Sleep and sleepiness in relation to stress and displaced work hours

A comparative analysis of sleep quality and time management skills between shift and non-shift police officers

PURPOSE

The sleep quality of police officers working in shifts is negatively affected due to long working hours and sleeping less during the day. In our study, we aimed to examine the differences in sleep quality and time management skills in police officers working with shift and non-shift system.

METHODS

106 police officers, 46 of whom worked in the shift system, 60 of whom worked in the non-shift system, and whose mean age was 27.6 ± 0.9 [min 20, max 40] were included in the study. Sleep quality was assessed with the Pittsburgh Sleep Quality Index[PSQI] and time management skills with the Time Management Questionnaire[TMQ].

RESULTS

While the TMQ total score was 80.91 ± 12.61 for police officers working in shifts, it was 72.41 ± 12.62 for police officers working non-shift. The PSQI total score was 5 in both groups. There was a difference between the TMQ time planning, TMQ time attitudes sub-dimensions, and TMQ total scores of police officers working in the shift system and those working in the non-shift system[p < 0.05]. While poor sleep quality was observed between both groups, there was no difference in sleep quality[p > 0.05].

CONCLUSION

There was no difference in sleep quality between police officers working in shifts and non-shifts. However, the time management skills of police officers working in shifts were better than those of police officers working in non-shifts. We believe that training programs to improve sleep health and time management skills in police officers are needed for both the sleep quality and well-being of police officers and public safety.

Job stressors in relation to burnout and compromised sleep among academic physicians in India

BACKGROUND

Burnout among physicians, especially in the academic setting, is an urgent concern, with adequate sleep one of the key focal points.

OBJECTIVE

To identify job stressors contributing to burnout and compromised sleep among academic physicians, using a comprehensive, theory-based instrument, the Occupational Stressor Index (OSI), whose specific form was created 'for physicians by physicians'.

METHODS

This parallel mixed-methods cross-sectional investigation was conducted among 109 physicians employed in a public teaching hospital, Jodhpur, India. Work conditions were evaluated by the physician-specific OSI (part I). The Copenhagen Burnout Index and Pittsburgh Sleep Quality Index (PSQI) were the outcome instruments (part II). Seventy-six physicians completed parts I and II.

RESULTS

The physicians were from wide-ranging specialties, and 82% of the cohort were residents. Mean total OSI scores were 87.4±8.1, with unit-change yielding adjusted odds-ratios (95% confidence-intervals) for personal (1.10 (1.02-1.18)) and work-related burnout (1.12 (1.04-1.22)), and PSQI (1.09 (1.01-1.17)). Significant multivariable associations with burnout and/or sleep indices included: working 7 days/week, lacking work-free vacation, insufficient rest breaks, interruptions, many patients in intensive-care, no separate time for non-clinical duties, pressure to publish, injury/suicide attempts of colleagues/staff, performing pointless tasks. The latter were described as administrative/clerical. Lacking genuine rest breaks was mainly patient-related, further compromised by emergency work and lacking separate time for non-clinical duties. Long workhours and exhausting schedule were cited as most difficult parts of work, while reducing workhours, improving work schedule, and hiring more staff most frequently recommended.

CONCLUSION

Specific working conditions potentially contributory to burnout and compromised sleep among physicians working in academic medicine are identified using a methodologically-rigorous, in-depth approach. These findings inform evidence-based interventions aimed at preserving physician mental health and work capacity.

Being robbed of an hour of sleep: The impact of the transition to Daylight Saving Time on work engagement depends on employees' chronotype

OBJECTIVE

Worldwide, over 70 countries advance their clocks in spring to Daylight Saving Time. Previous research has already demonstrated that the clock change negatively impacts employees at work. However, this research implicitly assumed that the clock change affects everyone to the same extent. In the current study, we propose that the massively prevalent Daylight Saving Time transition may have an effect on employees' sleep and their work engagement that is dependent upon employees' chronotype.

METHODS

We conducted a longitudinal study with 155 full-time employees who filled out online surveys on three Mondays around the transition to Daylight Saving Time.

RESULTS

Results showed that the transition to Daylight Saving Time resulted in decreased work engagement measured 1day as well as 1week after the transition to Daylight Saving Time. Lower sleep quality (but not shorter sleep duration) partly explained this effect. The negative effect of the transition to Daylight Saving Time on work engagement 1day after the transition was more pronounced for employees with later chronotypes ("owls") than for those with earlier chronotypes ("larks").

CONCLUSION

In summary, our study shows that the transition to Daylight Saving Time has an adverse short-time impact on private life and working life and should, therefore, also be considered in organizations. Because later chronotypes are especially prone to adverse effects of the transition, interventions targeted for this group might be especially helpful.

The night before night shift: Chronotype impacts total sleep and rapid eye movement sleep during a strategically delayed sleep

Transition to night shift may be improved by strategically delaying the main sleep preceding a first night shift. However, the effects of delayed timing on sleep may differ between chronotypes. Therefore, the study aim was to compare the impacts of chronotype on sleep quality and architecture during a normally timed sleep opportunity and a delayed sleep opportunity. Seventy-two (36 female, 36 male) healthy adults participated in a laboratory study. Participants were provided with a normally timed sleep opportunity (23:00-08:00) and a delayed sleep opportunity (03:00-12:00) over two consecutive nights in a sleep laboratory. Sleep was monitored by polysomnography (PSG), and chronotype was determined from dim light melatonin onset (DLMO). A tertile split of DLMO defined early (20:24 ± 0:42 h), intermediate (21:31 ± 0:12 h), and late chronotype (22:56 ± 0:54 h) categories. Although there was no main effect of chronotype on any sleep measure, early chronotypes obtained less total sleep with delayed sleep than with normally timed sleep (p = 0.044). Intermediate and late chronotypes obtained more rapid eye movement (REM) sleep with delayed sleep than with normally timed sleep (p = 0.013, p = 0.012 respectively). Wake was more elevated for all chronotypes in the later hours of the delayed sleep opportunity than at the start of the sleep opportunity. Strategically delaying the main sleep preceding a first night shift appears to benefit intermediate and late chronotypes (i.e., more REM sleep), but not early chronotypes (i.e., less total sleep). Circadian processes appear to elevate wakefulness for all chronotypes in the later stages of a delayed sleep opportunity.

