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Charles LE, Gu JK, Violanti JM. Impact of Shiftwork on Retinal Vasculature Diameters over a 5-Year Period: A Preliminary Investigation Using the BCOPS Study Data. Int J Environ Res Public Health 2024; 21:439. [PMID: 38673350 PMCID: PMC11050094 DOI: 10.3390/ijerph21040439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 03/06/2024] [Accepted: 03/27/2024] [Indexed: 04/28/2024]
Abstract
Our aim was to investigate the impact of shiftwork on changes in central retinal arteriolar equivalent (CRAE), a measure of arteriolar width, and central retinal venular equivalent (CRVE), a measure of venular width, over five years. The participants were 117 officers (72.7% men) examined at the first (2011-2014) and second (2015-2019) follow-up examinations in the Buffalo Cardio-Metabolic Occupational Police Stress study. Shiftwork data were obtained from the City of Buffalo, NY payroll records. Retinal diameters were measured using a standardized protocol. ANCOVA was used to compare mean change in CRAE and CRVE between the two examinations across shiftwork categories. Among men only, those who worked ≥70% hours on day shifts had a larger decrease in mean CRAE (-7.13 µm ± 2.51) compared to those who worked <70% day (-0.08 ± 0.96; p = 0.011). Among patrol officers, those who worked ≥70% day had a larger decrease in CRAE compared to those who worked <70% day (p = 0.015). Also, officers who worked ≥70% day had an increase in mean CRVE (µm) (4.56 ± 2.56) compared to those who worked <70% (-2.32 ± 1.32; p = 0.027). Over the five-year period, we observed adverse changes in arteriolar and venular diameters among officers who worked ≥70% on day shifts. The results should be interpreted with caution due to the small sample sizes.
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Affiliation(s)
- Luenda E. Charles
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505-2888, USA;
| | - Ja K. Gu
- Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV 26505-2888, USA;
| | - John M. Violanti
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY 14214-8001, USA;
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Barger LK, Zhang Y, Lammers-van der Holst HM, Snoep D, Murphy AS, Desnoyers B, Duffy JF. Feasibility, effectiveness, and acceptability of an afternoon-evening sleep schedule in older nightshift workers. Sleep Adv 2024; 5:zpae010. [PMID: 38404951 PMCID: PMC10894508 DOI: 10.1093/sleepadvances/zpae010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 01/23/2024] [Indexed: 02/27/2024]
Abstract
Study Objectives To explore the feasibility, effectiveness, and acceptability of an afternoon-evening sleep schedule in older (age 50-65 years) nightshift workers. Methods We used a three-part strategy: a screening survey to identify individuals who said they could adopt an 8-hour afternoon-evening sleep schedule; a field study where daily diary and actigraphy data were collected during a baseline week and intervention week, with randomization to self-selected sleep, 8-hour afternoon-evening time in bed (TIB), or 8-hour self-selected TIB; and follow-up focus groups to understand the acceptability of the intervention. Results Gender (p < 0.001), Hispanic ethnicity (p = 0.023), the care of children (p = 0.014), and chronotype (p = 0.012), predicted the reported ability to spend 8 hours in bed in the afternoon-evening. Participants assigned to the 8-hour self-selected and 8-hour afternoon-evening groups significantly increased their TIB and sleep duration compared to baseline (p < 0.05), while the control group did not. Although spending 8 hours in bed was feasible for the participants during the study, focus group discussions indicated participants would not continue an 8-hour TIB schedule after the study due to family responsibilities and other activities of daily living. Conclusions Spending 8 hours in bed between successive night shifts, initiated at both a self-selected time and in the afternoon-evening, increased the sleep duration of older shiftworkers, but most would not continue such a schedule on their own. Additional research is needed to find countermeasures for the reduced sleep duration experienced by most shiftworkers that are not only effective, but also compatible with shiftworkers' lifestyles.
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Affiliation(s)
- Laura K Barger
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Yuan Zhang
- Solomont School of Nursing, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Heidi M Lammers-van der Holst
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | | | - Audra S Murphy
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham Women’s Hospital, Boston, MA, USA
| | - Brian Desnoyers
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham Women’s Hospital, Boston, MA, USA
| | - Jeanne F Duffy
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham Women’s Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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Faulkner R, Rangel T, Penders RA, Saul T, Bindler R, Miller L, Wilson M. Differences in nutritional profile by chronotype among 12-h day shift and night shift nurses. Chronobiol Int 2024; 41:17-28. [PMID: 38093633 DOI: 10.1080/07420528.2023.2294036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 12/07/2023] [Indexed: 01/16/2024]
Abstract
Acute care nurses may suffer substantial fatigue if working night shift or if assigned a shift contrasting their preferred sleep-wake patterns, called chronotype. Nurses are at higher risk for diet-related, metabolic diseases compared to other healthcare professionals. Yet, the impact of preferred chronotype and mismatch to assigned shift on nutritional intake and risk for metabolic disease among acute care nurses is unclear. This observational study analyzed dietary data from 52 acute care nurses. Participants completed the revised morningness-eveningness questionnaire which gives a total score between 4 and 26. Lower scores (<12) were flagged as evening type (E-type), higher scores (>17) defined as morning type (M-type), and scores between 12 and 17 were categorized as neither types (N-type). N-type participants were considered chronotype matched when assigned to either shift, whereas E-types were only considered matched if assigned to night shift, and M-types matched only if assigned to day shift. Participants also recorded all dietary intake for 7 d (reflecting a typical workweek) in the MyFitnessPal phone application. Findings indicated that eveningness nurses had markers of MetS, including a significantly larger body mass index and waist circumference than N-types (p < 0.05). E-types also consumed, on average, more calories than other chronotypes (m = 1833.7 kcal), although this was not a statistically significant finding. Mismatched day (n = 7, 13.4%) and night (n = 5, 9.6%) nurses in our sample consumed, on average, more calories (m = 1935.1 kcal, m = 1981.2 kcal, respectively) than matched day (n = 24, 46.2%, m = 1642.6 kcal) or night (n = 16, 30.8%, m = 1599.1 kcal) nurses, although this finding was not statistically significant. Mismatched day nurses consumed significantly less fiber than day matched nurses (median = 10.9 g versus median = 18.5 g, p = 0.04), while night mismatched consumed significantly more fiber compared to night matched (median = 21 g versus median = 12.2 g, p = 0.05) nurses. Participant diets overall did not follow recommendations by the United States Department of Agriculture (USDA), who consumed a higher percentage of calories from saturated fats and a smaller percentage of calories from fiber, habits which increase risk for metabolic syndrome. Further research surrounding nutritional pathways utilizing larger samples is needed to uncover relationships with metabolic syndrome especially for eveningness-type nurses or if working a shift mismatched with preferred chronotype.
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Affiliation(s)
- Rachel Faulkner
- Clinical Nutrition, Providence Sacred Heart Medical Center, Spokane, Washington, USA
| | - Teresa Rangel
- Clinical Nutrition, Providence Sacred Heart Medical Center, Spokane, Washington, USA
| | - Rebecca A Penders
- Clinical Nutrition, Providence Sacred Heart Medical Center, Spokane, Washington, USA
| | - Trisha Saul
- Clinical Nutrition, Providence Southern California Health and Services; Irvine, Irvine California, USA
| | - Ross Bindler
- Clinical Nutrition, Providence Southern California Health and Services; Irvine, Irvine California, USA
- Clinical Nutrition, Washington State University College of Nursing; Spokane, Spokane Washington, USA
| | - Lindsey Miller
- Clinical Nutrition, Lincoln Memorial University DeBusk College of Osteopathic Medicine, Knoxville, Tennessee, USA
| | - Marian Wilson
- Clinical Nutrition, Washington State University College of Nursing; Spokane, Spokane Washington, USA
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Erratum: Nightshift work and nighttime eating are associated with higher insulin and leptin levels in hospital nurses. Front Endocrinol (Lausanne) 2023; 14:1240127. [PMID: 37424865 PMCID: PMC10327635 DOI: 10.3389/fendo.2023.1240127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 06/14/2023] [Indexed: 07/11/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fendo.2022.876752.].
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Wirth MD, Meyer J, Jessup A, Dawson RM. Barriers and Facilitators of Diet, Physical Activity Levels, and Sleep Among Nursing Undergraduates and Early-Career Nurses: A Qualitative Descriptive Study. Am J Health Promot 2023:8901171231179437. [PMID: 37263962 DOI: 10.1177/08901171231179437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE Mechanisms leading to burnout, associated with high turnover in nursing, may start as early as in nursing school. Given health habits (e.g., diet, physical activity, and sleep) can exacerbate or lessen the impact of burnout, this study examined current barriers and facilitators to healthy diet, physical activity levels, and sleep among nursing undergraduates (UGs) and early-career nurses (ECNs). RESEARCH DESIGN Qualitative descriptive study. SAMPLE 25 nursing UGs and 25 ECNs (within 3 years of graduation) from a Southeastern college of nursing. DATA COLLECTION AND ANALYSIS After development of theory-informed interview guides, participants conducted interviews either in-person or by phone, which were audio-recorded and transcribed. Braun and Clarke's six-step thematic analysis was used to analyze the transcripts. RESULTS All but one (aged 54) UG was in their early 20s and ECNs were in their early to mid-20s. Most participants were white, females. Time and stress were the strongest barriers among UGs and ECNs for adherence to healthy diet, physical activity, although stress did act as a facilitator for physical activity in a subset of both UGs and ECNs. Shiftwork was a common barrier to healthy behaviors among ECNs. CONCLUSION The fact that the more common and stronger barriers to healthier behaviors among UGs and ECNs were the same give credence to the idea that processes associated with burnout begin during or before nursing education and are persistent.
