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Ricciardelli R, Taillieu TL, McElheran M, Cramm H, Ajith H, Johnston MS, Carleton RN. Sleep quality and mental disorder symptoms among correctional workers in Ontario, Canada. Sci Rep 2024; 14:14963. [PMID: 38942803 PMCID: PMC11213858 DOI: 10.1038/s41598-024-65891-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/25/2024] [Indexed: 06/30/2024] Open
Abstract
Correctional workers (CWs) report high levels of work stressors, frequent exposures to potentially psychologically traumatic events (PPTEs), and substantial mental health challenges. There is evidence of associations between sleep disturbances and diverse mental health challenges, including preliminary evidence from public safety personnel; however, replications and extensions would better inform interventions to support mental health. The current study was designed to examine associations between quality of sleep, work stress, and mental health disorders in a sample of diverse CWs employed in a provincial correctional service in Ontario, Canada. Data were analyzed from 943 CWs who participated in the cross-sectional, web-based Ontario Provincial Correctional Worker Mental Health and Well-Being Study conducted from December 2017 to June 2018. Sleep quality indicators included symptoms of insomnia, total hours of sleep per night on work nights and off-shift nights, number of days feeling rested per week, and overall sleep quality. Descriptive statistics, analyses of variance, correlational analyses, and logistic regression were used to examine relationships among sleep quality, stress of shift work, and mental health disorder symptoms. CWs slept an average of 6.0 h per night when working and 7.2 h during off-shift nights. CWs reported waking up feeling rested an average of 2.6 days per week and rated their overall quality of sleep in the fair to poor range. Many CWs (64.9%) screened positive for clinically significant symptoms of insomnia. There were also differences across occupational groups such that CWs working as correctional officers reported the most sleep problems. There were statistically significant relationships between insomnia and mental health disorder symptoms. Higher levels of stress from shift work were associated with worse sleep quality. CWs, especially those working as correctional officers in a provincial prison, reported many indicators consistent with poorer quality of sleep. Poor quality of sleep was also associated with work stress and mental health disorders.
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Affiliation(s)
- Rosemary Ricciardelli
- School of Maritime Studies, Fisheries and Marine Institute, Memorial University of Newfoundland, 155 Ridge Road, St. John's, NL, A1C 5R3, Canada.
| | - Tamara L Taillieu
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada
| | | | - Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, Canada
| | - Harsha Ajith
- Memorial University of Newfoundland, St. John's, Canada
| | - Matthew S Johnston
- School of Maritime Studies, Fisheries and Marine Institute, Memorial University of Newfoundland, St. John's, Canada
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Reynolds AC, Loffler KA, Grivell N, Brown BW, Adams RJ. Diagnosis and management of sleep disorders in shift workers, with patient informed solutions to improve health services research and practice. Sleep Med 2024; 113:131-141. [PMID: 38016359 DOI: 10.1016/j.sleep.2023.11.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 11/15/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND The combination of shift work and an unmanaged sleep disorder carries health and safety risks. Yet, diagnosis rates for sleep disorders are low in shift workers. The aim of this study was to understand the experience of sleep disorder diagnosis and treatment in shift workers, and consider patient informed solutions to improve access to health services. METHODS Semi-structured interviews were conducted with 16 Australian shift workers with a diagnosed sleep disorder. Patient journey mapping and reflexive thematic analysis were used to understand diagnosis and management experiences. RESULTS There were highly variable experiences with diagnosis and management, often taking >5 years to seek help from a health care provider (HCP) after noticing symptoms of a sleep disorder. Three themes were constructed, including 'the cause of the problem', 'prioritising work', and '(dis)satisfaction and (dis)connection'. Extent of patient and HCP awareness of sleep disorders, and a prevailing attitude of shift work being 'the problem' impacted diagnosis, as did organisational needs (including rostering, which had both positive and negative influences on help seeking). Relationships with HCPs were important, and living on non-standard time was both a barrier and an enabler to sleep disorder care. Participants identified the need for education and awareness, prompts and easy access to screening and referral pathways, and tailored models of care. CONCLUSION Education and awareness initiatives for shift workers, their employers and HCPs, together with development of a model of care for shift workers with sleep disorders may address some of the unique barriers to diagnosis and management.
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Affiliation(s)
- Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia.
| | - Kelly A Loffler
- Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia; Health Data and Clinical Trials, Flinders University, Bedford Park, SA, Australia
| | - Nicole Grivell
- Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Brandon Wj Brown
- Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
| | - Robert J Adams
- Flinders Health and Medical Research Institute (Sleep Health) / Adelaide Institute for Sleep Health, Flinders University, Bedford Park, SA, Australia
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Boersma GJ, Mijnster T, Vantyghem P, Kerkhof GA, Lancel M. Shift work is associated with extensively disordered sleep, especially when working nights. Front Psychiatry 2023; 14:1233640. [PMID: 38161719 PMCID: PMC10755475 DOI: 10.3389/fpsyt.2023.1233640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/17/2023] [Indexed: 01/03/2024] Open
Abstract
Background Shift work is generally associated with working and sleeping out of phase with the endogenous, circadian sleep-wake cycle. This exerts detrimental effects on sleep health. The present study aimed at evaluating the presence of short and long sleep as well as sleep disorders within a broad range of shift work schedules and elucidating the role of sociodemographic factors therein. Methods A large dataset containing information on sleep was collected through advertisement in a Belgium newspaper (De Standaard). Adult, working individuals were selected (n = 37,662) and categorized based on their work schedule (regular day, early morning, evening, night, and rotating shift). In this cross-sectional study, prevalence rates of short sleep (≤6 h), long sleep (≥9 h) and sleep disorders (screened with Holland Sleep Disorders Questionnaire), and associations between these sleep variables and sociodemographics (age, sex, education, living companion(s)) were analyzed using binominal logistic regression analyses. Results In the total sample all sociodemographic factors affected prevalences of short, long and disordered sleep, consistent with previous studies. Compared to day workers, shift workers more frequently reported short sleep, most prominently night workers (26 vs. 50%) (p < 0.001). Furthermore, all sleep disorders as well as sleep disorder comorbidity were more common in shift workers, again most pronounced in night workers (all p < 0.05). In night shift workers the level of education had the strongest associations with disturbed sleep with a two-fold higher prevalence of short and disordered sleep in low relative to academic educated groups (all p < 0.02). Conclusion Shift work is related not only to curtailed sleep and shift work disorder, but also to a plethora of sleep disorders, including insomnia, sleep-related breathing disorders and sleep-related movement disorders. Our findings imply that education on coping strategies may be especially important for young and/or lower educated shift workers.
