Hospital, 46010 Valencia, Spain;
- Department of Health Sciences, European University of Valencia, 46010 Valencia, Spain
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11
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Beranek P, Dunican IC, Cruickshank T, Turner M. Better sleep hygiene is associated with better sleep health in mining shift workers in Australia. J Sleep Res 2025:e14457. [PMID: 39794917 DOI: 10.1111/jsr.14457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 12/17/2024] [Accepted: 12/18/2024] [Indexed: 01/13/2025]
Abstract
Australia's mine sites are largely situated in remote locations and operate around the clock. Many shift workers fly to site, where they work 12-hr shifts and sleep in camp accommodation before they return home for the period rostered off work. Mining shift workers experience poor sleep, yet limited research is available on contributing factors. This study investigated, for the first time, the relationship between the sleep health and sleep hygiene in this population. A survey was disseminated to shift workers in the mining industry, utilising a cross-sectional study design. The Sleep Health Index and Sleep Hygiene Index questionnaires were used to evaluate their sleep health and sleep hygiene, respectively. In total, 470 shift workers (mean age [years]: 39 ± 12, mean body mass index [kg m-2]: 28 ± 5) were included, which involved 132 females. Average scores for the Sleep Health Index and Sleep Hygiene Index were 76 ± 15 and 30 ± 7, respectively. Better sleep health was observed in shift workers with better sleep hygiene (β = -0.52, SE = 0.09 [-0.71, -0.34], p < 0.001). Differences in Sleep Health Index scores were found for individual Sleep Hygiene Index items related to "sleep regularity", "sleep environment", "mental health" and "time in bed extension". However, no differences in Sleep Health Index scores were found for items related to "caffeine, alcohol or nicotine consumption" or "exercise" close to bedtime and "bedtime activities" (p > 0.05 for all). These findings demonstrate a relationship between sleep hygiene and sleep health; therefore, it may be possible to improve the sleep of shift workers by improving their sleep hygiene.
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Affiliation(s)
- Philipp Beranek
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Ian C Dunican
- Centre for Sleep Science, School of Human Sciences, The University of Western Australia, Crawley, Western Australia, Australia
- Melius Consulting, Mount Hawthorn, Western Australia, Australia
| | - Travis Cruickshank
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
- Perron Institute for Neurological and Translational Sciences, Perth, Western Australia, Australia
| | - Mitchell Turner
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- Centre for Precision Health, Edith Cowan University, Joondalup, Western Australia, Australia
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12
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Vallières A, Pappathomas A, Garnier SDB, Mérette C, Carrier J, Paquette T, Bastien CH. Behavioural therapy for shift work disorder improves shift workers' sleep, sleepiness and mental health: A pilot randomised control trial. J Sleep Res 2024; 33:e14162. [PMID: 38443322 PMCID: PMC11596990 DOI: 10.1111/jsr.14162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 01/22/2024] [Indexed: 03/07/2024]
Abstract
The present study evaluates the efficacy of behavioural therapy adapted for shift work disorder with a randomised control design in a healthcare population. Forty-three night shift workers (m. age: 34 years; 77% women) experiencing shift work disorder were randomised to either the behavioural therapy for shift work disorder (BT-SWD) or a waiting-list control group offered after the waiting period. Participants completed questionnaires on insomnia, sleepiness and mental health pre- and post-treatment, pre- and post-waiting, and at follow-up, and a sleep diary. As night shift workers alternate between sleeping during the day after their night shifts and transitioning to nighttime sleep on days off, insomnia severity and sleep variables were analysed for daytime and nighttime sleep. The BT-SWD involved sleep restriction therapy, stimulus control and fixed sleep periods in the dark. Statistical analyses were performed under intent-to-treat and per-protocol approaches. Repeated-measures two-way ANCOVA analysis, controlling for age, sex and pre-treatment daytime total sleep time, was performed with Bonferroni corrections, and between-group effect sizes computed. Fourteen participants dropped out after randomisation. Under the intent-to-treat analysis, BT-SWD participants had a significant greater decrease in daytime insomnia severity and an increase in daytime total sleep time at post-treatment than the control group, with large between-group effect sizes (-1.25 and 0.89). These corresponding results were also significant with large effect sizes under the per-protocol analysis. Sleepiness, anxiety and depression levels improved at post-treatment and maintained at follow-up when the BT-SWD treated controls were added to the BT-SWD group. The behavioural therapy for shift work disorder can be used to improve the sleep and mental health of healthcare night workers.
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Affiliation(s)
- Annie Vallières
- École de psychologieUniversité LavalQuébecQuébecCanada
- Centre de recherche CERVOQuébecQuébecCanada
- Centre de recherche du Centre hospitalier universitaire de Québec‐Université LavalQuébecQuébecCanada
| | - Alric Pappathomas
- École de psychologieUniversité LavalQuébecQuébecCanada
- Centre de recherche CERVOQuébecQuébecCanada
- Centre de recherche du Centre hospitalier universitaire de Québec‐Université LavalQuébecQuébecCanada
| | | | - Chantal Mérette
- Centre de recherche CERVOQuébecQuébecCanada
- Département de psychiatrie et de neurosciences, Faculté de médecineUniversité LavalQuébecQuébecCanada
| | - Julie Carrier
- Département de psychologieUniversité de MontréalMontréalQuébecCanada
- Centre d'étude avancée en médecine du sommeil, CIUSSS‐NIMMontréalQuébecCanada
| | - Tyna Paquette
- Centre d'étude avancée en médecine du sommeil, CIUSSS‐NIMMontréalQuébecCanada
| | - Célyne H. Bastien
- École de psychologieUniversité LavalQuébecQuébecCanada
- Centre de recherche CERVOQuébecQuébecCanada
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13
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Ell J, Brückner HA, Johann AF, Steinmetz L, Güth LJ, Feige B, Järnefelt H, Vallières A, Frase L, Domschke K, Riemann D, Lehr D, Spiegelhalder K. Digital cognitive behavioural therapy for insomnia reduces insomnia in nurses suffering from shift work disorder: A randomised-controlled pilot trial. J Sleep Res 2024; 33:e14193. [PMID: 38485134 PMCID: PMC11596998 DOI: 10.1111/jsr.14193] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/14/2024] [Accepted: 02/23/2024] [Indexed: 11/28/2024]
Abstract
Insomnia is a primary symptom of shift work disorder, yet it remains undertreated. This randomised-controlled pilot trial examined the efficacy of a digital, guided cognitive behavioural therapy for insomnia adapted to shift work (SleepCare) in nurses with shift work disorder. The hypothesis was that SleepCare reduces insomnia severity compared with a waitlist control condition. A total of 46 unmedicated nurses suffering from shift work disorder with insomnia (age: 39.7 ± 12.1 years; 80.4% female) were randomised to the SleepCare group or the waitlist control group. The primary outcome measure was the Insomnia Severity Index. Other questionnaires on sleep, mental health and occupational functioning, sleep diary data and actigraphy data were analysed as secondary outcomes. Assessments were conducted before (T0), after the intervention/waitlist period (T1), and 6 months after treatment completion (T2). The SleepCare group showed a significant reduction in insomnia severity from T0 to T1 compared with the control condition (β = -4.73, SE = 1.12, p < 0.001). Significant improvements were observed in sleepiness, dysfunctional beliefs about sleep, pre-sleep arousal, sleep effort, self-reported sleep efficiency and sleep onset latency. No significant effect was found in actigraphy data. Depressive and anxiety symptoms, cognitive irritation and work ability improved significantly. Overall, satisfaction and engagement with the intervention was high. SleepCare improved insomnia severity, sleep, mental health and occupational functioning. This is the first randomised-controlled trial investigating the efficacy of digital cognitive behavioural therapy for insomnia in a population suffering from shift work disorder with insomnia. Future research should further explore these effects with larger sample sizes and active control conditions.
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Affiliation(s)
- Johanna Ell
- Department of Psychiatry and Psychotherapy, Faculty of MedicineMedical Centre ‐ University of Freiburg, University of FreiburgFreiburgGermany
| | - Hanna A. Brückner
- Department of Health Psychology and Applied Biological PsychologyLeuphana University of LüneburgLüneburgGermany
| | - Anna F. Johann
- Department of Psychiatry and Psychotherapy, Faculty of MedicineMedical Centre ‐ University of Freiburg, University of FreiburgFreiburgGermany
- Institute of Medical Psychology and Medical Sociology, Faculty of MedicineUniversity of FreiburgFreiburgGermany
| | - Lisa Steinmetz
- Department of Psychiatry and Psychotherapy, Faculty of MedicineMedical Centre ‐ University of Freiburg, University of FreiburgFreiburgGermany
| | - Lara J. Güth
- Department of PsychologyUniversity of FreiburgFreiburgGermany
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Faculty of MedicineMedical Centre ‐ University of Freiburg, University of FreiburgFreiburgGermany
| | - Heli Järnefelt
- Finnish Institute of Occupational Health (FIOH)HelsinkiFinland
| | - Annie Vallières
- École de psychologieUniversité Laval QuébecQuébecQuebecCanada
- Centre de recherche CERVOQuébecQuebecCanada
- Centre de recherche du CHU de Québec‐Université LavalQuébecQuebecCanada
| | - Lukas Frase
- Department of Psychiatry and Psychotherapy, Faculty of MedicineMedical Centre ‐ University of Freiburg, University of FreiburgFreiburgGermany
- Department of Psychosomatic Medicine and Psychotherapy, Faculty of MedicineMedical Centre ‐ University of Freiburg, University of FreiburgFreiburgGermany
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Faculty of MedicineMedical Centre ‐ University of Freiburg, University of FreiburgFreiburgGermany
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Faculty of MedicineMedical Centre ‐ University of Freiburg, University of FreiburgFreiburgGermany
- Faculty of Medicine, Center for Basics in NeuroModulation (NeuroModulBasics)University of FreiburgFreiburgGermany
| | - Dirk Lehr
- Department of Health Psychology and Applied Biological PsychologyLeuphana University of LüneburgLüneburgGermany
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Faculty of MedicineMedical Centre ‐ University of Freiburg, University of FreiburgFreiburgGermany
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14
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Bello AT, Sarafian MH, Wimborne EA, Middleton B, Revell VL, Raynaud FI, Chowdhury NR, van der Veen DR, Skene DJ, Swann JR. Exposing 24-hour cycles in bile acids of male humans. Nat Commun 2024; 15:10014. [PMID: 39562795 PMCID: PMC11576969 DOI: 10.1038/s41467-024-53673-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 10/17/2024] [Indexed: 11/21/2024] Open
Abstract
Bile acids are trans-genomic molecules arising from the concerted metabolism of the human host and the intestinal microbiota and are important for digestion, energy homeostasis and metabolic regulation. While diurnal variation has been demonstrated in the enterohepatic circulation and the gut microbiota, existing human data are poorly resolved, and the influence of the host circadian system has not been determined. Using entrained laboratory protocols, we demonstrate robust daily rhythms in the circulating bile acid pool in healthy male participants. We identify temporal relationships between bile acids and plasma lipids and show that these relationships are lost following sleep deprivation. We also highlight that bile acid rhythmicity is predominantly lost when environmental timing cues are held constant. Here we show that the environment is a stronger determinant of these temporal dynamics than the intrinsic circadian system of the host. This has significance for the intimate relationship between circadian timing and metabolism.
