Insomnia: Therapeutic Options for Women

Associations between night work and anxiety, depression, insomnia, sleepiness and fatigue in a sample of Norwegian nurses

Background

Night work has been reported to be associated with various mental disorders and complaints. We investigated relationships between night work and anxiety, depression, insomnia, sleepiness and fatigue among Norwegian nurses.

Methods

The study design was cross-sectional, based on validated self-assessment questionnaires. A total of 5400 nurses were invited to participate in a health survey through the Norwegian Nurses' Organization, whereof 2059 agreed to participate (response rate 38.1%). Nurses completed a questionnaire containing items on demographic variables (gender, age, years of experience as a nurse, marital status and children living at home), work schedule, anxiety/depression (Hospital Anxiety and Depression Scale), insomnia (Bergen Insomnia Scale), sleepiness (Epworth Sleepiness Scale) and fatigue (Fatigue Questionnaire). They were also asked to report number of night shifts in the last 12 months (NNL). First, the parameters were compared between nurses i) never working nights, ii) currently working nights, and iii) previously working nights, using binary logistic regression analyses. Subsequently, a cumulative approach was used investigating associations between NNL with the continuous scores on the same dependent variables in hierarchical multiple regression analyses.

Results

Nurses with current night work were more often categorized with insomnia (OR = 1.48, 95% CI = 1.10–1.99) and chronic fatigue (OR = 1.78, 95% CI = 1.02–3.11) than nurses with no night work experience. Previous night work experience was also associated with insomnia (OR = 1.45, 95% CI = 1.04–2.02). NNL was not associated with any parameters in the regression analyses.

Conclusion

Nurses with current or previous night work reported more insomnia than nurses without any night work experience, and current night work was also associated with chronic fatigue. Anxiety, depression and sleepiness were not associated with night work, and no cumulative effect of night shifts during the last 12 months was found on any parameters.

Distress, sleep difficulty, and fatigue in women co-infected with HIV and HPV

Women with HIV infection report elevated and persisting psychosocial distress, sleep difficulty, and fatigue. The objective of this study was to examine psychosocial distress, sleep difficulty, and fatigue in a group of lower socioeconomic status women co-infected with HIV and HPV (N = 60). After controlling for relevant health behavioral and medical variables, multiple regression analyses indicated that greater psychosocial distress was associated with greater fatigue (p < .01), as well as greater sleep difficulty (p < .01). Sleep difficulty partially mediated the relationship between distress and fatigue (Sobel test, z = 2.39, p = .02). Stress management and sleep-based cognitive behavioral intervention approaches may be useful for treating fatigue in these women, possibly through reductions in psychosocial distress and improvements in sleep quality.

Sleep disorders: causes, effects, and solutions

Until recently, sleep has been a mystery even to scientists. Research has defined sleep function and the effects of sleep deprivation. Sleep disorders are interrelated with medical and psychiatric illnesses. This article presents insomnia, jet lag, and shift work sleep disorders and reviews issues related to women's health and sleep. Pharmacologic and behavioral treatments for sleep conditions are explored.