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Affiliation(s)
- G. J. Boersma
- Forensic Psychiatric Hospital, GGZ Drenthe Mental Health Institute, Assen, Netherlands
| | - T. Mijnster
- Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe Mental Health Institute, Assen, Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
| | - P. Vantyghem
- De Standaard (Daily Newspaper), Mediahuis, Brussels, Belgium
| | - G. A. Kerkhof
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
- Sleep Disorders Center, Haaglanden Medical Center (HMC), The Hague, Netherlands
| | - Marike Lancel
- Forensic Psychiatric Hospital, GGZ Drenthe Mental Health Institute, Assen, Netherlands
- Centre of Expertise on Sleep and Psychiatry, GGZ Drenthe Mental Health Institute, Assen, Netherlands
- Department of Clinical Psychology and Experimental Psychopathology, University of Groningen, Groningen, Netherlands
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Zhang MX, Wu AM, Zhang LZ, Lam LW. Work hard and sleep better: Work autonomy attenuates the longitudinal effect of workaholism on sleep problem among Chinese working adults. Glob Ment Health (Camb) 2023; 10:e75. [PMID: 38024803 PMCID: PMC10663694 DOI: 10.1017/gmh.2023.68] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 09/02/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
The prevalence of workaholism has negative consequences on human health. Lack of sleep, a well-known problem among adults in modern society, is often attributed to overwork as a result of workaholism. Yet there is a lack of empirical research examining how and when workaholism will lead to sleep problems. To answer this question and to examine the longitudinal effect of workaholism on sleep in China, we investigate the mediating role of perceived evening responsibilities of work and the moderating effect of work autonomy. Two hundred and five Chinese working adults (58.0% female) voluntarily completed the online questionnaires at Time 1 (T1) and Time 2 (T2; 1-month later). Results showed that workaholism at T1 had a significant and positive correlation with sleep problem at T2. Further analysis suggested that perceived evening responsibilities of work fully mediated the relationship between workaholism and sleep problem. Work autonomy was shown to buffer the positive effect of workaholism on perceived evening responsibilities of work and attenuate the indirect effect of workaholism on sleep problem. While workers should be made aware of the negative impact of workaholism on sleep, organizations should also consider interventions to enhance employees' autonomy and control of their work.
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Affiliation(s)
- Meng Xuan Zhang
- Department of Medical Humanities, School of Humanities, Southeast University, Nanjing, China
| | - Anise M.S. Wu
- Department of Psychology, Faculty of Social Sciences, University of Macau, Macao, China
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, China
| | - Ling Z. Zhang
- Department of Management and Marketing, Faculty of Business Administration, University of Macau, Macao, China
| | - Long W. Lam
- Centre for Cognitive and Brain Sciences, University of Macau, Macao, China
- Department of Management and Marketing, Faculty of Business Administration, University of Macau, Macao, China
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Wu J, Zhang S, Wu X, Mei W. The effect of off-hours hip surgery on patients' outcomes: a RECORD-compliant retrospective, propensity score-matched cohort study. Minerva Anestesiol 2023; 89:613-624. [PMID: 36700332 DOI: 10.23736/s0375-9393.22.16945-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
BACKGROUND Off-hours working may have negative impacts on the performance of clinicians, leading to possible adverse outcomes of patients. We aimed to explore the impact of off-hours hip surgery on early postoperative outcomes. METHODS All patients who underwent hip surgery between January 2015, and December 2020 in our hospital were evaluated in this retrospective cohort study. We measured in-hospital mortality, some postoperative complications, and some intraoperative prognostic indicators. Propensity score matching (PSM) was used to adjust for confounding baseline factors. RESULTS We identified 143 patients in the original cohort. After PSM, 266 patients in the on-hours group were matched with 105 similar patients in the off-hours group. Compared with the on-hours group, the off-hours group had more general anesthesia (81.0% vs. 62.4%; RR, 1.30; 95% CI, 1.14 to 1.48; P=0.001), higher amount of intraoperative CRBC (0 U [0-2] vs. 0 U [0-0]; P=0.032) and FFP transfusion (0 mL [0-150] vs. 0 mL [0-0]; P=0.005), higher dosage of intraoperative sufentanil (24.5±14.5 μg vs. 20.7±13.9 μg; P=0.020), higher incidence of postoperative renal dysfunction (13.3% vs. 6.4%; RR, 2.09; 95% CI, 1.07 to 4.08; P=0.029), hypotension (2.9% vs. 0%; P=0.022), and hypoxemia (3.8% vs. 0.4%; RR, 10.13; 95% CI, 1.15 to 89.61; P=0.024), and higher in-hospital mortality (2.9% vs. 0%; P=0.022). CONCLUSIONS Off-hours hip surgery was associated with adverse early postoperative prognosis, suggesting that more attention should be paid to off-hours hip surgery.
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Affiliation(s)
- Jiayi Wu
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuang Zhang
- Department of Anesthesiology, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, China
| | - Xi Wu
- Department of Anesthesiology, Tongji Medical College, Xiehe Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Mei
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China -
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Bayo Jimenez MT, Frenis K, Hahad O, Steven S, Cohen G, Cuadrado A, Münzel T, Daiber A. Protective actions of nuclear factor erythroid 2-related factor 2 (NRF2) and downstream pathways against environmental stressors. Free Radic Biol Med 2022; 187:72-91. [PMID: 35613665 DOI: 10.1016/j.freeradbiomed.2022.05.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Revised: 04/23/2022] [Accepted: 05/19/2022] [Indexed: 12/14/2022]
Abstract
Environmental risk factors, including noise, air pollution, chemical agents, ultraviolet radiation (UVR) and mental stress have a considerable impact on human health. Oxidative stress and inflammation are key players in molecular pathomechanisms of environmental pollution and risk factors. In this review, we delineate the impact of environmental risk factors and the protective actions of the nuclear factor erythroid 2-related factor 2 (NRF2) in connection to oxidative stress and inflammation. We focus on well-established studies that demonstrate the protective actions of NRF2 and its downstream pathways against different environmental stressors. State-of-the-art mechanistic considerations on NRF2 signaling are discussed in detail, e.g. classical concepts like KEAP1 oxidation/electrophilic modification, NRF2 ubiquitination and degradation. Specific focus is also laid on NRF2-dependent heme oxygenase-1 induction with detailed presentation of the protective down-stream pathways of heme oxygenase-1, including interaction with BACH1 system. The significant impact of all environmental stressors on the circadian rhythm and the interactions of NRF2 with the circadian clock will also be considered here. A broad range of NRF2 activators is discussed in relation to environmental stressor-induced health side effects, thereby suggesting promising new mitigation strategies (e.g. by nutraceuticals) to fight the negative effects of the environment on our health.
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Affiliation(s)
- Maria Teresa Bayo Jimenez
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Katie Frenis
- Department of Hematology and Oncology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Omar Hahad
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany; Leibniz Insitute for Resilience Research (LIR), Mainz, Germany
| | - Sebastian Steven
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany
| | - Guy Cohen
- The Skin Research Institute, The Dead Sea and Arava Science Center, Masada, 86910, Israel; Ben Gurion University of the Negev, Eilat Campus, Eilat, 8855630, Israel
| | - Antonio Cuadrado
- Departamento de Bioquímica, Facultad de Medicina, Centro de Investigación Biomédica en Red Sobre Enfermedades Neurodegenerativas (CIBERNED), Instituto de Investigación Sanitaria La Paz (IdiPaz), Instituto de Investigaciones Biomédicas 'Alberto Sols' UAM-CSIC, Universidad Autónoma de Madrid, Madrid, Spain
| | - Thomas Münzel
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
| | - Andreas Daiber
- Department of Cardiology, Cardiology I, University Medical Center of the Johannes Gutenberg-University, Langenbeckstraße 1, 55131, Mainz, Germany; German Center for Cardiovascular Research (DZHK), Partner Site Rhine-Main, Mainz, Germany.