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Affiliation(s)
- Michael D Wirth
- College of Nursing, University of South Carolina, Columbia, SC, USA
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Jaclyn Meyer
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Angela Jessup
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Robin M Dawson
- College of Nursing, University of South Carolina, Columbia, SC, USA
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Marot LP, Lopes TDVC, Balieiro LCT, Crispim CA, Moreno CRC. Impact of Nighttime Food Consumption and Feasibility of Fasting during Night Work: A Narrative Review. Nutrients 2023; 15:nu15112570. [PMID: 37299533 DOI: 10.3390/nu15112570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/23/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023] Open
Abstract
Shift work has been associated with an increased risk of developing chronic non-communicable diseases, such as obesity. The reduction in overnight fasting and its physiological consequences seem to affect the metabolic health of shift workers, but little has been discussed regarding the feasibility and implications of maintaining a night-long fast during work. This narrative review aims to discuss the impact of eating behavior on the reduction of overnight fasting in shift workers, as well as possible nutritional strategies involving fasting that have been tested for shift workers, to contribute to the establishment of nutritional guidelines for them. We used various databases and search engines to retrieve relevant articles, reviews, and investigations. Despite the potential benefits of overnight fasting for other groups, few studies have investigated this approach in the context of shift work. Generally, it seems to be a feasible and metabolically beneficial strategy for shift workers. However, it is essential to investigate the potential risks and benefits of reducing the fasting time for shift workers, considering social, hedonic, and stress-related factors. Furthermore, randomized clinical trials are necessary to establish safe and feasible strategies for shift workers to practice different fasting windows.
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Affiliation(s)
- Luisa Pereira Marot
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38405-320, Brazil
| | - Tássia do Vale Cardoso Lopes
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38405-320, Brazil
| | | | - Cibele Aparecida Crispim
- Chrononutrition Research Group, Faculty of Medicine, Federal University of Uberlândia, Uberlândia 38405-320, Brazil
| | - Cláudia Roberta Castro Moreno
- Department of Health, Life Cycles and Society, School of Public Health, University of São Paulo, Sao Paulo 01246-904, Brazil
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McIntosh E, Ferguson SA, Dorrian J, Coates AM, Leung G, Gupta CC. "Mars Bar and a Tin of Red Bull Kept Me and My Patients Alive": Exploring Barriers to Healthy Eating through Facebook Comments of Shiftworkers. Nutrients 2023; 15:959. [PMID: 36839319 PMCID: PMC9959479 DOI: 10.3390/nu15040959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/03/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023] Open
Abstract
The negative impact of an unhealthy diet on the shiftworker population has been well-documented. However, little evidence exists on the underlying reasons for unhealthy eating behaviours and the existing barriers to healthy eating withinshiftwork environments. This qualitative study investigated the dietary behaviours reported by shiftworkers through Facebook comments. Comments were collected if they were on public shiftworker-relevant posts pertaining to dietary news or dietary information on Facebook and were posted by self-identified shiftworkers, relatives of shiftworkers, or partners of shiftworkers. A thematic analysis of the 144 comments collected generated four categories that can be used to understand the motivations for eating behaviour on-shift: what shiftworkers eat, where food is sourced from, when food is eaten, and why certain foods are chosen. Results reveal motivations, attitudes, and both internal and external barriers to healthy eating behaviours, as well as similarities and differences across shiftwork industries. Recommendations for future research include further explorations on the link between scheduled eating (e.g., time-restricted eating) and shiftwork, the impact of a rotating shift arrangements on dietary health behaviours, and the impact of interpersonal relationships on shiftworker dietary choices. Understanding these motivations will inform strategies to promote healthy eating and help understand barriers for shiftworkers.
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Affiliation(s)
- Emma McIntosh
- Appleton Institute, School of Health, Medical, and Applied Sciences, Central Queensland University, Adelaide 5034, Australia
| | - Sally A. Ferguson
- Appleton Institute, School of Health, Medical, and Applied Sciences, Central Queensland University, Adelaide 5034, Australia
| | - Jillian Dorrian
- UniSA Justice and Society, University of South Australia, Adelaide 5072, Australia
| | - Alison M. Coates
- Alliance for Research in Exercise, Nutrition and Activity (ARENA) Research Centre, University of South Australia, Adelaide 5000, Australia
| | - Gloria Leung
- Department of Nutrition, Dietetics and Food, Monash University, Notting Hill 3168, Australia
| | - Charlotte C. Gupta
- Appleton Institute, School of Health, Medical, and Applied Sciences, Central Queensland University, Adelaide 5034, Australia
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Haghayegh S, Liu Y, Zhang Y, Strohmaier S, Papantoniou K, Markt S, Giovannucci E, Schernhammer E. Rotating Night Shift Work and Bladder Cancer Risk in Women: Results of Two Prospective Cohort Studies. Int J Environ Res Public Health 2023; 20:2202. [PMID: 36767572 PMCID: PMC9915636 DOI: 10.3390/ijerph20032202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/18/2023] [Accepted: 01/22/2023] [Indexed: 06/18/2023]
Abstract
Bladder cancer is the sixth most common cancer in the United States. Night shift work has previously been linked with cancer risk. Whether there is an association between rotating night shift work and bladder cancer in women has not been studied previously. Eligible participants in the Nurses' Health Study (NHS, n = 82,147, 1988-2016) and Nurses' Health Study II (NHSII, n = 113,630, 1989-2015) were prospectively followed and a total of 620 and 122 incident bladder cancer cases were documented during the follow-up of NHS and NHSII, respectively. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) for bladder cancer incidence. We observed a significantly increased risk of bladder cancer among women with >5 years of night shift work history compared with women who never worked rotating night shifts in NHS (HR = 1.24; 95%CI = 1.01-1.54, p for trend = 0.06), but not in the pooled NHS and NHS II (HR = 1.18; 95%CI = 0.97-1.43, p for trend = 0.08). Secondary analyses stratified by smoking status showed no significant interaction (p = 0.89) between the duration of rotating night shift work and smoking status. In conclusion, our results did not provide strong evidence for an association between rotating night shift work and bladder cancer risk.
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Affiliation(s)
- Shahab Haghayegh
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Yue Liu
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Yin Zhang
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Kyriaki Papantoniou
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Sarah Markt
- Department of Population and Quantitative Health Sciences, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Edward Giovannucci
- Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
| | - Eva Schernhammer
- Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA 02115, USA
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA 02115, USA
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Abrahamsen AS, Johannesen Á, Debes F, van Leeuwen WMA, Weihe P. Working environment and fatigue among fishers in the north Atlantic: a field study. Int Marit Health 2023; 74:1-14. [PMID: 36974488 DOI: 10.5603/imh.2023.0001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/13/2023] [Accepted: 01/16/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND This study investigates how Faroese deep-sea fishers' exposure to work-related stressors affects their sleep, sleepiness, and levels of fatigue. Being constantly exposed to the unpredictable and harsh North Atlantic Ocean, having long work hours and split sleep for up to 40 days consecutively, they will arguably suffer from fatigue. MATERIALS AND METHODS One hundred and fifty seven fishers participated in this study, and data was gathered throughout 202 days at sea. Subjective data was collected at the start and end of trips via questionnaires, sleep and sleepiness diaries and supplemented by objective sleep data through actigraphs. Ship movements were logged with a gyroscope connected to a laptop. A noise metre measured each work station and resting area, and noise exposure profiles were calculated based on each participant's activity and location. Linear mixed-effect models investigated the effects of work exposure variables on sleep efficiency, and cumulative link mixed models measured effects on the Karolinska Sleepiness Scale and physical fatigue scale. RESULTS Time of day followed by ship movement were the exposure variables with the highest impact on the outcome variables of sleep efficiency, sleepiness and physical fatigue. The number of days at sea revealed correlations to outcome variables either by itself or interacting with the sleep periods per day. Crew size, shift system or noise did not impact outcome variables when in the model with other variables. Larger catches improved sleep efficiency but did not affect sleepiness and physical fatigue ratings. CONCLUSIONS The findings indicate a chronically fatigued fisher population, and recommends urgent attention being paid to improving the structure of vessels and installing stabilators for greater stability at sea; work schedules being evaluated for protection of health; and work environments being designed that fulfill human physiological requirements in order to ensure the wellbeing and safety of those at sea.
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Affiliation(s)
- Annbjørg Selma Abrahamsen
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands.
- Faculty of Health Sciences, The Faroese University, Tórshavn, Faroe Islands.
| | - Ása Johannesen
- Department of Technology and Environment, Fiskaaling, Hvalvík, Faroe Islands
| | - Fróði Debes
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands
| | - Wessel M A van Leeuwen
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Pál Weihe
- Department of Occupational Medicine and Public Health, The Faroese Hospital System, Tórshavn, Faroe Islands
- Faculty of Health Sciences, The Faroese University, Tórshavn, Faroe Islands
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Maisey G, Cattani M, Devine A, Dunican IC. Fatigue Risk Management Systems Diagnostic Tool: Validation of an Organizational Assessment Tool for Shift Work Organizations. Saf Health Work 2022; 13:408-414. [PMID: 36579003 PMCID: PMC9772465 DOI: 10.1016/j.shaw.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/25/2022] [Accepted: 08/07/2022] [Indexed: 12/31/2022] Open
Abstract
Background This study aimed to determine and define the elements of an Fatigue Risk Management System (FRMS) diagnostic tool to assist an organization in systematically assessing its level of implementation of an FRMS. Methods A modified Delphi process was used involving 16 participants with expertise in sleep science, chronobiology, and fatigue risk management within occupational settings. The study was undertaken in two stages 1) review of elements and definitions; 2) review of statements for each element. Each stage involved an iterative process, and a consensus rule of ≥ 60% was applied to arrive at a final list of elements, definitions, and statements. Results Stage 1: a review of elements (n = 12) and definitions resulted in a final list of 14 elements and definitions with a consensus of ≥ 60% achieved after 2 Delphi rounds. Stage 2: a review of statements (n = 131) resulted in a final list of 119 statements with a consensus of ≥ 60% achieved after 2 Delphi rounds. Conclusion The final FRMS diagnostic tool will enable an organization to systematically assess the level of implementation of their current FRMS and identify gaps and opportunities to reduce risk.
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Affiliation(s)
- Gemma Maisey
- Corresponding author. School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia.
