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Yang L, Gan YH, He XY, Deng YT, Zhang W, You J, Kuo K, Zhang YR, Huang SY, Wu BS, Guo Y, Zhang Y, Dong Q, Feng JF, Cheng W, Yu JT. Shift work effects on incident neuropsychiatric disorders and shift work tolerance. J Affect Disord 2024; 362:323-333. [PMID: 38971194 DOI: 10.1016/j.jad.2024.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 02/28/2024] [Accepted: 07/03/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND Shift work is associated with susceptibility to several neuropsychiatric disorders. This study aims to investigate the effect of shift work on the incidence of neuropsychiatric disorders, and highlighting how individual variability may influence the association. METHODS UK Biobank participants with employment information were included. Cox survival was conducted in main and subgroup analyses. Correlation analyses explored the impact of shift work on brain structures, and mediation analyses were performed to elucidate the shared underlying mechanisms. Shift work tolerance was evaluated through survival analyses contrasting the risks associated with five neuropsychiatric disorders in shift versus non-shift workers across different demographic or occupational strata. RESULTS The analysis encompassed 254,646 participants. Shift work was associated with higher risk of dementia (HR 1.29, 95 % CI 1.10-1.52), anxiety (1.08, 1.01-1.15), depression (1.29, 1.22-1.36), and sleep disorders (1.18, 1.09-1.28), but not stroke (p = 0.20). Shift work was correlated with decreasing volume of various brain regions, particularly in thalamus, lateral orbitofrontal, and middle temporal. Mediation analysis revealed that increased immune response and glucose levels are common pathways linking shift work to these disorders. We observed diversity in shift work tolerance across different individual characteristics, among which socioeconomic status and length of working hours were the most essential. LIMITATIONS Self-reported employment information may cause misclassification and recall bias. And since we focused on the middle-aged population, the conclusions may not be representative of younger or older populations. CONCLUSIONS Our findings indicated the need to monitor shift worker health and provide personalized management to help adapt to shift work.
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Affiliation(s)
- Liu Yang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yi-Han Gan
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiao-Yu He
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yue-Ting Deng
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wei Zhang
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
| | - Jia You
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
| | - Kevin Kuo
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Ya-Ru Zhang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shu-Yi Huang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Bang-Sheng Wu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu Guo
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yi Zhang
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qiang Dong
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
| | - Jin-Tai Yu
- Department of Neurology and National Center for Neurological Disorders, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
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Zheng Z, Pan J, Chen Z, Gao P, Gao J, Jiang H, Zhang X. The association between shift work, shift work sleep disorders and premature ejaculation in male workers. BMC Public Health 2024; 24:1772. [PMID: 38961338 PMCID: PMC11223354 DOI: 10.1186/s12889-024-19141-1] [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: 01/01/2024] [Accepted: 06/13/2024] [Indexed: 07/05/2024] Open
Abstract
OBJECTIVE Shift work and Shift Work Sleep Disorder (SWSD) are known to affect the secretion of several neurotransmitters and hormones associated with premature ejaculation (PE). However, their specific influence on the regulation of male ejaculation remains unclear. This study explores the relationship between shift work, SWSD, and PE. METHODS From April to October 2023, a cross-sectional survey was conducted across five regions of China to explore the work schedules, sleep quality, and sexual function of male workers. Participants' sleep quality was evaluated using a validated SWSD questionnaire, and their erectile function and ejaculatory control were assessed with the International Inventory of Erectile Function (IIEF-5) scores and Premature Ejaculation Diagnostic Tool (PEDT) scores, respectively. Univariate and multivariate linear regression analyses were employed to identify risk factors associated with PE. Confounders were controlled using multiple regression models, and clinical prediction models were developed to predict PE onset and assess the contribution of risk factors. RESULTS The study included 1239 eligible participants, comprising 840 non-shift workers and 399 shift workers (148 with SWSD and 251 without SWSD). Compared to non-shift working males, those involved in shift work (β 1.58, 95% CI 0.75 - 2.42, p < 0.001) and those suffering from SWSD (β 2.86, 95% CI 1.86 - 3.85, p < 0.001) they had significantly higher PEDT scores. Additionally, we identified daily sleep of less than six hours, depression, anxiety, diabetes, hyperlipidemia, frequent alcohol consumption (more than twice a week), and erectile dysfunction as risk factors for PE. The predictive model for PE demonstrated commendable efficacy. CONCLUSION Both shift work and SWSD significantly increase the risk of premature ejaculation, with the risk magnifying in tandem with the duration of shift work. This study reveals the potential impact of shift work and SWSD on PE and provides new theoretical foundations for the risk assessment and prevention of this condition.
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Affiliation(s)
- Zhenming Zheng
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui Province, 230022, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
| | - Jiashan Pan
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui Province, 230022, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
| | - Zhimin Chen
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui Province, 230022, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
| | - Pan Gao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui Province, 230022, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
| | - Jingjing Gao
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui Province, 230022, China
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China
| | - Hui Jiang
- Andrology Center, Peking University First Hospital, No. 8 Xishiku Street, Xicheng District, Beijing, 100034, China.
| | - Xiansheng Zhang
- Department of Urology, the First Affiliated Hospital of Anhui Medical University, No. 218 Jixi Road, Shushan District, Hefei, Anhui Province, 230022, China.
- Institute of Urology, Anhui Medical University, Hefei, Anhui, China.
- Anhui Province Key Laboratory of Urological and Andrological Diseases Research and Medical Transformation, Hefei, Anhui, China.
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Yook S, Choi SJ, Lee H, Joo EY, Kim H. Long-term night-shift work is associated with accelerates brain aging and worsens N3 sleep in female nurses. Sleep Med 2024; 121:69-76. [PMID: 38936046 DOI: 10.1016/j.sleep.2024.06.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/12/2024] [Accepted: 06/13/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND Shift work disrupts circadian rhythms and alters sleep patterns, resulting in various health problems. To quantitatively assess the impact of shift work on brain health, we evaluated the brain age index (BAI) derived from sleep electroencephalography (EEG) results in night-shift workers and compared it with that in daytime workers. METHODS We studied 45 female night shift nurses (mean age: 28.2 ± 3.3 years) and 44 female daytime workers (30.5 ± 4.7 years). Sleep EEG data were analyzed to calculate BAI. The BAI of night shift workers who were asleep during the daytime with those of daytime workers who were asleep at night were statistically compared to explore associations between BAI, duration of shift work, and sleep quality. RESULTS Night-shift workers exhibited significantly higher BAI (2.14 ± 6.04 vs. 0 ± 5.35), suggesting accelerated brain aging and altered sleep architecture, including reduced delta and sigma wave frequency activity during non-rapid eye movement sleep than daytime workers. Furthermore, poor deep sleep quality, indicated by a higher percentage of N1, lower percentage of N3, and higher arousal index, was associated with increased BAI among shift workers. Additionally, a longer duration of night-shift work was correlated with increased BAI, particularly in older shift workers. CONCLUSION Night-shift work, especially over extended periods, may be associated with accelerated brain aging, as indicated by higher BAI and alterations in sleep architecture. Interventions are necessary to mitigate the health impacts of shift work. Further research on the long-term effects and potential strategies for sleep improvement and mitigating brain aging in shift workers is warranted.
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Affiliation(s)
- Soonhyun Yook
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, 90033, USA
| | - Su Jung Choi
- Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul, 03063, South Korea
| | - Hanul Lee
- Department of Neurology, Samsung Medical Center, Seoul, 06351, South Korea
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, School of Medicine, Sungkyunkwan University, Seoul, 06351, South Korea.
| | - Hosung Kim
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, 90033, USA
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Liang C, Xu Y, Xia Q, Xiao D, Gu J, Zhu X, Chen C, Chen Z, Hua D. Assessment of retinal and choroidal microvasculature in night shift medical workers by OCT angiography. Sci Rep 2024; 14:12718. [PMID: 38830921 PMCID: PMC11148059 DOI: 10.1038/s41598-024-62863-w] [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: 02/06/2024] [Accepted: 05/22/2024] [Indexed: 06/05/2024] Open
Abstract
This study evaluated retinal and choroidal microvascular changes in night shift medical workers and its correlation with melatonin level. Night shift medical workers (group A, 25 workers) and non-night shift workers (group B, 25 workers) were recruited. The images of macula and optic nerve head were obtained by swept-source OCT-angiography. Vessel density of retina, choriocapillaris (CC), choriocapillaris flow deficit (CC FD), choroidal thickness (CT) and choroidal vascularity index (CVI) were measured. 6-sulfatoxymelatonin concentration was analyzed from the morning urine. CC FD and CVI were significantly decreased and CT was significantly increased in group A (all P < 0.05). 6-sulfatoxymelatonin concentration was significantly lower in group A (P < 0.05), which was significantly positively correlated with CC FD size (r = 0.318, P = 0.024) and CVI of the most regions (maximum r-value was 0.482, P < 0.001), and was significantly negatively associated with CT of all regions (maximum r-value was - 0.477, P < 0.001). In night shift medical workers, the reduction of melatonin was significantly correlated with CT thickening, CVI reduction and CC FD reduction, which suggested that they might have a higher risk of eye diseases. CC FD could be a sensitive and accurate indicator to reflect CC perfusion.
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Affiliation(s)
- Congbi Liang
- Eye Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China
| | - Yishuang Xu
- Eye Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China
| | - Qinyun Xia
- Eye Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China
| | - Di Xiao
- Eye Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China
| | - Jingsai Gu
- Eye Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China
| | - Xiangxiang Zhu
- Eye Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China
| | - Changzheng Chen
- Eye Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.
| | - Zhen Chen
- Eye Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.
| | - Dihao Hua
- Eye Center, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuchang District, Wuhan, 430060, Hubei, China.
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Ahn J, Yeo H, Lee S, Hwang Y, Jeon S, Kim SJ. Shift schedules and circadian preferences: the association with sleep and mood. Front Public Health 2024; 12:1283543. [PMID: 38741905 PMCID: PMC11090041 DOI: 10.3389/fpubh.2024.1283543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 04/08/2024] [Indexed: 05/16/2024] Open
Abstract
Object We explored the circadian preferences of non-shift workers (non-SWs) and various types of shift workers (SWs), and the associations of these preferences with sleep and mood. Methods In total, 4,561 SWs (2,419 women and 2,142 men aged 37.00 ± 9.80 years) and 2,093 non-SWs (1,094 women and 999 men aged 37.80 ± 9.73 years) completed an online survey. Of all SWs, 2,415 (1,079 women and 1,336 men aged 37.77 ± 9.96 years) reported regularly rotating or fixed schedules ("regular SWs"), and 2,146 (1,340 women and 806 men aged 36.12 ± 9.64 years) had irregular schedules ("irregular SWs"). Of the regular SWs, 2,040 had regularly rotating schedules, 212 had fixed evening schedules, and 163 had fixed night schedules. All participants completed the Morningness-Eveningness Questionnaire (MEQ) exploring circadian preferences, the short form of the Center for Epidemiological Studies-Depression Scale (CES-D) evaluating depression, the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS). Results Compared to non-SWs, SWs had lower MEQ scores, i.e., more eveningness, after controlling for age, gender, income, occupation, and weekly work hours (F = 87.97, p < 0.001). Irregular SWs had lower MEQ scores than regular SWs (F = 50.89, p < 0.001). Among regular SWs, the MEQ scores of fixed evening and fixed night SWs were lower than those of regularly rotating SWs (F = 22.42, p < 0.001). An association between the MEQ and ESS scores was apparent in non-SWs (r = -0.85, p < 0.001) but not in SWs (r = 0.001, p = 0.92). Conclusion SWs exhibited more eveningness than non-SWs; eveningness was particularly prominent in SWs with irregular or fixed evening/night shifts. Eveningness was associated with sleepiness only in non-SWs, but not in SWs.