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Duggan NM, Hasdianda MA, Baker O, Jambaulikar G, Goldsmith AJ, Condella A, Azizoddin D, Landry AI, Boyer EW, Eyre AJ. The Effect of Noise-Masking Earbuds (SleepBuds) on Reported Sleep Quality and Tension in Health Care Shift Workers: Prospective Single-Subject Design Study. JMIR Form Res 2022; 6:e28353. [PMID: 35315781 PMCID: PMC8984824 DOI: 10.2196/28353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 08/06/2021] [Accepted: 12/14/2021] [Indexed: 11/13/2022] Open
Abstract
Background Shift work is associated with sleep disorders, which impair alertness and increase risk of chronic physical and mental health disease. In health care workers, shift work and its associated sleep loss decrease provider wellness and can compromise patient care. Pharmacological sleep aids or substances such as alcohol are often used to improve sleep with variable effects on health and well-being. Objective We tested whether use of noise-masking earbuds can improve reported sleep quality, sleepiness, and stress level in health care shift workers, and increase alertness and reaction time post night shift. Methods Emergency medicine resident physicians were recruited for a prospective, single-subject design study. Entrance surveys on current sleep habits were completed. For 14 days, participants completed daily surveys reporting sleep aid use and self-rated perceived sleepiness, tension level, and last nights’ sleep quality using an 8-point Likert scale. After overnight shifts, 3-minute psychomotor vigilance tests (PVT) measuring reaction time were completed. At the end of 14 days, participants were provided noise-masking earbuds, which they used in addition to their baseline sleep regimens as they were needed for sleep for the remainder of the study period. Daily sleep surveys, post–overnight shift PVT, and earbud use data were collected for an additional 14 days. A linear mixed effects regression model was used to assess changes in the pre- and postintervention outcomes with participants serving as their own controls. Results In total, 36 residents were recruited, of whom 26 participants who completed daily sleep surveys and used earbuds at least once during the study period were included in the final analysis. The median number of days of earbud use was 5 (IQR 2-9) days of the available 14 days. On days when residents reported earbud use, previous nights’ sleep quality increased by 0.5 points (P<.001, 95% CI 0.23-0.80), daily sleepiness decreased by 0.6 points (P<.001, 95% CI –0.90 to –0.34), and total daily tension decreased by 0.6 points (P<.001, 95% CI –0.81 to –0.32). These effects were more pronounced in participants who reported worse-than-average preintervention sleep scores. Conclusions Nonpharmacological noise-masking interventions such as earbuds may improve daily sleepiness, tension, and perceived sleep quality in health care shift workers. Larger-scale studies are needed to determine this interventions’ effect on other populations of shift workers’ post–night shift alertness, users’ long-term physical and mental health, and patient outcomes.
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Affiliation(s)
- Nicole M Duggan
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - M Adrian Hasdianda
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Olesya Baker
- Center for Clinical Investigation, Brigham and Women's Hospital, Boston, MA, United States
| | - Guruprasad Jambaulikar
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Andrew J Goldsmith
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Anna Condella
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Desiree Azizoddin
- Health Promotion Research Center, Department of Family and Preventive Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Adaira I Landry
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Edward W Boyer
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
| | - Andrew J Eyre
- Department of Emergency Medicine, Brigham and Women's Hospital, Boston, MA, United States
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Li H, Liu M, Zhang C. Women with polycystic ovary syndrome (PCOS) have reduced melatonin concentrations in their follicles and have mild sleep disturbances. BMC Womens Health 2022; 22:79. [PMID: 35313872 PMCID: PMC8935689 DOI: 10.1186/s12905-022-01661-w] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 03/04/2022] [Indexed: 11/11/2022] Open
Abstract
Background Polycystic ovary syndrome (PCOS) is a common gynecologic disorder related to abnormal circadian rhythm. Therefore, we aimed to find whether the level of melatonin, a rhythm regulating hormone changed in the ovarian microenvironment in this disease. Methods The melatonin concentrations in follicular fluid (FF) were measured in 35 PCOS and 36 non-PCOS women undergoing in vitro fertilization (IVF) treatment. Results The FF melatonin concentration was significantly lower in PCOS women than non-PCOS women (p = 0.045) and it was found positively correlated with serum basal FSH level (r = 0.308, p = 0.013). In IVF procedures, there was no significant difference in the fertilization rate of oocytes between the two groups, but the high-quality embryogenesis rate on the third day of the PCOS group was significantly lower than that of the control group (p = 0.042), which showed a weak positive correlation with the FF melatonin concentration (rs = 0.240, p = 0.044). Furthermore, there was no significant difference in overall pregnancy outcome. The PSQI questionnaire showed that sleep disorders were more likely to exist in the PCOS group, though there was no significant difference. Conclusion The obtained results suggested PCOS women had lower melatonin concentrations in the ovarian microenvironment.
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Affiliation(s)
- Hongwanyu Li
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200135, China.,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China
| | - Mei Liu
- Department of Obstetrics, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, No. 42 Wenhua xi Road, Jinan, 250011, Shandong, China
| | - Cong Zhang
- Center for Reproductive Medicine, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200135, China. .,Shandong Provincial Key Laboratory of Animal Resistance Biology, College of Life Sciences, Shandong Normal University, Jinan, Shandong, China. .,Shanghai Key Laboratory for Assisted Reproduction and Reproductive Genetics, Shanghai, China.
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Brown BWJ, Crowther ME, Appleton SL, Melaku YA, Adams RJ, Reynolds AC. Shift work disorder and the prevalence of help seeking behaviors for sleep concerns in Australia: A descriptive study. Chronobiol Int 2022; 39:714-724. [PMID: 35253569 DOI: 10.1080/07420528.2022.2032125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Shift work disorder (SWD) is a circadian rhythm sleep-wake disorder, defined by symptoms of insomnia and excessive levels of sleepiness resulting from work that occurs during non-standard hours. Sleep problems are common in shift workers, yet our understanding of help seeking behaviours for sleep in shift workers is limited. The primary aim of this study was to examine the help seeking behaviours of Australian workers who meet criteria for SWD. Of the 448 (46% of sample, n = 964 total) Australian workers reporting non-standard work hours, 10.5% (n = 41) met the criteria for probable shift work disorder (pSWD). Non-standard workers with pSWD did not seek help for sleep problems at higher rates than workers without SWD. Of the small proportion of workers with pSWD who sought help, general practitioners were the most common healthcare professionals for sleep problems. Self-management was common in workers with pSWD, with a high self-reported prevalence of alcohol use (31.7%) as a sleep management strategy, and caffeine consumption (76.9%) as a sleepiness management strategy. The majority of individuals with pSWD reported the mentality of 'accept it and keep going' as a sleepiness management strategy, highlighting a potential barrier to help seeking behaviour in workers with pSWD. These findings provide novel insight into the help seeking behaviours of those with pSWD. There is a need for further research to understand why individuals at risk for SWD are not actively seeking help, and to develop health promotion and intervention strategies to improve help seeking when needed.