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Affiliation(s)
- Adesola T Bello
- Section of Nutrition, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | | | - Elizabeth A Wimborne
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Benita Middleton
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Victoria L Revell
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
- Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
| | - Florence I Raynaud
- Centre for Cancer Drug Discovery, Division of Cancer Therapeutics, The Institute of Cancer Research, London, UK
| | - Namrata R Chowdhury
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Daan R van der Veen
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Debra J Skene
- Chronobiology Section, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Jonathan R Swann
- Section of Nutrition, Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
- School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
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15
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Zhang Y, Murphy A, Lammers-van der Holst HM, Barger LK, Duffy JF. Night Shift Work and Sleep Experiences in Older Night Shift Nurses. West J Nurs Res 2024:1939459241299779. [PMID: 39535119 DOI: 10.1177/01939459241299779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
BACKGROUND Working at night leads to misalignment between the biological clock and the work/sleep schedule, resulting in sleepiness and impaired performance during the night shift and poor quality, shortened sleep during the day; this is greatly impaired in older individuals. OBJECTIVE To describe night work and sleep experiences from the perspective of older (aged 50-65) nurses. METHODS Seven virtual focus groups were formed comprising 19 older nurses who worked regular 8-hour night shifts (at least 6 consecutive hours between midnight and 6 am) to learn about their shift work and sleep experiences. Two facilitators and 2 research assistants independently reviewed and coded the transcripts using qualitative content analysis. RESULTS Nine themes were identified in 3 domains: (a) night shift challenges and difficulties, including first night shift is most difficult; never feel rested working nights; and personal health concerns and benefits from working nights; (b) sleep challenges and difficulties, including inconsistent sleep timing when switching between nights and days; extended (24+ hours) time awake before and after consecutive nights; difficulty maintaining long and sound daytime sleep; and napping before night shifts for better performance; and (c) family and social challenges and support, including childcare, family, personal obligations, and social activities affect sleep; aging of self and children influences sleep and prioritization of sleep. CONCLUSIONS The findings help understand challenges and struggles to obtain adequate sleep and safe work performance in older night shift nurses. These insignts are critical for designing and implementing feasible and acceptable interventions to improve sleep in this high-risk occupational group.
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Affiliation(s)
- Yuan Zhang
- Zuckerberg College of Health Sciences, Solomont School of Nursing, University of Massachusetts Lowell, Lowell, MA, USA
| | - Audra Murphy
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Laura K Barger
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Jeanne F Duffy
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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16
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Varma P, Rahman SA. Lighting the path forward: the value of sleep- and circadian-informed lighting interventions in shift work. Sleep 2024; 47:zsae214. [PMID: 39301963 PMCID: PMC11543622 DOI: 10.1093/sleep/zsae214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Indexed: 09/22/2024] Open
Affiliation(s)
- Prerna Varma
- School of Psychological Sciences, Monash University, Melbourne, VIC, Australia
| | - Shadab A Rahman
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
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17
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Tahmasian M, Küppers V. The toll of 24/7 societal demands: the brain health risks of shift work. Sleep 2024; 47:zsae134. [PMID: 38878293 PMCID: PMC11381559 DOI: 10.1093/sleep/zsae134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/10/2024] Open
Affiliation(s)
- Masoud Tahmasian
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Center Jülich, Jülich, Germany
- Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
- Institute of Systems Neuroscience, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
| | - Vincent Küppers
- Institute of Neuroscience and Medicine, Brain and Behaviour (INM-7), Research Center Jülich, Jülich, Germany
- Department of Nuclear Medicine, University Hospital and Medical Faculty, University of Cologne, Cologne, Germany
- Institute of Systems Neuroscience, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University, Düsseldorf, Germany
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18
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Yoshioka T, So R, Funada S, Tsutsumi S, Nakaya T, Okubo R, Minami T, Tabuchi T. Association of night-shift work with gambling and problem gambling among workers in Japan: A nationwide cross-sectional study. Addict Behav 2024; 156:108071. [PMID: 38805772 DOI: 10.1016/j.addbeh.2024.108071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/24/2024] [Accepted: 05/20/2024] [Indexed: 05/30/2024]
Abstract
BACKGROUND AND AIMS Night-shift work disturbs sleep and is associated with poor health conditions among workers. We aimed to investigate the association between night-shift work and gambling among workers and the association between night-shift work and problem gambling in working and gambling participants. METHODS This cross-sectional study used data from an online survey conducted between February 6 and 27, 2023 in Japan. A total of 21,134 workers participated in this study, including 9,739 respondents who had gambled in the past year. We estimated the association between night-shift work and gambling among workers and the association between night-shift work and problem gambling among those who gambled at the survey. We defined problem gambling as a score ≥ 8 on the Problem Gambling Severity Index. All estimates were weighted using a nationally representative survey in Japan. We fitted multivariable weighted logistic regression models after adjusting for 14 confounders. RESULTS The weighted prevalence of gambling among non-night and night-shift workers was 42.1 % and 55.4 %, respectively. When focusing on workers gambling in the survey, the prevalence of problem gambling among non-night and night-shift workers was 8.8 % and 24.2 %, respectively. The weighted multivariable logistic regression analyses showed that night-shift work was associated with gambling participation among workers (adjusted odds ratio [aOR], 1.39, 95 % confidence interval [CI] 1.25-1.53, p < 0.001). In addition, night-shift work was associated with problem gambling among those who gambled (aOR 1.94, 95 % CI 1.57-2.40, p < 0.001). CONCLUSIONS Night-shift work was associated with gambling among workers and with problem gambling among those who gambled.
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Affiliation(s)
- Takashi Yoshioka
- Health Technology Assessment Unit, Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan; Institute of Clinical Epidemiology, Showa University, Tokyo, Japan.
| | - Ryuhei So
- Department of Psychiatry, Okayama Psychiatric Medical Center, Okayama, Japan; CureApp, Inc., Tokyo, Japan
| | - Satoshi Funada
- Health Technology Assessment Unit, Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Shiori Tsutsumi
- Graduate School of Health Management, Keio University, Kanagawa, Japan; Department of Drug Dependence Research, National Institute of Mental Health, Tokyo, Japan
| | - Tomoki Nakaya
- Graduate School of Environmental Studies, Tohoku University, Miyagi, Japan
| | - Ryo Okubo
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Hokkaido, Japan
| | - Tetsuji Minami
- Division of Quality Assurance Programs, Institute for Cancer Control, National Cancer Center, Tokyo, Japan
| | - Takahiro Tabuchi
- Division of Epidemiology, School of Public Health, Tohoku University Graduate School of Medicine, Miyagi, Japan; Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan; The Tokyo Foundation for Policy Research, Tokyo, Japan
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19
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Tu Z, He J, Ji X, Zhai Q, Tian J. A latent profile analysis of shift work tolerance among Chinese male sailors during a prolonged non-24-h rotating shift schedule at sea. Chronobiol Int 2024; 41:1176-1188. [PMID: 39132867 DOI: 10.1080/07420528.2024.2387017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Revised: 07/15/2024] [Accepted: 07/27/2024] [Indexed: 08/13/2024]
Abstract
Shift work tolerance (SWT) refers to the ability to adapt to shift work without significant adverse consequences. The present study aimed to examine the individual differences in SWT and their predictors and outcomes. Latent profile analyses were conducted using cross-sectional data collected form 448 Chinese male sailors who experienced a prolonged (>30 d) non-24-h rotating shift schedule at sea. Depression, anxiety, sleep disturbance, fatigue, domestic disruption, job satisfaction, work engagement, digestive and cardiovascular symptoms were included as indicators of SWT. The results showed that there existed 2 latent profiles of SWT named as High SWT group and Low SWT group. High SWT group was characterized by low levels on all negative bio-psycho-social outcomes but high levels of work engagement and job satisfaction, while Low SWT group exhibited completely opposite characteristics compared to High SWT group. The level of hardiness could predict profile membership that those with higher level of hardiness were more likely to belong to High SWT group. However, there were no significant differences observed in job performance between two groups. In conclusion, hardiness can serve as a predictor of personnel selection for shift work and hardiness-based intervention programs should be encouraged among the shift workers.
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Affiliation(s)
- Zhihao Tu
- Navy Medical Center, Naval Medical University, Shanghai, China
- Department of Psychology, Qingdao Special Servicemen Recuperation Center of PLA Navy, Qingdao, China
- Department of General Medicine, the First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Jingwen He
- Department of Psychology, Naval Medical University, Shanghai, China
| | - Xin Ji
- Navy Medical Center, Naval Medical University, Shanghai, China
| | - Qin Zhai
- Navy Medical Center, Naval Medical University, Shanghai, China
| | - Jianquan Tian
- Navy Medical Center, Naval Medical University, Shanghai, China
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20
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Megha KB, Arathi A, Shikha S, Alka R, Ramya P, Mohanan PV. Significance of Melatonin in the Regulation of Circadian Rhythms and Disease Management. Mol Neurobiol 2024; 61:5541-5571. [PMID: 38206471 DOI: 10.1007/s12035-024-03915-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024]
Abstract
Melatonin, the 'hormone of darkness' is a neuronal hormone secreted by the pineal gland and other extra pineal sites. Responsible for the circadian rhythm and seasonal behaviour of vertebrates and mammals, melatonin is responsible for regulating various physiological conditions and the maintenance of sleep, body weight and the neuronal activities of the ocular sites. With its unique amphiphilic structure, melatonin can cross the cellular barriers and elucidate its activities in the subcellular components, including mitochondria. Melatonin is a potential scavenger of oxygen and nitrogen-reactive species and can directly obliterate the ROS and RNS by a receptor-independent mechanism. It can also regulate the pro- and anti-inflammatory cytokines in various pathological conditions and exhibit therapeutic activities against neurodegenerative, psychiatric disorders and cancer. Melatonin is also found to show its effects on major organs, particularly the brain, liver and heart, and also imparts a role in the modulation of the immune system. Thus, melatonin is a multifaceted candidate with immense therapeutic potential and is still considered an effective supplement on various therapies. This is primarily due to rectification of aberrant circadian rhythm by improvement of sleep quality associated with risk development of neurodegenerative, cognitive, cardiovascular and other metabolic disorders, thereby enhancing the quality of life.