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Affiliation(s)
- Jihye Ahn
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Hyewon Yeo
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Somi Lee
- Forest Clinic, Seolleung, Republic of Korea
| | - Yunjee Hwang
- Department of Brain & Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Republic of Korea
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Kumari R, Verma V, Singaravel M. Simulated Chronic Jet Lag Affects the Structural and Functional Complexity of Hippocampal Neurons in Mice. Neuroscience 2024; 543:1-12. [PMID: 38354900 DOI: 10.1016/j.neuroscience.2024.01.026] [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: 06/14/2023] [Revised: 12/21/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024]
Abstract
There has been a long history that chronic circadian disruption such as jet lag or shift work negatively affects brain and body physiology. Studies have shown that circadian misalignment act as a risk factor for developing anxiety and mood-related depression-like behavior. Till date, most studies focused on simulating jet lag in model animals under laboratory conditions by repeated phase advances or phase delay only, while the real-life conditions may differ. In the present study, adult male mice were subjected to simulated chronic jet lag (CJL) by alternately advancing and delaying the ambient light-dark (LD) cycle by 9 h every 2 days, thereby covering a total of 24 days. The effect of CJL was then examined for a range of stress and depression-related behavioral and physiological responses. The results showed that mice exposed to CJL exhibited depression-like behavior, such as anhedonia. In the open field and elevated plus maze test, CJL-exposed mice showed increased anxiety behavior compared to LD control. In addition, CJL-exposed mice showed an increased level of serum corticosterone and proinflammatory cytokine, TNF-α in both serum and hippocampus. Moreover, CJL-exposed mice exhibited a reduction in structural complexity of hippocampal CA1 neurons along with decreased expression of neurotrophic growth factors, BDNF and NGF in the hippocampus compared to LD control. Taken together, our findings suggest that simulated chronic jet lag adversely affects structural and functional complexity in hippocampal neurons along with interrelated endocrine and inflammatory responses, ultimately leading to stress, anxiety, and depression-like behavior in mice.
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Affiliation(s)
- Ruchika Kumari
- Chronobiology Lab, Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India
| | - Vivek Verma
- Chronobiology Lab, Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India
| | - Muniyandi Singaravel
- Chronobiology Lab, Department of Zoology, Institute of Science, Banaras Hindu University, Varanasi, Uttar Pradesh 221005, India.
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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: 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: 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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Yook S, Choi SJ, Zang C, Joo EY, Kim H. Are there effects of light exposure on daytime sleep for rotating shift nurses after night shift?: an EEG power analysis. Front Neurosci 2024; 18:1306070. [PMID: 38601092 PMCID: PMC11004303 DOI: 10.3389/fnins.2024.1306070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 03/11/2024] [Indexed: 04/12/2024] Open
Abstract
Introduction Night-shift workers often face various health issues stemming from circadian rhythm shift and the consequent poor sleep quality. We aimed to study nurses working night shifts, evaluate the electroencephalogram (EEG) pattern of daytime sleep, and explore possible pattern changes due to ambient light exposure (30 lux) compared to dim conditions (<5 lux) during daytime sleep. Moethods The study involved 31 participants who worked night shifts and 24 healthy adults who had never worked night shifts. The sleep macro and microstructures were analyzed, and electrophysiological activity was compared (1) between nighttime sleep and daytime sleep with dim light and (2) between daytime sleep with dim and 30 lux light conditions. Results The daytime sleep group showed lower slow or delta wave power during non-rapid eye movement (NREM) sleep than the nighttime sleep group. During daytime sleep, lower sigma wave power in N2 sleep was observed under light exposure compared to no light exposure. Moreover, during daytime sleep, lower slow wave power in N3 sleep in the last cycle was observed under light exposure compared to no light exposure. Discussion Our study demonstrated that night shift work and subsequent circadian misalignment strongly affect sleep quality and decrease slow and delta wave activities in NREM sleep. We also observed that light exposure during daytime sleep could additionally decrease N2 sleep spindle activity and N3 waves in the last sleep cycle.
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Affiliation(s)
- Soonhyun Yook
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Su Jung Choi
- Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul, Republic of Korea
| | - Cong Zang
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
| | - Eun Yeon Joo
- Department of Neurology, Neuroscience Center, Samsung Medical Center, Samsung Biomedical Research Institute, School of Medicine, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hosung Kim
- USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, Los Angeles, CA, United States
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Han E, Lee Y, Lee S, Kim S, Ham S, Lee W, Choi WJ, Kang SK. Association Between Flexible Work Arrangement and Sleep Problems Among Paid Workers: Using 6th Korean Working Conditions Survey. Saf Health Work 2024; 15:53-58. [PMID: 38496277 PMCID: PMC10944152 DOI: 10.1016/j.shaw.2023.12.005] [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: 07/20/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 03/19/2024] Open
Abstract
Background As social distancing persists and interest in work-life balance grows, more companies are adopting flexible work policies. While there have been studies on sleep disorders associated with different types of work, such as shift work, research exploring the relationship between flexible work schedules and sleep disorders is still limited, particularly among Korean workers. Methods We performed a secondary analysis of the 6th Korean Working Conditions Survey, focusing on 31,243 paid workers out of a total of 50,538 participants. We defined flexible workers as those who set their own working hours. Sleep disorders were divided into three categories: 'difficulty falling asleep,' 'frequent waking during sleep,' and 'waking up feeling exhausted and fatigued.' Using scores derived from three specific symptoms, the Minimal Insomnia Symptoms Scale (MISS) was calculated to assess the prevalence of insomnia. We used chi-square tests to analyze demographic and job-related differences. A multivariate logistic regression analysis was employed to identify any relationship between flexible work schedules and sleep disorders. Results Significant differences were found between flexible and non-flexible workers regarding age, income level, education level, and job type. Flexible workers reported sleep-related symptoms significantly more often. The odds ratio for insomnia was 1.40 (95% CI 1.21-1.61). For males, the odds ratio was 1.68 (1.36-2.08). Conclusion This study establishes a correlation between flexible work schedules and sleep disorders among Korean salaried workers. Potential causes could include changes in circadian rhythm, increased work demands, and extended working hours. To precisely determine causality and associated diseases, further research is required.
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Affiliation(s)
- Eunseun Han
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
- Department of Medicine, Graduate School of Gachon University, Incheon, Republic of Korea
| | - Yongho Lee
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
- Department of Medicine, Graduate School of Gachon University, Incheon, Republic of Korea
| | - Sanghyuk Lee
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
- Department of Medicine, Graduate School of Gachon University, Incheon, Republic of Korea
| | - Shinhyeong Kim
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
- Department of Occupational and Environmental Health, Graduate School of Public Health, Gachon University, Incheon, Republic of Korea
| | - Seunghon Ham
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
- Department of Occupational and Environmental Medicine, College of Medicine, Gachon University, Incheon, Republic of Korea
| | - Wanhyung Lee
- Department of Preventive Medicine, College of Medicine, Chung-Ang University, 06973, Seoul, Republic of Korea
| | - Won-Jun Choi
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
- Department of Occupational and Environmental Medicine, College of Medicine, Gachon University, Incheon, Republic of Korea
| | - Seong-Kyu Kang
- Department of Occupational and Environmental Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea
- Department of Occupational and Environmental Medicine, College of Medicine, Gachon University, Incheon, Republic of Korea
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10
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Jeong H, Yeo H, Lee KH, Kim N, Shin J, Seo MC, Jeon S, Lee YJ, Kim SJ. Brain structural correlates of subjective sleepiness and insomnia symptoms in shift workers. Front Neurosci 2024; 18:1330695. [PMID: 38440391 PMCID: PMC10909910 DOI: 10.3389/fnins.2024.1330695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Accepted: 02/06/2024] [Indexed: 03/06/2024] Open
Abstract
Background Studies on the brain structures of shift workers are limited; thus, this cross-sectional study aimed to compare the brain structures and the brain structural correlates of subjective sleepiness and insomnia symptoms between shift workers and non-shift workers. Methods Shift workers (n = 63) and non-shift workers (n = 58) completed questionnaires assessing subjective sleepiness and insomnia symptoms. Cortical thickness, cortical surface area, and subcortical volumes were measured by magnetic resonance imaging. The brain morphometric measures were compared between the groups, and interaction analyses using the brain morphometric measures as the dependent variable were performed to test the interactions between the study group and measures of sleep disturbance (i.e., subjective sleepiness and insomnia symptoms). Results No differences in cortical thickness, cortical surface area, or subcortical volumes were detected between shift workers and non-shift workers. A single cluster in the left motor cortex showed a significant interaction between the study group and subjective sleepiness in the cortical surface area. The correlation between the left motor cortex surface area and the subjective sleepiness level was negative in shift workers and positive in non-shift workers. Significant interaction between the study group and insomnia symptoms was present for the left/right putamen volumes. The correlation between the left/right putamen volumes and insomnia symptom levels was positive in shift workers and negative in non-shift workers. Conclusion Left motor cortex surface area and bilateral putamen volumes were unique structural correlates of subjective sleepiness and insomnia symptoms in shift workers, respectively.
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Affiliation(s)
- Hyunwoo Jeong
- Department of Education and Training, Yonsei University College of Medicine, Severance Hospital, Seoul, Republic of Korea
| | - Hyewon Yeo
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Hwa Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Nambeom Kim
- Neuroscience Research Institute, Gachon University, Incheon, Republic of Korea
| | - Jiyoon Shin
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Cheol Seo
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry and Center for Sleep and Chronobiology, Seoul National University Hospital, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
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11
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Booker LA, Spong J, Hodge B, Deacon-Crouch M, Bish M, Mills J, Skinner TC. Differences in shift and work-related patterns between metropolitan and regional/rural healthcare shift workers and the occupational health and safety risks. Aust J Rural Health 2024; 32:141-151. [PMID: 38063243 DOI: 10.1111/ajr.13075] [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: 04/30/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVES To explore if there are differences in shift patterns and work-related factors between metropolitan and regional/rural healthcare shift workers and their risk of poor sleep and mental health. Furthermore, explore whether these factors impact on medical errors, workplace and car/near car accidents. DESIGN A cross-sectional study. SETTING An anonymous online survey of healthcare shift workers in Australia. PARTICIPANTS A total of 403 nurses, midwives and paramedics completed the survey. MAIN OUTCOME MEASURES Sample characteristics, employment location, shift work-related features, sleep and mental health measurements, workplace accidents, medical errors and car/near car accident post shift. RESULTS Regional/rural healthcare shift workers were significantly older, had more years' experience, worked more nights, on-call and hours per week. Those in metropolitan areas took significantly longer (minutes) to travel to work, had higher levels of anxiety, increased risk of shift work disorder, reported significantly more workplace accidents and were more likely to have a car/near car accident when commuting home post shift. Both groups reported ~25% having a medical error in the past year. Workplace accidents were related to more on-call shifts and poor sleep quality. Medical errors were associated with fewer years' experience, more evening shifts and increased stress. Car accidents were associated with metropolitan location and increased depression. CONCLUSION Differences in work-related factors between metropolitan and regional/rural healthcare shift workers were observed. Some of these factors contributed to occupational health and safety risks. Further exploration is needed to understand how to reduce occupational health and safety risks, and improve employee and patient safety both in both regional/rural and metropolitan areas.
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Affiliation(s)
- Lauren A Booker
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin Health, Melbourne, Victoria, Australia
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Brad Hodge
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Melissa Deacon-Crouch
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Melanie Bish
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Jane Mills
- Department of Rural Health Sciences, La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Timothy C Skinner
- School of Psychology & Public Health, La Trobe University, Bendigo, Victoria, Australia
- Department of Psychology, Centre for Health and Society, University of Copenhagen, Copenhagen, Denmark
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12
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Agrawal P, Singh SM, Able C, Kohn TP, Herati AS. Sleep disorders are associated with testosterone deficiency and erectile dysfunction-a U.S. claims database analysis. Int J Impot Res 2024; 36:78-82. [PMID: 36473958 DOI: 10.1038/s41443-022-00649-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 11/21/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022]
Abstract
The relationship between male genitourinary conditions and sleep disorders has previously only been reported in single-institution studies with small cohorts. Our objective was to assess the association of erectile dysfunction (ED) and testosterone deficiency with various sleep disorders using a large claims database. The TriNetX Diamond database was queried in June 2022. In men aged 40-70 years, insomnia, sleep apnea, and circadian rhythm sleep disorder were each independently assessed to determine the association with ED and testosterone deficiency and then followed by propensity score matching performed for age, hypertension, hyperlipidemia, diabetes mellitus, ischemic heart disease, tobacco usage, and obesity. Testosterone deficiency was more likely to be found in men diagnosed with sleep apnea (odds ratio (OR) 1.66 [95% confidence interval (CI) 1.65-1.67]), insomnia (OR 1.74 [95% CI 1.73-1.76]), and circadian rhythm dysfunction (OR 2.63 [95% CI 2.54-2.73]) compared to matched controls. ED was more likely to be found in men diagnosed with sleep apnea (OR 1.02 [95% CI 1.01-1.03]), insomnia (OR 1.30 [95% CI 1.30-1.31]), and circadian rhythm dysfunction (OR 1.54 [95% CI 1.49-1.59]) compared to matched controls. Our results emphasize the negative impact of poor sleep on diseases of the male genitourinary system by identifying these relationships in the largest cohort in the U.S. reported to date.