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Affiliation(s)
- Brandon W J Brown
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute of Sleep Health, Flinders University, Adelaide, Australia
| | | | - Sarah L Appleton
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute of Sleep Health, Flinders University, Adelaide, Australia
| | - Yohannes Adama Melaku
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute of Sleep Health, Flinders University, Adelaide, Australia
| | - Robert J Adams
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute of Sleep Health, Flinders University, Adelaide, Australia
| | - Amy C Reynolds
- Flinders Health and Medical Research Institute (Sleep Health)/Adelaide Institute of Sleep Health, Flinders University, Adelaide, Australia
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Maisey G, Cattani M, Devine A, Lo J, Fu SC, Dunican IC. Digging for data: How sleep is losing out to roster design, sleep disorders, and lifestyle factors. APPLIED ERGONOMICS 2022; 99:103617. [PMID: 34700190 DOI: 10.1016/j.apergo.2021.103617] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/10/2021] [Accepted: 10/19/2021] [Indexed: 06/13/2023]
Abstract
Shift workers employed at a remote mining operation may experience sleep loss, impaired alertness, and consequently negative health and safety outcomes. This study determined the sleep behaviors and prevalence of risk for sleep disorders among shift workers; and quantified alertness for a roster cycle. Sleep duration was significantly less following; night shift by 77 ± 7 min and day shift by 30 ± 7 min. The wake after sleep onset was less by 23 ± 3 min for night shifts and 22 ± 3 min for day shifts (p < 0.05 for all). The prevalence of risk for sleep apnea was 31%, insomnia was 8%, and shiftwork disorder was 44%. Average alertness for all working hours was 75%. Shiftwork in remote mining operations is a significant factor that leads to sleep loss and reduced alertness, which is exacerbated by the high prevalence of risk for sleep disorders.
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Affiliation(s)
- Gemma Maisey
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia.
| | - Marcus Cattani
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia
| | - Amanda Devine
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth, W.A., Australia
| | - Shih Ching Fu
- School of Science, Edith Cowan University, Perth, W.A., Australia
| | - Ian C Dunican
- School of Medical and Health Science, Edith Cowan University, Perth, W.A., Australia
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Impact of Income and Industry on New-Onset Diabetes among Employees: A Retrospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031090. [PMID: 35162114 PMCID: PMC8834605 DOI: 10.3390/ijerph19031090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Accepted: 01/13/2022] [Indexed: 12/04/2022]
Abstract
The purpose of this study was to investigate the impact of income and industry type on the risk of developing diabetes among Japanese workers, including how this impact is affected by sex. A total of 24,516 employees at small- and medium-sized enterprises in Japan aged 40–74 years who underwent health examinations in fiscal years 2010–2015 were included in this retrospective cohort study. Generalized linear regression models were used to assess the association between new-onset diabetes and income and industry. In men, the cumulative incidence rate was significantly higher in the low-income group; it was highest in the transportation and postal service industries. Although income and industry were independent risk factors for developing diabetes in men, an interaction was found between income and industry, which was affected by participants’ sex: in specific industries (i.e., lifestyle-related, personal services, and entertainment services), men had a significantly higher risk of developing diabetes in the high-income group, and women had a significantly higher risk of developing diabetes in the low-income group. These findings highlight important factors to consider in assessing diabetes risk and suggest that efficient primary and secondary prevention should be encouraged in industries where workers have a high risk of diabetes.
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Cramm H, Richmond R, Jamshidi L, Edgelow M, Groll D, Ricciardelli R, MacDermid JC, Keiley M, Carleton RN. Mental Health of Canadian Firefighters: The Impact of Sleep. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413256. [PMID: 34948864 PMCID: PMC8701315 DOI: 10.3390/ijerph182413256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 12/25/2022]
Abstract
Volunteer and career firefighters are at risk of major depressive disorders, posttraumatic stress disorder (PTSD), alcohol use disorder, and other mental health disorders due to the demanding and unpredictable nature of their employment. The mental health risks are exacerbated by the need to work extended hours, night shifts, and/or rotating schedules, or the competing demands of other employment, especially in volunteer firefighters. The mental health disorders and risk factors interact with altered sleeping patterns. In the current study, we examined volunteer and career firefighters regarding the association between mental health and sleep, drawing from a national Canadian mental health survey of 1217 firefighters. Most (69%) of the firefighters reported less than ideal sleep quality and 21% screened positive for clinical insomnia, with no significant difference between volunteer and career subgroups. Firefighters with insomnia had higher odds ratios (OR) and frequencies for PTSD (OR = 4.98), generalized anxiety disorder (OR = 7.15), panic disorder (OR = 6.88), social phobia (OR = 4.98), and major depressive disorder (OR = 7.91), than firefighters without insomnia. The burden of sleep disorders and their association with mental health disorders suggests that sleep should be considered in health monitoring and self-management, environmental design, fire service work-organization policies, and health programming.
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Affiliation(s)
- Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Rachel Richmond
- School of Rehabilitation Therapy, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Laleh Jamshidi
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
| | - Megan Edgelow
- School of Rehabilitation Therapy, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Dianne Groll
- Department of Psychiatry, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Rose Ricciardelli
- Department of Sociology, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada
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de Almondes KM, Marín Agudelo HA, Jiménez-Correa U. Impact of Sleep Deprivation on Emotional Regulation and the Immune System of Healthcare Workers as a Risk Factor for COVID 19: Practical Recommendations From a Task Force of the Latin American Association of Sleep Psychology. Front Psychol 2021; 12:564227. [PMID: 34093295 PMCID: PMC8172768 DOI: 10.3389/fpsyg.2021.564227] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 04/13/2021] [Indexed: 01/14/2023] Open
Abstract
Healthcare workers who are on the front line of coronavirus disease 2019 (COVID-19) and are also undergoing shift schedules face long work hours with few pauses, experience desynchronization of their circadian rhythm, and an imbalance between work hours effort and reward in saving lives, resulting in an impact on work capacity, aggravated by the lack of personal protective equipment (PPE), few resources and precarious infrastructure, and fear of contracting the virus and contaminating family members. Some consequences are sleep deprivation, chronic insomnia, stress-related sleep disorders, and post-traumatic stress disorder. These sleep alterations critically affect mental health, precipitating or perpetuating anxiety, stress, and depression, resulting in the inability to regulate positive and negative emotions. Pre-existing sleep disorders are an important risk factor for the development and maintenance of PSTD when individuals are exposed to an important stressor such as a COVID-19 pandemic. At the same time, how an individual regulates the emotion associated with worries during daytime functioning impacts nighttime sleep, precipitating and perpetuating difficulties in sleeping. All of these changes in sleep and emotional regulation also alter the immune system. Sleep deprivation is commonly associated with chronic inflammatory diseases, due to the desynchronizations in circadian rhythms, causing possible psychophysiological disorders and impaired neuroimmune-endocrine homeostasis. From this perspective, we clarify in this article how sleep disorders affect the immune system and emotional regulation, explaining their phenomenological and neurobiological mechanisms, and discussing elements of cognitive and behavioral coping for health professionals to adopt and manage a healthier sleep pattern in the COVID-19 outbreak.