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Affiliation(s)
- K B Megha
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum, 695 012, Kerala, India
| | - A Arathi
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum, 695 012, Kerala, India
| | - Saini Shikha
- CSIR-Institute of Microbial Technology, Sector 39-A, Chandigarh, 160036, India
| | - Rao Alka
- CSIR-Institute of Microbial Technology, Sector 39-A, Chandigarh, 160036, India
- Academy of Scientific and Innovation Research (AcSIR), Ghaziabad, 201002, India
| | - Prabhu Ramya
- P.G. Department of Biotechnology, Government Arts College, Trivandrum, 695 014, India
| | - P V Mohanan
- Toxicology Division, Biomedical Technology Wing, Sree Chitra Tirunal Institute for Medical Sciences and Technology (Govt. of India), Poojapura, Trivandrum, 695 012, Kerala, India.
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Vallières A, Crawford MR. Changing the organizational work schedule of shift workers leads to improved sleep-an editorial. Sleep 2024; 47:zsae103. [PMID: 38682541 PMCID: PMC11236944 DOI: 10.1093/sleep/zsae103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Indexed: 05/01/2024] Open
Affiliation(s)
- Annie Vallières
- École de psychologie, Université Laval, Québec, QC, Canada
- Centre de recherche CERVO, Québec, QC, Canada
- Centre de recherche du CHU de Québec-Université Laval, Québec, QC, Canada
| | - Megan R Crawford
- Strathclyde Centre for Sleep Health, Department of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
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22
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Elliott J, Hodges C, Boots M, Pattinson R, Gillen E, Whybrow D, Bundy C. Mixed shift rotations, sleep, burnout and well-being in professions similar to radiographers: A systematic review. Radiography (Lond) 2024; 30:1194-1200. [PMID: 38901073 DOI: 10.1016/j.radi.2024.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 05/23/2024] [Accepted: 05/30/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION Delivering 24 h healthcare requires rotational shift work from doctors and the medical imaging team, while contributing to safe and timely care of patients. Additional service pressure and staff shortfall leads to workload pressures, adjusted shift patterns and risk of burnout. Evidence should be sought to the effects of this work on staff. METHODS This systematic review followed PRISMA reporting guidelines, using a convergent mixed methods approach according to Guidance from Joanna Briggs International. Quantitative trends and results were qualified in order to thematically analyse in conjunction with qualitative data and discussed together in context. Following initial searching, returned articles were screened by title and abstract. A team of 3 reviewers undertook blinded critical appraisal of those suitable, with quality assurance from a 4th team member. Papers passing a threshold of 75% on JBI appraisal tools were accepted for synthesis. Data extraction of appropriate articles retrieved was undertaken in parallel. RESULTS Following screening and critical appraisal, 13 studies were returned focusing exclusively on Non Consultant Doctors. No studies investigated diagnostic radiographers. 85% (n = 11) reported negative association between shift work and the three themes of sleep/fatigue, burnout and wellbeing: including after the introduction of shift pattern control or adjusted shift patterns. The remainder showed no change, or any improvement nullified by countermeasures to maintain service delivery. CONCLUSION Current working practices and shift plans in the target population showed detrimental effects on the participants - this can be suggested that Diagnostic Radiographers may suffer fatigue, burnout and poor mental health from stretched shift working patterns. IMPLICATIONS FOR PRACTICE Further study into the effects of shift work on Diagnostic Radiographers and other allied health professionals is indicated - relating to the above themes in the context of errors and patient safety. Additional research into Non Consultant Doctors, shift work effects and the context of wider service delivery required; with suitable interventions and education to maximise understanding of legal working practices, monitoring and self-management of symptoms.
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23
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Duong HA, Baba K, DeBruyne JP, Davidson AJ, Ehlen C, Powell M, Tosini G. Environmental circadian disruption re-writes liver circadian proteomes. Nat Commun 2024; 15:5537. [PMID: 38956413 PMCID: PMC11220080 DOI: 10.1038/s41467-024-49852-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/21/2024] [Indexed: 07/04/2024] Open
Abstract
Circadian gene expression is fundamental to the establishment and functions of the circadian clock, a cell-autonomous and evolutionary-conserved timing system. Yet, how it is affected by environmental-circadian disruption (ECD) such as shiftwork and jetlag are ill-defined. Here, we provided a comprehensive and comparative description of male liver circadian gene expression, encompassing transcriptomes, whole-cell proteomes and nuclear proteomes, under normal and after ECD conditions. Under both conditions, post-translation, rather than transcription, is the dominant contributor to circadian functional outputs. After ECD, post-transcriptional and post-translational processes are the major contributors to whole-cell or nuclear circadian proteome, respectively. Furthermore, ECD re-writes the rhythmicity of 64% transcriptome, 98% whole-cell proteome and 95% nuclear proteome. The re-writing, which is associated with changes of circadian regulatory cis-elements, RNA-processing and protein localization, diminishes circadian regulation of fat and carbohydrate metabolism and persists after one week of ECD-recovery.
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Affiliation(s)
- Hao A Duong
- Department of Pharmacology and Toxicology, Morehouse School of Medicine, Atlanta, GA, 30310, USA.
- Department of Neurobiology, Morehouse School of Medicine, Atlanta, GA, 30310, USA.
| | - Kenkichi Baba
- Department of Pharmacology and Toxicology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
- Department of Neurobiology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
| | - Jason P DeBruyne
- Department of Pharmacology and Toxicology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
- Department of Neurobiology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
| | - Alec J Davidson
- Department of Neurobiology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
| | - Christopher Ehlen
- Department of Neurobiology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
| | - Michael Powell
- Department of Microbiology, Biochemistry and Immunology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
| | - Gianluca Tosini
- Department of Pharmacology and Toxicology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
- Department of Neurobiology, Morehouse School of Medicine, Atlanta, GA, 30310, USA
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24
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Suriá-Martínez R, García-Castillo F, López-Sánchez C, Villegas E, Carretón C. Online Games and Cognitive Distortions: A Comparative Analysis in Students with and without Disabilities. Eur J Investig Health Psychol Educ 2024; 14:1868-1880. [PMID: 39056638 PMCID: PMC11276528 DOI: 10.3390/ejihpe14070123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 06/13/2024] [Accepted: 06/19/2024] [Indexed: 07/28/2024] Open
Abstract
Online games have experienced significant growth in recent years, with gaming becoming a popular form of entertainment for people of all ages. However, their impact on cognition, especially among vulnerable groups such as students with disabilities, is a topic that requires deeper exploration. The objectives of this study are twofold: firstly, to understand the typology of risk players (non-risk players, players with problems, and pathological players); and secondly, to compare cognitive distortions among students with problematic profiles. Both objectives will be analyzed based on the presence or absence of disability. A total of 704 students from various Spanish universities (135 with disabilities and 569 without disabilities), aged between 18 and 38, participated in the study by completing the Gamblers Belief Questionnaire (GBQ), aimed at measuring cognitive distortions related to gambling problems, as well as the Massachusetts Gambling Screen questionnaire, aimed at measuring gambling addiction. The results indicate a higher percentage of students with disabilities showing a greater risk profile for addiction. Additionally, this group of students exhibits more cognitive distortions. These findings underscore the need for a comprehensive approach to addressing online gaming addiction and cognitive distortions among university students, with and without disabilities. Preventive measures are necessary, such as education on responsible technology use and the promotion of alternative activities. Moreover, specific intervention strategies need to be developed, including access to psychological health services for this student population.
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Affiliation(s)
- Raquel Suriá-Martínez
- Department of Comunication and Social Psychology, Universidad de Alicante, 03690 San Vicente del Raspeig, Spain; (C.L.-S.); (C.C.)
| | | | - Carmen López-Sánchez
- Department of Comunication and Social Psychology, Universidad de Alicante, 03690 San Vicente del Raspeig, Spain; (C.L.-S.); (C.C.)
| | - Esther Villegas
- Department of Social Work and Social Affairs, Universidad de Alicante, 03690 San Vicente del Raspeig, Spain;
| | - Carmen Carretón
- Department of Comunication and Social Psychology, Universidad de Alicante, 03690 San Vicente del Raspeig, Spain; (C.L.-S.); (C.C.)
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Chen S, Liu Q, Yan J. The influence of shift work: A bibliometric analysis of research progress and frontiers on health effects. Chronobiol Int 2024; 41:577-586. [PMID: 38588406 DOI: 10.1080/07420528.2024.2337885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
Shift work has been found to disrupt the circadian system, leading to negative health effects. The objective of this study was to assess the progress and frontiers in research on the health-related influence of shift work. The study analyzed 3,696 data points from Web of Science, using the bibliometric software CiteSpace to visualize and analyze the field. The results showed a steady increase in annual publications, particularly in the last 5 years, with a rapid increase in publications from China. The United States contributed the most to the number of publications and worldwide collaborations. The most prolific institution and author were the Brigham and Women's Hospital and Professor Bjorn Bjorvatn, respectively. The Journal of Chronobiology International ranked at the top and focused primarily on shift worker research. In the first decade of study, the primary focus was on the associations between shift work and cardiovascular disease and metabolic disorders. Over time, research on the health effects of shift work has expanded to include cancer and mental health, with subsequent studies investigating molecular mechanisms. This study provides a comprehensive and intuitive analysis of the negative health impacts of shift work. It highlights existing research hotspots and provides a roadmap for future studies. Further research is needed to explore the adverse health consequences and related mechanisms of shift work exposure, as well as interventions to mitigate its health effects.
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Affiliation(s)
- Shibo Chen
- Department of Blood Purification Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qingquan Liu
- Department of Blood Purification Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Nephrology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jianjun Yan
- Department of Blood Purification Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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26
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Cavanaugh D, Urbanucci A, Mohamed NE, Tewari AK, Figueiro M, Kyprianou N. Link between circadian rhythm and benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS). Prostate 2024; 84:417-425. [PMID: 38193363 PMCID: PMC10922447 DOI: 10.1002/pros.24656] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/21/2023] [Accepted: 12/08/2023] [Indexed: 01/10/2024]
Abstract
BACKGROUND Benign prostatic hyperplasia (BPH) is the most common urologic disease in aging males, affecting 50% of men over 50 and up to 80% of men over 80 years old. Its negative impact on health-related quality of life implores further investigation into its risk factors and strategies for effective management. Although the exact molecular mechanisms underlying pathophysiological onset of BPH are poorly defined, the current hypothesized contributors to BPH and lower urinary tract symptoms (LUTS) include aging, inflammation, metabolic syndrome, and hormonal changes. These processes are indirectly influenced by circadian rhythm disruption. In this article, we review the recent evidence on the potential association of light changes/circadian rhythm disruption and the onset of BPH and impact on treatment. METHODS A narrative literature review was conducted using PubMed and Google Scholar to identify supporting evidence. The articles referenced ranged from 1975 to 2023. RESULTS A clear relationship between BPH/LUTS and circadian rhythm disruption is yet to be established. However, common mediators influence both diseases, including proinflammatory states, metabolic syndrome, and hormonal regulation that can be asserted to circadian disruption. Some studies have identified a possible relationship between general LUTS and sleep disturbance, but little research has been done on the medical management of these diseases and how circadian rhythm disruption further affects treatment outcomes. CONCLUSIONS There is evidence to implicate a relationship between BPH/LUTS and circadian rhythm disruptions. However, there is scarce literature on potential specific link in medical management of the disease and treatment outcomes with circadian rhythm disruption. Further study is warranted to provide BPH patients with insights into circadian rhythm directed appropriate interventions.