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Affiliation(s)
- Pranjal Agrawal
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sajya M Singh
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Corey Able
- University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Taylor P Kohn
- The James Buchanan Brady Urological Institute at Johns Hopkins, Baltimore, MD, USA.
| | - Amin S Herati
- The James Buchanan Brady Urological Institute at Johns Hopkins, Baltimore, MD, USA
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13
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Booker LA, Fitzgerald J, Mills J, Bish M, Spong J, Deacon‐Crouch M, Skinner TC. Sleep and fatigue management strategies: How nurses, midwives and paramedics cope with their shift work schedules-a qualitative study. Nurs Open 2024; 11:e2099. [PMID: 38268269 PMCID: PMC10803889 DOI: 10.1002/nop2.2099] [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: 08/05/2023] [Revised: 12/07/2023] [Accepted: 01/05/2024] [Indexed: 01/26/2024] Open
Abstract
AIMS To understand the benefits and challenges of shift work, and the coping strategies used by nurses, midwives and paramedics to manage the impact of shift work on sleep and fatigue from shift work. DESIGN A single case study with embedded units. METHODS Twenty-seven participants were interviewed exploring their shift work experiences, coping strategies used to improve sleep, and what their recommendations are for improving shift work management. Interviews were completed between November and December 2022. RESULTS Participants enjoyed the lifestyle, flexibility and financial rewards offered by working shift work. However, fatigue and sleep deprivation undermined these benefits, as it impacted their ability to enjoy social and family events. There were also concerns of long-term health consequences of shift work and delivery of care. Changes to rostering practices and sleep and shift work education were common recommendations. CONCLUSION This study provides insights on how healthcare professionals manage sleep and fatigue due to shift work and the inadequate support. There is absence of adequate policies, processes and training at an organizational, academic and personal level on how to best manage sleep and fatigue when working shift work. Future research is needed to explore how to equip healthcare shift workers with the skills to successfully manage their schedules to mitigate the negative impact that poor sleep and fatigue has on the health and safety of themselves and their patients. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE Understanding the specific challenges of shift work and how workers manage their shift work schedules is critical for improving the health and safety of themselves and their patients. This study identified that there is insufficient training regarding sleep and shift work management strategies, potentially leading to occupational health and safety concerns. Further education and training to equip staff with the necessary information, training and guidance to staff on how to reduce fatigue risk is required. PATIENT OR PUBLIC CONTRIBUTION This study involved healthcare shift workers in semi-structured interviews. Data gathered from a previous survey that participants were involved in helped shape the interview topics and the study design.
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Affiliation(s)
- Lauren A. Booker
- School of Psychology & Public HealthLa Trobe UniversityBendigoVictoriaAustralia
- Institute for Breathing and Sleep, Austin HealthMelbourneAustralia
| | - Jarrah Fitzgerald
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Jane Mills
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Melanie Bish
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Jo Spong
- Institute for Breathing and Sleep, Austin HealthMelbourneAustralia
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Melissa Deacon‐Crouch
- Department of Rural Health Sciences, La Trobe Rural Health SchoolLa Trobe UniversityBendigoVictoriaAustralia
| | - Timothy C. Skinner
- School of Psychology & Public HealthLa Trobe UniversityBendigoVictoriaAustralia
- Department of Psychology, Centre for Health and SocietyUniversity of CopenhagenCopenhagenDenmark
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14
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Lim J, Lee J, Jeon S, Lee S, Kim SJ. Effects of co-sleeping with a shift worker on sleep, mood and cognition. SSM Popul Health 2023; 24:101530. [PMID: 37869583 PMCID: PMC10587613 DOI: 10.1016/j.ssmph.2023.101530] [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: 04/15/2023] [Revised: 10/04/2023] [Accepted: 10/04/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Although the negative effects of shift work on workers' sleep and mood are well-known, the effects of shift work on their sleep partners' sleep and mood have rarely been investigated. The current study explored the effects of co-sleeping with a shift worker (SW) on the partner's subjective sleep quality, daytime sleepiness, depressive symptoms, and cognitive disturbances. Methods Online sleep and work-environment self-report questionnaires (e.g., including the presence of co-sleepers, work schedules of the co-sleepers, and their work schedules) were administered. The questionnaires also included the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), the Cognitive Failures Questionnaire (CFQ), and the short-term Center for Epidemiologic Studies-Depression scale (CES-D). Participants consisted of co-sleepers of SWs (n = 657), co-sleepers of non-SWs (n = 2186), and solo sleepers (n = 2432). Results Significant between-group differences in the PSQI, ESS, CFQ, and CES-D were observed after controlling for age, gender, work shift, and parenting (p < 0.001). Co-sleepers of SWs showed higher PSQI, ESS, CFQ, and CES-D scores than co-sleepers of non-SWs and solo sleepers. Solo sleepers reported significantly higher PSQI and CES-D scores than co-sleepers of non-SWs. The PSQI, ESS, CFQ, and CES-D scores were significantly correlated in all groups. The association between the ESS and PSQI was stronger in co-sleepers of SWs than in solo sleepers. The association between the ESS and CES-D was stronger in co-sleepers of SWs than in solo sleepers. Conclusions Co-sleeping with SWs is associated with poor sleep quality, daytime sleepiness, depressive symptoms, and cognitive disturbances in the partner.
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Affiliation(s)
- Joonyoung Lim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jooyoung Lee
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Somi Lee
- 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
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15
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Jain N, Lehrer HM, Chin BN, Tracy EL, Evans MA, Krafty RT, Buysse DJ, Hall MH. Heart rate and heart rate variability following sleep deprivation in retired night shift workers and retired day workers. Psychophysiology 2023; 60:e14374. [PMID: 37409638 PMCID: PMC10770290 DOI: 10.1111/psyp.14374] [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: 07/11/2022] [Revised: 05/24/2023] [Accepted: 06/14/2023] [Indexed: 07/07/2023]
Abstract
Shift workers experience poor sleep and dysregulated cardiac autonomic function during sleep. However, it is unknown if this dysregulation persists into retirement, potentially accelerating the age-associated risk for adverse cardiovascular outcomes. Using sleep deprivation as a physiological challenge to cardiovascular autonomic function, we compared heart rate (HR) and high-frequency heart rate variability (HF-HRV) during baseline and recovery sleep following sleep deprivation between retired night shift and day workers. Participants were retired night shift (N = 33) and day workers (N = 37) equated on age (mean [standard deviation] = 68.0 [5.6] years), sex (47% female), race/ethnicity (86% White), and body mass index. Participants completed a 60-h lab protocol including one night of baseline polysomnography-monitored sleep, followed by 36 h of sleep deprivation and one night of recovery sleep. Continuously recorded HR was used to calculate HF-HRV. Linear mixed models compared HR and HF-HRV during non-rapid eye movement (NREM) and REM sleep between groups during baseline and recovery nights. Groups did not differ on HR or HF-HRV during NREM or REM sleep (ps > .05) and did not show differential responses to sleep deprivation. In the full sample, HR increased and HF-HRV decreased from baseline to recovery during NREM (ps < .05) and REM (ps < .01). Both groups exhibited cardiovascular autonomic changes during recovery sleep following 36 h of sleep deprivation. Sleep deprivation appears to induce cardiovascular autonomic changes that persist into recovery sleep in older adults, regardless of shift work history.
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Affiliation(s)
- Naveen Jain
- School of Medicine, University of Pittsburgh
| | | | | | | | | | - Robert T. Krafty
- Department of Biostatistics and Bioinformatics, Emory University
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16
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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: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [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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Fuchs F, Robin-Choteau L, Schneider A, Hugueny L, Ciocca D, Serchov T, Bourgin P. Delaying circadian sleep phase under ultradian light cycle causes time-of-day-dependent alteration of cognition and mood. Sci Rep 2023; 13:20313. [PMID: 37985784 PMCID: PMC10662432 DOI: 10.1038/s41598-023-44931-9] [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: 04/18/2023] [Accepted: 10/13/2023] [Indexed: 11/22/2023] Open
Abstract
Light exerts powerful and pervasive effects on physiology and behaviour. These effects can be indirect, through clock synchronization and phase adjustment of circadian rhythms, or direct, independent of the circadian process. Exposure to light at inappropriate times, as commonly experienced in today's society, leads to increased prevalence of circadian, sleep and mood disorders as well as cognitive impairments. In mice, exposure to an ultradian 3.5 h light/3.5 h dark cycle (T7) for several days has been shown to impair behaviour through direct, non-circadian, photic effects, a claim we challenge here. We first confirmed that T7 cycle induces a lengthening of the circadian period resulting in a day by day phase-delay of both activity and sleep rhythms. Spatial novelty preference test performed at different circadian time points in mice housed under T7 cycle demonstrated that cognitive deficit was restrained to the subjective night. Mice under the same condition also showed a modification of stress-induced despair-like behaviour in the forced swim test. Therefore, our data demonstrate that ultradian light cycles cause time-of-day-dependent alteration of cognition and mood through clock period lengthening delaying circadian sleep phase, and not through a direct photic influence. These results are of critical importance for the clinical applications of light therapy in the medical field and for today's society to establish lighting recommendations for shift work, schools, hospitals and homes.
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Affiliation(s)
- Fanny Fuchs
- Institute for Cellular and Integrative Neurosciences (INCI)-UPR 3212-CNRS/University of Strasbourg, 8 allée du Général Rouvillois, 67000, Strasbourg, France
- Sleep Disorders Center and CIRCSom (International Research Center for ChronoSomnology), Strasbourg University Hospital, 1 place de l'Hôpital, 67000, Strasbourg, France
| | - Ludivine Robin-Choteau
- Institute for Cellular and Integrative Neurosciences (INCI)-UPR 3212-CNRS/University of Strasbourg, 8 allée du Général Rouvillois, 67000, Strasbourg, France
- European Center for Diabetes Studies (CEED), Strasbourg, France
| | - Aline Schneider
- Institute for Cellular and Integrative Neurosciences (INCI)-UPR 3212-CNRS/University of Strasbourg, 8 allée du Général Rouvillois, 67000, Strasbourg, France
| | - Laurence Hugueny
- Institute for Cellular and Integrative Neurosciences (INCI)-UPR 3212-CNRS/University of Strasbourg, 8 allée du Général Rouvillois, 67000, Strasbourg, France
- Sleep Disorders Center and CIRCSom (International Research Center for ChronoSomnology), Strasbourg University Hospital, 1 place de l'Hôpital, 67000, Strasbourg, France
| | - Dominique Ciocca
- Chronobiotron-UMS3415-CNRS/University of Strasbourg, Strasbourg, France
| | - Tsvetan Serchov
- Institute for Cellular and Integrative Neurosciences (INCI)-UPR 3212-CNRS/University of Strasbourg, 8 allée du Général Rouvillois, 67000, Strasbourg, France
| | - Patrice Bourgin
- Institute for Cellular and Integrative Neurosciences (INCI)-UPR 3212-CNRS/University of Strasbourg, 8 allée du Général Rouvillois, 67000, Strasbourg, France.
- Sleep Disorders Center and CIRCSom (International Research Center for ChronoSomnology), Strasbourg University Hospital, 1 place de l'Hôpital, 67000, Strasbourg, France.
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18
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Jung SK, Lim HK, Jeong Y, Lee SJ, Park JS, Song IS. Influence of shift work on periodontitis according to the occupation group. Sci Rep 2023; 13:17921. [PMID: 37863993 PMCID: PMC10589210 DOI: 10.1038/s41598-023-45222-z] [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: 05/22/2023] [Accepted: 10/17/2023] [Indexed: 10/22/2023] Open
Abstract
This study aimed to investigate the effects of shift work on periodontal disease in blue-and white-collar workers and to examine the interaction effects between occupation and work patterns. Data were collected from the Korea National Health and Nutrition Examination Survey conducted by the Korean Ministry of Health and Welfare for a total of nine years from 2007 to 2015. Participants with missing outcome variables were excluded from the analysis and a total of 32,336 participants were included in the final analysis. Univariable odds ratios (OR) were calculated using a logistic regression model with 95% confidence interval (CI). A multivariable logistic regression analysis was performed using the backward elimination method. The CONTRAST statement was used to analyze the interaction effect between occupation and work patterns. Multivariable logistic regression analysis revealed that interaction effects are present between the terms, occupational type and work pattern. Crude OR of shift work for periodontitis was 1.269 [CI 1.213-1.327, P < 0.05]. However, following adjustment for multiple confounding factors and the interaction effect term considered, this OR (1.269) increased to 1.381 [CI 1.253-1.523] in white-collar group while it decreased to 1.198 [1.119-1.283] in blue-collar. Crude OR of blue-collar (OR = 3.123, CI 2.972-3.281, P < 0.05) decreased to 1.151 [CI 1.049-1.262] when interaction effect to the shift work was considered. Shift work pattern increases the risk for periodontitis and this adverse effect is greater when white-collar workers are engaged comparing to blue-collar. The result of this study suggests that 24/7 lifestyle of the modern society poses health risks to the relevant people and the potential harm can be greater to white-collar workers.