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Affiliation(s)
- Katie Moraes de Almondes
- AMBSONO Sleep Clinic, Department of Psychology and Postgraduate Program in Psychobiology, Federal University of Rio Grande do Norte, Natal, Brazil
| | | | - Ulises Jiménez-Correa
- Sleep Disorders Clinic, Research Division, Medicine Faculty, National Autonomous University of Mexico, Mexico City, Mexico
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Shockey TM, Tsai RJ, Cho P. Prevalence of Diagnosed Diabetes Among Employed US Adults by Demographic Characteristics and Occupation, 36 States, 2014 to 2018. J Occup Environ Med 2021; 63:302-310. [PMID: 33350659 PMCID: PMC8669571 DOI: 10.1097/jom.0000000000002117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To assess the prevalence of diagnosed diabetes among employed US adults from 36 states by occupation group using data from 2014 to 2018 Behavioral Risk Factor Surveillance System. METHODS Prevalence of diabetes was calculated by 22 broad and 93 detailed occupation groups among a sample of 366,633 employed respondents. Wald chi-square values were used to determine the significance of associations between diabetes and occupation groups after adjusting for sex, age, and race/ethnicity. RESULTS The prevalence of diabetes was 6.4% among employed US adults. The three broad occupation groups with the highest adjusted prevalence of diabetes were protective services (8.9%), farming, fishing, and forestry (8.8%), and community and social services (8.4%). CONCLUSIONS Prevalence of diabetes differed by occupation. Work-related factors (eg, shift work, job stress) should be further examined in relation to risk of developing diabetes.
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Affiliation(s)
- Taylor M Shockey
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio (Dr Shockey, Dr Tsai); Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia (Dr Cho)
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Pallesen S, Bjorvatn B, Waage S, Harris A, Sagoe D. Prevalence of Shift Work Disorder: A Systematic Review and Meta-Analysis. Front Psychol 2021; 12:638252. [PMID: 33833721 PMCID: PMC8021760 DOI: 10.3389/fpsyg.2021.638252] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
Objectives: No systematic review or meta-analysis concerning the prevalence of shift work disorder (SWD) has been conducted so far. The aim was thus to review prevalence studies of SWD, to calculate an overall prevalence by a random effects meta-analysis approach and investigate correlates of SWD prevalence using a random-effects meta-regression. Methods: Systematic searches were conducted in ISI Web of Science, PsycNET, PubMed, and Google Scholar using the search terms “shift work disorder” and “shift work sleep disorder.” No restrictions in terms of time frame were used. Included studies had to present original data on the prevalence of SWD in an occupational sample published in English. A total of 349 unique hits were made. In all, 29 studies were finally included from which two authors independently extracted data using predefined data fields. The meta-regression included four predictors (diagnostic criteria, study country, type of workers, and sample size). Results: The overall prevalence of SWD was 26.5% (95% confidence interval = 21.0–32.8). Cochran Q was 1,845.4 (df = 28, p < 0.001), and the I2 was 98.5%, indicating very high heterogeneity across the observed prevalence estimates. Diagnostic criteria (International Classification of Sleep Disorders-2 = 0, International Classification of Sleep Disorders-3 = 1) and sample size were inversely related to SWD prevalence. Conclusions: The prevalence of SWD was high across the included studies. The between-study disparity was large and was partly explained by diagnostic criteria and sample size. In order to facilitate comparative research on SWD, there is a need for validation and standardization of assessment methodology as well as agreement in terms of sample restrictions.
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Affiliation(s)
- Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, Norway.,Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Optentia, The Vaal Triangle Campus of the North-West University, Vanderbijlpark, South Africa
| | - Bjørn Bjorvatn
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Siri Waage
- Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Anette Harris
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
| | - Dominic Sagoe
- Department of Psychosocial Science, University of Bergen, Bergen, Norway
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Salivary Biomarkers and Work-Related Stress in Night Shift Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063184. [PMID: 33808679 PMCID: PMC8003447 DOI: 10.3390/ijerph18063184] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 03/03/2021] [Accepted: 03/07/2021] [Indexed: 12/12/2022]
Abstract
Work organization, such as shifts and night work, can interfere with the perception of work-related stress and therefore on the development of pathological conditions. Night shift work, particularly, can have a negative impact on workers’ wellbeing by interfering with the biological sphere. The aim of this study is to evaluate the associations between work activities, shift work effects and stress-related responses in 106 dock workers enrolled in southeast Italy. Dock workers’ tasks consist of complex activities that seemed to affect more sleep quality than work-related stress. An analysis of salivary biomarkers such as cortisol, α-amylase, melatonin and lysozyme was performed along with validated psycho-diagnostic questionnaires. Alpha-amylase showed a significant negative correlation with the effort/reward imbalance score; thus, the measurement of salivary α-amylase is proposed as a sensitive and non-invasive biomarker of work-related stress. This study may provide new insights into developing strategies for the management of night shift work. Salivary biomarkers should be further investigated in the future in order to develop simple and effective tools for the early diagnosis of work-related stress or its outcomes.
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17
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Retzer L, Reindl R, Zauter S, Richter K. Bevorzugen Frauen Face-to-Face-Beratung bei Insomnie? SOMNOLOGIE 2021. [DOI: 10.1007/s11818-020-00292-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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18
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Alsharari AF, Abuadas FH, Hakami MN, Darraj AA, Hakami MW. Impact of night shift rotations on nursing performance and patient safety: A cross-sectional study. Nurs Open 2021; 8:1479-1488. [PMID: 33449446 PMCID: PMC8046148 DOI: 10.1002/nop2.766] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/26/2020] [Accepted: 12/15/2020] [Indexed: 01/16/2023] Open
Abstract
Aim Hospitals operate on a 24‐hr basis, with shiftwork being unavoidable for most nurses. This study aims to explore the impact of night shiftwork rotations on nurses' physiological status, work performance and patient safety concerns among nurses in public hospitals. Design A descriptive predictive correlational design using a self‐administered questionnaire. Methods Electronic and printable survey questionnaires were distrusted among nurses working in public hospitals in multiple regions of Saudi Arabia. The study recruited 1,256 nurses from different nationalities, hospital work units and work experience. Results A large proportion of nurses on night shiftwork encountered patient safety issues (85.7%) and physiological consequences (93.6%). Counselling sessions and programmes to support at‐risk nurses are recommended.