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Galinde AAS, Al-Mughales F, Oster H, Heyde I. Different levels of circadian (de)synchrony -- where does it hurt? F1000Res 2022; 11:1323. [PMID: 37125019 PMCID: PMC10130703 DOI: 10.12688/f1000research.127234.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/24/2022] [Indexed: 11/16/2022] Open
Abstract
A network of cellular timers ensures the maintenance of homeostasis by temporal modulation of physiological processes across the day. These so-called circadian clocks are synchronized to geophysical time by external time cues (or zeitgebers). In modern societies, natural environmental cycles are disrupted by artificial lighting, around-the-clock availability of food or shiftwork. Such contradictory zeitgeber input promotes chronodisruption, i.e., the perturbation of internal circadian rhythms, resulting in adverse health outcomes. While this phenomenon is well described, it is still poorly understood at which level of organization perturbed rhythms impact on health and wellbeing. In this review, we discuss different levels of chronodisruption and what is known about their health effects. We summarize the results of disrupted phase coherence between external and internal time vs. misalignment of tissue clocks amongst each other, i.e., internal desynchrony. Last, phase incoherence can also occur at the tissue level itself. Here, alterations in phase coordination can emerge between cellular clocks of the same tissue or between different clock genes within the single cell. A better understanding of the mechanisms of circadian misalignment and its effects on physiology will help to find effective tools to prevent or treat disorders arising from modern-day chronodisruptive environments.
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Affiliation(s)
- Ankita AS. Galinde
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
| | - Faheem Al-Mughales
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
- Biochemistry Department, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - Henrik Oster
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
| | - Isabel Heyde
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
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12
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Galinde AAS, Al-Mughales F, Oster H, Heyde I. Different levels of circadian (de)synchrony -- where does it hurt? F1000Res 2022; 11:1323. [PMID: 37125019 PMCID: PMC10130703 DOI: 10.12688/f1000research.127234.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/15/2023] [Indexed: 04/05/2023] Open
Abstract
A network of cellular timers ensures the maintenance of homeostasis by temporal modulation of physiological processes across the day. These so-called circadian clocks are synchronized to geophysical time by external time cues (or zeitgebers). In modern societies, natural environmental cycles are disrupted by artificial lighting, around-the-clock availability of food or shift work. Such contradictory zeitgeber input promotes chronodisruption, i.e., the perturbation of internal circadian rhythms, resulting in adverse health outcomes. While this phenomenon is well described, it is still poorly understood at which level of organization perturbed rhythms impact on health and wellbeing. In this review, we discuss different levels of chronodisruption and what is known about their health effects. We summarize the results of disrupted phase coherence between external and internal time vs. misalignment of tissue clocks amongst each other, i.e., internal desynchrony. Last, phase incoherence can also occur at the tissue level itself. Here, alterations in phase coordination can emerge between cellular clocks of the same tissue or between different clock genes within the single cell. A better understanding of the mechanisms of circadian misalignment and its effects on physiology will help to find effective tools to prevent or treat disorders arising from modern-day chronodisruptive environments.
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Affiliation(s)
- Ankita AS. Galinde
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
| | - Faheem Al-Mughales
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
- Biochemistry Department, Faculty of Medicine and Health Sciences, Taiz University, Taiz, Yemen
| | - Henrik Oster
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
| | - Isabel Heyde
- Institute of Neurobiology, Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, 23562, Germany
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13
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Hagan-Haynes K, Pratt S, Lerman S, Wong I, Baker A, Flower D, Riethmeister V. US research needs related to fatigue, sleep, and working hours among oil and gas extraction workers. Am J Ind Med 2022; 65:840-856. [PMID: 34775611 DOI: 10.1002/ajim.23310] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/27/2021] [Accepted: 10/29/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND During 2003-2013, 1189 US oil and gas extraction (OGE) workers died while working, resulting in an average annual workplace fatality rate seven times that for all US workers. OGE work commonly involves long hours, shiftwork, irregular schedules, and long commutes, but effects of these factors on fatigue, occupational injury, and illness in OGE are largely unknown. METHODS A scoping review of relevant OGE research during 2000-2019 was completed and supplemented by input from a NIOSH-sponsored Forum. RESULTS Seventy-eight papers were identified; 76% reported only offshore research. Five themes for research needs emerged: build knowledge about the impacts of fatigue; explore interactions between on- and off-the-job risk factors; identify and evaluate interventions; assess effectiveness of technology; and increase the diffusion of fatigue risk management information. CONCLUSIONS Further collaboration between researchers and OGE operators and contractors can lead to action-oriented recommendations to mitigate the effects of fatigue, inadequate sleep, and shiftwork.
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Affiliation(s)
- Kyla Hagan-Haynes
- Western States Division, National Institute for Occupational Safety & Health, Denver, Colorado, USA
| | - Stephanie Pratt
- Strategic Innovative Solutions LLC, Morgantown, West Virginia, USA
| | | | - Imelda Wong
- Division of Science Integration, National Institute for Occupational Safety & Health, Cincinnati, Ohio, USA
| | - Angela Baker
- Royal Dutch Shell, Human Factors, The Hague, The Netherlands
| | - David Flower
- British Petroleum, Global Health, London, United Kingdom
| | - Vanessa Riethmeister
- Royal Dutch Shell, High Risk Transport, The Hague, South Hollands, The Netherlands
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14
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Wangsan K, Chaiear N, Sawanyawisuth K, Klainin-Yobas P, Simajareuk K, Boonsawat W. Which Shiftwork Pattern Is the Strongest Predictor for Poor Sleep Quality in Nurses? Int J Environ Res Public Health 2022; 19:13986. [PMID: 36360864 PMCID: PMC9658910 DOI: 10.3390/ijerph192113986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/20/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Shiftwork is related to an increased risk of several diseases, including gastric ulcers, myocardial infarction, and diabetes. Several shiftwork patterns are related to poor sleep quality, such as a quick returns or extended shifts. This study aimed to find the shiftwork patterns strongly associated with poor sleep quality amongst nurses. A cross-sectional analytical study was conducted among nurses working for at least one month. The sub-groups were the good sleep quality group (n = 150) and the poor sleep quality group (n = 472). Eligible participants were asked to complete a self-reported questionnaire comprising personal characteristics, job characteristics, shiftwork characteristics, and sleep quality. Factors associated with poor sleep quality were determined using logistic regression analysis. Two factors associated with poor sleep quality remained in the final model: viz., depression and backward rotational shift. The only independent factor for poor sleep quality was a backward rotational shift with an adjusted odds ratio (95% CI) of 1.946 (1.344, 2.871). In conclusion, compared with other shift patterns, backward shiftwork was the most significant factor associated with poor sleep quality and should be avoided.
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Affiliation(s)
- Kampanat Wangsan
- Department of Community, Family and Occupational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
- Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Naesinee Chaiear
- Department of Community, Family and Occupational Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Kittisak Sawanyawisuth
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
| | - Piyanee Klainin-Yobas
- Alice Lee Center for Nursing Studies, Yong Loo Lin School of Medicine Clinical Research Centre, National University of Singapore, Singapore 119077, Singapore
| | - Kanjana Simajareuk
- Nursing Division, Srinagarind Hospital, Faculty of Medicine, Khon Kaen 40002, Thailand
| | - Watchara Boonsawat
- Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand
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15
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Hilditch CJ, Wong LR, Bathurst NG, Feick NH, Pradhan S, Santamaria A, Shattuck NL, Flynn‐Evans EE. Rise and shine: The use of polychromatic short-wavelength-enriched light to mitigate sleep inertia at night following awakening from slow-wave sleep. J Sleep Res 2022; 31:e13558. [PMID: 35102669 PMCID: PMC9787581 DOI: 10.1111/jsr.13558] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Revised: 12/01/2021] [Accepted: 01/14/2022] [Indexed: 12/30/2022]
Abstract
Sleep inertia is the brief period of performance impairment and reduced alertness experienced after waking, especially from slow-wave sleep. We assessed the efficacy of polychromatic short-wavelength-enriched light to improve vigilant attention, alertness and mood immediately after waking from slow-wave sleep at night. Twelve participants (six female, 23.3 ± 4.2 years) maintained an actigraphy-confirmed sleep schedule of 8.5 hr for 5 nights, and 5 hr for 1 night prior to an overnight laboratory visit. In the laboratory, participants were awakened from slow-wave sleep, and immediately exposed to either dim, red ambient light (control) or polychromatic short-wavelength-enriched light (light) for 1 hr in a randomized crossover design. They completed a 5-min Psychomotor Vigilance Task, the Karolinska Sleepiness Scale, and Visual Analogue Scales of mood at 2, 17, 32 and 47 min after waking. Following this testing period, lights were turned off and participants returned to sleep. They were awakened from their subsequent slow-wave sleep period and received the opposite condition. Compared with the control condition, participants exposed to light had fewer Psychomotor Vigilance Task lapses (χ2 [1] = 5.285, p = 0.022), reported feeling more alert (Karolinska Sleepiness Scale: F1,77 = 4.955, p = 0.029; Visual Analogue Scalealert : F1,77 = 8.226, p = 0.005), and reported improved mood (Visual Analogue Scalecheerful : F1,77 = 8.615, p = 0.004). There was no significant difference in sleep-onset latency between conditions following the testing period (t10 = 1.024, p = 0.330). Our results suggest that exposure to polychromatic short-wavelength-enriched light immediately after waking from slow-wave sleep at night may help improve vigilant attention, subjective alertness, and mood. Future studies should explore the potential mechanisms of this countermeasure and its efficacy in real-world environments.