Cognitive Performance During Night Work in the Cold

Objective: The objective of this study was to investigate how night work at low ambient temperatures affects cognitive performance (short-term memory and reaction time), skin- and core temperature, thermal comfort, sleepiness, and cortisol. We hypothesized that cognitive performance is reduced at night compared with daytime and worsened when exposed to low ambient temperatures.

Method: Eleven male subjects were recruited to perform three tests in a climatic chamber at night and daytime: Night –2°C, Night 23°C and Day 23°C. Each test lasted 6 h. Cognitive performance (short-term memory and reaction time), skin- and core temperature, thermal sensation and comfort, cortisol levels and sleepiness were measured during the tests.

Results: A lower mean skin temperature and corresponding lower thermal sensation were observed at Night –2°C compared to Day 23°C and Night 23°C. Night work caused increased sleepiness and lower cortisol levels, but was not affected by changes in ambient temperatures, thermal comfort, or skin temperatures. There was no effect of either day/night work nor ambient temperature on the short-term memory or reaction time test.

Conclusion: Lower skin- and core temperature were observed at night when exposed to low ambient temperature (–2°C), but there was no effect on short-term memory or reaction time. Increased sleepiness and lower cortisol levels were observed at night compared to daytime and was not influenced by low ambient temperature at night. The result from this study suggests that cognitive performance (short-term memory and reaction time) is not adversely affected by night work when exposed to low ambient temperatures if adequate protective clothing is worn.

COVID-19, Religious Coping, and Weight Change in the Orthodox Jewish Community

Given links between stress and obesity, it is likely that individuals gained weight during the COVID-19 lockdown. Research suggests that religiosity facilitates coping, which may have lessened the relationship between stress and weight gain during the COVID-19 lockdown. We examined this relationship among Orthodox Jews (n = 731). Results indicated that stress was marginally associated with weight gain, and that this was moderated by intrinsic religiosity (IR). For those with low IR, stress correlated with weight gain, while for those with mean or higher IR, stress and weight change were unrelated. Results suggest that for some, religiosity may moderate links between stress and weight gain during times of crisis.

A pilot study on essential oil aroma stimulation for enhancing slow-wave EEG in sleeping brain

Sleep quality is important to health and life quality. Lack of sleep can lead to a variety of health issues and reduce in daytime function. Recent study by Fultz et al. also indicated that sleep is crucial to brain metabolism. Delta power in sleep EEG often indicates good sleep quality while alpha power usually indicates sleep interruptions and poor sleep quality. Essential oil has been speculated to improve sleep quality. Previous studies also suggest essential oil aroma may affect human brain activity when applied awake. However, those studies were often not blinded, which makes the effectiveness and mechanism of aroma a heavily debated topic. In this study, we aim to explore the effect of essential oil aroma on human sleep quality and sleep EEG in a single-blinded setup. The aroma was released when the participants are asleep, which kept the influence of psychological expectation to the minimum. We recruited nine young, healthy participants with regular lifestyle and no sleep problem. All participants reported better sleep quality and more daytime vigorous after exposing to lavender aroma in sleep. We also observed that upon lavender aroma releases, alpha wave in wake stage was reduced while delta wave in slow-wave sleep (SWS) was increased. Lastly, we found that lavender oil promote occurrence of SWS. Overall, our study results show that essential oil aroma can be used to promote both subjective and objective sleep quality in healthy human subjects. This makes aroma intervention a potential solution for poor sleep quality and insomnia.

Using Ecological Momentary Assessment to Examine the Effects of Duty Status on Acute Stress and Tiredness in Firefighters: A Pilot Study

OBJECTIVE

Characterize firefighters' acute stress and tiredness by duty status (ie, "off night/day," "on night/day").

METHODS

Thirty nine career firefighters completed three, eight-day smartphone-based ecological momentary assessment periods with seven surveys per day assessing stress and tiredness. Mixed-effects location scale models examined duty status effects on stress and tiredness.

RESULTS

Firefighters' lowest stress and tiredness levels were when off-duty (β = 16.27 and β = 24.71, respectively) and their highest levels were when on-duty (β = 24.47 and β = 32.18, respectively). Within-subject effects of duty status accounted for a larger proportion of variability in stress and tiredness for all duty types, except for stress when "on-duty night/off-duty day."

CONCLUSIONS

Firefighters had more similar stress and tiredness outcomes when they were on-duty and less similar outcomes when off-duty. This could be due to firefighters having more similar experiences when they are on- versus off-duty.