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Affiliation(s)
- Dana Cavanaugh
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Tisch Cancer Institute at Mount Sinai, New York, NY, USA
| | - Alfonso Urbanucci
- Prostate Cancer Research Center, Faculty of Medicine and Health Technology and FiCanMid, Tampere University, Tampere, Finland
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, Oslo, Norway
| | - Nihal E. Mohamed
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Tisch Cancer Institute at Mount Sinai, New York, NY, USA
| | - Ashutosh K. Tewari
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Tisch Cancer Institute at Mount Sinai, New York, NY, USA
| | - Mariana Figueiro
- Tisch Cancer Institute at Mount Sinai, New York, NY, USA
- Light and Health Research Center, Department of Population Health Science and Policy, Mount Sinai Health, New York, NY, USA
| | - Natasha Kyprianou
- Department of Urology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Tisch Cancer Institute at Mount Sinai, New York, NY, USA
- Department of Oncological Sciences, Icahn School of medicine at Mount Sinai, New York, NY, USA
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27
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Moreno-Cortés ML, Meza-Alvarado JE, García-Mena J, Hernández-Rodríguez A. Chronodisruption and Gut Microbiota: Triggering Glycemic Imbalance in People with Type 2 Diabetes. Nutrients 2024; 16:616. [PMID: 38474745 PMCID: PMC10934040 DOI: 10.3390/nu16050616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 01/27/2024] [Accepted: 01/28/2024] [Indexed: 03/14/2024] Open
Abstract
The desynchronization of physiological and behavioral mechanisms influences the gut microbiota and eating behavior in mammals, as shown in both rodents and humans, leading to the development of pathologies such as Type 2 diabetes (T2D), obesity, and metabolic syndrome. Recent studies propose resynchronization as a key input controlling metabolic cycles and contributing to reducing the risk of suffering some chronic diseases such as diabetes, obesity, or metabolic syndrome. In this analytical review, we present an overview of how desynchronization and its implications for the gut microbiome make people vulnerable to intestinal dysbiosis and consequent chronic diseases. In particular, we explore the eubiosis-dysbiosis phenomenon and, finally, propose some topics aimed at addressing chronotherapy as a key strategy in the prevention of chronic diseases.
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Affiliation(s)
- María Luisa Moreno-Cortés
- Laboratorio de Biomedicina, Instituto de Investigaciones Biológicas, Universidad Veracruzana, Xalapa 91190, Veracruz, Mexico;
| | | | - Jaime García-Mena
- Departamento de Genética y Biología Molecular, Cinvestav, Av. Instituto Politécnico Nacional 2508, CDMX 07360, Mexico;
| | - Azucena Hernández-Rodríguez
- Laboratorio de Biomedicina, Instituto de Investigaciones Biológicas, Universidad Veracruzana, Xalapa 91190, Veracruz, Mexico;
- Facultad de Bioanálisis, Universidad Veracruzana, Xalapa 91010, Veracruz, Mexico
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Reynolds AC, Loffler KA, Grivell N, Brown BW, Adams RJ. Diagnosis and management of sleep disorders in shift workers, with patient informed solutions to improve health services research and practice. Sleep Med 2024; 113:131-141. [PMID: 38016359 DOI: 10.1016/j.sleep.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND The combination of shift work and an unmanaged sleep disorder carries health and safety risks. Yet, diagnosis rates for sleep disorders are low in shift workers. The aim of this study was to understand the experience of sleep disorder diagnosis and treatment in shift workers, and consider patient informed solutions to improve access to health services. METHODS Semi-structured interviews were conducted with 16 Australian shift workers with a diagnosed sleep disorder. Patient journey mapping and reflexive thematic analysis were used to understand diagnosis and management experiences. RESULTS There were highly variable experiences with diagnosis and management, often taking >5 years to seek help from a health care provider (HCP) after noticing symptoms of a sleep disorder. Three themes were constructed, including 'the cause of the problem', 'prioritising work', and '(dis)satisfaction and (dis)connection'. Extent of patient and HCP awareness of sleep disorders, and a prevailing attitude of shift work being 'the problem' impacted diagnosis, as did organisational needs (including rostering, which had both positive and negative influences on help seeking). Relationships with HCPs were important, and living on non-standard time was both a barrier and an enabler to sleep disorder care. Participants identified the need for education and awareness, prompts and easy access to screening and referral pathways, and tailored models of care. CONCLUSION Education and awareness initiatives for shift workers, their employers and HCPs, together with development of a model of care for shift workers with sleep disorders may address some of the unique barriers to diagnosis and management.
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Affiliation(s)
- Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia.
| | - Kelly A Loffler
- Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia; Health Data and Clinical Trials, Flinders University, Bedford Park, SA, Australia
| | - Nicole Grivell
- Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Brandon Wj Brown
- Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Robert J Adams
- Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
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Boersma GJ, Mijnster T, Vantyghem P, Kerkhof GA, Lancel M. Shift work is associated with extensively disordered sleep, especially when working nights. Front Psychiatry 2023; 14:1233640. [PMID: 38161719 PMCID: PMC10755475 DOI: 10.3389/fpsyt.2023.1233640] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/17/2023] [Indexed: 01/03/2024] Open
Abstract
Background Shift work is generally associated with working and sleeping out of phase with the endogenous, circadian sleep-wake cycle. This exerts detrimental effects on sleep health. The present study aimed at evaluating the presence of short and long sleep as well as sleep disorders within a broad range of shift work schedules and elucidating the role of sociodemographic factors therein. Methods A large dataset containing information on sleep was collected through advertisement in a Belgium newspaper (De Standaard). Adult, working individuals were selected (n = 37,662) and categorized based on their work schedule (regular day, early morning, evening, night, and rotating shift). In this cross-sectional study, prevalence rates of short sleep (≤6 h), long sleep (≥9 h) and sleep disorders (screened with Holland Sleep Disorders Questionnaire), and associations between these sleep variables and sociodemographics (age, sex, education, living companion(s)) were analyzed using binominal logistic regression analyses. Results In the total sample all sociodemographic factors affected prevalences of short, long and disordered sleep, consistent with previous studies. Compared to day workers, shift workers more frequently reported short sleep, most prominently night workers (26 vs. 50%) (p < 0.001). Furthermore, all sleep disorders as well as sleep disorder comorbidity were more common in shift workers, again most pronounced in night workers (all p < 0.05). In night shift workers the level of education had the strongest associations with disturbed sleep with a two-fold higher prevalence of short and disordered sleep in low relative to academic educated groups (all p < 0.02). Conclusion Shift work is related not only to curtailed sleep and shift work disorder, but also to a plethora of sleep disorders, including insomnia, sleep-related breathing disorders and sleep-related movement disorders. Our findings imply that education on coping strategies may be especially important for young and/or lower educated shift workers.
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Affiliation(s)
- G. J. Boersma
- Forensic Psychiatric Hospital, GGZ Drenthe Mental Health Institute, Assen, Netherlands
| | - T. Mijnster
- Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe Mental Health Institute, Assen, Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - P. Vantyghem
- De Standaard (Daily Newspaper), Mediahuis, Brussels, Belgium
| | - G. A. Kerkhof
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
- Sleep Disorders Center, Haaglanden Medical Center (HMC), The Hague, Netherlands
| | - Marike Lancel
- Forensic Psychiatric Hospital, GGZ Drenthe Mental Health Institute, Assen, Netherlands
- Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe Mental Health Institute, Assen, Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
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30
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Papantoniou K, Konrad P, Haghayegh S, Strohmaier S, Eliassen AH, Schernhammer E. Rotating Night Shift Work, Sleep, and Thyroid Cancer Risk in the Nurses' Health Study 2. Cancers (Basel) 2023; 15:5673. [PMID: 38067376 PMCID: PMC10705158 DOI: 10.3390/cancers15235673] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/27/2023] [Accepted: 11/28/2023] [Indexed: 02/12/2024] Open
Abstract
Night shift work has been associated with breast, prostate, and colorectal cancer, but evidence on other types of cancer is limited. We prospectively evaluated the association of rotating night shift work, sleep duration, and sleep difficulty with thyroid cancer risk in the Nurses' Health Study 2 (NHS2). We assessed rotating night shift work duration (years) at baseline and throughout follow-up (1989-2015) and sleep characteristics in 2001. Cox proportional hazard models, adjusted for potential confounders, were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for (a) shift work duration, (b) sleep duration, and (c) difficulty falling or staying asleep. We stratified the analyses of night shift work by sleep duration and sleep difficulty. Over 26 years of follow-up, 588 incident cases were identified among 114,534 women in the NHS2 cohort. We observed no association between night shift work and the risk of thyroid cancer. Difficulty falling or staying asleep was suggestively associated with a higher incidence of thyroid cancer when reported sometimes (HR 1.26, 95% CI 0.95, 1.66) and all or most of the time (HR 1.35, 95% CI 1.00, 1.81). Night shift workers (10+ years) with sleep difficulty all or most of the time (HR 1.47; 0.58-3.73) or with >7 h of sleep duration (HR 2.17; 95% CI, 1.21-3.92) had a higher risk of thyroid cancer. We found modest evidence for an increased risk of thyroid cancer in relation to sleep difficulty, which was more pronounced among night shift workers.
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Affiliation(s)
- Kyriaki Papantoniou
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
| | - Peter Konrad
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
| | - Shahab Haghayegh
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA; (S.H.); (A.H.E.)
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
| | - A. Heather Eliassen
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA; (S.H.); (A.H.E.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria; (P.K.); (S.S.); (E.S.)
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Department of Medicine, Harvard Medical School, Boston, MA 02115, USA; (S.H.); (A.H.E.)