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Affiliation(s)
- Cassie J. Hilditch
- Fatigue Countermeasures LaboratorySan José State UniversitySan JoséCaliforniaUSA
| | - Lily R. Wong
- Fatigue Countermeasures LaboratorySan José State UniversitySan JoséCaliforniaUSA
| | - Nicholas G. Bathurst
- Fatigue Countermeasures LaboratoryNASA Ames Research CenterMoffett FieldCaliforniaUSA
| | - Nathan H. Feick
- Fatigue Countermeasures LaboratorySan José State UniversitySan JoséCaliforniaUSA
| | - Sean Pradhan
- Fatigue Countermeasures LaboratorySan José State UniversitySan JoséCaliforniaUSA,School of BusinessMenlo CollegeAthertonCaliforniaUSA
| | - Amanda Santamaria
- Cognitive and Systems Neuroscience Research HubUniversity of South AustraliaMagillSouth AustraliaAustralia
| | - Nita L. Shattuck
- Operations Research DepartmentHuman Systems Integration ProgramNaval Postgraduate SchoolMontereyCaliforniaUSA
| | - Erin E. Flynn‐Evans
- Fatigue Countermeasures LaboratoryNASA Ames Research CenterMoffett FieldCaliforniaUSA
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16
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Choi MY, Malspeis S, Sparks JA, Cui J, Yoshida K, Costenbader KH. Association of Sleep Deprivation and the Risk of Developing Systemic Lupus Erythematosus Among Women. Arthritis Care Res (Hoboken) 2022; 75:1206-1212. [PMID: 36094865 PMCID: PMC10008454 DOI: 10.1002/acr.25017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 07/14/2022] [Accepted: 09/08/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVE Sleep deprivation has been associated with risk of autoimmune diseases. Using the Nurses' Health Study (NHS) (1986-2016) and NHSII (1989-2017) cohorts, we aimed in the present study to investigate whether sleep deprivation was associated with risk of developing systemic lupus erythematosus (SLE). METHODS Average sleep duration in a 24-hour period was reported in the NHS (1986-2014) and NHSII (1989-2009). Lifestyle, exposure, and medical information was collected on biennial questionnaires. Adjusted Cox regression analyses modeled associations between cumulative average sleep duration (categorical variables) and incident SLE. Interactions between sleep duration and shiftwork, bodily pain (using the Short Form 36 [SF-36] questionnaire), and depression were examined. RESULTS We included 186,072 women with 187 incident SLE cases during 4,246,094 person-years of follow-up. Chronic low sleep duration (≤5 hours/night versus reference >7-8 hours) was associated with increased SLE risk (adjusted hazard ratio [HRadj ] 2.47 [95% confidence interval (95% CI) 1.29, 4.75]), which persisted after the analysis was lagged (4 years; HRadj 3.14 [95% CI 1.57, 6.29]) and adjusted for shiftwork, bodily pain, and depression (HRadj 2.13 [95% CI 1.11, 4.10]). We detected additive interactions between low sleep duration and high bodily pain (SF-36 score <75) with an attributable proportion (AP) of 64% (95% CI 40%, 87%) and an HR for SLE of 2.97 (95% CI 1.86, 4.75) for those with both risk factors compared to those with neither. Similarly, there was an interaction between low sleep duration and depression, with an AP of 68% (95% CI 49%, 88%) and an HR for SLE of 2.82 (95% CI 1.64, 4.85). CONCLUSION Chronic low sleep duration was associated with higher SLE risk, with stronger effects among those with bodily pain and depression, highlighting the potential role of adequate sleep in disease prevention.
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Affiliation(s)
- May Y Choi
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and University of Calgary, Calgary, Alberta, Canada
| | - Susan Malspeis
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jeffrey A Sparks
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jing Cui
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kazuki Yoshida
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Karen H Costenbader
- Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts
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17
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Alonzo R, Anderson KK, Rodrigues R, Klar N, Chiodini P, Montero-Odasso M, Stranges S. Does Shiftwork Impact Cognitive Performance? Findings from the Canadian Longitudinal Study on Aging (CLSA). Int J Environ Res Public Health 2022; 19:10124. [PMID: 36011754 PMCID: PMC9408351 DOI: 10.3390/ijerph191610124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 08/11/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
Few large nationwide studies have investigated the relationship between shiftwork and cognitive performance, and little is known about whether and how psychological distress may impact this relationship. This study aimed to examine: (1) the cross-sectional relationship between shiftwork (yes/no) and some aspects of cognitive performance (declarative memory and executive functioning) and (2) the potential moderating effect of psychological distress among 20,610 community-dwelling adults from the comprehensive cohort of the Canadian Longitudinal Study on Aging (CLSA). Differences by sex and retirement status were also explored. Shiftwork was significantly associated with poorer performance for executive functioning (interference condition: ß = 0.47, 95% CI: 0.31 to 0.63; MAT: ß = -0.85, 95% CI: -1.21 to -0.50) but not for declarative memory. Completely and not/partly retired males showed poorer cognitive performance on executive functioning. However, no evidence of a moderating effect by psychological distress was found. Our findings confirm the association between shiftwork and cognitive performance and highlight important health correlates of shiftwork.
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Affiliation(s)
- Rea Alonzo
- Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada
| | - Kelly K. Anderson
- Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada
- Lawson Health Research Institute, London, ON N6C 2R5, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada
| | - Rebecca Rodrigues
- Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada
| | - Neil Klar
- Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada
| | - Paolo Chiodini
- Medical Statistics Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Manuel Montero-Odasso
- Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada
- Gait and Brain Laboratory, Parkwood Institute, Lawson Health Research Institute, London, ON N6C 0A7, Canada
- Department of Medicine, Division of Geriatric Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada
| | - Saverio Stranges
- Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada
- Departments of Family Medicine and Medicine, Schulich School of Medicine & Dentistry, Western University, London, ON N6A 5C1, Canada
- Department of Precision Health, Luxembourg Institute of Health, Strassen, L-1445 Luxembourg, Luxembourg
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18
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McHill AW, Hull JT, Klerman EB. Chronic Circadian Disruption and Sleep Restriction Influence Subjective Hunger, Appetite, and Food Preference. Nutrients 2022; 14:1800. [PMID: 35565768 DOI: 10.3390/nu14091800] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 01/20/2023] Open
Abstract
Chronic circadian disruption (CCD), such as occurs during rotating shiftwork, and insufficient sleep are each independently associated with poor health outcomes, including obesity and glucose intolerance. A potential mechanism for poor health is increased energy intake (i.e., eating), particularly during the circadian night, when the physiological response to energy intake is altered. However, the contributions of CCD and insufficient sleep to subjective hunger, appetite, food preference, and appetitive hormones are not clear. To disentangle the influences of these factors, we studied seventeen healthy young adults in a 32-day in-laboratory study designed to distribute sleep, wakefulness, and energy intake equally across all phases of the circadian cycle, thereby imposing CCD. Participants were randomized to the Control (1:2 sleep:wake ratio, n = 8) or chronic sleep restriction (CSR, 1:3.3 sleep:wake ratio, n = 9) conditions. Throughout each waking episode the participants completed visual analog scales pertaining to hunger, appetite, and food preference. A fasting blood sample was collected to assess appetitive hormones. CCD was associated with a significant decrease in hunger and appetite in a multitude of domains in both the Control and CSR groups. This change in hunger was significantly correlated with changes in the ghrelin/leptin ratio. These findings further our understanding of the contributions of CCD and insufficient sleep on subjective hunger and appetite as well as of their possible contributions to adverse health behaviors.
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19
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Erickson ML, Wang W, Counts J, Redman LM, Parker D, Huebner JL, Dunn J, Kraus WE. Field-Based Assessments of Behavioral Patterns During Shiftwork in Police Academy Trainees Using Wearable Technology. J Biol Rhythms 2022; 37:260-271. [PMID: 35416084 DOI: 10.1177/07487304221087068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Circadian misalignment, as occurs in shiftwork, is associated with numerous negative health outcomes. Here, we sought to improve data labeling accuracy from wearable technology using a novel data pre-processing algorithm in 27 police trainees during shiftwork. Secondarily, we explored changes in four metabolic salivary biomarkers of circadian rhythm during shiftwork. Using a two-group observational study design, participants completed in-class training during dayshift for 6 weeks followed by either dayshift or nightshift field-training for 6 weeks. Using our novel algorithm, we imputed labels of circadian misaligned sleep episodes that occurred during daytime, which were previously were mislabeled as non-sleep by Garmin, supported by algorithm performance analysis. We next assessed changes to resting heart rate and sleep regularity index during dayshift versus nightshift field-training. We also examined changes in field-based assessments of salivary cortisol, uric acid, testosterone, and melatonin during dayshift versus nightshift. Compared to dayshift, nightshift workers experienced larger changes to resting heart rate, sleep regularity index (indicating reduced sleep regularity), and alterations in sleep/wake activity patterns accompanied by blunted salivary cortisol. Salivary uric acid and testosterone did not change. These findings show wearable technology combined with specialized data pre-processing can be used to monitor changes in behavioral patterns during shiftwork.
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Affiliation(s)
| | - Will Wang
- Department of Biomedical Engineering, Duke University, Durham, North Carolina
| | - Julie Counts
- Duke Molecular Physiology Institute, Duke University, Durham, North Carolina
| | - Leanne M Redman
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, Louisiana
| | - Daniel Parker
- Duke Molecular Physiology Institute, Duke University, Durham, North Carolina
| | - Janet L Huebner
- Duke Molecular Physiology Institute, Duke University, Durham, North Carolina
| | - Jessilyn Dunn
- Department of Biomedical Engineering, Duke University, Durham, North Carolina.,Department of Biostatistics & Bioinformatics, Duke University, Durham, North Carolina
| | - William E Kraus
- Duke Molecular Physiology Institute, Duke University, Durham, North Carolina.,Department of Biomedical Engineering, Duke University, Durham, North Carolina
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20
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Dugdale Z, Eiter B, Chaumont Menéndez C, Wong I, Bauerle T. Findings from a systematic review of fatigue interventions: What's (not) being tested in mining and other industrial environments. Am J Ind Med 2022; 65:248-261. [PMID: 35184307 DOI: 10.1002/ajim.23334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 01/10/2022] [Accepted: 01/31/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Fatigue negatively impacts mineworker health and safety. In this paper, we identify fatigue interventions tested on industrial shiftworkers and explore their effects and the factors that may influence application in an industrial setting such as a mine site. METHODS This review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist. A structured, systematic search of the literature was conducted to identify relevant studies published between 1980 and 2020. Researchers independently conducted article screening and study quality appraisals against pre-established criteria, and then extracted data and conducted a narrative synthesis of the included studies. RESULTS Seven intervention studies, out of 1651 articles initially screened, were retained for narrative synthesis. Four studies tested the alerting effects of bright-light treatment, one evaluated the effectiveness of blue-light blocking glasses at improving daytime sleep quality and nighttime vigilance, and two examined whether sleep hygiene and alertness management trainings improved sleep quality or alertness. There was substantial evidence for the use of bright-light treatments to improve night shiftworker alertness, but insufficient evidence to draw conclusions about the effectiveness of blue-light blocking glasses and sleep hygiene and alertness management trainings due to the small number of studies included. Shiftworkers were mostly male and employed in industrial subsectors such as production and manufacturing, oil and gas, and transportation. No mining-specific intervention studies were identified. CONCLUSIONS Future research is needed to identify effective fatigue risk management interventions for the mining industry as well as best practices for implementing these interventions with mineworkers.