Influence of Sleeping Patterns in Health and Academic Performance Among University Students

Sleep problems in university students are important and have implications for health, quality of life, and academic performance. Using an ex post facto design, a total sample of 855 students (55.7% women) participated in the study. Sleep assessment was conducted using the Pittsburgh Sleep Quality Index, the Nightmare Frequency Scale, the Nightmare Proneness Scale, and the Composite Morningness Scale. Women show a higher risk [OR = 2.61] of presenting poor sleep quality (> 5 points on the PSQI) compared with men (p < 0.001). Similarly, women reported a greater frequency of nightmares (p < 0.001, d = 0.60), greater propensity for nightmares (p < 0.001, d = 0.70) and a higher score on Item-5h of the PSQI regarding nightmares (p < 0.001, d = 0.59). Women, compared with men, show higher risk [OR = 2.84] for a sleep disorder related to nightmares (p = 0.012). Women need more time to reach a state of alertness after getting up (p = 0.022), and there was an interaction between sex and the alertness factor when evaluating the subjective quality of sleep (p = 0.030). Women show worse sleep quality and a higher frequency and propensity for suffering nightmares. When considering the relationship between sleep quality and academic performance, it is observed that students with poor sleep quality obtain lower academic scores (M = 7.21, SD = 0.805) than those with good sleep quality (M = 7.32, SD = 0.685), an effect that reaches significance (t = 2.116, p = 0.035). Regarding the relationship between the categorized chronotype and academic performance, students with a morning chronotype achieve better academic results (M = 7.41, SD = 0.89) than their evening counterparts (M = 7.15, SD = 0.76), although these differences have a small effect size (d = 0.31).

Psychosocial Aspects at work and the Quality of Sleep of Professors in Higher Education

The present study aims to investigate the association between psychosocial aspects at work and the quality of sleep of professors in a public university in Feira de Santana, Bahia, Brazil. A cross-sectional study was conducted, with descriptive, bivariate and multivariate analysis, including a random sample of 423 professors. The psychosocial aspects work aspects were associated to a perception of poor sleep quality. In analysis of effect modifiers, the variable "practice of physical activity" modified the main association under test. Among professors that did not practice physical activity, the following variables kept statistically associated to the perception of poor sleep quality: having children (PR = 1.33, CI 95% 1.02-1.74), poor self-rated health (PR = 1.49; CI 95% 1.24-1.79) and quality of life self-evaluation (PR = 1.60, CI 95% 1.45-2.00), insufficient time for regular leisure activities (PR = 1.52, CI 95% 1.23-1.86) and high psychological demand (PR = 1.40, CI 95% 1.14-1.72). In final analysis, high strain and passive work were experiences associated to the perception of a poor sleep quality among professors that did not practice physical activity. The results confirmed that the adverse psychosocial aspects at work are associated to negative impacts on the professor's quality of sleep.

Working Time Society consensus statements: Evidence-based effects of shift work on physical and mental health

Potential effects of shift work on health are probably related to the misalignment between the light-dark cycle and the human activity-rest cycle. Light exposure at night mediates these effects, including social misalignment and leads to an inversion of activity and rest, which, in turn, is linked to changes in behaviours. This article reviews the epidemiological evidence on the association between shift work and health, and possible mechanisms underlying this association. First, evidence from findings of the meta-analyses and systematic reviews published in the last 10 yr is presented. In addition, it reports the larger single-occupation studies and recent large population-based studies of the general workforce. Koch's postulates were used to evaluate the evidence related to the development of disease as a result of exposure to shift work. Finally, we discussed limitations of the multiple pathways that link shift work with specific disorders and the methodological challenges facing shift work research. We concluded that the clearest indications of shift work being the cause of a disease are given when there is a substantial body of evidence from high quality field studies showing an association and there is good evidence from laboratory studies supporting a causal explanation of the link.

Sleep Quality among Police Officers: Implications and Insights from a Systematic Review and Meta-Analysis of the Literature

Poor sleep is associated with bad health outcomes, worse wellbeing and decreases in performance, productivity and safety at work. Police officers are exposed to several risk factors including extended work schedules, shift work, occupational stress, dangerous and traumatic events and can, as such, develop sleep problems. The aim of the present study was to analyze the sleep quality among police officers. A systematic literature search, in PubMed/MEDLINE, PsycINFO, Scopus, ISI/Web of Science (WoS) and the Cochrane Library was conducted. Original articles, published in English, French, Italian, Spanish and Portuguese, the primary objective of which was the evaluation of the quality of sleep through the Pittsburgh Sleep Quality Index (PSQI) in Police Forces, were selected. From an initial sample of 1,149 studies, 13 articles were included in the meta-analysis (3,722 police officers). The pooled prevalence of bad sleep quality in police officers was 51% [95%CI 42–60%]. The pooled global score of the PSQI was 5.6 [95%CI 5.0–6.3], corresponding to a low average quality. At the meta-regressions, statistically significant associations could be found for work seniority (in terms of years of service) and being on shift. The poor quality of sleep in police officers could have negative consequences for workers’ health and for the safety of third parts. The implementation of health and sleep hygiene promotion programs in police forces is strongly recommended.

Are Engaged Workaholics Protected against Job-Related Negative Affect and Anxiety before Sleep? A Study of the Moderating Role of Gender

Although the interplay between workaholism and work engagement could explain several open questions regarding the Heavy Work Investment (HWI) phenomenon, few studies have addressed this issue. Thus, with the purpose of filling this literature gap, the present study aimed at examining a model where job-related negative affect mediates the relationship between the interplay of workaholism and work engagement, and anxiety before sleep. Since gender could have a role in the way the interplay would impact on the theorized model, we also hypothesized a moderated role of gender on the specific connection concerning the interplay between workaholism and work engagement, in relation to job-related negative affect. Conditional process analysis was conducted on a sample of 146 participants, balanced for gender. Results supported the mediating model and indicated the presence of a moderated role of gender, such that engaged workaholic women reported significantly less job-related negative affect than disengaged workaholic women. On the contrary, the interplay between workaholism and work engagement did not seem significant for men. Results are discussed in light of the limitations and future directions of the research in this field, as well as the ensuing practical implications.