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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31
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Huang Y, Zhang H, Qin Z, Zou Y, Feng Z, Cheng J. The impact of meaning in life and professional happiness on the turnover intention of health care workers: a cross-sectional study from China. HUMAN RESOURCES FOR HEALTH 2023; 21:92. [PMID: 38012739 PMCID: PMC10680312 DOI: 10.1186/s12960-023-00878-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/16/2023] [Indexed: 11/29/2023]
Abstract
INTRODUCTION The turnover and shortage of health care workers (HCWs) have been a worldwide problem for healthcare organizations. The primary aim of this study was to identify the factors influencing the intention of Chinese HCWs to leave their job, especially meaning in life and professional happiness. METHODS This observational cross-sectional study, conducted among 1125 full-time HCWs, assessed demographic variables, meaning in life, professional happiness, and turnover intention by a survey. The survey was distributed to HCWs in three tertiary hospitals. The data were analyzed by T-tests, ANOVA, Kruskal-Wallis tests and hierarchical linear regression model. RESULTS There were statistically significant differences in turnover intention of HCWs by gender, age, role, educational level, years in practice, and number of monthly night shifts. HCWs' meaning in life and professional happiness were negatively associated with the turnover intention. Furthermore, after controlling for other factors, meaning in life explained 3.7% of the turnover intention and professional happiness explained 13.4%. CONCLUSION In our study, positive psychological factors were related to turnover intentions. Professional happiness was the strongest predictor. Thus, health human resource managers should foster positive psychology among HCWs to reduce their turnover.
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Affiliation(s)
- Yuting Huang
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Huilin Zhang
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zuming Qin
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Ying Zou
- Clinical Nursing Teaching and Research Section, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- School of Nursing, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Zhiling Feng
- Trade Union, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Jiao Cheng
- Youth League Committee, Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
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32
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He SK, Wang JH, Li T, Yin S, Cui JW, Xiao YF, Tang Y, Wang J, Bai YJ. Sleep and circadian rhythm disturbance in kidney stone disease: a narrative review. Front Endocrinol (Lausanne) 2023; 14:1293685. [PMID: 38089624 PMCID: PMC10711275 DOI: 10.3389/fendo.2023.1293685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 11/08/2023] [Indexed: 12/18/2023] Open
Abstract
The circadian rhythm generated by circadian clock genes functions as an internal timing system. Since the circadian rhythm controls abundant physiological processes, the circadian rhythm evolved in organisms is salient for adaptation to environmental change. A disturbed circadian rhythm is a trigger for numerous pathological events. Recently, accumulated data have indicated that kidney stone disease (KSD) is related to circadian rhythm disturbance. However, the mechanism between them has not been fully elucidated. In this narrative review, we summarized existing evidence to illustrate the possible association between circadian rhythm disturbance and KSD based on the epidemiological studies and risk factors that are linked to circadian rhythm disturbance and discuss some chronotherapies for KSD. In summary, KSD is associated with systemic disorders. Metabolic syndrome, inflammatory bowel disease, and microbiome dysbiosis are the major risk factors supported by sufficient data to cause KSD in patients with circadian rhythm disturbance, while others including hypertension, vitamin D deficiency, parathyroid gland dysfunction, and renal tubular damage/dysfunction need further investigation. Then, some chronotherapies for KSD were confirmed to be effective, but the molecular mechanism is still unclear.
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Affiliation(s)
- Si-Ke He
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jia-Hao Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Li
- Department of Urology, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Shan Yin
- Department of Urology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Jian-Wei Cui
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yun-Fei Xiao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yin Tang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Jia Wang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Yun-Jin Bai
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
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Kim SY, Lee KH, Lee HY, Jeon JE, Park CW, Shin J, Seo MC, Jeon S, Kim SJ, Lee YJ. Circadian misalignment alters resting-state functional connectivity of the salience network in rotating shift workers. Sleep 2023; 46:zsad237. [PMID: 37682120 DOI: 10.1093/sleep/zsad237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/14/2023] [Indexed: 09/09/2023] Open
Abstract
STUDY OBJECTIVES This study compared resting-state functional connectivity (rsFC) of the salience network (SN) between rotating shift workers (RSWs) and controls. Furthermore, we examined whether rsFC of the SN was correlated with sleep, emotion, cognition, and attention. METHODS The 60 RSWs and 57 controls enrolled in this study completed self-report questionnaires and sleep diaries to assess subjective sleep quality, and polysomnography and actigraphy to evaluate objective sleep and 24-hour rest-activity rhythm parameters. The participants also underwent resting-state functional magnetic resonance imaging and structural T1 scans. We performed a seed-based rsFC analysis of the SN using the anterior cingulate cortex (ACC) and anterior insula (AI) as seed regions. Furthermore, AI and ACC rsFC were compared in RSWs and controls, and we analyzed correlations between rsFC and variables of interest showing significant group differences. RESULTS Compared with controls, RSWs showed reduced rsFC between the ACC and right insula, and increased rsFC of the ACC with the left occipital lobe and right superior frontal gyrus extending to the supplementary motor area (SFG/SMA). Moreover, RSWs showed reduced rsFC between the right AI and right superior parietal lobule (SPL). Finally, rsFC between the ACC and right AI was correlated with 24-hour rest-activity rhythmicity. CONCLUSIONS Although RSWs did not show sleep disturbance, emotional distress, cognitive impairment, or attention deficits, alterations of right insula, left occipital lobe, right SFG/SMA, and right SPL rsFC in the SN indicate that impairments in salience detection and top-down attentional control may emerge in shift workers over time.
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Affiliation(s)
- Sun-Young Kim
- Department of Psychiatry, Ewha Womans University College of Medicine, Ewha Womans University Seoul Hospital, Seoul, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ha Young Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jeong Eun Jeon
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Cho Won Park
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jiyoon Shin
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Cheol Seo
- Department of Psychiatry, Veteran Health Service Medical Center, Seoul, Republic of Korea
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, Republic of Korea
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Kalkanis A, Demolder S, Papadopoulos D, Testelmans D, Buyse B. Recovery from shift work. Front Neurol 2023; 14:1270043. [PMID: 38020633 PMCID: PMC10651732 DOI: 10.3389/fneur.2023.1270043] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
One fifth of today's workforce is engaged in shift work and exposed to various mental and physical health risks including shift work disorder. Efficiently recovering from shift work through physical and mental interventions allows us to mitigate negative effects on health, enables a better work-life balance and enhances our overall wellbeing. The aim of this review is to provide a state-of-the-art overview of the available literature. The role of sleep timing and naps, light therapy and psychotherapy, diet and exercise in recovery from shift work is presented here. We further review the impact of shift schedules and social support on post-shift unwinding.
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Affiliation(s)
- Alexandros Kalkanis
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Saartje Demolder
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Dimitrios Papadopoulos
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
| | - Dries Testelmans
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Laboratory of Respiratory Disease and Thoracic Surgery (BREATH), KU Leuven-University, Leuven, Belgium
| | - Bertien Buyse
- Department of Respiratory Diseases, Louvain University Center for Sleep and Wake Disorders (LUCS), University Hospitals Leuven, KU Leuven, Leuven, Belgium
- Laboratory of Respiratory Disease and Thoracic Surgery (BREATH), KU Leuven-University, Leuven, Belgium
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Kwon S, Lee Y, Seo E, Kim D, Lee J, Jeong Y, Kim J, Jeong J, Lee W. Association between shift work and the risk of hypothyroidism in adult male workers in Korea: a cohort study. Ann Occup Environ Med 2023; 35:e41. [PMID: 38029275 PMCID: PMC10654535 DOI: 10.35371/aoem.2023.35.e41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/30/2023] [Accepted: 10/06/2023] [Indexed: 12/01/2023] Open
Abstract
Background Shift work has been reported to have several harmful effects on the human body. However, a small number of studies have evaluated the association between shift work and adverse effects on the thyroid. In our longitudinal study, we examined the causal association between shift work and the risk of hypothyroidism. Methods A Kangbuk Samsung Cohort Study was conducted on 112,648 men without thyroid disease at baseline who were followed up at least once between 2012 and 2019. Shift work status and shift schedule types were categorized using standardized questionnaires. Hypothyroidism was defined using the reference ranges of serum thyroid-stimulating hormones and free thyroxine levels. Hazard ratios (HRs) and 95% confidence intervals (CIs) for incident hypothyroidism were estimated using Cox proportional hazards regression analyses with the daytime work group as the reference. Results During the 501,237 person-years of follow-up, there were 6,306 incident cases of hypothyroidism (incidence density, 1.26 per 100 person-years). The multivariable-adjusted HR of incident hypothyroidism for the shift work total group that included all shifts compared with the daytime work group was 1.27 (95% CI: 1.15-1.40). For the fixed evening, fixed night, rotating shift, and other shift workers, the multivariable-adjusted HRs (95% CI) were 1.11 (0.76-1.61), 2.18 (1.20-3.93), 1.39 (1.23-1.56), and 1.00 (0.82-1.22), respectively. In subgroup analyses by age, the association between shift work and hypothyroidism was more pronounced in younger participants (< 40 years; HR: 1.31; 95% CI: 1.16-1.47). Conclusions Our large-scale cohort study showed an association between shift work and the incidence of hypothyroidism, especially in younger workers with night shifts.
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Affiliation(s)
- Seonghyeon Kwon
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yesung Lee
- Medical Support Division, Pyeongchang Country Public Health Clinic, Pyeongchang, Korea
| | - Eunhye Seo
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Daehoon Kim
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jaehong Lee
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Youshik Jeong
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jihoon Kim
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jinsook Jeong
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Woncheol Lee
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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36
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Zhang Y, Murphy J, Lammers-van der Holst HM, Barger LK, Lai YJ, Duffy JF. Interventions to improve the sleep of nurses: A systematic review. Res Nurs Health 2023; 46:462-484. [PMID: 37710916 PMCID: PMC10539041 DOI: 10.1002/nur.22337] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2023] [Revised: 08/03/2023] [Accepted: 08/18/2023] [Indexed: 09/16/2023]
Abstract
Nurses are at a high risk for short sleep duration and poor sleep quality due to irregular work schedules and high occupational stress. Considering the effect of nurses' sleep on the safety and health of themselves and their patients, it is important to promote healthy sleep for nurses. We sought to synthesize the published experimental and quasi-experimental studies that address interventions to improve sleep in nurses. A systematic search was conducted for studies published in English up until May 15, 2023, using the databases PubMed, CINAHL, Academic Search Ultimate, and PsycINFO. In total, 38 articles were included, covering 22 experimental and 16 quasi-experimental studies with sample sizes ranging from 9 to 207. Studies were assessed using the Cochrane Risk of Bias tool and considered as low to medium quality. Thirty-six of the 38 studies reported positive findings for at least one sleep outcome. Intervention types included aroma therapy, dietary supplements, cognitive behavioral therapy, light therapy, mind-body therapy, sleep education, exercise, napping, shift schedule modification, and multicomponent intervention, all of which showed moderate effectiveness in promoting sleep outcomes of nurses. Comparing and contrasting studies on specific interventions for improving sleep in nurses is sparse and often equivocal. With the variations of research methodology and outcome measures, it is difficult to make a conclusion about each intervention's effectiveness on specific sleep outcomes. Additional high-quality research, including randomized controlled trials, is needed to evaluate strategies for improving sleep in this unique, safety-sensitive occupational group.