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Affiliation(s)
- Seok-Ki Jung
- Department of Orthodontics, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Ho-Kyung Lim
- Department of Oral and Maxillofacial Surgery, Korea University Guro Hospital, Seoul, Republic of Korea
| | - Yujin Jeong
- Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sung Jae Lee
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea
| | - Jung Soo Park
- Department of Periodontology, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
| | - In-Seok Song
- Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, 73 Goryeodae-ro, Seongbuk-gu, Seoul, 02841, Republic of Korea.
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Gao Y, Fu X, Hu H, Li T, Yuan L, Zhang J, Wu Y, Wang M, Ke Y, Li X, Hu F, Zhang M, Sun L, Wen H, Guan R, Gao P, Chai W, Zhao Y, Hu D. Impact of shift work on dementia: a systematic review and dose-response meta-analysis. Public Health 2023; 223:80-86. [PMID: 37625271 DOI: 10.1016/j.puhe.2023.07.029] [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: 05/09/2023] [Revised: 06/26/2023] [Accepted: 07/21/2023] [Indexed: 08/27/2023]
Abstract
OBJECTIVES Although shift work has been reported as having a link to dementia, evidence remains inconsistent, and a comprehensive dose-response meta-analysis of the association is still lacking. We therefore conducted this meta-analysis to explore the association between shift work and the risk of dementia. STUDY DESIGN Systematic review and dose-response meta-analysis. METHODS PubMed, Embase, and Web of Science databases were systematically searched. Fixed or random-effects models were used to estimate the summary relative risks (RRs) and 95% confidence intervals (95% CIs). Generalized least squares regression was used to estimate dose-response associations, and restricted cubic splines were used to examine possible linear or non-linear associations. RESULTS Five articles (10 studies) with 72,999 participants and 23,067 cases were eventually included in the meta-analysis. The summary RRs and 95% CIs of dementia risk with shift work and night shift work versus daytime work were 1.13 (95% CI: 1.05-1.21, I2 = 46.70%) and 1.13 (95% CI: 1.03-1.24, I2 = 9.20%), respectively. The risk of dementia increased by 1% (RR = 1.01, 95% CI: 1.01-1.02, I2 = 41.3%) with each 1-year increase in the duration of shift work. We found a non-linear dose-response association between the duration of shift work and the risk of dementia (Pnon-linearity = 0.006). Though the shape of the curve was steeper with the duration of shift work <7 years, the increase was more gradual after 7 years. CONCLUSION Our findings suggest that shift work may be a risk factor for future dementia and that controlling the length of shift work is a feasible measure that may contribute to prevent dementia.
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Affiliation(s)
- Y Gao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - X Fu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - H Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - T Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - L Yuan
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - J Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - Y Wu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - M Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - Y Ke
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - X Li
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - F Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, 518060, People's Republic of China
| | - M Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Medical School, Shenzhen, Guangdong, 518060, People's Republic of China
| | - L Sun
- Department of Social Medicine and Health Management, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - H Wen
- Department of Clinical Medicine, Zhengzhou Shuqing Medical College, 6 Gongming Road, Erqi District, Zhengzhou, Henan, 450064, People's Republic of China
| | - R Guan
- Department of Famarcy, Shenzhen University General Hospital, Shenzhen, Guangdong, 518055, People's Republic of China
| | - P Gao
- Department of Neurology, Shenzhen University General Hospital, Shenzhen, Guangdong, 518055, People's Republic of China
| | - W Chai
- Department of Neurology, Shenzhen University General Hospital, Shenzhen, Guangdong, 518055, People's Republic of China
| | - Y Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China
| | - D Hu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, People's Republic of China.
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20
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Seo JW, Lee J, Jeon S, Hwang Y, Kim J, Lee S, Kim SJ. Fatigue and somatization in shift-workers: Effects of depression and sleep. J Psychosom Res 2023; 173:111467. [PMID: 37619432 DOI: 10.1016/j.jpsychores.2023.111467] [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: 05/20/2022] [Revised: 08/12/2023] [Accepted: 08/15/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE We investigated the differences in fatigue and somatization between shift and non-shift workers and explored the effects of sleep and depression on fatigue and somatization in shift workers. METHODS In total, 4543 shift workers and 2089 non-shift workers completed self-reported questionnaires. The Center for Epidemiologic Studies Depression Scale (CESD), Pittsburgh Sleep Quality Index (PSQI), Fatigue Severity Scale (FSS), and Somatization subscale of the Symptom Checklist 90-item version (SCL-SOM) were used to measure depression, sleep quality, fatigue, and somatization, respectively. Fatigue and somatization were compared between shift and non-shift workers after controlling for different sets of covariates. RESULTS Compared to non-shift workers, shift workers reported higher FSS (mean difference: 2.19 ± 0.30, p < 0.01) and SCL-SOM (mean difference: 1.77 ± 0.21, p < 0.01) scores after controlling for age, gender, presence of medical illness, occupational category, monthly income, length of service, and weekly working hours. The between-group difference in FSS score was no longer significant after additionally controlling for CES-D (p = 0.15) or PSQI (p = 0.18). The between-group difference in SCL-SOM score showed only non-significant trends after additionally controlling for CES-D (p = 0.09) or PSQI (p = 0.07). The group difference in SCL-SOM scores disappeared after controlling for both CES-D and PSQI scores (p = 0.99). CONCLUSIONS Shift workers had higher fatigue and somatization levels than non-shift workers and the group difference was associated with disturbed sleep and depressed mood in shift workers.
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Affiliation(s)
- Jin Won Seo
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jooyoung Lee
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Sehyun Jeon
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yunjee Hwang
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Jichul Kim
- Department of Psychiatry, Sungkyunkwan University College of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Somi Lee
- 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.
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21
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Imes CC, Tucker SJ, Trinkoff AM, Chasens ER, Weinstein SM, Dunbar-Jacob J, Patrician PA, Redeker NS, Baldwin CM. Wake-up Call: Night Shifts Adversely Affect Nurse Health and Retention, Patient and Public Safety, and Costs. Nurs Adm Q 2023; 47:E38-E53. [PMID: 37643236 DOI: 10.1097/naq.0000000000000595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
The purpose of this mini review is to (1) summarize the findings on the impact of night shift on nurses' health and wellness, patient and public safety, and implications on organizational costs and (2) provide strategies to promote night shift nurses' health and improve organizational costs. The night shift, compared with day shift, results in poorer physical and mental health through its adverse effects on sleep, circadian rhythms, and dietary and beverage consumption, along with impaired cognitive function that increases nurse errors. Nurse administrators and health care organizations have opportunities to improve nurse and patient safety on night shifts. Low-, moderate-, and higher-cost measures that promote night nurses' health and well-being can help mitigate these negative outcomes. The provided individual and organizational recommendations and innovations support night shift nurses' health, patient and public safety, and organizational success.
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Affiliation(s)
- Christopher C Imes
- School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania (Drs Imes, Chasens, and Dunbar-Jacob); College of Nursing, The Ohio State University, Columbus (Dr Tucker); School of Nursing, University of Maryland, Baltimore (Dr Trinkoff); School of Nursing, Purdue University Global, West Lafayette, Indiana (Ms Weinstein); School of Nursing, The University of Alabama at Birmingham (Dr Patrician); School of Nursing, University of Connecticut, Storrs (Dr Redeker); and Edson College of Nursing and Health Innovation, Arizona State University, Phoenix (Dr Baldwin)
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22
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Ren JJ, Zhang PD, Li ZH, Zhang XR, Zhong WF, Chen PL, Huang QM, Wang XM, Gao PM, Mao C. Association of Night Shifts and Lifestyle Risks With Incident Dementia. J Gerontol A Biol Sci Med Sci 2023; 78:1725-1732. [PMID: 37115786 DOI: 10.1093/gerona/glad116] [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: 12/14/2022] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND Little is known about the combined relationship between night shifts and lifestyle risks with incident dementia or their potential interactions. To evaluate the association of night shifts and lifestyle risks with incident dementia and further analyze their interactions. METHODS A total of 276 059 participants were included in this study from the UK Biobank cohort. Cox proportional hazards models were used to investigate the combined association of night shifts and lifestyle risks with incident dementia. RESULTS Participants with always night shifts and 3 or 4 unhealthy lifestyle factors had the highest risk of incident all-cause dementia (hazard ratio: 3.15, 95% confidence interval [CI]: 1.74-5.69). An additive interaction was found between night shifts and lifestyle risks for incident all-cause dementia (p < .001), with a relative excess risk due to the interaction of 0.14 (95% CI: 0.11-0.45). The attributable proportions of the combined effect on the incidence of all-cause dementia were 22.6% (95% CI: 20.91%-26.75%) for night shift work, 65.0% (95% CI: 63.12%-69.80%) for unhealthy lifestyle factors, and 12.1% (95% CI: 8.67%-18.04%) for their interaction. CONCLUSIONS Both night shifts and lifestyle risks were associated with a higher risk of incident dementia. The combined impact was higher than the increase in the risks related to each single factor. Our results indicated that most incident dementia cases might be prevented by a healthy lifestyle, and the benefits would be greater among night shift workers. Further studies are needed to confirm our results and explore the underlying mechanisms.
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Affiliation(s)
- Jiao-Jiao Ren
- Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Pei-Dong Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
- Department of Neurosurgery, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong, China
| | - Zhi-Hao Li
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xi-Ru Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Wen-Fang Zhong
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Pei-Liang Chen
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Qing-Mei Huang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Xiao-Meng Wang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
| | - Ping-Ming Gao
- Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China
- The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Chen Mao
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China
- Microbiome Medicine Center, Department of Laboratory Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China
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23
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Khan D, Edgell H, Rotondi M, Tamim H. The association between shift work exposure and cognitive impairment among middle-aged and older adults: Results from the Canadian Longitudinal Study on Aging (CLSA). PLoS One 2023; 18:e0289718. [PMID: 37610977 PMCID: PMC10446236 DOI: 10.1371/journal.pone.0289718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 07/23/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Shift work, especially rotating and night shift work, has been linked to a wide range of detrimental health outcomes. Occupational factors like shift work and their potential impact on cognitive functions have received little attention, and the evidence is inconclusive. The objective of our study is to explore associations between shift work exposure and cognitive impairment indicators based on comparisons with the normative standards from the Canadian population. METHODS Cross-sectional analyses were performed using baseline Canadian Longitudinal Study on Aging database, including 47,811 middle-aged and older adults (45-85 years). Three derived shift work variables were utilized: ever exposed to shift work, shift work exposure in longest job, and shift work exposure in current job. Four cognitive function tests were utilized, Rey Auditory Verbal Learning Tests (immediate and delayed) representing memory domain, and Animal Fluency, and Mental Alteration, representing the executive function domain. All cognitive test scores included in study were normalized and adjusted for the participant's age, sex, education and language of test administration (English and French), which were then compared to normative data to create "cognitive impairment' variables. Unadjusted and adjusted multivariable logistic regression models were used to determine associations between shift work variables and cognitive impairment individually (memory and executive function domains), and also for overall cognitive impairment. RESULT Overall, one in every five individuals (21%) reported having been exposed to some kind of shift work during their jobs. Exposure to night shift work (both current and longest job) was associated with overall cognitive impairment. In terms of domain-based measures, night shift work (longest job) was associated with memory function impairment, and those exposed to rotating shift work (both current and longest job) showed impairment on executive function measures, when compared to daytime workers. CONCLUSION This study suggests disruption to the circadian rhythm, due to shift work has negative impact on cognitive function in middle-aged and older adults and this warrants further investigation.