Self-Reported Perceptions of Sleep Quality and Resilience Among Dance Students

This study examined relationships between self-perceived sleep quality and resilience among 116 dance students (Mean age = 21.6 years; SD = 4.348). who self-reported sleep quality with the Pittsburgh Sleep Quality Index (PSQI) and personal resilience with the Resilience Scale (RS). Most participants (59.5%) reported poor sleep quality on the PSQI, with 62.9% of the women and 42.1% of the men ( p = .092) scoring higher than five points on this instrument. On the RS, a large majority of the participants (75%) obtained scores less than 147, indicating low resilience, with no significant gender differences observed. Those reporting poor sleep quality (PSQI scores > 5) obtained lower resilience scores (RS < 147) than those reporting good sleep quality (PSQI scores ≤ 5; p = .025), and participants with poorer sleep quality were at higher risk of low resilience (Odds Ratio = 3.273) relative to those with good sleep quality ( p = .006). Those with shorter duration sleep (claiming they slept <7 hours/night) were also at higher risk for low resilience (Odds Ratio = 3.266), relative to those with longer duration sleep (>7 hours/night). These findings can help students and dance professionals improve their performance and face pressures inherent in dance practice. Follow-up research should verify these findings in varied populations with objective sleep measures and observational data from multiple respondents.

Physiological and autonomic stress responses after prolonged sleep restriction and subsequent recovery sleep in healthy young men

Purpose

Sleep restriction is increasingly common and associated with the development of health problems. We investigated how the neuroendocrine stress systems respond to prolonged sleep restriction and subsequent recovery sleep in healthy young men.

Methods

After two baseline (BL) nights of 8 h time in bed (TIB), TIB was restricted to 4 h per night for five nights (sleep restriction, SR, n = 15), followed by three recovery nights (REC) of 8 h TIB, representing a busy workweek and a recovery weekend. The control group (n = 8) had 8 h TIB throughout the experiment. A variety of autonomic cardiovascular parameters, together with salivary neuropeptide Y (NPY) and cortisol levels, were assessed.

Results

In the control group, none of the parameters changed. In the experimental group, heart rate increased from 60 ± 1.8 beats per minute (bpm) at BL, to 63 ± 1.1 bpm after SR and further to 65 ± 1.8 bpm after REC. In addition, whole day low-frequency to-high frequency (LF/HF) power ratio of heart rate variability increased from 4.6 ± 0.4 at BL to 6.0 ± 0.6 after SR. Other parameters, including salivary NPY and cortisol levels, remained unaffected.

Conclusions

Increased heart rate and LF/HF power ratio are early signs of an increased sympathetic activity after prolonged sleep restriction. To reliably interpret the clinical significance of these early signs of physiological stress, a follow-up study would be needed to evaluate if the stress responses escalate and lead to more unfavourable reactions, such as elevated blood pressure and a subsequent elevated risk for cardiovascular health problems.

Association between depressive symptoms and morningness-eveningness, sleep duration and rotating shift work in Japanese nurses

Higher depressive symptoms have been reported in rotating shift workers compared with day workers. Depressive symptoms in adults who do not engage in night work have also been shown to be associated with chronotype and sleep duration. This study examines associations between depressive symptoms, morningness-eveningness (i.e. the degree to which people prefer to be active in the morning or the evening), sleep duration and rotating shift work. Japanese nurses (1252 day workers and 1780 rotating shift workers, aged 20-59) were studied using a self-administered questionnaire. The questionnaire covered depressive symptoms, morningness-eveningness, sleep habits and demographic characteristics of the participants. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to determine the levels of depressive symptoms. A Japanese version of the Morningness-Eveningness Questionnaire (MEQ) was used to measure morningness-eveningness. The CES-D score of shift workers was significantly (p < 0.05) higher than that of day workers. The MEQ score was significantly (p < 0.05) lower (i.e. greater eveningness) in shift workers than in day workers. Sleep duration on the day shift was significantly (p < 0.05) shorter in shift workers than in day workers. Simple linear regression revealed that the MEQ score, sleep duration on the day shift and current work shift (i.e. rotating shift work) were significantly (p < 0.05) associated with the CES-D score. Multivariate linear regression indicated that greater eveningness and shorter sleep duration were independently associated with higher CES-D scores, while rotating shift work was not. These associations between the MEQ score, the sleep duration and the CES-D score were also confirmed in both day workers and shift workers when the groups were analyzed separately. These results suggest that greater eveningness and shorter sleep duration on the day shift were independently associated with higher levels of depressive symptoms, which may explain associations between rotating shift workers and depressive symptoms. These findings have important implications for the development of novel strategies for preventing poor mental health in day workers and rotating shift workers.

Reliability of Actigraphy and Subjective Sleep Measurements in Adults: The Design of Sleep Assessments

STUDY OBJECTIVES

The aim of the study was to investigate how many nights of measurement are needed for a reliable measure of sleep in a working population including adult women and men.

METHODS

In all, 54 individuals participated in the study. Sleep was assessed for 7 consecutive nights using actigraphy as an objective measure, and the Karolinska sleep diary for a subjective measure of quality. Using intra-class correlation and the Spearman-Brown formula, calculations of how many nights of measurements were required for a reliable measure were performed. Differences in reliability according to whether or not weekend measurements were included were investigated. Further, the correlation between objectively (actigraphy) measured sleep and subjectively measured sleep quality was studied over the different days of the week.