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Affiliation(s)
- Zoë Dugdale
- Spokane Mining Research Division National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention Spokane Washington USA
| | - Brianna Eiter
- Spokane Mining Research Division National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention Spokane Washington USA
| | - Cammie Chaumont Menéndez
- Division of Safety Research National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention Morgantown West Virginia USA
| | - Imelda Wong
- Division of Science Integration National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention Cincinnati Ohio USA
| | - Tim Bauerle
- Spokane Mining Research Division National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention Spokane Washington USA
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21
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Storz MA, Lombardo M, Rizzo G, Müller A, Lederer AK. Bowel Health in U.S. Shift Workers: Insights from a Cross-Sectional Study (NHANES). Int J Environ Res Public Health 2022; 19:ijerph19063334. [PMID: 35329018 PMCID: PMC8954046 DOI: 10.3390/ijerph19063334] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/07/2022] [Accepted: 03/09/2022] [Indexed: 11/24/2022]
Abstract
Working outside of regular daytime hours is increasingly common in current societies and poses a substantial challenge to an individual’s biological rhythm. Disruptions of the gastrointestinal tract’s circadian rhythm and poor dietary choices subsequent to shiftwork may predispose the shift workforce to an increased risk of gastrointestinal disorders, including constipation, peptic ulcer disease, and erosive gastritis. We investigated bowel health in a US population of shift workers, using data from the National Health and Nutrition Examination Survey, and compared bowel movement (BM) frequency and defecation patterns between 2007 day workers and 458 shift workers (representing 55,305,037 US workers). Using bivariate and multivariate logistic regression techniques, our results suggested no association between shiftwork status and BM frequency, bowel leakage of gas, and stool consistency. Constipation prevalence was high but comparable in both groups (6.90% vs. 7.09%). The low fiber intake observed in both groups (15.07 vs. 16.75 g/day) could play a potential role here. The two groups did not differ with regard to other nutrients that may influence BM frequency and stool consistency (e.g., carbohydrate or caffeine intake). Additional studies including food group analyses and fecal biomarkers are warranted for a better understanding of GI health in shift workers.
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Affiliation(s)
- Maximilian Andreas Storz
- Center for Complementary Medicine, Department of Internal Medicine II, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (A.M.); (A.-K.L.)
- Correspondence:
| | - Mauro Lombardo
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, 00166 Rome, Italy;
| | - Gianluca Rizzo
- Independent Researcher, Via Venezuela 66, 98121 Messina, Italy;
| | - Alexander Müller
- Center for Complementary Medicine, Department of Internal Medicine II, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (A.M.); (A.-K.L.)
| | - Ann-Kathrin Lederer
- Center for Complementary Medicine, Department of Internal Medicine II, Freiburg University Hospital, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany; (A.M.); (A.-K.L.)
- Department of General, Visceral and Transplantation Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, 55116 Mainz, Germany
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22
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Storz MA, Rizzo G, Lombardo M. Shiftwork Is Associated with Higher Food Insecurity in U.S. Workers: Findings from a Cross-Sectional Study (NHANES). Int J Environ Res Public Health 2022; 19. [PMID: 35270538 DOI: 10.3390/ijerph19052847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/23/2022] [Accepted: 02/25/2022] [Indexed: 12/05/2022]
Abstract
The number of shift workers has increased substantially within the last decades to keep pace with the increasingly complex societal need for 24 h services. Shift work has been associated with unhealthy lifestyles and a lower overall diet quality. Little is known, however, with regard to food security and consumer behavior in shift workers. The present study sought to address this gap in the literature, exploring a sample of n = 4418 day workers and n = 1065 shift workers in the United States. Using cross-sectional data from the National Health and Nutrition Examination Surveys (NHANES, 2007−2010), we found that shiftwork was associated with a lower amount of money spent on eating out and higher food insecurity issues. Compared to day workers, a higher proportion of shift workers reported receipt of food stamps (12.5% vs. 23.4%, p < 0.001) and worried about running out of food (3.95% vs. 8.05%, p < 0.001). These associations remained significant after adjustment for confounders when using multivariate logistic regression. The number of not-home-prepared meals did not differ between both groups. In light of the population health disparities and adverse health outcomes associated with food insecurity, novel strategies are urgently warranted to improve the situation of shift workers.
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23
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Molzof HE, Peterson CM, Thomas SJ, Gloston GF, Johnson RL, Gamble KL. Nightshift Work and Nighttime Eating Are Associated With Higher Insulin and Leptin Levels in Hospital Nurses. Front Endocrinol (Lausanne) 2022; 13:876752. [PMID: 35615722 PMCID: PMC9124849 DOI: 10.3389/fendo.2022.876752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Circadian misalignment between behaviors such as feeding and endogenous circadian rhythms, particularly in the context of shiftwork, is associated with poorer cardiometabolic health. We examined whether insulin and leptin levels differ between dayshift versus nightshift nurses, as well as explored whether the timing of food intake modulates these effects in nightshift workers. METHODS Female nurses (N=18; 8 dayshift and 10 nightshift) completed daily diet records for 8 consecutive days. The nurses then completed a 24-h inpatient stay, during which blood specimens were collected every 3 h (beginning at 09:00) and meals were consumed at regular 3-h intervals (09:00, 12:00, 15:00, and 18:00). Specimens were analyzed for insulin and leptin levels, and generalized additive models were used to examine differences in mean insulin and leptin levels. RESULTS Mean insulin and leptin levels were higher in nightshift nurses by 11.6 ± 3.8 mU/L (p=0.003) and 7.4 ± 3.4 ng/ml (p=0.03), respectively, compared to dayshift nurses. In an exploratory subgroup analysis of nightshift nurses, predominately eating at night (21:00 - 06:00) was associated with significantly higher insulin and leptin levels than consuming most calories during the daytime (06:00 - 21:00). CONCLUSIONS In our study of hospital nurses, working the nightshift was associated with higher insulin and leptin levels, and these effects were driven by eating predominately at night. We conclude that although nightshift work may raise insulin and leptin levels, eating during the daytime may attenuate some of the negative effects of nightshift work on metabolic health.
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Affiliation(s)
- Hylton E. Molzof
- Department of Psychiatry and Behavioral Sciences, Division of Sleep Medicine, Stanford University, Stanford, CA, United States
| | - Courtney M. Peterson
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL, United States
| | - S. Justin Thomas
- Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Gabrielle F. Gloston
- Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Russell L. Johnson
- Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Karen L. Gamble
- Department of Psychiatry and Behavioral Neurobiology, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
- *Correspondence: Karen L. Gamble,
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Kovac K, Vincent GE, Paterson JL, Ferguson SA. "I Want to Be Safe and Not Still Half Asleep": Exploring Practical Countermeasures to Manage the Risk of Sleep Inertia for Emergency Service Personnel Using a Mixed Methods Approach. Nat Sci Sleep 2022; 14:1493-1510. [PMID: 36052102 PMCID: PMC9427208 DOI: 10.2147/nss.s370488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/08/2022] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The aim of this exploratory cross-sectional mixed methods study was to determine 1) whether sleep inertia, the temporary state of impaired vigilance performance upon waking, is perceived to be a concern by emergency service personnel, 2) what strategies are currently used by emergency service workplaces to manage sleep inertia, 3) the barriers to implementing reactive sleep inertia countermeasures, and 4) what strategies personnel suggest to manage sleep inertia. PARTICIPANTS AND METHODS A sample (n = 92) of employed and volunteer Australian emergency service personnel (fire and rescue, ambulance, police, state-based rescue and recovery personnel) completed an online survey. Data collected included demographic variables and work context, experiences of sleep inertia in the emergency role, barriers to sleep inertia countermeasures, and existing workplace sleep inertia countermeasures and recommendations. Quantitative data were analysed using descriptive statistics, and qualitative data were thematically analysed. RESULTS Approximately 67% of participants expressed concern about sleep inertia when responding in their emergency role. Despite this, there were few strategies to manage sleep inertia in the workplace. One major barrier identified was a lack of time in being able to implement sleep inertia countermeasures. Fatigue management strategies, such as reducing on-call periods, and operational changes, such as screening calls to reduce false alarms, were suggested by participants as potential strategies to manage sleep inertia. CONCLUSION Sleep inertia is a concern for emergency service personnel and thus more research is required to determine effective sleep inertia management strategies to reduce the risks associated with sleep inertia and improve personnel safety and those in their care. In addition, future studies could investigate strategies to integrate reactive sleep inertia countermeasures into the emergency response procedure.