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Affiliation(s)
- Abdalkarem F Alsharari
- Nursing Department, College of Applied Medical Sciences, Jouf University, Sakakah, Saudi Arabia
| | - Fuad H Abuadas
- Nursing Department, College of Applied Medical Sciences, Jouf University, Sakakah, Saudi Arabia
| | - Mohammed N Hakami
- College of Nursing, King Saud University, Riyadh, Saudi Arabia.,Ministry of Health, Riyadh, Saudi Arabia
| | - Adel A Darraj
- Ministry of Health, Riyadh, Saudi Arabia.,Sydney Nursing School, University of Sydney, Sydney, NSW, Australia
| | - Magbool W Hakami
- College of Nursing, King Saud University, Riyadh, Saudi Arabia.,Ministry of Health, Riyadh, Saudi Arabia
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Zhang Y, Shen J, Zhou Z, Sang L, Zhuang X, Chu M, Tian T, Xiao J, Lian Y. Relationships among shift work, hair cortisol concentration and sleep disorders: a cross-sectional study in China. BMJ Open 2020; 10:e038786. [PMID: 33191254 PMCID: PMC7668377 DOI: 10.1136/bmjopen-2020-038786] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The present study was designed to demonstrate the relationships among shift work, hair cortisol concentration (HCC) and sleep disorders. DESIGN A cross-sectional study. SETTING Three petroleum administrations in Karamay city of Xinjiang, China. PARTICIPANTS 435 individuals including 164 males and 271 females participated in the research. OUTCOME MEASURES Information on shift work was collected by a self-administered questionnaire. HCC was determined using an automatic radioimmunoassay instrument. Sleep quality was measured on the Pittsburgh Sleep Quality Index scale. RESULTS Shiftwork was associated with an increased prevalence of sleep disorders compared with the fixed day shift (two shifts: OR 3.11, 95% CI 1.57 to 6.19; three shifts: OR 2.87, 95% CI 1.38 to 5.98; four shifts: OR 2.22, 95% CI 1.17 to 4.18; others: OR 3.88, 95% CI= 1.36 to 11.08). Workers with different shift patterns had higher HCC levels than day workers ((fixed day shift: geometric mean±geometric SD=2.33±1.65; two shifts: 3.76±1.47; three shifts: 3.15±1.64; four shifts: 3.81±1.55; others: 3.60±1.33) ng/g hair, η2=0.174) and high HCC was associated with the higher prevalence of sleep disorders (OR 4.46, 95% CI 2.70 to 7.35). The mediating effect of HCC on the relationship between shift work and sleep disorders was 0.25 (95% CI 0.09 to 0.41). CONCLUSION We found that, when compared with the fixed day shift, shiftwork was associated with both the higher HCC, and also with an increased risk of sleep disorders. High HCC was associated with the occurrence of sleep disorders. In addition, HCC had mediating effect in shift work and sleep disorders. Thus, HCC can be considered as an early marker of shiftwork circadian disruption to early detection and management of sleep disorders.
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Affiliation(s)
- Yu Zhang
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Jiayang Shen
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Ziqi Zhou
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Lingli Sang
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Xun Zhuang
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Minjie Chu
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Tian Tian
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Jing Xiao
- Department of Occupational Environmental Toxicology, School of Public Health, Nantong University, Nantong, Jiangsu, China
| | - Yulong Lian
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, Nantong, Jiangsu, China
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20
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Circadian misalignment increases mood vulnerability in simulated shift work. Sci Rep 2020; 10:18614. [PMID: 33122670 PMCID: PMC7596056 DOI: 10.1038/s41598-020-75245-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 10/08/2020] [Indexed: 01/05/2023] Open
Abstract
Night shift work can associate with an increased risk for depression. As night workers experience a 'misalignment' between their circadian system and daily sleep-wake behaviors, with negative health consequences, we investigated whether exposure to circadian misalignment underpins mood vulnerability in simulated shift work. We performed randomized within-subject crossover laboratory studies in non-shift workers and shift workers. Simulated night shifts were used to induce a misalignment between the endogenous circadian pacemaker and sleep/wake cycles (circadian misalignment), while environmental conditions and food intake were controlled. Circadian misalignment adversely impacted emotional state, such that mood and well-being levels were significantly decreased throughout 4 days of continuous exposure to circadian misalignment in non-shift workers, as compared to when they were under circadian alignment (interaction of "circadian alignment condition" vs. "day", mood: p < 0.001; well-being: p < 0.001; adjusted p-values). Similarly, in shift workers, mood and well-being levels were significantly reduced throughout days of misalignment, as compared to circadian alignment (interaction of "circadian alignment condition" vs. "day", mood: p = 0.002; well-being: p = 0.002; adjusted p-values). Our findings indicate that circadian misalignment is an important biological component for mood vulnerability, and that individuals who engage in shift work are susceptible to its deleterious mood effects.
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21
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Good Sleep Quality and Progressive Increments in Vigilance During Extended Night Shifts: A 14-Day Actigraphic Study in Underground Miners. J Occup Environ Med 2020; 62:e754-e759. [PMID: 33086220 DOI: 10.1097/jom.0000000000002056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Assess the change in sleep and vigilance of underground miners during long periods of extended shifts. METHODS Seventy miners worked 14 consecutive 12-hour day and/or night shifts. Also, they wore an actigraph and completed a visual analog scale for vigilance four times per shift. Linear regression models with mixed effects were used. RESULTS Sleep efficiency was higher during day shifts than during night shifts (86,5 vs 85.5, P < 0.05) but sleep duration did not differ (6:34 vs 6:44, n.s.). Mean vigilance level at Time 3 (02h00) was significantly lower than that at Time 1 (19h00) during the first 10 night shifts whereas mean vigilance level at Time 4 (05h30) remained significantly lower for the 14 night shifts. CONCLUSIONS Underground miners exhibit good sleep quality despite evidence of limited circadian adaptation in terms of nighttime vigilance.
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22
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Vanttola P, Puttonen S, Karhula K, Oksanen T, HÄrmÄ M. Employees with shift work disorder experience excessive sleepiness also on non-work days: a cross-sectional survey linked to working hours register in Finnish hospitals. INDUSTRIAL HEALTH 2020; 58:366-374. [PMID: 32074541 PMCID: PMC7417498 DOI: 10.2486/indhealth.2019-0179] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
A considerable proportion of shift workers have work schedule-related insomnia and/or excessive sleepiness, a phenomenon described as shift work disorder (SWD). There is yet a lack of evidence on whether or not employees recover from symptoms of SWD between work shifts. We studied whether SWD and its subtypes are associated with insomnia and excessive sleepiness during weekly non-work days and with 24-h sleep time. Hospital employees answered a survey on SWD, insomnia and excessive sleepiness on weekly non-work days, and 24-h sleep. To identify shift workers with night shifts (n=2,900, 18% with SWD) and SWD, we linked survey responses to employers' register on working hours. SWD included three subtypes: insomnia only (SWD-I, 4%, n=102), excessive sleepiness only (SWD-Es, 8%, n=244), and both insomnia and excessive sleepiness (SWD-IEs, 6%, n=183). Based on regression analyses, SWD was associated with excessive sleepiness on non-work days (OR: 1.42, 95% CI: 1.07-1.88) and with insomnia on non-work days (0.53, 0.31-0.91). SWD-I was associated with excessive sleepiness on non-work days (2.25, 1.31-3.87) and with shorter sleep (7-7.5 h: 1.96, 1.06-3.63; ≤6.5h: 2.39, 1.24-4.59; reference: ≥8 h). The results suggest that especially employees with SWD-I may need longer time to overcome excessive sleepiness than allowed by their roster.