RESULTS/CONCLUSIONS

The results concerning actigraphy sleep measures suggest that data from at least 2 nights are to be recommended when assessing sleep percent and at least 5 nights when assessing sleep efficiency. For actigraphy-measured total sleep time, more than 7 nights are needed. At least 6 nights of measurements are required for a reliable measure of self-reported sleep. Fewer nights (days) are required if measurements include only week nights. Overall, there was a low correlation between the investigated actigraphy sleep parameters and subjective sleep quality, suggesting that the two methods of measurement capture different dimensions of sleep.

Factors associated with self-reported driver sleepiness and incidents in city bus drivers

Driver fatigue has received increased attention during recent years and is now considered to be a major contributor to approximately 15-30% of all crashes. However, little is known about fatigue in city bus drivers. It is hypothesized that city bus drivers suffer from sleepiness, which is due to a combination of working conditions, lack of health and reduced sleep quantity and quality. The overall aim with the current study is to investigate if severe driver sleepiness, as indicated by subjective reports of having to fight sleep while driving, is a problem for city based bus drivers in Sweden and if so, to identify the determinants related to working conditions, health and sleep which contribute towards this. The results indicate that driver sleepiness is a problem for city bus drivers, with 19% having to fight to stay awake while driving the bus 2-3 times each week or more and nearly half experiencing this at least 2-4 times per month. In conclusion, severe sleepiness, as indicated by having to fight sleep during driving, was common among the city bus drivers. Severe sleepiness correlated with fatigue related safety risks, such as near crashes.

Development of statistical models for predicting muscle and mental activities during repetitive precision tasks

This study was conducted to develop muscle and mental activities on repetitive precision tasks. A laboratory experiment was used to address the objectives. Surface electromyography was used to measure muscle activities from eight upper limb muscles, while electroencephalography recorded mental activities from six channels. Fourteen university students participated in the study. The results show that muscle and mental activities increase for all tasks, indicating the occurrence of muscle and mental fatigue. A linear relationship between muscle activity, mental activity and time was found while subjects were performing the task. Thus, models were developed using those variables. The models were found valid after validation using other students' and workers' data. Findings from this study can contribute as a reference for future studies investigating muscle and mental activity and can be applied in industry as guidelines to manage muscle and mental fatigue, especially to manage job schedules and rotation.

Conceptualisation of ageing in relation to factors of importance for extending working life - a review

AIM

The aim of this study was to explore and understand the complexity of ageing in relation to factors of importance for extending working life.

METHOD

Discourse analysis of documents was used in an integrative review including 128 articles.

RESULT

Four different conceptualisation of ageing are shown to affect older workers' ability to extend their working life: (a) biological ageing people's health in relation to their physical and mental work environment, their pace of work and recuperation needs; (b) chronological ageing statutory retirement age and policies and economic incentives devised for older workers by society, unions and organisations/enterprises; (c) social ageing inclusion in different social groups, the attitude of managers, organisations and family members, the leisure activities and surrounding environment; and (d) mental/cognitive ageing self-crediting, motivating and meaningful activities, competence and skills in working life. CONCLUSIONS SOCIETIES TODAY FOCUS MOSTLY ON CHRONOLOGICAL AGEING AND ARE LOOKING TO INCREASE THE RETIREMENT AGE WITH REGARD TO STATUTORY PENSION SYSTEMS, EG BEYOND 65 YEARS OF AGE THE INTER-RELATIONSHIPS BETWEEN CHRONOLOGICAL, MENTAL, BIOLOGICAL AND SOCIAL AGEING AND THE NINE AREAS IDENTIFIED AS BEING IMPORTANT TO OLDER WORKERS IN THESE RESPECTS NEED TO BE CONSIDERED WHEN AIMING TO PROVIDE A SUSTAINABLE WORKING LIFE FOR THE INCREASING NUMBERS OF OLDER WORKERS IN MODERN SOCIETY THE THEORETICAL MODEL DEVELOPED IS A CONTRIBUTION TO THE CRITICAL DEBATE THAT CAN BE APPLIED BY SOCIETIES, EMPLOYERS AND MANAGERS IN ORDER TO PROVIDE OLDER WORKERS WITH AN INCLUSIVE AND SUSTAINABLE EXTENDED WORKING LIFE.

Why are job stressors relevant for psychiatry?

Work-related mental health disorders are a major public health problem. Consequently, psychiatrists encounter many patients whose clinical state is profoundly affected by work conditions. Psychiatrists therefore, need training in occupational/stress medicine. This would help integrate health services for these patients, aimed at preservation of work fitness and mental health.

Knowledge-based identification of sleep stages based on two forehead electroencephalogram channels

Sleep quality is important, especially given the considerable number of sleep-related pathologies. The distribution of sleep stages is a highly effective and objective way of quantifying sleep quality. As a standard multi-channel recording used in the study of sleep, polysomnography (PSG) is a widely used diagnostic scheme in sleep medicine. However, the standard process of sleep clinical test, including PSG recording and manual scoring, is complex, uncomfortable, and time-consuming. This process is difficult to implement when taking the whole PSG measurements at home for general healthcare purposes. This work presents a novel sleep stage classification system, based on features from the two forehead EEG channels FP1 and FP2. By recording EEG from forehead, where there is no hair, the proposed system can monitor physiological changes during sleep in a more practical way than previous systems. Through a headband or self-adhesive technology, the necessary sensors can be applied easily by users at home. Analysis results demonstrate that classification performance of the proposed system overcomes the individual differences between different participants in terms of automatically classifying sleep stages. Additionally, the proposed sleep stage classification system can identify kernel sleep features extracted from forehead EEG, which are closely related with sleep clinician's expert knowledge. Moreover, forehead EEG features are classified into five sleep stages by using the relevance vector machine. In a leave-one-subject-out cross validation analysis, we found our system to correctly classify five sleep stages at an average accuracy of 76.7 ± 4.0 (SD) % [average kappa 0.68 ± 0.06 (SD)]. Importantly, the proposed sleep stage classification system using forehead EEG features is a viable alternative for measuring EEG signals at home easily and conveniently to evaluate sleep quality reliably, ultimately improving public healthcare.