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Affiliation(s)
- Katya Kovac
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | - Grace E Vincent
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Wayville, SA, Australia
| | - Jessica L Paterson
- Flinders Institute of Mental Health and Wellbeing, College of Education, Psychology and Social Work, Flinders University, Bedford Park, SA, Australia
| | - Sally A Ferguson
- School of Health, Medical and Applied Sciences, Appleton Institute, Central Queensland University, Wayville, SA, Australia
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25
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Nakao H, Nomura O, Kubota M, Ishiguro A. Long-term impact of overnight shiftwork implementation on pediatric residents' mental wellness: A repeated cross-sectional survey. J Occup Health 2022; 64:e12349. [PMID: 35906714 PMCID: PMC9338226 DOI: 10.1002/1348-9585.12349] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 06/25/2022] [Accepted: 07/21/2022] [Indexed: 11/10/2022] Open
Abstract
Objectives The Japanese government partially enacted the “Work Style Reform Bill” in 2019. The National Center for Child Health and Development (NCCHD) introduced an Overnight Call Shift (OCS) system for pediatrician training. We conducted a follow‐up survey in 2019 to investigate the long‐term effectiveness of the OCS system to improve the pediatric residents' mental wellness at NCCHD. Methods We conducted a questionnaire‐based cross‐sectional survey for pediatric residents in 2019 to compare the data with those of the previous survey in 2012. The questionnaire includes demographic data, working conditions data, and mental wellness assessment by the Center for Epidemiologic Studies Depression scale (CES‐D) and the Maslach Burnout Inventory (MBI). Results The collection rate for the 2019 survey was 94.5% (37 participants/39 eligible). Compared to 2012, there were no significant changes in demographic data and working hours, a significant increase by about 30% in residents who took daytime off after night work, about 10% decrease in residents who scored 16 and above on the CES‐D, and a significant decrease in the mean score for depersonalization (DP) in the MBI. Multiple regression analyses showed that daytime off after night work was the decreasing factor for CES‐D and Emotional exhaustion (EE). Conclusions The overnight shiftwork system shortened the pediatric residents' duty hours somewhat, and imposed an impact on the pediatric residents' mental wellness.
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Affiliation(s)
- Hiro Nakao
- Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Setagaya-ku, Japan.,Center for Postgraduate Education and Training, National Center for Child Health and Development, Setagaya-ku, Japan
| | - Osamu Nomura
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Setagaya-ku, Japan.,Department of Emergency and Disaster Medicine, Hirosaki University, Hirosaki, Japan
| | - Mitsuru Kubota
- Department of General Pediatrics and Interdisciplinary Medicine, National Center for Child Health and Development, Setagaya-ku, Japan
| | - Akira Ishiguro
- Center for Postgraduate Education and Training, National Center for Child Health and Development, Setagaya-ku, Japan
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26
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Wirth MD, Fekedulegn D, Andrew ME, McLain AC, Burch JB, Davis JE, Hébert JR, Violanti JM. Longitudinal and cross-sectional associations between the dietary inflammatory index and objectively and subjectively measured sleep among police officers. J Sleep Res 2021; 31:e13543. [PMID: 34967055 PMCID: PMC9240102 DOI: 10.1111/jsr.13543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 12/01/2021] [Accepted: 12/18/2021] [Indexed: 11/30/2022]
Abstract
Police officers experience exposures associated with increased inflammation, such as the stress associated with shiftwork and poor-quality diet, both of which have been shown to affect sleep duration and quality. This study examined the longitudinal and cross-sectional effects of the Energy-density Dietary Inflammatory Index (E-DII™) on objectively and subjectively measured sleep among police officers. Data were derived from the Buffalo Cardio-Metabolic Occupational Police Stress Cohort (n = 464 at baseline), with longitudinal data collected from 2004 to 2019. A food frequency questionnaire obtained estimated dietary intake from which E-DII scores were calculated. Dependent variables were objectively (Micro Motion Logger Sleep Watch™) and subjectively (Pittsburgh Sleep Quality Index) measured sleep quality and quantity. The analyses included a series of linear mixed-effects models used to examine cross-sectional and longitudinal associations between the E-DII and sleep quantity and quality. Cross-sectionally, more pro-inflammatory diets were associated with higher wake-after-sleep-onset but improved subjective sleep quality. In models accounting for both longitudinal and cross-sectional effects, for every 1-unit increase in the E-DII scores over time (representing a pro-inflammatory change), wake-after-sleep-onset increased by nearly 1.4 min (p = 0.07). This result was driven by officers who primarily worked day shifts (β = 3.33, p = 0.01). Conversely, for every 1-unit increase in E-DII score, the Pittsburgh Sleep Quality Index global score improved. More pro-inflammatory diets were associated with increased wake-after-sleep-onset, an objective measure of sleep quality. Intervention studies to reduce dietary inflammatory potential may provide greater magnitude of effect for changes in sleep quality.
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Affiliation(s)
- Michael D Wirth
- College of Nursing, University of South Carolina, Columbia, South Carolina, USA.,Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Nutrition, Connecting Health Innovations, LLC, Columbia, South Carolina, USA
| | - Desta Fekedulegn
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Michael E Andrew
- Bioanalytics Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - James B Burch
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,WJB Dorn VA Medical Center, Columbia, South Carolina, USA.,Department of Family Medicine and Population Health, School of Medicine, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jean E Davis
- College of Nursing, University of South Carolina, Columbia, South Carolina, USA
| | - James R Hébert
- Department of Epidemiology and Biostatistics and Cancer Prevention and Control Program, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA.,Department of Nutrition, Connecting Health Innovations, LLC, Columbia, South Carolina, USA
| | - John M Violanti
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, New York, USA
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27
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Grant LK, St Hilaire MA, Brainard GC, Czeisler CA, Lockley SW, Rahman SA. Endogenous circadian regulation and phase resetting of clinical metabolic biomarkers. J Pineal Res 2021; 71:e12752. [PMID: 34118084 DOI: 10.1111/jpi.12752] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/09/2021] [Accepted: 06/10/2021] [Indexed: 11/30/2022]
Abstract
Shiftwork and circadian disruption are associated with adverse metabolic effects. Therefore, we examined whether clinical biomarkers of metabolic health are under endogenous circadian regulation using a 40 hours constant routine protocol (CR; constant environmental and behavioral conditions) and evaluated the impact of typical daily conditions with periodic sleep and meals (baseline; 8 hours sleep at night, four meals during a 16 hour wake episode) on the phase and amplitude of these rhythms. Additionally, we tested whether these circadian rhythms are reset during simulated shiftwork. Under CR (n = 16 males, mean age ± SD = 23.4 ± 2.3 years), we found endogenous circadian rhythms in cholesterol, HDL and LDL, albumin and total protein, and VLDL and triglyceride. The rhythms were masked under baseline conditions except for cholesterol, which had near-identical phases under both conditions. Resetting of the cholesterol rhythm and Dim Light Melatonin Onset (DLMO) was then tested in a study of simulated shiftwork (n = 25, 14 females, 36.3 ± 8.9 years) across four protocols; two with abrupt 8 hour delay shifts and exposure to either blue-enriched or standard white light; and either an abrupt or gradual 8 hour advance (1.6 hours/day over 5 days) both with exposure to blue-enriched white light. In the delay protocols, the cholesterol rhythm shifted later by -3.7 hours and -4.2 hours, respectively, compared to -6.6 hours and -4.7 hours, for DLMO. There was a significant advance in cholesterol in the abrupt (+5.1 hours) but not the gradual (+2.1 hours) protocol, compared to +3.1 hours and +2.8 hours in DLMO, respectively. Exploratory group analysis comparing the phases of all metabolic biomarkers under both studies showed evidence of phase shifts due to simulated shiftwork. These results show that clinical biomarkers of metabolic health are under endogenous circadian regulation but that the expression of these rhythms is substantially influenced by environmental factors. These rhythms can also be reset, which has implications for understanding how both behavioral changes and circadian shifts due to shiftwork may disrupt metabolic function.
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Affiliation(s)
- Leilah K Grant
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Melissa A St Hilaire
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - George C Brainard
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Charles A Czeisler
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Steven W Lockley
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
| | - Shadab A Rahman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
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28
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McHill AW, Velasco J, Bodner T, Shea SA, Olson R. Rapid changes in overnight blood pressure after transitioning to early-morning shiftwork. Sleep 2021; 45:6346467. [PMID: 34369575 DOI: 10.1093/sleep/zsab203] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 07/13/2021] [Indexed: 11/12/2022] Open
Abstract
Risk for adverse cardiovascular events increases when blood pressure does not decrease at night ("non-dipping", <10% decrease from daytime blood pressure). Shiftwork alters relationships between behaviors and endogenous circadian rhythms (i.e., circadian disruption along with variable sleep timing), and chronic shiftwork increases cardiovascular disease risk. To determine whether transitioning into shiftwork changes the overnight blood pressure dipping pattern, we leveraged a natural experiment that occurs when newly-hired bus operators transition from a daytime training schedule into an early-morning shiftwork or daywork schedule. Twenty participants were studied in a 90-day protocol upon new employment and underwent cardio-metabolic health assessments, including ambulatory blood pressure monitoring, and weekly sleep-wake diaries. Measurements were repeated after ~30 and 90 days after transitioning to a day or an early-morning shiftwork schedule. Newly-hired shiftworkers displayed dramatic changes in overnight blood pressure, with 62% converting from a healthy dipping blood pressure to the non-dipping pattern, resulting in 93% of shiftworkers displaying a non-dipping phenotype at 90-days. In contrast, 50% of dayworkers had a non-dipping profile at baseline and this decreased to 0% at 90-days, a significant difference from shiftworkers (p=0.001). At 90-days, overnight blood pressure dipping was ~7% less in shiftworkers than dayworkers (-6.3% [95%CI -3.7 to -8.8%] vs -13.1% [-10.3 to -15.9%]: p<0.01), with changes in dipping associated with changes in sleep timing variability (r 2=0.28, p=0.03). The observed changes in overnight blood pressure dipping in newly-hired early-morning shiftworkers, which were associated with sleep timing variability, may be an early warning sign of increased cardiovascular risk among shiftworkers.