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Affiliation(s)
- Durdana Khan
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Heather Edgell
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Michael Rotondi
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
| | - Hala Tamim
- School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada
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24
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Mehra R, Pulman A, Dogan H, Murphy J, Bitters F. A Tailored mHealth App for Improving Health and Well-Being Behavioral Transformation in UK Police Workers: Usability Testing via a Mixed Methods Study. JMIR Hum Factors 2023; 10:e42912. [PMID: 37540549 PMCID: PMC10439470 DOI: 10.2196/42912] [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: 10/04/2022] [Revised: 04/24/2023] [Accepted: 04/30/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND When considering the policing environment of 2022, many roles previously in the domain of warranted officers (police officer) are now performed by nonwarranted police staff equivalents. These police staff roles have expanded rapidly into other areas such as investigations, custody, and contact management, which were traditionally seen as police officer functions and put staff under some of the same stresses as police officers. A UK police force requested help in investigating technologies that could be used to improve health and well-being for both officers and staff. OBJECTIVE The aim of this study was to create a health and well-being app for police officers and staff, which considered the unique requirements of the users throughout the designing, building, prototyping, and testing stages. METHODS This study involved quantitative approaches (demographic web-based survey questions and the System Usability Scale) and qualitative approaches (open web-based survey questions and semistructured interviews). Unsupervised usability testing of a prototype app was undertaken by members (N=48) of the commissioning client using their smartphones. After completing a preregistration application for screening purposes, participants downloaded a trial version of the app. Then, they completed a web-based questionnaire after testing the app for 10 days. A subsample of participants (9/48, 19%) was interviewed. Deductive thematic analysis was undertaken to identify key themes and subthemes. RESULTS Data collected during usability testing concerned the 6 domains of the app-food and diet, activity, fluid intake, sleep, good mental health, and financial well-being-and informed the creation of improved design during prototyping. Some usability and design issues and suggestions for improvements were also addressed and implemented-including shift management and catch-up cards-during this cycle of development. CONCLUSIONS This study highlights the importance of coparticipation with officers and staff across the entire development cycle, to coproduce a human-centered design methodology to enable the development of a considered and user-centered solution. It demonstrates the need for producing a multifunctional tool rather than focusing purely on an individual element for this user group. It also highlights how linking and being able to track optional, personalized elements of health data against one another, cross-referenced to individual shift patterns, might help to inform and provide users with a chance for reflection and therefore influence behavior change.
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Affiliation(s)
- Richa Mehra
- Bournemouth University, Faculty of Science and Technology, Bournemouth, United Kingdom
| | - Andy Pulman
- Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, United Kingdom
| | - Huseyin Dogan
- Bournemouth University, Faculty of Science and Technology, Bournemouth, United Kingdom
| | - Jane Murphy
- Bournemouth University, Faculty of Health and Social Sciences, Bournemouth, United Kingdom
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25
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Allen L, Cooper S, Missen K. Perceptions of being a registered nurse (PRN): development and validation of a survey tool. BMC Nurs 2023; 22:159. [PMID: 37165374 PMCID: PMC10170037 DOI: 10.1186/s12912-023-01324-7] [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: 06/15/2022] [Accepted: 04/29/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND Nursing students enter nursing programs with idealistic perceptions of what it is to be a nurse. Upon graduation, many find these perceptions mismatched with the actual nurse's role. This can lead to discontentment in their chosen career. These issues highlight the importance of nursing students developing an understanding of the nurse's role during their undergraduate nursing education. One way to accomplish this is to assess perceptions and address them accordingly during the nursing program. Survey tools assessing perceptions of nursing exist but lack contemporary and multicultural foci. AIM To develop a feasible, valid, and reliable survey tool to identify nursing students' perceptions of being a nurse. DESIGN/METHODS In Phase 1, a literature review and Nominal Group Technique meetings were used to generate primary survey items. Phase 2 included a pre-pilot and online pilot testing of the Perceptions of being a Registered Nurse (PRN) survey tool with 797 nursing students across all year levels at three Australian Universities. RESULTS The 34-item PRN survey tool uses a five-point Likert scale to measure nursing students' perceptions of nursing, including factors influencing a nurse's well-being, attributes and qualities of nurses, the role of the nurse, and nursing professionalism. The Item-Content validity index was high (> 0.78), and the inter-item correlation validity was identified by Pearson's product-moment coefficient of r = .712. Internal reliability was confirmed with a Cronbach's alpha = 0.83. Based upon the participation completion rate, the survey tool was deemed applicable and feasible. The majority of respondents believed that nurses have altruistic attributes; however, perceptions of nursing varied significantly when rating factors influencing the physical, emotional, and social well-being of a nurse. In later stages of training, respondents were more likely to agree that nursing is physically and emotionally demanding and that nurses experience social isolation due to shift work, finding it difficult to achieve a work-life balance. CONCLUSIONS The PRN survey tool was found to be valid, reliable, and feasible. Future use and outcomes from PRN assessments may lead to changes to nursing curricula that enhance nursing students' perceptions of nursing.
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Affiliation(s)
- Louise Allen
- Institute of Health and Wellbeing, Federation University, Room 2W-144, Gippsland Campus, Churchill, VIC, Australia.
| | - Simon Cooper
- Healthcare Research, Institute of Health and Wellbeing, Federation University, Berwick Campus, Berwick, VIC, Australia
| | - Karen Missen
- Institute of Health and Wellbeing, Federation University, Gippsland Campus, Churchill, VIC, Australia
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26
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Camargo EF, Nóbrega OT. Glymphatic system, sleep, and shift work: a new paradigm in occupational and mental health? Dement Neuropsychol 2023; 17:e20220077. [PMID: 37223843 PMCID: PMC10202331 DOI: 10.1590/1980-5764-dn-2022-0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 05/25/2023] Open
Affiliation(s)
- Einstein Francisco Camargo
- Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, Brasília DF, Brazil
| | - Otávio Toledo Nóbrega
- Universidade de Brasília, Faculdade de Ciências da Saúde, Programa de Pós-Graduação em Ciências da Saúde, Brasília DF, Brazil
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27
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Gusman E, Standlee J, Reid KJ, Wolfe LF. Work-Related Sleep Disorders: Causes and Impacts. Semin Respir Crit Care Med 2023; 44:385-395. [PMID: 37072022 DOI: 10.1055/s-0043-1767787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Insufficient sleep syndrome, shift work disorder, and obstructive sleep apnea (OSA) not only significantly impact the health of affected individuals, but also pose a threat to public safety. This article describes the clinical manifestations and impact of these sleep disorders, particularly as they pertain to workers' health and those with safety-sensitive positions. Sleep deprivation, circadian rhythm disruptions, and excessive daytime sleepiness-hallmarks of insufficient sleep, shift work disorder, and OSA, respectively-all lead to a series of cognitive deficits and impaired concentration that affect workers in a wide variety of fields. We describe the health consequences of these disorders along with treatment strategies, with a focus on current regulatory standards and the under-recognition of OSA in commercial drivers. Given its large scale, there is a need for improved guidelines and regulations for the screening, diagnosis, treatment, and long-term follow-up of OSA in commercial motor vehicle drivers. Increased recognition of the ways in which these sleep disorders impact workers will pave the way for significant improvements in occupational health and safety.
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Affiliation(s)
- Elen Gusman
- Department of Pulmonary and Critical Care Medicine, Northwestern Medicine, Chicago, Illinois
| | - Jordan Standlee
- Department of Neurology, University of Michigan, Ann Arbor, Michigan
| | - Kathryn J Reid
- Department of Neurology, Division of Sleep Medicine, Northwestern Medicine, Chicago, Illinois
- Center for Circadian and Sleep Medicine, Northwestern Medicine, Chicago, Illinois
| | - Lisa F Wolfe
- Department of Pulmonary and Critical Care Medicine, Northwestern Medicine, Chicago, Illinois
- Department of Neurology, Division of Sleep Medicine, Northwestern Medicine, Chicago, Illinois
- Center for Circadian and Sleep Medicine, Northwestern Medicine, Chicago, Illinois
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28
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Alaminos-Torres A, Martínez-Álvarez JR, Martínez-Lorca M, López-Ejeda N, Marrodán Serrano MD. Fatigue, Work Overload, and Sleepiness in a Sample of Spanish Commercial Airline Pilots. Behav Sci (Basel) 2023; 13:bs13040300. [PMID: 37102814 PMCID: PMC10135893 DOI: 10.3390/bs13040300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/20/2023] [Accepted: 03/28/2023] [Indexed: 04/05/2023] Open
Abstract
Commercial aviation pilots are an occupational group that work in particular conditions, with frequent schedule changes, shift work, unfavorable environmental conditions, etc. These circumstances can lead to fatigue, work overload (WO), and daytime sleepiness, factors that can affect their health and safety. This study aimed to assess the prevalence and the association between these parameters in a sample of Spanish commercial airline pilots. The Raw TLX, Fatigue Severity Scale, and the Epworth Sleepiness Scale questionnaires were administered in a sample of 283 participants. The relationships of the total scores between all the questionnaires were studied by the chi-square test and the risk scores (odds ratio) were calculated. Different models using multiple linear regression were carried out to evaluate the effects of WO, fatigue, and daytime sleepiness, among the total scores, age, and flight hours. Additionally, the internal consistency of each questionnaire was estimated. A total of 28.2% presented WO above the 75th percentile, with mental and temporal demand the dimensions with the greatest weight. A total of 18% of pilots presented fatigue, 15.8% moderate sleepiness, and 3.9% severe sleepiness. We observed an association among WO, fatigue, and daytime sleepiness, important factors related to pilot health and aviation safety.
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Affiliation(s)
- Ana Alaminos-Torres
- Physical Anthropology Unit, Department of Biodiversity, Ecology and Evolution, Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain
- EPINUT Research Group, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Jesús Román Martínez-Álvarez
- EPINUT Research Group, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
- Spanish Society of Dietetics and Food Sciences, Pozuelo de Alarcón, 28224 Madrid, Spain
| | - Manuela Martínez-Lorca
- Department of Psychology, Faculty of Health Sciences, University of Castilla-La Mancha, 45600 Talavera de la Reina, Spain
| | - Noemí López-Ejeda
- Physical Anthropology Unit, Department of Biodiversity, Ecology and Evolution, Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain
- EPINUT Research Group, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - María Dolores Marrodán Serrano
- Physical Anthropology Unit, Department of Biodiversity, Ecology and Evolution, Faculty of Biological Sciences, Complutense University of Madrid, 28040 Madrid, Spain
- EPINUT Research Group, Faculty of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
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29
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Chin BN, Lehrer HM, Tracy EL, Barinas-Mitchell E, Wilckens KA, Carroll LW, Buysse DJ, Hall MH. Cardiometabolic function in retired night shift workers and retired day workers. Sci Rep 2023; 13:5204. [PMID: 36997580 PMCID: PMC10063655 DOI: 10.1038/s41598-022-20743-1] [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: 02/11/2022] [Accepted: 09/19/2022] [Indexed: 04/01/2023] Open
Abstract
Night shift work is associated with poor cardiometabolic outcomes, even post-retirement. However, the characteristics of cardiometabolic function in retired night shift workers (RNSW) compared to retired day workers (RDW) are not well-understood. Rigorous characterization of cardiometabolic dysfunction in RNSW and RDW will inform targeted risk stratification for RNSW. This observational study evaluated whether RNSW (n = 71) had poorer cardiometabolic function than RDW (n = 83). We conducted a multimodal assessment of cardiometabolic function including metabolic syndrome prevalence, brachial artery flow-mediated dilation, and carotid intima-media thickness. Main analyses tested overall group differences. Sex-stratified follow-up analyses tested group differences separately in men and women. RNSW had 2.6-times higher odds of metabolic syndrome prevalence than RDW in unadjusted analyses (95% CI [1.1,6.3]); this association was not significant when adjusting for age, race and education. RNSW and RDW (Mage = 68.4; 55% female) did not differ in percent flow-mediated dilation or carotid intima-media thickness. In sex-stratified analyses, women RNSW had 3.3-times higher odds of having high body mass index than women RDW (95% CI [1.2,10.4]). Men RNSW had 3.9-times higher odds of having high triglycerides than men RDW (95% CI [1.1,14.2]). No other group differences were observed. We found mixed evidence that night shift work exposure was associated with cardiometabolic dysfunction in retirement, possibly in a sex-specific manner.
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Affiliation(s)
- Brian N Chin
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
- Department of Psychology, Trinity College, Hartford, CT, 06106, USA
| | - H Matthew Lehrer
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Eunjin Lee Tracy
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | | | - Kristine A Wilckens
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Lucas W Carroll
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
| | - Daniel J Buysse
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA.