Job stress, burnout, and job satisfaction in sleep apnea patients

OBJECTIVE

To assess job stress, burnout, and job satisfaction in patients with obstructive sleep apnea syndrome (OSAS).

METHODS

A total of 182 patients with OSAS and 71 healthy individuals completed the Job Content Questionnaire, the Maslach Burnout Inventory - General Survey, the Index of Job Satisfaction, the Epworth Sleepiness Scale, and the Pittsburgh Sleep Quality Index. All participants were assessed with full-night polysomnography.

RESULTS

Survey scores of patients diagnosed with OSAS only differed from those of the control group in the emotional exhaustion dimension (P = 0.015). According to a multivariate analysis, the apnea-hypopnea index (AHI) was only correlated with perceived support at work (β coefficient = 0.142; P = 0.048). Associations were found between subjective sleep quality, perceived support from coworkers, and supervisors (β = 0.157; P = 0.025), psychological demands (β = 0.226; P = 0.001), emotional exhaustion (β = 0,405; P = 0.000), and cynicism (β = 0.224; P = 0.002). The study also revealed associations between excessive daytime sleepiness and the burnout dimensions emotional exhaustion (β = 0.232; P = 0.000) and cynicism (β = 0.139; P = 0.048).

CONCLUSION

Objective parameters of OSAS such as the AHI seem to have limited influence on the psychosocial aspects of the occupational life of patients with OSAS. There is evidence of significant associations between the subjective symptoms of the disease, such as daytime sleepiness, subjective sleep quality, job stress, and burnout.

Chronotype modulates sleep duration, sleep quality, and social jet lag in shift-workers

This study explores chronotype-dependent tolerance to the demands of working morning, evening, and night shifts in terms of social jet lag, sleep duration, and sleep disturbance. A total of 238 shift-workers were chronotyped with the Munich ChronoType Questionnaire for shift-workers (MCTQ(Shift)), which collects information about shift-dependent sleep duration and sleep timing. Additionally, 94 shift-workers also completed those items of the Sleep Questionnaire from the Standard Shift-Work Index (SSI) that assess sleep disturbances. Although all participants worked morning, evening, and night shifts, subsamples differed in rotation direction and speed. Sleep duration, social jet lag, and sleep disturbance were all significantly modulated by the interaction of chronotype and shift (mixed-model ANOVAs). Earlier chronotypes showed shortened sleep duration during night shifts, high social jet lag, as well as higher levels of sleep disturbance. A similar pattern was observed for later chronotypes during early shifts. Age itself only influenced sleep duration and quality per se, without showing interactions with shifts. We found that workers slept longer in fast, rotating shift schedules. Since chronotype changes with age, investigations on sleep behavior and circadian misalignment in shift-workers have to consider chronotype to fully understand interindividual and intraindividual variability, especially in view of the current demographic changes. Given the impact of sleep on health, our results stress the importance of chronotype both in understanding the effects of shift-work on sleep and in devising solutions to reduce shift-work-related health problems.

Noisy and individual, but doable: shift-work research in humans

Working around the clock is common for many occupations, as diverse as nurses, truck drivers, physicians, steel workers, and pilots. Each shift-work profession is individual in more aspects than just work hours and individual work scenarios, each posing a different impact on the health of workers. Related health problems in shift workers, therefore, are also diverse and encompass sleep problems, metabolic and cardiovascular system disturbances, as well as cancer. Little is known about how all these individual factors influence a shift worker's health status, partly because many shift-work studies show inconsistent results. In addition, these individual factors create many methodological difficulties for researchers who investigate such work scenarios. This chapter presents examples from our laboratory and field studies of shift workers, which emphasize the importance of taking individual circumstances into account. Both study approaches, laboratory and field based, are needed to fully account for the difficulties that shift-work studies pose on both workers and researchers. Finally, understanding the mechanisms that underpin interindividual differences in response to shift work will advance our understanding of how to design better and healthier shift-work schedules in the future.

Recommendations for the prevention of breast cancer in shift workers

The functioning of the human body is regulated by the rhythmical change between rest and activity. The SCN (suprachiasmatic nucleus) is responsible for the central control of the biorhythm and the genetic prediction of the individual chronotype, whereas peripheral time cues such as light, social contacts and times of meals modulate the rhythmical activity of the body. Shift workers suffer from a disruption of the sleep-wake rhythm, insomnia and a lack of melatonin. These factors might trigger the development of breast cancer in female shift workers. The growing amount of data which indicate the high risk of breast cancer in female shift workers demonstrates the need for the implementation of prevention strategies against insomnia in shift workers. These strategies include regular sleep education courses on the prevention of sleep disorders in companies. The individual chronotype could be an important predictor for the adaptability to shift work.