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Affiliation(s)
- Andrew W McHill
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, Portland OR, USA.,Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR, USA
| | - Josie Velasco
- Sleep, Chronobiology, and Health Laboratory, School of Nursing, Oregon Health & Science University, Portland OR, USA.,Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR, USA
| | - Todd Bodner
- Department of Psychology, Portland State University, Portland OR, USA
| | - Steven A Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR, USA.,School of Public Health, OHSU-Portland State University, Portland, OR, USA
| | - Ryan Olson
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland OR, USA.,Department of Psychology, Portland State University, Portland OR, USA.,School of Public Health, OHSU-Portland State University, Portland, OR, USA
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29
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Bouillon-Minois JB, Trousselard M, Pereira B, Schmidt J, Clinchamps M, Thivel D, Ugbolue UC, Moustafa F, Occelli C, Vallet G, Dutheil F. Protocol of the Study on Emergency Health Care Workers' Responses Evaluated by Karasek Questionnaire: The SEEK-Study Protocol. Int J Environ Res Public Health 2021; 18:4068. [PMID: 33921527 PMCID: PMC8069162 DOI: 10.3390/ijerph18084068] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/02/2021] [Accepted: 04/03/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Stress is a significant public health concern that can be self-evaluated using the job control demands model from Karasek. Emergency health care workers are particularly exposed to stress because of the intrinsic characteristics associated with the job (i.e., life-threatening emergencies, overcrowding, lack of bed spaces). However, these attributes have never been studied using the Karasek model. METHODS An observational, prospective, multicentric study in French Emergency Departments will be conducted using a cohort of emergency health care workers. Four questionnaires before a control day and after a nightshift will be assessed every 5 years in the same emergency departments. Also, the Karasek questionnaire, a sociodemographic questionnaire, the Maslach Burnout Inventory scale, the Hospital Anxiety, Depression Scale, and a food intake questionnaire will be evaluated. Salivary biomarkers (cortisol, immunoglobulin A, lysozyme) will be collected from every emergency health care worker who consents to participating in the study. CONCLUSION This study will provide a point of care for the emergency health care workers' stress situation every 5 years. Ethics: This protocol was registered in Clinical Trials under the identification NCT02401607 after the French Ethics Committee's approval.
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Affiliation(s)
- Jean-Baptiste Bouillon-Minois
- Emergency Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (J.S.); (F.M.)
- LaPSCo, Université Clermont Auvergne, CNRS, 63000 Clermont-Ferrand, France; (G.V.); (F.D.)
| | - Marion Trousselard
- French Armed Forces Biomedical Research Institute, BP73, 91223 Brétigny-sur-Orge, France;
- APEMAC/EPSAM, EA 4360, Ile du Saulcy, BP 30309, 57006 Metz, France
| | - Bruno Pereira
- Clinical Research and Innovation Direction, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - Jeannot Schmidt
- Emergency Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (J.S.); (F.M.)
| | - Maelys Clinchamps
- Occupational and Environmental Medicine, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
| | - David Thivel
- Laboratory of the Metabolic Adaptations to Exercise under Physiological and Pathological Conditions (AME2P), Université Clermont Auvergne, 63000 Clermont-Ferrand, France;
| | - Ukadike Chris Ugbolue
- Institute for Clinical Exercise & Health Science, University of the West of Scotland, Glasgow G720LH, UK;
- Department of Biomedical Engineering, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Farès Moustafa
- Emergency Department, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (J.S.); (F.M.)
| | - Céline Occelli
- Emergency Department, CHU Nice, 06000 Nice, France;
- Emergency Department, Université Côte d’Azur, 06000 Nice, France
| | - Guillaume Vallet
- LaPSCo, Université Clermont Auvergne, CNRS, 63000 Clermont-Ferrand, France; (G.V.); (F.D.)
| | - Frédéric Dutheil
- LaPSCo, Université Clermont Auvergne, CNRS, 63000 Clermont-Ferrand, France; (G.V.); (F.D.)
- Occupational and Environmental Medicine, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France;
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30
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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31
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Maisey G, Cattani M, Devine A, Lo J, Dunican IC. The Sleep of Shift Workers in a Remote Mining Operation: Methodology for a Randomized Control Trial to Determine Evidence-Based Interventions. Front Neurosci 2021; 14:579668. [PMID: 33488343 PMCID: PMC7817759 DOI: 10.3389/fnins.2020.579668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 12/03/2020] [Indexed: 11/21/2022] Open
Abstract
Shiftwork may adversely impact an individual’s sleep-wake patterns and result in sleep loss (<6 h. following night shift), due to the circadian misalignment and the design of rosters and shifts. Within a mining operation, this sleep loss may have significant consequences due to fatigue, including an increased risk of accidents and chronic health conditions. This study aims to (i) determine the efficacy of an intervention that comprises a sleep education program and biofeedback through a smartphone app on sleep quality, quantity, and alertness (ii) determine the prevalence of risk for a potential sleep disorder, and (iii) quantify and describe the sleep habits and behaviors of shift workers in a remote mining operation. This study consists of a randomized controlled trial whereby eighty-eight shift workers within a remote mining operation are randomized to a control group or one of three different treatment groups that are: (i) a sleep education program, (ii) biofeedback on sleep through a smartphone app, or (iii) a sleep education program and biofeedback on sleep through a smartphone app. This study utilizes wrist-activity monitors, biomathematical modeling, and a survey instrument to obtain data on sleep quantity, quality, and alertness. A variety of statistical methods will determine the prevalence of risk for a potential sleep disorder and associations with body mass index, alcohol, and caffeine consumption. A generalized linear mixed model will examine the dependent sleep variables assessed at baseline and post-intervention for the control group and intervention groups, as well as within and between groups to determine changes. The findings from this study will contribute to the current understanding of sleep and alertness behaviors, and sleep problems and disorders amongst shift workers. Importantly, the results may inform fatigue policy and practice on interventions to manage fatigue risk within the mining industry. This study protocol may have a broader application in other shiftwork industries, including oil and gas, aviation, rail, and healthcare.
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Affiliation(s)
- Gemma Maisey
- School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia
| | - Marcus Cattani
- School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia
| | - Amanda Devine
- School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia
| | - Johnny Lo
- School of Science, Edith Cowan University, Perth, WA, Australia
| | - Ian C Dunican
- School of Medical and Health Science, Edith Cowan University, Perth, WA, Australia
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Shi X, Qi H, Wang S, Li Z, Li Z, Fan F. Sleep Reactivity and Depressive Symptoms Among Chinese Female Student Nurses: A Longitudinal Mediation Analysis. Front Psychiatry 2021; 12:748064. [PMID: 34658979 PMCID: PMC8511416 DOI: 10.3389/fpsyt.2021.748064] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 09/08/2021] [Indexed: 11/27/2022] Open
Abstract
Previous cross-sectional studies have documented that sleep reactivity was associated with depressive symptoms, but the potential mechanisms underlying this relationship were understudied. Therefore, the present study with a longitudinal prospective design was to reveal the mediating roles of sleep disturbance and emotion regulation difficulties (ERD) between sleep reactivity and depressive symptoms. This study included 725 student nurses who were followed up periodically for 9 months, with an interval of three months. All participants completed questionnaires regarding sleep reactivity, sleep disturbance, ERD, and depressive symptoms. Adjusted analyses suggested that the direct effect of sleep reactivity on depressive symptoms was non-significant. The bootstrap procedure revealed two significant indirect effects: from sleep reactivity to depressive symptoms with sleep disturbance as a mediator and from sleep reactivity to depressive symptoms with sleep disturbance and ERD as sequential mediators. Therefore, sleep reactivity might be considered as an indicator of shiftwork adaptability in the evaluation of recruitment. Psychological interventions aimed at developing healthy sleep habits and emotion regulation skills may be helpful in decreasing the risk of depression.
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Affiliation(s)
| | - Haiying Qi
- South China Normal University, Guangzhou, China
| | | | - Zihan Li
- Hebei University, Baoding, China
| | | | - Fang Fan
- South China Normal University, Guangzhou, China
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Yaw AM, McLane-Svoboda AK, Hoffmann HM. Shiftwork and Light at Night Negatively Impact Molecular and Endocrine Timekeeping in the Female Reproductive Axis in Humans and Rodents. Int J Mol Sci 2020; 22:E324. [PMID: 33396885 PMCID: PMC7795361 DOI: 10.3390/ijms22010324] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 12/24/2020] [Accepted: 12/25/2020] [Indexed: 01/17/2023] Open
Abstract
Shiftwork, including work that takes place at night (nightshift) and/or rotates between day and nightshifts, plays an important role in our society, but is associated with decreased health, including reproductive dysfunction. One key factor in shiftwork, exposure to light at night, has been identified as a likely contributor to the underlying health risks associated with shiftwork. Light at night disrupts the behavioral and molecular circadian timekeeping system, which is important for coordinated timing of physiological processes, causing mistimed hormone release and impaired physiological functions. This review focuses on the impact of shiftwork on reproductive function and pregnancy in women and laboratory rodents and potential underlying molecular mechanisms. We summarize the negative impact of shiftwork on female fertility and compare these findings to studies in rodent models of light shifts. Light-shift rodent models recapitulate several aspects of reproductive dysfunction found in shift workers, and their comparison with human studies can enable a deeper understanding of physiological and hormonal responses to light shifts and the underlying molecular mechanisms that may lead to reproductive disruption in human shift workers. The contributions of human and rodent studies are essential to identify the origins of impaired fertility in women employed in shiftwork.
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Affiliation(s)
| | | | - Hanne M. Hoffmann
- Department of Animal Science and the Reproductive and Developmental Science Program, Michigan State University, East Lansing, MI 48824, USA
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Harrison EM, Schmied EA, Easterling AP, Yablonsky AM, Glickman GL. A Hybrid Effectiveness-Implementation Study of a Multi-Component Lighting Intervention for Hospital Shift Workers. Int J Environ Res Public Health 2020; 17:E9141. [PMID: 33297521 PMCID: PMC7730086 DOI: 10.3390/ijerph17239141] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/12/2020] [Accepted: 11/25/2020] [Indexed: 12/13/2022]
Abstract
Simple lighting solutions may mitigate the harmful effects of shiftwork. This hybrid effectiveness-implementation study evaluated a multi-component lighting intervention in hospital nurses that included 6500 K architectural lighting in the nurses' station plus optional behavioral components (a lightbox, blueblocker glasses, eyemasks) with instruction about appropriately timed usage. Selective improvements from baseline were observed in on-shift performance, sleep quality, and caffeine consumption in day workers (all p < 0.05); off-shift sleepiness scores improved for night workers (p < 0.05). Further, self-reported measures of quality of life improved for both groups (p < 0.05). Preliminary implementation data from interviews and questionnaires suggest perceived benefits and high acceptability of the intervention.