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Affiliation(s)
- Yuan Zhang
- Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA 01854
| | - Jennifer Murphy
- Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA 01854
| | | | - Laura K. Barger
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115
| | - Yun-Ju Lai
- Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA 01854
| | - Jeanne F. Duffy
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA 02115
- Division of Sleep Medicine, Harvard Medical School, Boston, MA 02115
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Streng AA, Van Dycke KCG, van Oostrom CTM, Salvatori DCF, Hulsegge G, Chaves I, Roenneberg T, Zander SAL, van Steeg H, van der Horst GTJ, van Kerkhof LWM. Impact of Simulated Rotating Shift Work on Mammary Tumor Development in the p53R270H©/+WAPCre Mouse Model for Breast Cancer. J Biol Rhythms 2023; 38:476-491. [PMID: 37357746 DOI: 10.1177/07487304231178340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Epidemiological studies associate night shift work with increased breast cancer risk. However, the underlying mechanisms are not clearly understood. To better understand these mechanisms, animal models that mimic the human situation of different aspects of shift work are needed. In this study, we used "timed sleep restriction" (TSR) cages to simulate clockwise and counterclockwise rotating shift work schedules and investigated predicted sleep patterns and mammary tumor development in breast tumor-prone female p53R270H©/+WAPCre mice. We show that TSR cages are effective in disturbing normal activity and estimated sleep patterns. Although circadian rhythms were not shifted, we observed effects of the rotating schedules on sleep timing and sleep duration. Sleep loss during a simulated shift was partly compensated after the shift and also partly during the free days. No effects were observed on body weight gain and latency time of breast cancer development. In summary, our study shows that the TSR cages can be used to model shift work in mice and affect patterns of activity and sleep. The effect of disturbing sleep patterns on carcinogenesis needs to be further investigated.
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Affiliation(s)
- Astrid A Streng
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Kirsten C G Van Dycke
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Conny T M van Oostrom
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Daniela C F Salvatori
- Experimental Pathology Services Lab, Central Laboratory Animal Facility, Leiden University Medical Center, Leiden, The Netherlands
- Department of Clinical Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands
| | - Gerben Hulsegge
- Sustainable Productivity and Employability, Netherlands Organization for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Inês Chaves
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Till Roenneberg
- Institute of Medical Psychology, Ludwig-Maximilians-University, Munich, Germany
| | - Serge A L Zander
- Experimental Pathology Services Lab, Central Laboratory Animal Facility, Leiden University Medical Center, Leiden, The Netherlands
| | - Harry van Steeg
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
| | - Gijsbertus T J van der Horst
- Department of Molecular Genetics, Erasmus MC Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Linda W M van Kerkhof
- Centre for Health Protection, National Institute for Public Health and the Environment (RIVM), Bilthoven, The Netherlands
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Mia S, Sonkar R, Williams L, Latimer MN, Rawnsley DR, Rana S, He J, Dierickx P, Kim T, Xie M, Habegger KM, Kubo M, Zhou L, Thomsen MB, Prabhu SD, Frank SJ, Brookes PS, Lazar MA, Diwan A, Young ME. Novel Roles for the Transcriptional Repressor E4BP4 in Both Cardiac Physiology and Pathophysiology. JACC Basic Transl Sci 2023; 8:1141-1156. [PMID: 37791313 PMCID: PMC10543917 DOI: 10.1016/j.jacbts.2023.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 10/05/2023]
Abstract
Circadian clocks temporally orchestrate biological processes critical for cellular/organ function. For example, the cardiomyocyte circadian clock modulates cardiac metabolism, signaling, and electrophysiology over the course of the day, such that, disruption of the clock leads to age-onset cardiomyopathy (through unknown mechanisms). Here, we report that genetic disruption of the cardiomyocyte clock results in chronic induction of the transcriptional repressor E4BP4. Importantly, E4BP4 deletion prevents age-onset cardiomyopathy following clock disruption. These studies also indicate that E4BP4 regulates both cardiac metabolism (eg, fatty acid oxidation) and electrophysiology (eg, QT interval). Collectively, these studies reveal that E4BP4 is a novel regulator of both cardiac physiology and pathophysiology.
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Affiliation(s)
- Sobuj Mia
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Ravi Sonkar
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Lamario Williams
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Mary N. Latimer
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - David R. Rawnsley
- Departments of Medicine, Cell Biology and Physiology, Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Samir Rana
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jin He
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Pieterjan Dierickx
- Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Teayoun Kim
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Min Xie
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kirk M. Habegger
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Masato Kubo
- Research Institute for Biomedical Science, Tokyo University of Science, Chiba, Japan
- Laboratory for Cytokine Regulation, RIKEN Center for Integrative Medical Sciences (IMS), RIKEN Yokohama Institute, Kanagawa, Japan
| | - Lufang Zhou
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Morten B. Thomsen
- Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Demark
| | - Sumanth D. Prabhu
- Departments of Medicine, Cell Biology and Physiology, Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Stuart J. Frank
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
- Endocrinology Section, Birmingham VAMC Medical Service, Birmingham, Alabama, USA
| | - Paul S. Brookes
- Department of Anesthesiology and Perioperative Medicine, University of Rochester, Rochester, New York, USA
| | - Mitchell A. Lazar
- Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Division of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Abhinav Diwan
- Departments of Medicine, Cell Biology and Physiology, Obstetrics and Gynecology, Washington University School of Medicine, St. Louis, Missouri, USA
- John Cochran VA Medical Center, St. Louis, Missouri, USA
| | - Martin E. Young
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
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Amiri S. Sleep quality and sleep-related issues in industrial workers: a global meta-analysis. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:154-167. [PMID: 34970939 DOI: 10.1080/10803548.2021.2024376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objectives. Sleep-related issues are important health issues. This study aimed to investigate the global prevalence of sleep-related issues in industrial workers. Methods. A syntax of keywords was used to search the PubMed, Web of Science and Scopus databases. The search time was limited to articles published until September 2020, and the search range was in English. Events and samples were extracted for each study to calculate the prevalence. For all subgroups, events and samples were extracted to calculate the results of the subgroups. The random-effects method was used in the analysis. Heterogeneity was examined at the levels of all analyses. Results. Forty-eight articles were included in the analysis as eligible studies. Sleep-related issues have 30% prevalence in the 95% confidence interval (CI) [25, 35%]. The prevalence of sleep-related issues in men was 38%, 95% CI [31, 45%] and in women was 32%, 95% CI [14, 50%]. The prevalence of poor sleep quality, insomnia, sleep duration <7 h, snoring and sleepiness was 36, 22, 37, 29 and 10%, respectively. Conclusions. Sleep-related issues have a high prevalence in industrial workers, and the cause of these differences needs to be addressed and increasing insights provided to prevent and treat sleep disorders.
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Affiliation(s)
- Sohrab Amiri
- Medicine, Quran and Hadith Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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40
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Gilavand A. Investigating the effectiveness of employing clinical faculty members in the shift work system during the Covid-19 pandemic in Iran: A cross-sectional study. Health Sci Rep 2023; 6:e1010. [PMID: 36570343 PMCID: PMC9771857 DOI: 10.1002/hsr2.1010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/10/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
Introduction Having an accurate attitude about shift work and choosing the right people to work in the shift work system increases organizational productivity and improves the employees' life quality. Consequently, the current research investigates the effectiveness of employing clinical faculty members in the shift work system during the Covid-19 pandemic. Materials and Methods In this descriptive study, 71 Iranian clinical faculty members with a history of shift work (night shift) during the Covid-19 pandemic participated. Circadian Type Inventory (CTI) was used to collect data. Results Based on the results of this research (Flexible/Rigid = Mean ± SD = 2.47 ± 18.17) and (Languid/Vigorous = Mean ± SD = 2.89 ± 15.35) which revealed that although clinical faculty members in normal conditions can overcome the feeling of sleepiness due to lack of sleep, they are not flexible and cannot work in the shift work system with the ability to stay awake at unusual times of the day or night. Pearson's correlation coefficient test also showed that as the value of the Languid/Vigorous component increases, the value of the Flexible/Rigid component also increases (r = 0.410). Likewise, there was no significant relationship between the main research variables and demographic characteristics. Discussion and Conclusion Clinical faculty members who are simultaneously responsible for the duties of teaching students, research, and treating patients, if they are employed in a shift work system, especially during the pandemic, it may lead to a decrease in the quality of teaching, lack of motivation in research and indifference toward students' affairs, reducing flexibility, inability to update what they have learned in the professional world, increasing medical errors and also reducing their ability to manage the class. Consequently, it is suggested to avoid using them in the shift work systems as much as possible.
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Affiliation(s)
- Abdolreza Gilavand
- Department of Education Development CenterAhvaz Jundishapur University of Medical SciencesAhvazIran
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Alcohol Mixed with Energy Drinks (AmED) Use among University Students: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14234985. [PMID: 36501015 PMCID: PMC9737502 DOI: 10.3390/nu14234985] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/10/2022] [Accepted: 11/20/2022] [Indexed: 11/25/2022] Open
Abstract
In the last decades, there has been a huge increase in the consumption of both Energy Drinks (EDs) and alcohol and, concurrently, these two trends generated the additional practice of mixing ED with alcohol, known as Alcohol mixed with Energy Drink (AmED). One of the most important group of AmED consumers is represented by young. Indeed, the study population of the researches in this field are mainly represented by college students and the results evidence a great range of negative consequences for health. The purpose of the systematic review was to explore the prevalence of AmED consumption among undergraduate students, together with motivations to their use, adverse effects and health-related behaviors associated to AmEDs use. The review was conducted according to the PRISMA Statement and PubMed, Scopus and Web of Science were interrogated. 42 articles, published from 2008 to 2021, were included in the review. An overall prevalence rate of 37% was estimated for AmEDs use in undergraduates, with geographical differences. Although a decrease in consumption was observed throughout the studied period, a continuous monitoring on this phenomenon is needed for identifying those risk groups that could develop risky behaviors related to AmEDs consumption and provide them targeted educational interventions.