Correlates to sleepiness on night shift among male workers engaged in three-shift work in a chemical plant: its association with sleep practice and job stress

The purpose of this study was to examine the correlation of sleepiness during night shift (SNS) in male shiftworkers with nonpharmacological self-management (nPSM) practices to facilitate good day sleep, and also with job stress. Sleepiness on the job and possible correlates to SNS among 157 male shiftworkers in a rotating three-shift schedule at a chemical plant were cross-sectionally investigated using a self-administered questionnaire. Multivariate analyses revealed that SNS was positively associated with drinking alcoholic beverages before day sleep, but inversely associated with subjective health status, being of the evening type, abstaining from caffeine before day sleep, having a bath before day sleep, job control, reward from work, feeling suited to the job, and support from colleagues. SNS correlated with certain nPSM practices and also with possible modifiers of job stress. These findings provide clues to developing countermeasures against SNS among shiftworkers. The effects of nPSM practices and job stress management on their day sleep and SNS should be examined in detail.

Pimavanserin tartrate, a 5-HT(2A) receptor inverse agonist, increases slow wave sleep as measured by polysomnography in healthy adult volunteers

OBJECTIVE

Determine the effects of pimavanserin tartrate [ACP-103; N-(4-flurophenylmethyl)-N-(1-methylpiperidin-4-yl)-N'-(4-(2-methylpropyloxy)phenylmethyl)carbamide], a selective serotonin 5-HT(2A) receptor inverse agonist, on slow wave sleep (SWS), other sleep parameters, and attention/vigilance.

METHODS

Forty-five healthy adults were randomized to pimavanserin (1, 2.5, 5, or 20 mg) or placebo in a double-blind fashion (n=9/group). Pimavanserin or placebo was administered once daily in the morning for 13 consecutive days. The effects of pimavanserin were measured after the first dose and again after 13 days. Sleep parameters were measured by polysomnography. Effects on attention/vigilance were measured by a continuous performance task.

RESULTS

Compared to placebo, pimavanserin significantly increased SWS following single and multiple dose administration. Pimavanserin also decreased number of awakenings. PSG variables not affected by pimavanserin included sleep period time, total sleep time, sleep onset latency, number of stage shifts, total time awake, early morning wake, and microarousal index. Changes in sleep architecture parameters, sleep profile parameters, and spectral power density parameters were consistent with a selective increase in SWS. Pimavanserin did not adversely affect performance on the continuous performance test measured in the evening before or morning after polysomnography.

CONCLUSIONS

These data suggest that pimavanserin selectively increases slow wave sleep and decreases awakenings, an effect that does not diminish with repeated administration.

Underexposure to light at work and its association to insomnia and sleepiness: a cross-sectional study of 13,296 workers of one transportation company

BACKGROUND

Light is a powerful synchronizer of the biological clock and of the sleep/wake cycle. Blind people have more sleep disturbances than people without eyesight problems. However, whether visually able people who are underexposed to bright natural light suffer from sleep wake disorders has never been examined. This study tried to assess the prevalence of sleep and wake disorders in subjects working in environments that are not exposed to natural light.

METHODOLOGY

A setting-controlled cross-sectional epidemiological study was carried out. A representative sample of 13,296 French employees of a single transportation company participated in the study. During working hours, 4635 subjects (34.9%) experienced no light exposure (NLE) and 8661 were partially or completely exposed (LE) to natural light. Sleep disorders, sleep quality, and sleepiness were assessed using subjective tools: the Sleep Disorders Questionnaire-French version (SDQFV) and the Epworth Sleepiness Scale (ESS). Light exposure was estimated on workers' schedules and by objective measurements of light intensity (lux meter).

PRINCIPAL FINDINGS

On a univariate analysis, complaints of poor sleep and sleepiness were significantly higher in NLE workers compared to LE: nonrestorative sleep (36.8% vs. 29.5%; P<.0001), insomnia (28.8% vs. 24.8%; P<.0001), severe insomnia (14.1% vs. 10.9%; P<.0001), and daytime somnolence (6.8% vs. 4.3%; P<.0001). After multivariate analysis, NLE has shown more insomnia (OR=1.8, 95% CI 1.3-2.3, P<.01) and hypersomnia (OR=1.9, 95% CI=1.3-2.4, P<.01) than LE.

SIGNIFICANCE

These data suggest that underexposure to natural light at work may significantly impair sleep and wake disorders in non-light-exposed workers.

Adaptation rate of 6-sulfatoxymelatonin and cognitive performance in offshore fleet shift workers: a field study

PURPOSE

To determine the total phase delay and adaptation rate of 6-sulfatoxymelatonin (aMT6s) on subjective and objective sleep quality and cognitive performance after 7 days of working night shifts (1800-0600 hours). The subjects studied were offshore fleet workers (N = 7).

METHODS

Seven days of urine samples were collected to determine the total phase delay and adaptation rate of aMT6s. Subjective and objective sleep quality was registered with sleep diaries and actigraphy on a daily basis. Cognitive performance, as measured by vigilance and reaction time, was measured with the Vienna test system on days 1 and 7. Light exposure was measured in the vessel compartments daily.

RESULTS

The rhythm of aMT6s shifted significantly from 4.78 +/- 0.94 h on day 1 to 8.84 +/- 1.76 h on day 7. Rate of adaptation was 0.84 h per day. Subjective sleep quality showed significant time effects on four variables, but objective sleep quality did not show any significant time effects. Vigilance and reaction time improved significantly from days 1 to 7. Light exposure intensities varied between 3 and 243 lux.

CONCLUSIONS

This field study showed that offshore fleet workers are able to adapt to the imposed regimen of 12-h night shifts. The adaptation is slower compared to other branches of the offshore industry, which most likely is due to lower light exposure. Subjective sleep quality improved to some extent, but the results were not conclusive. No significant effects were observed in the objective measures. Cognitive performance improved significantly, which was likely to be caused by the extended working hours on day 1 and an entrainment of the suprachiasmatic nuclei (SCN).