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Western Psychiatric Hospital, 3811 O'Hara Street, Pittsburgh, PA, 15213, USA
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Barnes-Farrell JL, Laguerre RA, Di Milia LV. An evaluation of morningness and schedule misfit using the revised Preferences Scale (PS-6): Implications for work and health outcomes among healthcare workers. Chronobiol Int 2023:1-14. [PMID: 36942679 DOI: 10.1080/07420528.2023.2193272] [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: 03/23/2023]
Abstract
The last several decades of shift work tolerance and circadian misalignment research has had mixed results regarding the adverse impact of shift work on work and health outcomes. This inconsistency is, in part, due to the circadian typology measure employed and the study methodology. Based on models of shift work and health, the present study examined associations between circadian misalignment, end-of-day strain, and job- and health-related outcomes using the revised Preferences Scale (PS-6). A sample of 129 healthcare workers (76.7% female) from the United States (67%) and Australia (34.1%) aged 22 to 64 responded to a self-report questionnaire on work schedules, work stressors, and well-being. Multiple regression analysis found that the preferences for cognitive activity subscale of the PS-6 moderated the association between shift work and strain (b = -.36, p < .001). Those who worked nights experienced more strain if their preferences for cognitive activity were misaligned, whereas no differences in strain were observed among day workers. Moderated-mediation analyses, on the basis 95% confidence intervals, found that shift work had a conditional indirect effect on work-family conflict, job satisfaction, and health-related quality of life, via strain, and the effect was moderated by preferences for cognitive activity. Findings provide additional evidence for the criterion and external validity of the PS-6, and importantly, the present study establishes further support for models of shift work and health. Overall, the analyses highlight the importance of exploring the interactions between shift work and different dimensions of morningness in shift work tolerance research.
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Affiliation(s)
- Janet L Barnes-Farrell
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Rick A Laguerre
- Department of Psychology, Montclair State University, Montclair, New Jersey, USA
| | - Lee V Di Milia
- School of Business and Law, Central Queensland University, Rockhampton, Australia
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Tagesschläfrigkeit bei Pflegepersonal. ZENTRALBLATT FÜR ARBEITSMEDIZIN, ARBEITSSCHUTZ UND ERGONOMIE 2023. [DOI: 10.1007/s40664-023-00495-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
Zusammenfassung
Hintergrund
Aufgrund von Arbeitszeiten, die außerhalb der normalen Tagesarbeitszeit liegen, kann es bei Pflegepersonal zu Störungen der inneren Uhr kommen. Durch zusätzliche Verpflichtungen im familiären Bereich kann sich möglicherweise eine Normalisierung der zirkadianen Störung bei weiblichen Pflegenden erschweren, da sie zu Hause nicht genug Zeit für Schlaf und Erholung finden.
Fragestellung
In der vorliegenden Arbeit soll explorativ untersucht werden, ob Beschäftigte in der Pflege ein höheres Risiko für Tagesschläfrigkeit haben als andere Berufsgruppen, die nicht im Schichtdienst arbeiten. Darüber hinaus soll ebenfalls explorativ analysiert werden, inwiefern das Geschlecht in Verbindung mit der Beschäftigung im Schichtdienst eine Rolle hinsichtlich der Tagesschläfrigkeit spielt.
Material und Methoden
Aus der 10.000er Baselinestichprobe der Hamburg City Health Study (HCHS) wurden alle Proband:innen selektiert, die beruflich in der Pflege tätig waren. Anhand des Alters, des Geschlechts und des Chronotyps wurden aus dem HCHS-Datensatz aktiv Beschäftigte im Verhältnis 1:3 gezogen, die aus Branchen mit vorwiegend keiner Schichtarbeit stammen (Kontrollen). Die Tagesschläfrigkeit wurde anhand des Epworth-Sleepiness-Scale-Fragebogens (ESS) erhoben.
Ergebnisse
In der Gesamtstichprobe der HCHS waren 4646 Personen aktiv beschäftigt. Unter diesen befanden sich 134 Personen, die angaben, in der Pflege zu arbeiten. Anhand des Matchings von 1:3 wurde ein Datensatz von 536 Personen erzeugt. Insgesamt konnte für 19 % der Stichprobe eine exzessive Tagesschläfrigkeit beobachtet werden, davon betroffen waren 25 % der Pflegenden und 17 % der Beschäftigten anderer Branchen. Weibliche Beschäftigte in der Pflege hatten im Vergleich zu Männern aus anderen Branchen ein statistisch signifikant erhöhtes Risiko für exzessive Tagesschläfrigkeit (OR 3,5; 95 % KI 1,32–9,23).
Diskussion
Anhand der Ergebnisse der bevölkerungsbezogenen Untersuchung zeigt sich, dass Pflegepersonal im Vergleich zu Branchen ohne Schichtarbeit öfter von Tagesschläfrigkeit betroffen ist. Inwieweit Frauen, die in der Pflege arbeiten ein noch höheres Risiko für Tagesschläfrigkeit besitzen, sollte in weiteren Studien anhand zusätzlicher Merkmale präziser untersucht werden.
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Meal timing variability of rotating shift workers throughout a complete shift cycle and its effect on daily energy and macronutrient intake: a field study. Eur J Nutr 2023; 62:1707-1718. [PMID: 36797507 DOI: 10.1007/s00394-023-03106-y] [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: 08/22/2022] [Accepted: 01/31/2023] [Indexed: 02/18/2023]
Abstract
PURPOSE To evaluate the meal timing variability of rotating shift workers throughout a complete shift schedule and its effect on daily energy and macronutrient intake. METHODS Thirty male shift-workers from a mining company were evaluated in a complete rotation shift cycle over 240 consecutive hours (10 days; two days of morning shifts, two days of evening shifts, 24 h free, two days of night shifts and three days off). Food intake related variables [meal timing, energy (kcal) and macronutrient intake (%)] were assessed by 24 h recall by a trained nutritionist. Mixed models were used to analyze the variation in meal timing and energy and macronutrient intake throughout the shift cycle, as well as the interaction between shift and time ranges (00:00-03:59, 04:00-07:59, 08:00-11:59, 12:00-15:59, 16:00-19:59, 20:00-23:59). RESULTS The first meal of the day was earlier on night shifts [D6 (3:44 ± 0:33) and D7 (5:52 ± 0:42)] compared to the other shifts (p < 0.001), except for D4 (evening shift; 5:51 ± 0:47) versus D7 (p = 0.999). Night shifts also showed a shorter night fasting (D5-D6, 9.3 h; D6-D7, 9.6 h) than most other nights (p < 0.05), except for the fasting between D1-D2 (11.3 h) and D3-D4 (11.2 h) (p > 0.05). There was no difference in 24 h energy intake throughout the shift cycle (p = 0.065). The analysis of interaction between shift and time ranges showed that night shift (D6) presented a higher intake of energy (441.5 ± 48.4 kcal), percentage of energy (D6: 17.8 ± 1.8%), fat (17.6 ± 2.0%), carbohydrate (17.0 ± 1.7%) and protein (16.4 ± 1.8%) between 00:00 and 03:59 compared with the other shift days (p < 0.05). CONCLUSION Night shifts seem to contribute to a longer eating window than other shifts. Moreover, there is a higher energy and macronutrients intake during night shifts, which reduces the night fast period and could have implications for metabolic dysregulation.
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Reynolds AC, Sweetman A, Crowther ME, Paterson JL, Scott H, Lechat B, Wanstall SE, Brown BW, Lovato N, Adams RJ, Eastwood PR. Is cognitive behavioral therapy for insomnia (CBTi) efficacious for treating insomnia symptoms in shift workers? A systematic review and meta-analysis. Sleep Med Rev 2023; 67:101716. [PMID: 36459948 DOI: 10.1016/j.smrv.2022.101716] [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: 07/11/2022] [Revised: 10/14/2022] [Accepted: 11/08/2022] [Indexed: 11/23/2022]
Abstract
Shift workers commonly report insomnia symptoms. Cognitive behavioral therapy for insomnia (CBTi) is the first line treatment for insomnia, however efficacy in shift workers is not well understood. This systematic review and meta-analysis evaluates existing trials of CBTi in shift working populations. A systematic literature search was conducted across seven electronic databases (n = 2120). Fifty-two full-text articles were reviewed and of these, nine studies (across ten publications with a total of 363 participants) were deemed suitable for inclusion. Heterogeneity was considerable between studies, with variability in study design, style and delivery of intervention, and follow-up times. Small sample sizes were common and attrition was high. Some studies modified aspects of CBTi for use in shift workers, while others were limited to psycho-education as part of larger intervention studies. Mean differences (MD) pre and post CBTi were modest for both the insomnia severity index (ISI; MD: -3.08, 95% CI: -4.39, -1.76) and the Pittsburgh sleep quality index (PSQI; MD: -2.38, 95% CI: -3.55, -1.21). Neither difference was of a magnitude considered to reflect a clinically significant improvement. Tailored approaches to CBTi are needed for shift workers to improve efficacy, ideally including co-production with workers to ensure interventions meet this population's needs.
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Affiliation(s)
- Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Bedford Park, South Australia, Australia.
| | - Alexander Sweetman
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Bedford Park, South Australia, Australia
| | - Meagan E Crowther
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Bedford Park, South Australia, Australia; Appleton Institute, CQUniversity Australia, Adelaide, South Australia, Australia
| | - Jessica L Paterson
- College of Education, Psychology and Social Work, Flinders University, Adelaide, South Australia, Australia
| | - Hannah Scott
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Bedford Park, South Australia, Australia
| | - Bastien Lechat
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Bedford Park, South Australia, Australia
| | - Sian E Wanstall
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Bedford Park, South Australia, Australia
| | - Brandon Wj Brown
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Bedford Park, South Australia, Australia
| | - Nicole Lovato
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Bedford Park, South Australia, Australia
| | - Robert J Adams
- Flinders Health and Medical Research Institute (Sleep Health), Flinders University, Bedford Park, South Australia, Australia
| | - Peter R Eastwood
- Flinders Health and Medical Research Institute, Flinders University, Bedford Park, South Australia, Australia
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Conway-Jones R, Dunlop E, Kyle S, Ray D, Roberts N, Farmer A. A scoping review of the evidence for the impact of pharmacological and non-pharmacological interventions on shift work related sleep disturbance in an occupational setting. Wellcome Open Res 2023; 6:198. [PMID: 37346814 PMCID: PMC10280030 DOI: 10.12688/wellcomeopenres.17002.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2022] [Indexed: 08/17/2023] Open
Abstract
Background: Shift work is essential in society but can be detrimental to health and quality of life and is associated with decreased productivity and increased risk of accidents. Interventions to reduce these consequences are needed, but the extent and range of trial evidence for interventions for those most affected by their shift-work schedules is unclear. We therefore carried out a scoping review to assess the availability of evidence to inform the development and evaluation of future interventions. Methods: We aimed to identify clinical trials of any intervention for shift work-related sleep disturbance that included a comparator group, where the intervention was delivered in an occupational setting. We searched Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, CINAHL, EMBASE, Medline and Science Citation Index from inception to 30 th March 2020 for relevant citations. Citations were screened by two independent reviewers, a third reviewer resolved disagreements. Data were extracted by two independent reviewers. Results: From 1250 unique citations, 14 studies met inclusion criteria for comparative trials of treatment in an occupational setting. There were five trials of hypnotics, five trials of stimulants, and four trials of non-pharmacological therapies (cognitive behavioural therapy, light therapy, aromatherapy and herbal medicine). Outcomes included sleep parameters, day-time sleepiness, and quality of life. There were no consistently reported outcomes across trials. Conclusions: Interventions fell into three distinct groups investigated in distinct time periods without progression from efficacy trials to wider-scale interventions. The lack of consistent patient-reported outcome measures limits synthesising findings. Some trials focussed on optimising sleep, others on reducing wake-time sleepiness. Adequately powered trials of existing interventions are needed, with the development and testing of novel combination treatments in patients with well-defined shift work sleep disorder. A core set of clinically relevant outcomes will develop and standardise the evidence-base for shift work sleep disorder.