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42
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Taylor DJ, Dietch JR, Wardle-Pinkston S, Slavish DC, Messman B, Ruggero CJ, Kelly K. Shift Work Disorder Index: initial validation and psychosocial associations in a sample of nurses. J Clin Sleep Med 2022; 18:2339-2351. [PMID: 35702020 PMCID: PMC9516570 DOI: 10.5664/jcsm.10108] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/02/2022] [Accepted: 05/02/2022] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Shift work is common yet does not always result in Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5)-defined shift work sleep disorder (SWD). This study reports on the reliability and validity of the DSM-5 informed Shift Work Disorder Index (SWDI), the presence of probable SWD in nurses, and demographic, sleep, and psychosocial correlates. METHODS Nurses (n = 454) completed the SWDI, psychosocial, and demographic questionnaires. Of the sample, n = 400 completed 14 days of sleep diaries, actigraphy, and additional questionnaires. RESULTS The global SWDI demonstrated excellent internal consistency (α = .94), as well as good convergent and divergent validity in the nurse sample. Thirty-one percent of nurses were past-month shift workers, with 14% (ie, 44% of shift workers) having probable SWD based on SWDI. Nurses who worked shift work and/or met SWD criteria were more likely to be younger and unmarried and less likely to have children than day workers and reported greater evening chronotype, insomnia, nightmares, and sleep-related impairment, greater depression, anxiety, posttraumatic stress, and perceived stress symptoms, as well as later and more variable sleep midpoint (actigraphy), shorter sleep duration (actigraphy, diaries), and lower sleep efficiency (diaries). CONCLUSIONS The SWDI is an efficient and valid self-report assessment of DSM-5-defined SWD. Shift work and/or SWD were prevalent and associated with worse sleep and psychosocial health, particularly among nurses with probable SWD. CITATION Taylor DJ, Dietch JR, Wardle-Pinkston S, et al. Shift Work Disorder Index: initial validation and psychosocial associations in a sample of nurses. J Clin Sleep Med. 2022;18(10):2339-2351.
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Affiliation(s)
- Daniel J. Taylor
- Department of Psychology, University of North Texas, Denton, Texas
- Department of Psychology, University of Arizona, Tucson, Arizona
| | - Jessica R. Dietch
- Department of Psychology, University of North Texas, Denton, Texas
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, California
- School of Psychological Science, Oregon State University, Corvallis, Oregon
| | - Sophie Wardle-Pinkston
- Department of Psychology, University of North Texas, Denton, Texas
- Department of Psychology, University of Arizona, Tucson, Arizona
| | | | - Brett Messman
- Department of Psychology, University of North Texas, Denton, Texas
| | | | - Kimberly Kelly
- Department of Psychology, University of North Texas, Denton, Texas
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Meyer N, Harvey AG, Lockley SW, Dijk DJ. Circadian rhythms and disorders of the timing of sleep. Lancet 2022; 400:1061-1078. [PMID: 36115370 DOI: 10.1016/s0140-6736(22)00877-7] [Citation(s) in RCA: 137] [Impact Index Per Article: 45.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 03/20/2022] [Accepted: 05/05/2022] [Indexed: 02/06/2023]
Abstract
The daily alternation between sleep and wakefulness is one of the most dominant features of our lives and is a manifestation of the intrinsic 24 h rhythmicity underlying almost every aspect of our physiology. Circadian rhythms are generated by networks of molecular oscillators in the brain and peripheral tissues that interact with environmental and behavioural cycles to promote the occurrence of sleep during the environmental night. This alignment is often disturbed, however, by contemporary changes to our living environments, work or social schedules, patterns of light exposure, and biological factors, with consequences not only for sleep timing but also for our physical and mental health. Characterised by undesirable or irregular timing of sleep and wakefulness, in this Series paper we critically examine the existing categories of circadian rhythm sleep-wake disorders and the role of the circadian system in their development. We emphasise how not all disruption to daily rhythms is driven solely by an underlying circadian disturbance, and take a broader, dimensional approach to explore how circadian rhythms and sleep homoeostasis interact with behavioural and environmental factors. Very few high-quality epidemiological and intervention studies exist, and wider recognition and treatment of sleep timing disorders are currently hindered by a scarcity of accessible and objective tools for quantifying sleep and circadian physiology and environmental variables. We therefore assess emerging wearable technology, transcriptomics, and mathematical modelling approaches that promise to accelerate the integration of our knowledge in sleep and circadian science into improved human health.
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Affiliation(s)
- Nicholas Meyer
- Insomnia and Behavioural Sleep Medicine Clinic, University College London Hospitals NHS Foundation Trust, London, UK; Department of Psychosis Studies, Institute of Psychology, Psychiatry, and Neuroscience, King's College London, London, UK
| | - Allison G Harvey
- Department of Psychology, University of California, Berkeley, CA, USA
| | - Steven W Lockley
- Division of Sleep and Circadian Disorders, Department of Medicine and Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Surrey Sleep Research Centre, Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK
| | - Derk-Jan Dijk
- Surrey Sleep Research Centre, Department of Clinical and Experimental Medicine, University of Surrey, Guildford, UK; UK Dementia Research Institute, Care Research and Technology Centre, Imperial College London and the University of Surrey, Guildford, UK.
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Declercq I, Van Den Eede F, Roelant E, Verbraecken J. SHIFTPLAN: a randomized controlled trial investigating the effects of a multimodal shift-work intervention on drivers' fatigue, sleep, health, and performance parameters. Trials 2022; 23:662. [PMID: 35978435 PMCID: PMC9382013 DOI: 10.1186/s13063-022-06573-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 07/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Shift work is commonly associated with health problems resulting from circadian misalignment and sleep restriction. About one in three shift workers is affected by insomnia and up to 90% report regular fatigue and/or sleepiness at the workplace. Epidemiological data shows that shift workers are at increased risk of cardiovascular disease, diabetes, obesity, breast cancer, mental-health problems, and shift-work disorder, which conditions typically lead to reduced work performance, processing errors, accidents at work, absenteeism, and reduced quality of life. Given these widespread and debilitating consequences, there is an urgent need for treatments that help improve the sleep, health, and functional performance of the shift-working population. The most common non-pharmacological recommendations are improved scheduling, bright-light exposure, napping, psychoeducation promoting sleep hygiene, and cognitive-behavioral techniques. The objectives of the present study are to investigate the effects of a multimodal shift-work intervention on perceived fatigue, sleepiness, physical and mental health, sleep parameters, and absenteeism. METHODS A randomized controlled interventional study comparing the two groups each comprising at least 80 drivers of a public transport company, using self-report questionnaires and health checks completed at intake and after 3 and 6 months following the start of the intervention or waiting-list period. The intervention consists of (a) healthy scheduling taking into account shift-rotation direction and speed, chronotype, resting time, and napping; (b) an education program specifically developed for shift workers; and (c) a dedicated information campaign for shift planners. The primary outcome is symptomatic burden in terms of sleepiness, and the key secondary outcome is symptomatic burden in terms of fatigue. Supplementary secondary outcomes are sleep parameters, absenteeism, general and clinical health, changes in mood, and anxiety. DISCUSSION Expected outcomes are significant improvements on all primary and secondary outcome parameters in the intervention group. To our knowledge, ours is the first randomized controlled study to systematically investigate the effects of a multimodal program on multiple health, sleep, and performance parameters in shift workers. Our research also aims at providing evidence-based practice guidelines for healthy scheduling in general and thus contribute to diminishing the serious health and economic burdens associated with shift work overall. TRIAL REGISTRATION EDGE registration number: 000339. CLINICALTRIALS gov NCT05452096.
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Affiliation(s)
- Inge Declercq
- Multidisciplinary Sleep Disorders Center, Antwerp University Hospital (UZA), Drie Eikenstraat 655 - 2650, Edegem, Belgium.
| | - Filip Van Den Eede
- Department of Psychiatry, Antwerp University Hospital (UZA), Drie Eikenstraat 655 - 2650, Edegem, Belgium.,Collaborative Antwerp Psychiatric Research Institute (CAPRI), Faculty of Medicine and Health Sciences, University of Antwerp (UA), Universiteitsplein 1, 2610, Antwerp, Belgium
| | - Ella Roelant
- Clinical Trial Center (CTC), CRC Antwerp, Antwerp University Hospital (UZA), University of Antwerp, Edegem, Belgium
| | - Johan Verbraecken
- Multidisciplinary Sleep Disorders Center, Antwerp University Hospital (UZA), Drie Eikenstraat 655 - 2650, Edegem, Belgium.,Medical Coordinator Multidisciplinary Sleep Disorders Center (UZA), LEMP FGGW UA, Antwerp University Hospital (UZA), Drie Eikenstraat 655 - 2650, Edegem, Belgium
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45
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Lee J, Kim M, Kim N, Hwang Y, Lee KH, Lee J, Lee YJ, Kim SJ. Evidence of White Matter Integrity Changes in the Anterior Cingulum Among Shift Workers: A Cross-Sectional Study. Nat Sci Sleep 2022; 14:1417-1425. [PMID: 35996418 PMCID: PMC9392483 DOI: 10.2147/nss.s369192] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 08/03/2022] [Indexed: 12/02/2022] Open
Abstract
Introduction We investigated the white matter integrity in shift and non-shift workers and its associations with sleep and activity. Methods Diffusion tensor imaging (DTI) was performed on 61 shift workers and 31 non-shift workers. Their sleep and activity profiles were assessed using the Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and actigraphy. Fractional anisotropy (FA) (a measure of white matter integrity) was calculated using DTI tractography. Results Shift workers exhibited higher FA values in the bilateral anterior cingulum than did non-shift workers. An increased FA in the right anterior cingulum was correlated with poor sleep quality (ie, a high PSQI score) in shift workers. An increased FA in the right anterior cingulum was also correlated with higher actigraphic activity indices (the mesor and M10 indices) in shift workers. Discussion The white matter integrity of the anterior cingulum was altered in shift workers, perhaps in association with sleep and activity disturbances.
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Affiliation(s)
- Jiye Lee
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Minjeong Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Nambeom Kim
- Department of Biomedical Engineering Research Center, Gachon University, Incheon, Republic of Korea
| | - Yunjee Hwang
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Hwa Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University, College of Medicine and Hospital, Seoul, Republic of Korea
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jooyoung Lee
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University, College of Medicine and Hospital, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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46
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Bullock B, Learmonth C, Davis H, Al Mahmud A. Mobile phone sleep self-management applications for early start shift workers: A scoping review of the literature. Front Public Health 2022; 10:936736. [PMID: 36033744 PMCID: PMC9399454 DOI: 10.3389/fpubh.2022.936736] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/20/2022] [Indexed: 01/25/2023] Open
Abstract
Poor sleep has significant impacts on both mental and physical well-being. This is especially the case for shift workers who rely on good sleep practices to manage the disruption caused by their working conditions. In recent years there has been a proliferation of sleep-focused mobile phone applications, some of which may be suitable for use by shift workers. There is limited evidence however, on whether these applications are sufficient in managing the sleep needs of the early start shift working population (i.e., those whose work schedules begin pre-dawn). This scoping review aims to identify and discuss peer-reviewed literature on mobile sleep applications used by early start shift workers for sleep-self management. Four databases (Scopus, EBSCOhost, CINAHL and PsycInfo) were searched for relevant literature using a pre-determined search string. The initial search using the term early start shift work returned no papers, however a broadened search on shift work in general found 945 papers for title and abstract screening, of which 21 were deemed eligible for full text screening. Two of these papers met the inclusion criteria for this review. The results highlight, firstly, the paucity of research on the use of mobile phone applications for sleep self-management amongst early start shift workers, and secondly, the need for further research on the effectiveness of mobile applications for sleep self-management amongst shift workers in general. A working definition of early start shift work that can be used to stimulate research in this understudied population of shift workers is also proposed.