Sleep complaints in middle-aged women and men: the contribution of working conditions and work-family conflicts

This study aimed to examine how physical working conditions, psychosocial working conditions and work-family conflicts are associated with sleep complaints, and whether health behaviours explain these associations. We used pooled postal questionnaire surveys collected in 2001-2002 among 40-60-year-old employees of the City of Helsinki (n = 5819, response rate 66%). Participants were classified as having sleep complaints if they reported sleep complaints at least once a week on average (24% of women and 20% of men). Independent variables included environmental work exposures, physical workload, computer work, Karasek's job strain and work-family conflicts. Age, marital status, occupational class, work arrangements, health behaviours and obesity were adjusted for. Most working conditions were associated strongly with sleep complaints after adjustment for age only. After adjustment for work-family conflicts, the associations somewhat attenuated. Work-family conflicts were also associated strongly with women's [odds ratio (OR) 5.90; confidence interval (CI) 4.16-8.38] and men's sleep (OR 2.56; CI 1.34-4.87). The associations remained robust even after controlling for unhealthy behaviours, obesity, health status, depression and medications. Physically strenuous working conditions, psychosocial job strain and work-family conflicts may increase sleep complaints. Efforts to support employees to cope with psychosocial stress and reach a better balance between paid work and family life might reduce sleep complaints. Sleep complaints need to be taken into account in worksite health promotion and occupational health care in order to reduce the burden of poor sleep.

Effects of examination stress on psychological responses, sleep and allergic symptoms in atopic and non-atopic students

BACKGROUND

Recent findings indicate that atopics may be more vulnerable to stress than non-atopics. However, the roles of psychological well-being and sleep in this presumed increased sensitivity are not known.

PURPOSE

To investigate the effects of a brief naturalistic stressor on psychological responses, sleep, and allergic symptoms and to compare those responses between atopic and non-atopic individuals.

METHODS

We assessed atopic and non-atopic students during a period without and during a period with examinations.

RESULTS

For both atopic and non-atopic students, tension, anxiety, and depression deteriorated in response to examination, as did sleep latency and sleep quality. Overall, atopics were more tense, had more anxiety, longer sleep latencies, and were less well rested than non-atopics. Non-atopic students rose from bed later during the examination period. In response to examination, atopic students reported increased frequency of stress behaviors (e.g., eating fast), while decreased stress behaviors were reported by non-atopic students. Allergic symptoms were not affected.

CONCLUSION

Atopic students were worse off in aspects of psychological well-being and sleep, but displayed only partly stronger responses to a stressor compared to non-atopic students. In spite of a broad negative response to examination, allergic symptoms were not affected.

Automatic slow eye movement (SEM) detection of sleep onset in patients with obstructive sleep apnea syndrome (OSAS): comparison between multiple sleep latency test (MSLT) and maintenance of wakefulness test (MWT)

OBJECTIVE

To determine whether automatic slow eye movement (SEM) analysis performs comparably to standard sleep onset criteria at the multiple sleep latency test (MSLT) and at the maintenance of wakefulness test (MWT) in patients with obstructive sleep apnea syndrome (OSAS).

METHODS

We compared sleep latencies obtained upon standard analysis of MSLT and MWT recordings with automatically detected SEM latencies in a population of 20 severe OSAS patients that randomly underwent the two tests 1 week apart.

RESULTS

Eight of 20 OSAS patients had EDS as answered by the Epworth Sleepiness Scale (ESS). Mean SEM latency performed comparably to standard sleep onset in both the MSLT (6.4+/-5.5 min versus 7.4+/-5.1 min, p=0.25) and the MWT (25.2+/-14.5 min versus 24.4+/-14.0 min, p=0.45) settings. Mean SEM latency significantly correlated with the sleep latency at the MSLT (r=0.52, p<0.05) and at the MWT (r=0.74, p<0.001). Finally, the Epworth Sleepiness Scale score correlated with SEM latency at the MWT (r=-0.62, p<0.01), but not at the MSLT.

CONCLUSIONS

Automatic SEM detection performed comparably to standard polysomnographic assessment of sleep onset, thus providing a simplified technical requirement for the MSLT and the MWT. Further studies are warranted to evaluate SEM detection of sleep onset in other sleep disorders with excessive daytime sleepiness.

Positive and negative consequences of sick leave for the individual, with special focus on part-time sick leave

Aims: To describe the consequences of long-term sick leave (>28 days) on working situation, health and lifestyle among employees from the public sector in Sweden. Methods: Employees in four county councils and two municipalities on long term sick leave on 1 November 2005 (n = 1,128) answered a questionnaire in February 2006. The response rate was 71.7%. Eighty seven per cent were still on sick leave when the questionnaire was answered: 54% part time and 33% full time. Results: Reporting positive consequences was rare but reporting negative consequences, such as effects on the development of salary, the possibilities of pursuing a career or to change to another job were common. Sick leave seemed to lead to a considerable loss of zest for work, even if the respondents were back in work full time. Regardless of the negative consequences at work, 92% of those on part-time sick leave believed that the part-time sick leave was good for them even if many thought it had negative consequences for employer and colleagues. Conclusions: Long-term sick leave has negative consequences for the individual in work situations, even for those back at work full time. The development of salary and career seem to be most affected. The attitude towards part-time sick leave was positive and this result indicates that there is a potential for an increased degree of partial return to work in the group of people on long-term sick leave.