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Affiliation(s)
| | - Ella Dunlop
- Medical Science Division, University of Oxford, Oxford, UK
| | - Simon Kyle
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - David Ray
- NIHR Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford, UK
| | - Nia Roberts
- The Bodleian Libraries, University of Oxford, Oxford, UK
| | - Andrew Farmer
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Cha EJ, Bang YR, Jeon HJ, Yoon IY. Network structure of insomnia symptoms in shift workers compared to non-shift workers. Chronobiol Int 2023; 40:246-252. [PMID: 36600639 DOI: 10.1080/07420528.2022.2163654] [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: 01/06/2023]
Abstract
Insomnia is a commonly occurring sleep problem in shift workers. So far, no studies have investigated how insomnia symptoms present differently in shift workers and non-shift workers. The purpose of this study was to compare the network structures and centrality indices of shift and non-shift workers using network analysis and network comparison test. Participants included 1339 hospital employees, where 542 were shift workers and 797 were non-shift workers. Overall, a significant difference between network structures were observed. In particular, daytime dysfunction emerged as a strongly connected symptom in shift workers, as evidenced by strength centrality. Increased use of sleeping medication and decreased habitual sleep efficiency were more strongly associated with increased daytime dysfunction in shift workers. Sleep latency and sleep quality were also more strongly linked in shift workers. These results are in part attributable to differing causes of insomnia in shift and non-shift workers. Furthermore, the results indicate that shift workers are more vulnerable and susceptible to changes in sleep-related indices, such as sleep efficiency and latency. The findings suggest that certain insomnia symptoms are more consequential in shift workers, emphasizing the need for a differentiated approach in treating insomnia according to shift work.
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Affiliation(s)
- Eun Jung Cha
- Department of Psychiatry, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - Young Rong Bang
- Department of Psychiatry, Ulsan University Hospital, Ulsan, Republic of Korea
| | - Hong Jun Jeon
- Department of Psychiatry, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea
| | - In-Young Yoon
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
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The prevalence of sleep loss and sleep disorders in young and old adults. AGING BRAIN 2023; 3:100057. [PMID: 36911264 PMCID: PMC9997161 DOI: 10.1016/j.nbas.2022.100057] [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: 06/27/2022] [Revised: 10/28/2022] [Accepted: 11/24/2022] [Indexed: 12/24/2022] Open
Abstract
The ability to sleep declines with age. The National Sleep Foundation, USA has recommended a minimum sleep amount for all ages. Individuals who experience sleep lesser than the recommended amount could be sleep-deprived. Several factors like stress, altered circadian cycle, medical conditions, etc. cause sleep deficiency. Almost 50-60 % of elderly population suffer from sleep disorders such as sleep apnea, restless legs syndrome, REM sleep behavior disorder, etc. Chronic sleep deprivation may further lead to the development of diseases such as Alzheimer's and Parkinson's. This paper reviews the prevalence of sleep disorders and consequences of sleep loss in young and old adults.
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Liao H, Pan D, Deng Z, Jiang J, Cai J, Liu Y, He B, Lei M, Li H, Li Y, Xu Y, Tang Y. Association of shift work with incident dementia: a community-based cohort study. BMC Med 2022; 20:484. [PMID: 36522755 PMCID: PMC9753386 DOI: 10.1186/s12916-022-02667-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 11/17/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Some observational studies had found that shift work would increase risks of metabolic disorders, cancers, and cardiovascular diseases, but there was no homogeneous evidence of such an association between shift work and incident dementia. This study aimed to investigate whether shift work would increase the risk of dementia in a general population. METHODS One hundred seventy thousand seven hundred twenty-two employed participants without cognitive impairment or dementia at baseline recruited between 2006 and 2010 were selected from the UK Biobank cohort study. Follow-up occurred through June 2021. Shift work status at baseline was self-reported by participants and they were categorized as non-shift workers or shift workers. Among shift workers, participants were further categorized as night shift workers or shift but non-night shift workers. The primary outcome was all-cause dementia in a time-to-event analysis, and the secondary outcomes were subtypes of dementia, including Alzheimer's disease, vascular dementia, and other types of dementia. RESULTS In total, 716 dementia cases were observed among 170,722 participants over a median follow-up period of 12.4 years. Shift workers had an increased risk of all-cause dementia as compared with non-shift workers after multivariable adjustment (hazard ratio [HR], 1.30, 95% confidence interval [CI], 1.08-1.58); however, among shift workers, night shift work was not associated with the risk of dementia (HR, 1.04, 95% CI, 0.73-1.47). We found no significant interaction between shift work and genetic predisposition to dementia on the primary outcome (P for interaction = 0.77). CONCLUSIONS Shift work at baseline was associated with an increased risk of all-cause dementia. Among shift workers, there was no significant association between night shift work and the risk of dementia. The increased incidence of dementia in shift workers did not differ between participants in different genetic risk strata for dementia.
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Affiliation(s)
- Huanquan Liao
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China
- Department of Neurology, the Seventh Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 517108, People's Republic of China
| | - Dong Pan
- Department of Neurology, the Eighth Affiliated Hospital, Sun Yat-Sen University, Shenzhen, 518033, People's Republic of China
| | - Zhenhong Deng
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China
| | - Jingru Jiang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China
| | - Jinhua Cai
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China
| | - Ying Liu
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China
| | - Baixuan He
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China
| | - Ming Lei
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China
| | - Honghong Li
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China
| | - Yi Li
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China
| | - Yongteng Xu
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China
| | - Yamei Tang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China.
- Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, 510120, People's Republic of China.
- Guangdong Province Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, 510062, People's Republic of China.
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Sweileh WM. Analysis and mapping of global research publications on shift work (2012-2021). J Occup Med Toxicol 2022; 17:22. [PMID: 36514070 PMCID: PMC9747264 DOI: 10.1186/s12995-022-00364-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/02/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The main objective of the study was to identify research trends, collaboration patterns, and the most impactful publications in the field of shift work. METHODS Documents published in scientific journals indexed in the Scopus database on shift work were retrieved and analyzed using the title/abstract search methodology. The study period was from January 1st, 2012, to December 31st, 2021. RESULTS Two thousand three hundred twenty-eight documents were retrieved with an h-index of 71 and an average number of 4.5 authors per document. The cumulative number of publications showed a linear growth pattern, while that of citations showed an exponential pattern. The most frequent author keywords, excluding keywords related to shift work, were sleep, fatigue, and nursing. The average annual growth rate was 4.3, and the average doubling time was 3.2. No significant correlation was found between the number of publications and national income among prolific countries. Cross-country research collaboration was weak while the degree of author-author collaboration was relatively high. The Chronobiology International journal was the most prolific, while Harvard University was the most active institution in the field of shift work. CONCLUSIONS Given the volume and the negative health impact of shift work, better human resource management is needed to create safer and healthier working schedules.
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Affiliation(s)
- Waleed M. Sweileh
- grid.11942.3f0000 0004 0631 5695Department of Physiology, Pharmacology/Toxicology, Division of Biomedical Sciences, College of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
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Chen X, Yin W, Wu J, Luo Y, Wu J, Li G, Jiang J, Yao Y, Wan S, Yi G, Tan X. A nomogram for predicting lung-related diseases among construction workers in Wuhan, China. Front Public Health 2022; 10:1032188. [PMID: 36579057 PMCID: PMC9792134 DOI: 10.3389/fpubh.2022.1032188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/24/2022] [Indexed: 12/14/2022] Open
Abstract
Objective To develop a prediction nomogram for the risk of lung-related diseases (LRD) in construction workers. Methods Seven hundred and fifty-two construction workers were recruited. A self- designed questionnaire was performed to collected relevant information. Chest X-ray was taken to judge builders' lung health. The potential predictors subsets of the risk of LRD were screened by the least absolute shrinkage and selection operator regression and univariate analysis, and determined by using multivariate logistic regression analysis, then were used for developing a prediction nomogram for the risk of LRD. C-index, calibration curve, receiver operating characteristic curve, decision curve analysis (DCA) and clinical impact curve analysis (CICA) were used to evaluation the identification, calibration, predictive ability and clinical effectiveness of the nomogram. Results Five hundred and twenty-six construction workers were allocated to training group and 226 to validation group. The predictors included in the nomogram were symptoms, years of dust exposure, work in shifts and labor intensity. Our model showed good discrimination ability, with a bootstrap-corrected C index of 0.931 (95% CI = 0.906-0.956), and had well-fitted calibration curves. The area under the curve (AUC) of the nomogram were (95% CI = 0.906-0.956) and 0.945 (95% CI = 0.891-0.999) in the training and validation groups, respectively. The results of DCA and CICA indicated that the nomogram may have clinical usefulness. Conclusion We established and validated a novel nomogram that can provide individual prediction of LRD for construction workers. This practical prediction model may help occupational physicians in decision making and design of occupational health examination.
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Affiliation(s)
- Xuyu Chen
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Wenjun Yin
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, China
| | - Jie Wu
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, China
| | - Yongbin Luo
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, China
| | - Jing Wu
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, China
| | - Guangming Li
- School of Public Health, Wuhan University, Wuhan, Hubei, China
| | - Jinfeng Jiang
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, China
| | - Yong Yao
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, China
| | - Siyu Wan
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, China
| | - Guilin Yi
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, China,*Correspondence: Guilin Yi
| | - Xiaodong Tan
- School of Public Health, Wuhan University, Wuhan, Hubei, China,Xiaodong Tan
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Ma Z, Wang D, Chen XY, Tao Y, Yang Z, Zhang Y, Huang S, Bu L, Wang C, Wu L, Fan F. Network structure of insomnia and depressive symptoms among shift workers in China. Sleep Med 2022; 100:150-156. [PMID: 36057245 DOI: 10.1016/j.sleep.2022.08.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/04/2022] [Accepted: 08/15/2022] [Indexed: 01/12/2023]
Abstract
A bidirectional relationship between insomnia and depression has been observed. However, few studies have used network analysis to explore the interaction patterns in that association at the symptom level. This study aimed to estimate network structures of insomnia and depressive symptoms among shift workers, as well as to compare the differences in network properties between individuals without and with insomnia symptoms and/or at risk of depression. A total of 1883 shift workers were included in our study. Insomnia symptoms were evaluated by three items based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, and depressive symptoms were assessed by the Center for Epidemiologic Studies Depression Scale. Network analyses were used for the statistical analysis. "Difficulty initiating sleep", "Hard to get started", and "Depressed mood" with higher expected influence (EI) values were identified as the most central symptoms within the insomnia-depressive networks among shift workers. The significant differences between individuals without and with insomnia symptoms and/or at risk of depression were observed in symptoms of "Difficulty initiating sleep" and "Hard to get started". "Depressed mood", "Difficulty initiating sleep", or "Hard to get started" were the most key symptoms that trigger and sustain the structure of insomnia and depressive symptom among shift workers. Hence, timely intervention for the above three symptoms in future research or clinical practice (e.g., cognitive behavioral therapy for insomnia) may be crucial in alleviating insomnia and depressive symptoms among shift workers.
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Affiliation(s)
- Zijuan Ma
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Xiao-Yan Chen
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yanqiang Tao
- Beijing Key Laboratory of Applied Experimental Psychology, Beijing Normal University, Beijing, China
| | - Zheng Yang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Yifan Zhang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Shuiqing Huang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Luowei Bu
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Chengchen Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Lili Wu
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Fang Fan
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China.
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Su K, Din ZU, Cui B, Peng F, Zhou Y, Wang C, Zhang X, Lu J, Luo H, He B, Kelley KW, Liu Q. A broken circadian clock: The emerging neuro-immune link connecting depression to cancer. Brain Behav Immun Health 2022; 26:100533. [PMID: 36281466 PMCID: PMC9587523 DOI: 10.1016/j.bbih.2022.100533] [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: 05/05/2022] [Revised: 09/26/2022] [Accepted: 10/04/2022] [Indexed: 11/07/2022] Open
Abstract
Circadian clocks orchestrate daily rhythms in many organisms and are essential for optimal health. Circadian rhythm disrupting events, such as jet-lag, shift-work, night-light exposure and clock gene alterations, give rise to pathologic conditions that include cancer and clinical depression. This review systemically describes the fundamental mechanisms of circadian clocks and the interacting relationships among a broken circadian clock, cancer and depression. We propose that this broken clock is an emerging link that connects depression and cancer development. Importantly, broken circadian clocks, cancer and depression form a vicious feedback loop that threatens systemic fitness. Arresting this harmful loop by restoring normal circadian rhythms is a potential therapeutic strategy for treating both cancer and depression.
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Affiliation(s)
- Keyu Su
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Zaheer Ud Din
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Bai Cui
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China,State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, 651 Dongfeng East Road, Guangzhou, Guangdong Province, 510060, China,Corresponding author. Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China.
| | - Fei Peng
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Yuzhao Zhou
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Cenxin Wang
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Xiaoyu Zhang
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Jinxin Lu
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Huandong Luo
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Bin He
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China
| | - Keith W. Kelley
- Department of Animal Sciences, College of ACES, University of Illinois at Urbana-Champaign, 212 Edward R. Madigan Laboratory, 1201 West Gregory Drive, Urbana, Il, 61801, USA
| | - Quentin Liu
- Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China,State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, 651 Dongfeng East Road, Guangzhou, Guangdong Province, 510060, China,Corresponding author. Institute of Cancer Stem Cell, Dalian Medical University, 9 West Section, Lvshun South Road, Dalian, Liaoning Province, 116044, China.