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Affiliation(s)
- Päivi Vanttola
- Finnish Institute of Occupational Health, Finland
- Faculty of Medicine, University of Helsinki, Finland
| | | | - Kati Karhula
- Finnish Institute of Occupational Health, Finland
| | | | - Mikko HÄrmÄ
- Finnish Institute of Occupational Health, Finland
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Chen D, Jiang M, Shi X, Geng F, Qi H, Zhang Y, Lai Y, Fan F. Predictors of the initiation of shift work disorder among Chinese intern nurses: a prospective study. Sleep Med 2020; 68:199-206. [DOI: 10.1016/j.sleep.2019.11.1263] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 11/20/2019] [Accepted: 11/27/2019] [Indexed: 12/20/2022]
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Thottakam BMVJ, Webster NR, Allen L, Columb MO, Galley HF. Melatonin Is a Feasible, Safe, and Acceptable Intervention in Doctors and Nurses Working Nightshifts: The MIDNIGHT Trial. Front Psychiatry 2020; 11:872. [PMID: 33192634 PMCID: PMC7481467 DOI: 10.3389/fpsyt.2020.00872] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/10/2020] [Indexed: 01/05/2023] Open
Abstract
Nightshift working is associated with sleep deprivation, fatigue and attention/concentration deficits which, in healthcare workers, may impact on patient safety. Clinical staff in the UK routinely work several 12 h nightshifts in a row at about 1-3 month intervals. We investigated the feasibility and acceptability of a crossover trial of melatonin administration in clinical staff working nightshifts with an exploration of effects on sleep measures and attention/concentration tasks. This was a pilot, double-blinded, randomized, placebo-controlled crossover feasibility trial in doctors and nurses working 3 consecutive nightshifts at a tertiary referral hospital in the UK. Twenty five male and female subjects were randomized to receive either 6mg Circadin™ slow release melatonin or placebo before sleep after each consecutive nightshift, followed by a washout period, before crossing over to the other experimental arm. We used actigraphy for objective assessment of sleep parameters. The trial design was feasible and acceptable to participants with negligible side effects, but elevated melatonin levels were prolonged during the active arm (P=0.016). Double digit addition testing, a concentration/attention task, improved with melatonin treatment (P<0.0001). Lapses of vigilance or judgement while doctors or nurses are working nightshifts could impact on patient safety and melatonin may be a useful intervention. This study supports the conclusion that a larger definitive trial of this design is both feasible and safe. Clinical Trial Registration: identifier ISRCTN15529655. https://www.isrctn.com/.
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Affiliation(s)
| | - Nigel R Webster
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom.,Intensive Care Unit, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - Lee Allen
- Intensive Care Unit, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - Malachy O Columb
- Anaesthesia and Intensive Care Medicine, Manchester University Hospitals NHS Foundation Trust, Wythenshawe, United Kingdom
| | - Helen F Galley
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, United Kingdom.,Intensive Care Unit, Aberdeen Royal Infirmary, Aberdeen, United Kingdom
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25
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Järnefelt H, Härmä M, Sallinen M, Virkkala J, Paajanen T, Martimo KP, Hublin C. Cognitive behavioural therapy interventions for insomnia among shift workers: RCT in an occupational health setting. Int Arch Occup Environ Health 2019; 93:535-550. [PMID: 31853633 PMCID: PMC7260280 DOI: 10.1007/s00420-019-01504-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 12/02/2019] [Indexed: 02/07/2023]
Abstract
Introduction The aim of the study was to compare the effectiveness of cognitive behavioural therapy interventions for insomnia (CBT-I) to that of a sleep hygiene intervention in a randomized controlled design among shift workers. We also studied whether the features of shift work disorder (SWD) affected the results. Methods A total of 83 shift workers with insomnia disorder were partially randomized into a group-based CBT-I, self-help CBT-I, or sleep hygiene control intervention. The outcomes were assessed before and after the interventions and at 6-month follow-up using questionnaires, a sleep diary, and actigraphy. Results Perceived severity of insomnia, sleep-related dysfunctional beliefs, burnout symptoms, restedness, recovery after a shift, and actigraphy-based total sleep time improved after the interventions, but we found no significant differences between the interventions. Mood symptoms improved only among the group-based CBT-I intervention participants. Non-SWD participants had more mental diseases and symptoms, used more sleep-promoting medication, and had pronounced insomnia severity and more dysfunctional beliefs than those with SWD. After the interventions, non-SWD participants showed more prominent improvements than those with SWD. Conclusions Our results showed no significant differences between the sleep improvements of the shift workers in the CBT-I interventions and of those in the sleep hygiene control intervention. Alleviation of mood symptoms seemed to be the main added value of the group-based CBT-I intervention compared to the control intervention. The clinical condition of the non-SWD participants was more severe and these participants benefitted more from the interventions than the SWD participants did. Trial registration ClinicalTrials.gov, NCT02523079.
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Affiliation(s)
- Heli Järnefelt
- Finnish Institute of Occupational Health (FIOH), Topeliuksenkatu 41 b, 00250, Helsinki, Finland. .,Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
| | - Mikko Härmä
- Finnish Institute of Occupational Health (FIOH), Topeliuksenkatu 41 b, 00250, Helsinki, Finland
| | - Mikael Sallinen
- Finnish Institute of Occupational Health (FIOH), Topeliuksenkatu 41 b, 00250, Helsinki, Finland.,Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Jussi Virkkala
- Finnish Institute of Occupational Health (FIOH), Topeliuksenkatu 41 b, 00250, Helsinki, Finland.,Department of Clinical Neurophysiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Teemu Paajanen
- Finnish Institute of Occupational Health (FIOH), Topeliuksenkatu 41 b, 00250, Helsinki, Finland
| | - Kari-Pekka Martimo
- Finnish Institute of Occupational Health (FIOH), Topeliuksenkatu 41 b, 00250, Helsinki, Finland
| | - Christer Hublin
- Finnish Institute of Occupational Health (FIOH), Topeliuksenkatu 41 b, 00250, Helsinki, Finland
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Khosravipour M, Shahmohammadi M, Athar HV. The effects of rotating and extended night shift work on the prevalence of metabolic syndrome and its components. Diabetes Metab Syndr 2019; 13:3085-3089. [PMID: 31765983 DOI: 10.1016/j.dsx.2019.11.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/11/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Some studies indicated night shift work can be associated with the higher risk of metabolic syndrome (MetS). However, the effect of both rotating and extended night shift work (12-hr rotating night) on MetS has not well-known. We aimed to examine and clarify the association among petrochemical workers. METHODS We recruited 1575 eligible workers in this study. According to shift work schedules the participants were divided into following groups: 12-hr fixed day and 12-hr rotating night. Biochemical data, including fasting blood sugar and lipid panel (TC, TG, LDL, and HDL) were determined by blood tests. Demographic data was obtained by interview at the time of blood pressure and anthropometric indices measurements. The National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) was applied to identify subjects with MetS. The Logistic regression models were used to predict risk of MetS and its components between study groups. RESULTS The prevalence of MetS was showed 18.4% (290/1575). We found a significant difference between study groups in the prevalence of MetS (p < 0.05). The odds ratios (ORs) and 95% confidence intervals (CIs) in the 12-hr rotating night group in comparison to the 12-hr fixed day shift group according to unadjusted and full adjusted logistic regression models were estimated 1.26 (0.96, 1.65) and 1.34 (1.01, 1.76), respectively. Among MetS components, we observed the significant higher risk in TG and HDL (P < 0.05). CONCLUSION This study suggests 12-hr rotating night shift as the high-risk group for MetS. More studies needed to confirm our findings.