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Affiliation(s)
- Ben Bullock
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Caitlin Learmonth
- Centre for Social Impact, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Hilary Davis
- Centre for Social Impact, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Abdullah Al Mahmud
- Centre for Design Innovation, Swinburne University of Technology, Hawthorn, VIC, Australia
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Kjørstad K, Faaland PM, Sivertsen B, Kallestad H, Langsrud K, Vethe D, Vestergaard CL, Harris A, Pallesen S, Scott J, Vedaa Ø. Sleep and work functioning in nurses undertaking inpatient shifts in a blue-depleted light environment. BMC Nurs 2022; 21:187. [PMID: 35850690 PMCID: PMC9290304 DOI: 10.1186/s12912-022-00973-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/30/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Blue-depleted light environments (BDLEs) may result in beneficial health outcomes for hospital inpatients in some cases. However, less is known about the effects on hospital staff working shifts. This study aimed to explore the effects of a BDLE compared with a standard hospital light environment (STLE) in a naturalistic setting on nurses' functioning during shifts and sleep patterns between shifts. METHODS Twenty-five nurses recruited from St. Olavs Hospital in Trondheim, Norway, completed 14 days of actigraphy recordings and self-reported assessments of sleep (e.g., total sleep time/sleep efficiency) and functioning while working shifts (e.g., mood, stress levels/caffeine use) in two different light environments. Additionally, participants were asked to complete several scales and questionnaires to assess the symptoms of medical conditions and mental health conditions and the side effects associated with each light environment. RESULTS A multilevel fixed-effects regression model showed a within-subject increase in subjective sleepiness (by 17%) during evening shifts in the BDLE compared with the STLE (p = .034; Cohen's d = 0.49) and an 0.2 increase in number of caffeinated beverages during nightshifts in the STLE compared with the BDLE (p = .027; Cohen's d = 0.37). There were no significant differences on any sleep measures (either based on sleep diary data or actigraphy recordings) nor on self-reported levels of stress or mood across the two conditions. Exploratory between-group analyses of questionnaire data showed that there were no significant differences except that nurses working in the BDLE reported perceiving the lighting as warmer (p = .009) and more relaxing (p = .023) than nurses working in the STLE. CONCLUSIONS Overall, there was little evidence that the change in the light environment had any negative impact on nurses' sleep and function, despite some indication of increased evening sleepiness in the BDLE. We recommend further investigations on this topic before BDLEs are implemented as standard solutions in healthcare institutions and propose specific suggestions for designing future large-scale trials and cohort studies. TRIAL REGISTRATION The study was registered before data collection was completed on the ISRCTN website ( ISRCTN21603406 ).
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Affiliation(s)
- Kaia Kjørstad
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Patrick M Faaland
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway
| | - Børge Sivertsen
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes gt. 7, 5015, Bergen, Norway.,Department of Research and Innovation, Helse-Fonna, Haugesund, HF, Norway
| | - Håvard Kallestad
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway
| | - Knut Langsrud
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway
| | - Daniel Vethe
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway
| | - Cecilie L Vestergaard
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Optentia, The Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
| | - Jan Scott
- Institute of Neuroscience, Newcastle University, Newcastle upon Tyne, UK
| | - Øystein Vedaa
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway. .,Department of Research and Development, St. Olavs University Hospital, Trondheim, Norway. .,Department of Health Promotion, Norwegian Institute of Public Health, Zander Kaaes gt. 7, 5015, Bergen, Norway.
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Sunde E, Harris A, Nielsen MB, Bjorvatn B, Lie SA, Holmelid Ø, Vedaa Ø, Waage S, Pallesen S. Protocol for a systematic review and meta-analysis on the associations between shift work and sickness absence. Syst Rev 2022; 11:143. [PMID: 35842678 PMCID: PMC9287923 DOI: 10.1186/s13643-022-02020-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Shift work, i.e., non-standard work hours, has been associated with both short- and long-term sickness absence. However, findings are inconsistent and inconclusive. Thus far, no comprehensive meta-analytic synthesis on the relationship between shift work and sickness absence has been published. The aims of the planned systematic review and meta-analysis are (1) to establish whether shift work is associated with sickness absence, (2) to determine if specific shift work characteristics relate to sickness absence (e.g., length and frequency of spells), and (3) to identify moderating factors affecting the relationship between shift work and sickness absence. METHODS Eligible studies will be identified using a predefined search strategy in several electronic databases (MEDLINE, Web of Science, PsychInfo, EMBASE, and ProQuest) and comprise peer-reviewed papers reporting original empirical findings on the association between shift work and sickness absence. Mainly observational studies with cross-sectional, prospective, or retrospective research design and case-control studies will be included. Risk of bias will be assessed using an adapted checklist previously employed to evaluate studies on sickness absence. To carry out the meta-analytic synthesis, a random effects meta-analysis will be conducted using the Comprehensive Meta-Analysis software. The review and meta-analysis will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Heterogeneity will be evaluated by Cochran's Q test and the I2 statistics. DISCUSSION The review and meta-analysis will be the first to conduct a meta-analytic synthesis of the evidence on the association between exposure to shift work and sickness absence, as well as identify relevant moderators affecting the relationship between shift work and sickness absence. Aggregation of the existing evidence will improve the knowledge on the association between shift work and sickness absence. Such knowledge can be used to guide scheduling of shift work to promote work schedules that are less detrimental to health and contribute to reduced sickness absence and higher work- and leisure-time productivity. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42022301200.
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Affiliation(s)
- Erlend Sunde
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway.
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway
| | - Morten Birkeland Nielsen
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway.,Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Stein Atle Lie
- Department of Clinical Dentistry, University of Bergen, Bergen, Norway.,Norwegian National Advisory Unit on Arthroplasty and Hip Fractures, Haukeland University Hospital, Bergen, Norway
| | - Øystein Holmelid
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway
| | - Øystein Vedaa
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway.,Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Siri Waage
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Christies gt. 12, 5015, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Optentia, The Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
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Adane A, Getnet M, Belete M, Yeshaw Y, Dagnew B. Shift-work sleep disorder among health care workers at public hospitals, the case of Sidama national regional state, Ethiopia: A multicenter cross-sectional study. PLoS One 2022; 17:e0270480. [PMID: 35802698 PMCID: PMC9269933 DOI: 10.1371/journal.pone.0270480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 06/12/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Shift-work disrupts circadian rhythm, resulting in disturbed sleep time and excessive sleepiness during the work shift. Little is known about shift-work sleep disorder among health care workers in Ethiopia. This study examined the magnitude and associated factors of shift-work sleep disorder among health care workers in Public Hospitals in Sidama National Regional State, Southern Ethiopia. Methods An institution-based cross-sectional study was carried out on 398 health care workers selected using a systematic random sampling technique. A self-administered structured questionnaire consisting of insomnia, sleepiness scales and international classification of sleep disorder criteria items was employed. Epi data version 4.6 and Stata 14 were used for data entry and statistical analysis respectively. Binary logistic regression was fitted to determine associated factors and decision for the statistical significance was made at p<0.05 in the multivariable binary logistic regression. Results Three hundred and ninety-eight health care workers (female = 53%) were included in the analysis with a response rate of 94.8%. The prevalence of shift-work sleep disorder was 33.67% (95% CI: 29.17%-38.45%). Being married (AOR = 1.88 (1.01–3.28)), three-shift (AOR = 1.078 (1.00–3.16)), ≥11 night shifts per month (AOR = 2.44 (1.36–4.38)), missing nap (AOR = 1.85 (1.04–3.30)), daily sleep time < 7hours (AOR = 1.88 (1.05–3.38)), khat chewing (AOR = 2.98 (1.27–8.09)), alcohol drinking (AOR = 2.6(1.45–4.92)), and cigarette smoking (AOR = 3.32 (1.35–8.14)) were significantly associated with shift-work sleep disorder. Conclusion This study showed a high prevalence of shift-work sleep disorder. Two shift schedule, napping, and reduction of substance use might reduce shift-work sleep disorder.
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Affiliation(s)
- Adugnaw Adane
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
- * E-mail:
| | - Mihret Getnet
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mekonnen Belete
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Yigizie Yeshaw
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Baye Dagnew
- Department of Human Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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50
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Brown BWJ, Crowther ME, Appleton SL, Melaku YA, Adams RJ, Reynolds AC. Shift work disorder and the prevalence of help seeking behaviors for sleep concerns in Australia: A descriptive study. Chronobiol Int 2022; 39:714-724. [PMID: 35253569 DOI: 10.1080/07420528.2022.2032125] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Shift work disorder (SWD) is a circadian rhythm sleep-wake disorder, defined by symptoms of insomnia and excessive levels of sleepiness resulting from work that occurs during non-standard hours. Sleep problems are common in shift workers, yet our understanding of help seeking behaviours for sleep in shift workers is limited. The primary aim of this study was to examine the help seeking behaviours of Australian workers who meet criteria for SWD. Of the 448 (46% of sample, n = 964 total) Australian workers reporting non-standard work hours, 10.5% (n = 41) met the criteria for probable shift work disorder (pSWD). Non-standard workers with pSWD did not seek help for sleep problems at higher rates than workers without SWD. Of the small proportion of workers with pSWD who sought help, general practitioners were the most common healthcare professionals for sleep problems. Self-management was common in workers with pSWD, with a high self-reported prevalence of alcohol use (31.7%) as a sleep management strategy, and caffeine consumption (76.9%) as a sleepiness management strategy. The majority of individuals with pSWD reported the mentality of 'accept it and keep going' as a sleepiness management strategy, highlighting a potential barrier to help seeking behaviour in workers with pSWD. These findings provide novel insight into the help seeking behaviours of those with pSWD. There is a need for further research to understand why individuals at risk for SWD are not actively seeking help, and to develop health promotion and intervention strategies to improve help seeking when needed.
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Affiliation(s)
- Brandon W J Brown
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute of Sleep Health, Flinders University, Adelaide, Australia
| | | | - Sarah L Appleton
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute of Sleep Health, Flinders University, Adelaide, Australia
| | - Yohannes Adama Melaku
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute of Sleep Health, Flinders University, Adelaide, Australia
| | - Robert J Adams
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute of Sleep Health, Flinders University, Adelaide, Australia
| | - Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute of Sleep Health, Flinders University, Adelaide, Australia
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