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A hypothalamic dopamine locus for psychostimulant-induced hyperlocomotion in mice. Nat Commun 2022; 13:5944. [PMID: 36209152 PMCID: PMC9547883 DOI: 10.1038/s41467-022-33584-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/22/2022] [Indexed: 11/29/2022] Open
Abstract
The lateral septum (LS) has been implicated in the regulation of locomotion. Nevertheless, the neurons synchronizing LS activity with the brain’s clock in the suprachiasmatic nucleus (SCN) remain unknown. By interrogating the molecular, anatomical and physiological heterogeneity of dopamine neurons of the periventricular nucleus (PeVN; A14 catecholaminergic group), we find that Th+/Dat1+ cells from its anterior subdivision innervate the LS in mice. These dopamine neurons receive dense neuropeptidergic innervation from the SCN. Reciprocal viral tracing in combination with optogenetic stimulation ex vivo identified somatostatin-containing neurons in the LS as preferred synaptic targets of extrahypothalamic A14 efferents. In vivo chemogenetic manipulation of anterior A14 neurons impacted locomotion. Moreover, chemogenetic inhibition of dopamine output from the anterior PeVN normalized amphetamine-induced hyperlocomotion, particularly during sedentary periods. Cumulatively, our findings identify a hypothalamic locus for the diurnal control of locomotion and pinpoint a midbrain-independent cellular target of psychostimulants. The psychostimulant-sensitive neural mechanism linking the circadian clock to locomotion is unknown. Here, hypothalamic A14 neurons are shown to time diurnal activity by entraining the lateral septum, and their activity is shown to be sensitive to amphetamine.
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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: 3] [Impact Index Per Article: 1.5] [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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Sooriyaarachchi P, Jayawardena R, Pavey T, King NA. Shift work and the risk for metabolic syndrome among healthcare workers: A systematic review and meta-analysis. Obes Rev 2022; 23:e13489. [PMID: 35734805 PMCID: PMC9539605 DOI: 10.1111/obr.13489] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Revised: 06/09/2022] [Accepted: 06/09/2022] [Indexed: 11/27/2022]
Abstract
Shift work, defined as work occurring outside typical daytime working hours, is associated with an increased risk for metabolic syndrome (MetS) due to several biological and environmental changes. The MetS refers to the clustering of several known cardiovascular risk factors, including insulin resistance, obesity, dyslipidemia, and hypertension. This systematic review aims to evaluate the literature on the association between shift work and the risk of MetS in employees of the health sector. A systematic search was conducted in PubMed, Web of Science, and Scopus databases using appropriate keywords for studies published before September 1, 2021. Eligible studies were those that compared the prevalence of MetS between day and shift healthcare workers; had a cross-sectional, case-control, or cohort study design; provided sufficient data for calculating odds ratios or relative risks with 95% confidence intervals; and articles in English. The Joanna Briggs Institute prevalence critical appraisal tool was used for quality analysis. Risk for MetS and related measures of effect size were retrieved from studies for meta-analysis. Twelve studies met the criteria for inclusion in the review and meta-analysis. Sample sizes ranged from 42 to 738, and the age range of subjects was between 18 and 65 years. Ten studies demonstrated high methodological quality, while two studies were of average quality. Ten out of 12 studies in the review demonstrated a higher risk in shift workers for developing MetS than day workers. The pooled OR of MetS in shift workers based on 12 studies was 2.17 (95% CI = 1.31-3.60, P = 0.003; I2 = 82%, P < 0.001). Shift workers exhibited more than a twofold increase in the chance of developing MetS in comparison with day workers.
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Affiliation(s)
- Piumika Sooriyaarachchi
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Health and Wellness Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Ranil Jayawardena
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia.,Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Toby Pavey
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Neil A King
- School of Exercise and Nutrition Sciences, Faculty of Health, Queensland University of Technology (QUT), Brisbane, Queensland, Australia
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Liao CW, Wei CF, Chen MH, Hsieh WS, Lin CC, Chen PC. Association between maternal shift work during pregnancy child overweight and metabolic outcomes in early childhood. Front Public Health 2022; 10:1006332. [PMID: 36249262 PMCID: PMC9565036 DOI: 10.3389/fpubh.2022.1006332] [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: 07/29/2022] [Accepted: 08/30/2022] [Indexed: 01/27/2023] Open
Abstract
Background Previous studies found that maternal shift work during pregnancy was associated with many reproductive hazards, including small for gestational age, preterm birth, stillbirth, and neurodevelopmental impairment. Some studies also showed that these children are more likely to become overweight in early childhood. However, the association with metabolic factors, such as insulin resistance and dyslipidemia, was less studied. Hence, we aimed to understand better the relationship between maternal shift work during pregnancy and the risk of childhood overweight and metabolic outcomes. Confounding factors were also discussed, including diet, exercise, and demographical factors. Methods We enrolled pregnant women before delivery in the Taiwan Birth Panel Study (TBPS) II conducted between 2010 and 2012, and followed the children of these participants in 2018. The objective of this study is to investigate the influence of prenatal and postnatal factors on infant and early childhood health. During the follow-up in 2018, we checked children's demographic data, obtained blood specimens, and checked their blood sugar, blood insulin, and lipid profiles. Structured questionnaires were used to evaluate demographic data. Multiple linear and logistic regressions were used to examine the associations between maternal shift work during pregnancy and child overweight, metabolic disorders, such as HOMA-IR, and lipid profiles. Results In this study, we included 407 mother-children pairs with different work shifts (350 day workers and 57 shift workers), and a sub-population without underweight children was also created (290 day workers and 47 shift workers). Shift work during pregnancy was associated with a higher Homeostasis Model Assessment-Insulin Resistance index (HOMA-IR) and a higher odds ratio for overweight in children born from mothers doing shift work during pregnancy after adjustment. The findings were attenuated when we investigated the effect of shift work before pregnancy. Conclusion Our study suggested that maternal shift work during pregnancy was associated with child overweight and insulin resistance in early childhood.
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Affiliation(s)
- Che-Wei Liao
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan,Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Chih-Fu Wei
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Mei-Huei Chen
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan,Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Wu-Shiun Hsieh
- Department of Pediatrics, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan,Department of Pediatrics, Cathay General Hospital, Taipei, Taiwan
| | - Ching-Chun Lin
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan,*Correspondence: Ching-Chun Lin
| | - Pau-Chung Chen
- Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, Taipei, Taiwan,Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan,Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan,National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan,Pau-Chung Chen
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Yang L, Luo Y, He L, Yin J, Li T, Liu S, Li D, Cheng X, Bai Y. Shift Work and the Risk of Cardiometabolic Multimorbidity Among Patients With Hypertension: A Prospective Cohort Study of UK Biobank. J Am Heart Assoc 2022; 11:e025936. [PMID: 36036170 PMCID: PMC9496406 DOI: 10.1161/jaha.122.025936] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Background Although the association between shift work and individual cardiometabolic diseases has been well studied, its role in the progression to cardiometabolic multimorbidity (CMM) remains unclear. In this study, we investigate the association between shift work and the incidence of CMM in patients with hypertension. Methods and Results This study is a population-based and prospective cohort study on 36 939 UK Biobank participants. We used competing risk models to examine the association between shift work and the risk of CMM, which was defined as coexistence of hypertension and diabetes, coronary heart disease, or stroke in our study. We also investigated the association between the frequency and duration of shift work and CMM risks. In addition, we conducted a cross-classification analysis with the combination of frequency and duration of shift work, chronotype and sleep duration as the exposure metrics. During a median follow-up of 11.6 years, a total of 5935 participants developed CMM. We found that usually/always night shift workers were associated with a 16% higher risk of CMM compared with day workers (hazard ratio [HR], 1.16 [95% CI, 1.02-1.31]). We also found that a higher frequency of night shifts (>10/month) was associated with increased risk of CMM (HR, 1.19 [95% CI, 1.06-1.34]) that was more pronounced for >10/month in combination with a morning chronotype or <7 hours or >8 hours of sleep duration (HR, 1.26 [95% CI, 1.02-1.56]; HR, 1.43 [95% CI, 1.19-1.72], respectively). Conclusions We find that night shift work is associated with higher CMM risk in patients with hypertension.
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Affiliation(s)
- Liu Yang
- Xiangya International Medical Center Xiangya Hospital, Central South University Changsha Hunan China.,Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Yi Luo
- Department of Cardiovascular Medicine The Third Xiangya Hospital, Central South University Changsha Hunan China.,Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China
| | - Lingfang He
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Jinghua Yin
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Tie Li
- Department of Cardiovascular Medicine Changsha County Second People's Hospital Changsha Hunan China
| | - Shuai Liu
- Department of General and Vascular Surgery Xiangya Hospital, Central South University Changsha Hunan China
| | - Dongjie Li
- Xiangya International Medical Center Xiangya Hospital, Central South University Changsha Hunan China.,Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Xunjie Cheng
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
| | - Yongping Bai
- Department of Geriatric Medicine, Center of Coronary Circulation Xiangya Hospital, Central South University Changsha Hunan China.,National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University Changsha Hunan China
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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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Wu S, Wu C, Wang X, Fei W, Fu Y. Mediating effect of circadian rhythm between work stress and sleep quality in Chinese shift-working nurses: A cross-sectional survey. Nurs Open 2022; 10:560-569. [PMID: 35964326 PMCID: PMC9834518 DOI: 10.1002/nop2.1322] [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: 12/11/2021] [Revised: 04/08/2022] [Accepted: 07/29/2022] [Indexed: 01/16/2023] Open
Abstract
AIM This study examined the mediating effect of circadian rhythm amplitude (LV) and stability (FR) between work stress and sleep quality among Chinese shift-working nurses (SWNs). DESIGN A cross-sectional study. METHODS Three-hundred and seventy-nine nurses working in shifts were investigated by convenient sampling from six hospitals in Shanghai, China. The mediating effect was analysed using the structural equation model with bootstrapping procedures. RESULTS Work stress could directly affect shift nurses' sleep quality and indirectly affect sleep quality through circadian rhythm amplitude and stability. The total indirect effects of work stress on sleep quality accounted for 36.7% of the total effect. The study revealed that poor sleep quality is very common among SWNs, which deserves attention. The mediating effect of the circadian rhythm provides new insights to improve sleep quality, not only by lightening the work stress but also by improving circadian rhythm in SWNs.
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Affiliation(s)
- Songqi Wu
- School of NursingShanghai University of Traditional Chinese MedicineShanghaiChina,Nursing DepartmentShanghai Tenth People's Hospital Affiliated to Tongji UniversityShanghaiChina
| | - Caiqin Wu
- School of NursingShanghai University of Traditional Chinese MedicineShanghaiChina
| | - Xiaohan Wang
- School of NursingShanghai University of Traditional Chinese MedicineShanghaiChina,School of Public HealthChina Medical UniversityShenyangChina
| | - Wenling Fei
- School of NursingShanghai University of Traditional Chinese MedicineShanghaiChina,Nursing DepartmentShanghai Tenth People's Hospital Affiliated to Tongji UniversityShanghaiChina
| | - Yue Fu
- School of NursingShanghai University of Traditional Chinese MedicineShanghaiChina
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Mantantzis K, Campos V, Darimont C, Martin FP. Effects of Dietary Carbohydrate Profile on Nocturnal Metabolism, Sleep, and Wellbeing: A Review. Front Public Health 2022; 10:931781. [PMID: 35910892 PMCID: PMC9326315 DOI: 10.3389/fpubh.2022.931781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/13/2022] [Indexed: 11/22/2022] Open
Abstract
Sleep is a crucial biological function and a well-established driver of health and wellbeing across the lifespan. In this review, we describe how sleep in humans is associated with specific circadian metabolic and physiological changes, and how the organization of sleep-wake states is related to regulation of nocturnal metabolism during fasting. Among the modifiable factors that can contribute to sleep-related benefits, emerging evidence suggests that diet and nocturnal changes in glucose regulation are strong determinants of sleep quality. Here, we review studies that have explored the importance of quantity and quality of dietary carbohydrates and proteins in modulation of sleep and sleep-related health benefits. Future research may guide the creation of nutritional solutions to improve sleep, which could lead to positive changes in health, wellbeing, and overall quality of life.
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