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Affiliation(s)
- Masoud Khosravipour
- Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Science, Kermanshah, Iran; Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Shahmohammadi
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Science, Kermanshah, Iran; Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hossein Valadi Athar
- Department of Occupational Health Engineering, School of Public Health, Kermanshah University of Medical Science, Kermanshah, Iran; Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran.
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Vanttola P, Puttonen S, Karhula K, Oksanen T, Härmä M. Prevalence of shift work disorder among hospital personnel: A cross-sectional study using objective working hour data. J Sleep Res 2019; 29:e12906. [PMID: 31410909 DOI: 10.1111/jsr.12906] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 06/24/2019] [Accepted: 07/18/2019] [Indexed: 12/23/2022]
Abstract
The prevalence of shift work disorder (SWD) has been studied using self-reported data and the International Classification of Sleep Disorders, Second Edition (ICSD-2) criteria. We examined the prevalence in relation to ICSD-2 and ICSD-3 criteria, work schedules and the number of non-day shifts (work outside 06:00-18:00 hours) using objective working-hours data. Secondly, we explored a minimum cut-off for the occurrence of SWD symptoms. Hospital shift workers without (n = 1,813) and with night shifts (n = 2,917) and permanent night workers (n = 84) answered a survey (response rate 69%) on SWD and fatigue on days off. The prevalence of SWD was calculated for groups with ≥1, ≥3, ≥5 and ≥7 monthly non-day shifts utilizing the working hours registry. ICSD-3-based SWD prevalence was 2.5%-3.7% (shift workers without nights), 2.6%-9.5% (shift workers with nights) and 6.0% (permanent night workers), depending on the cut-off of non-day shifts (≥7-1/month, respectively). The ICSD-2-based prevalence was higher: 7.1%-9.2%, 5.6%-33.5% and 16.7%, respectively. The prevalence was significantly higher among shift workers with than those without nights (p-values <.001) when using the cut-offs of ≥1-3 non-day shifts. Shift workers with nights who had ≥3 days with ICSD-3-based SWD symptoms/month more commonly had fatigue on days off (49.3%) than those below the cut-off (35.8%, p < .05). The ICSD-3 criteria provided lower estimates for SWD prevalence than ISCD-2 criteria, similarly to exclusion of employees with the fewest non-day shifts. The results suggest that a plausible cut-off for days with ICSD-3-based SWD symptoms is ≥3/month, resulting in 3%-6% prevalence of SWD.
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Affiliation(s)
- Päivi Vanttola
- Finnish Institute of Occupational Health, Helsinki, Finland.,Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | | | - Kati Karhula
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Tuula Oksanen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Mikko Härmä
- Finnish Institute of Occupational Health, Helsinki, Finland
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FISCHER FM, SILVA-COSTA A, GRIEP RH, SMOLENSKY MH, BOHLE P, ROTENBERG L. Working Time Society consensus statements: Psychosocial stressors relevant to the health and wellbeing of night and shift workers. INDUSTRIAL HEALTH 2019; 57:175-183. [PMID: 30700668 PMCID: PMC6449638 DOI: 10.2486/indhealth.sw-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
This consensus report summarizes the negative impact of work-related psychosocial factors and job stressors on the health and wellbeing of shift workers. Psychosocial factors may (a) directly affect work schedules or (b) mediate or moderate relationships between work schedules, circadian factors, and health. In this paper, prominent psychosocial models (e.g. Job Strain and Effort-Reward Imbalance) are used to help assess detrimental effects, including pathophysiologic outcomes. Several studies indicate the psychosocial environment can be more problematic for shift workers compared to regular day workers. This is likely due to shift worker's experiencing greater risks of low job control, high physical work demands, lower support from supervisors, and greater levels of over-commitment. Workplace violence is another frequently encountered psychosocial stressor for shift workers more likely to be in regular contact with the general public, such as police officers, security personnel, professional drivers, and other service employees being at elevated risk. A large body of literature confirms night and irregular shift schedules increase risk for injury. Non-diurnal schedules can trigger and worsen such incidents, especially under unsafe conditions. The problem of workplace violence for shift workers, in terms of severity and consequences, is probably underestimated, especially when present among other occupational stressors. Practical considerations and recommendations for action to mitigate the detrimental effects of psychosocial stressors on night and shift workers are presented.
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Affiliation(s)
- Frida Marina FISCHER
- Department of Environmental Health, School of Public Health,
University of São Paulo, Brazil
- *To whom correspondence should be addressed. E-mail:
| | - Aline SILVA-COSTA
- Department of Collective Health, Federal University of
Triângulo Mineiro, Brazil
| | - Rosane Harter GRIEP
- Laboratory of Health and Environment Education, Oswaldo Cruz
Institute, Brazil
| | - Michael H. SMOLENSKY
- Department of Biomedical Engineering, Cockrell School of
Engineering, The University of Texas at Austin, USA
| | - Philip BOHLE
- Faculty of Health Sciences, The University of Sydney,
Australia
| | - Lucia ROTENBERG
- Laboratory of Health and Environment Education, Oswaldo Cruz
Institute, Brazil
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Cheng P, Drake CL. Psychological Impact of Shift Work. CURRENT SLEEP MEDICINE REPORTS 2018; 4:104-109. [PMID: 29984133 PMCID: PMC6029716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
PURPOSE OF REVIEW Technology and globalization have been central forces driving the need for shift work. This review examines recent scientific developments that inform our understanding of how psychological process contribute to and are impacted by shift work. RECENT FINDINGS Nascent research is beginning to expand beyond circadian misalignment to elucidate the phenomenology of shift work and the associated psychological impairments. Psychological processes and their interaction with biology are considered in the pathophysiology of shift work sleep disorder. Additionally, a review of the adverse consequences of shift work in the cognitive, emotional, and psychosocial domains are reviewed and discussed. SUMMARY The phenomenology of shift work encompasses multiple domains of biopsychosocial functioning. As such, interventions to reduce the adverse impact of shift work may benefit from an integrated approach.
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Affiliation(s)
- Philip Cheng
- Henry Ford Health System, 39450 West 12 Mile Road, Novi, MI 48377
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