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Affiliation(s)
- Elizabeth M. Harrison
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA; (A.P.E.); (G.L.G.)
- Leidos, Inc., San Diego, CA 92121, USA
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA 92016, USA;
| | - Emily A. Schmied
- School of Public Health, San Diego State University, San Diego, CA 92182, USA;
| | - Alexandra P. Easterling
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA; (A.P.E.); (G.L.G.)
- Leidos, Inc., San Diego, CA 92121, USA
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA 92016, USA;
| | - Abigail M. Yablonsky
- Health and Behavioral Sciences Department, Naval Health Research Center, San Diego, CA 92016, USA;
- Naval Medical Center, San Diego, CA 92134, USA
| | - Gena L. Glickman
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA; (A.P.E.); (G.L.G.)
- Departments of Psychiatry and Neuroscience, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
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Chappel SE, Aisbett B, Considine J, Ridgers ND. The accumulation of, and associations between, nurses' activity levels within their shift in the emergency department. Ergonomics 2020; 63:1525-1534. [PMID: 32757886 DOI: 10.1080/00140139.2020.1807062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 07/13/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study was to examine emergency nurses' activity levels and associations between hourly activity levels within-shifts. Fifty emergency nurses (45 females, 5 males) wore ActiGraph accelerometers and completed work diaries for up to 4 weeks. A sub-group (n = 42) also wore activPALs. Multilevel analyses examined temporal associations between hourly periods. In any hourly period, increased time spent in moderate- to vigorous-intensity physical activity (MVPA) was associated with less time spent in MVPA in the following hourly period. In any afternoon hourly period, increased time spent in MVPA was associated with more time spent in light-intensity physical activity in the following hourly period. No other associations were significant. Emergency nurses maintain activity levels within-shifts, except when more time spent in MVPA was associated with less time spent in MVPA in the following hour; a potential recovery strategy. Future research should determine how emergency nurses maintain their activity levels within-shifts. Practitioner Summary: Emergency nursing is physically demanding; however, it is unknown how active they are during hourly periods within-shifts. Emergency nurses' activity levels were maintained within hourly periods of a shift. Except for an increase in MVPA in 1 h was associated with a decrease in MVPA in the following hour. Abbreviations: CPR: cardiopulmonary resusitation; LPA: light-intensity physical activity; MPA: moderate-intenisty physical activity; MVPA: moderate- to vigorous-intensity physical activity; SED: sedentary.
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Affiliation(s)
- Stephanie E Chappel
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Brad Aisbett
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
| | - Julie Considine
- School of Nursing and Midwifery and Centre for Quality and Patient Safety Research, Deakin University, Geelong, Australia
- Centre for Quality and Patient Safety Research - Eastern Health Partnership, Box Hill, Australia
| | - Nicola D Ridgers
- School of Exercise and Nutrition Science, Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Australia
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Niessen P, Stockinger C, Zoeller I. Analyzing the effect of social interaction on job demands and health in the example of flexible shiftwork. Int J Occup Saf Ergon 2020; 28:315-323. [PMID: 32643562 DOI: 10.1080/10803548.2020.1789318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
In the literature, shiftwork-related stress is often connected with health complaints. However, it has been shown that these are not equally distributed. Further reasons must exist as to why stress resulting from shiftwork only affects health in some cases. In a study with 653 employees working in highly flexible shiftwork conditions, an examination was made of the factors affecting the relationship between job demands and health status. The results show that satisfaction with leadership influences whether unevenly distributed work and time pressure have a significant impact on health. The factor of other people living in the household significantly influences whether time pressure and emotional stress lead to health complaints. The study concluded that the impact of social interaction as a resource is not limited to the workplace. Social interaction, as a personal resource, can be helpful in both the professional and private spheres.
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Affiliation(s)
- Pia Niessen
- Institute for Ergonomics and Human Factors, Technical University of Darmstadt, Germany
| | | | - Ilka Zoeller
- Institute for Ergonomics and Human Factors, Technical University of Darmstadt, Germany
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Silva FRD, Guerreiro RDC, Andrade HDA, Stieler E, Silva A, de Mello MT. Does the compromised sleep and circadian disruption of night and shiftworkers make them highly vulnerable to 2019 coronavirus disease (COVID-19)? Chronobiol Int 2020; 37:607-617. [PMID: 32432519 DOI: 10.1080/07420528.2020.1756841] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Rotating and permanent night shiftwork schedules typically result in acute and sometimes chronic sleep deprivation plus acute and sometimes chronic disruption of the circadian time structure. Immune system processes and functionalities are organized as circadian rhythms, and they are also strongly influenced by sleep status. Sleep is a vital behavioral state of living beings and a modulator of immune function and responsiveness. Shiftworkers show increased risk for developing viral infections due to possible compromise of both innate and acquired immunity responses. Short sleep and sleep loss, common consequences of shiftwork, are associated with altered integrity of the immune system. We discuss the possible excess risk for COVID-19 infection in the context of the common conditions among shiftworkers, including nurses, doctors, and first responders, among others of high exposure to the contagion, of sleep imbalance and circadian disruption. ABBREVIATIONS ACE2: Angiotensin-converting enzyme 2; APC: Antigen.-presenting .cells; CCL: Chemokine (C-C motif) ligand; CD+: .Adhesion molecule expression; COVID-19: 2019 coronavirus disease; DCs: Dendritic cells; GH: Growth hormone; HPA: Hypothalamic-pituitary-adrenal; HSF: Heat shock factor; HSP70: Heat shock protein 70; HSP90: Heat shock protein 90; IL: Interleukin; INFγ: Interferon-gamma; LT/LB: T/B lymphocytes; MHC: Major histocompatibility complex; NK: Natural .killer; RAAS: renin-angiotensin-aldosterone system; SARS: .Severe acute respiratory syndrome; SCN: Suprachiasmatic nucleus;SD: Sleep deprivation; SNS: Sympathetic nervous system; Th1/Th2: T helper lymphocytes 1/2; TLR2/TLR4: Toll-like receptor 2/4; TNF-α: Tumor .necrosis .factor alpha; VEGF: Vascular endothelial growth factor.
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Affiliation(s)
| | | | | | - Eduardo Stieler
- Department of Sports, Universidade Federal de Minas Gerais , Belo Horizonte, Brazil
| | - Andressa Silva
- Department of Sports, Universidade Federal de Minas Gerais , Belo Horizonte, Brazil
| | - Marco Túlio de Mello
- Department of Sports, Universidade Federal de Minas Gerais , Belo Horizonte, Brazil
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38
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Bahougne T, Kretz M, Angelopoulou E, Jeandidier N, Simonneaux V. Impact of Circadian Disruption on Female Mice Reproductive Function. Endocrinology 2020; 161:5758065. [PMID: 32100021 DOI: 10.1210/endocr/bqaa028] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 02/25/2020] [Indexed: 12/12/2022]
Abstract
In female mammals, cycles in reproductive function depend both on the biological clock synchronized to the light/dark cycle and on a balance between the negative and positive feedbacks of estradiol, whose concentration varies during oocyte maturation. In women, studies report that chronodisruptive environments such as shiftwork may impair fertility and gestational success. The objective of this study was to explore the effects of shifted light/dark cycles on both the robustness of the estrous cycles and the timing of the preovulatory luteinizing hormone (LH) surge in female mice. When mice were exposed to a single 10-hour phase advance or 10-hour phase delay, the occurrence and timing of the LH surge and estrous cyclicity were recovered at the third estrous cycle. By contrast, when mice were exposed to chronic shifts (successive rotations of 10-hoursour phase advances for 3 days followed by 10-hour phase delays for 4 days), they exhibited a severely impaired reproductive activity. Most mice had no preovulatory LH surge at the beginning of the chronic shifts. Furthermore, the gestational success of mice exposed to chronic shifts was reduced, because the number of pups was 2 times lower in shifted than in control mice. In conclusion, this study reports that exposure of female mice to a single phase shift has minor reproductive effects, whereas exposure to chronically disrupted light/dark cycles markedly impairs the occurrence of the preovulatory LH surge, leading to reduced fertility.
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Affiliation(s)
- Thibault Bahougne
- Institut des Neurosciences Cellulaires et Intégratives, (UPR CNRS 3212) and University of Strasbourg, Strasbourg, France
- Service d'Endocrinologie et Diabète, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Mathilda Kretz
- Institut des Neurosciences Cellulaires et Intégratives, (UPR CNRS 3212) and University of Strasbourg, Strasbourg, France
- Service d'Endocrinologie et Diabète, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Eleni Angelopoulou
- Institut des Neurosciences Cellulaires et Intégratives, (UPR CNRS 3212) and University of Strasbourg, Strasbourg, France
| | - Nathalie Jeandidier
- Service d'Endocrinologie et Diabète, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Valérie Simonneaux
- Institut des Neurosciences Cellulaires et Intégratives, (UPR CNRS 3212) and University of Strasbourg, Strasbourg, France
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Stothard ER, Ritchie HK, Birks BR, Eckel RH, Higgins J, Melanson EL, Wright KP Jr, McHill AW. Early Morning Food Intake as a Risk Factor for Metabolic Dysregulation. Nutrients 2020; 12:E756. [PMID: 32182981 DOI: 10.3390/nu12030756] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 03/06/2020] [Accepted: 03/11/2020] [Indexed: 02/08/2023] Open
Abstract
Increased risk of obesity and diabetes in shift workers may be related to food intake at adverse circadian times. Early morning shiftwork represents the largest proportion of shift workers in the United States, yet little is known about the impact of food intake in the early morning on metabolism. Eighteen participants (9 female) completed a counterbalanced 16 day design with two conditions separated by ~1 week: 8 h sleep opportunity at habitual time and simulated early morning shiftwork with 6.5 h sleep opportunity starting ~1 h earlier than habitual time. After wake time, resting energy expenditure (REE) was measured and blood was sampled for melatonin and fasting glucose and insulin. Following breakfast, post-prandial blood samples were collected every 40 min for 2 h and the thermic effect of food (TEF) was assessed for 3.25 h. Total sleep time was decreased by ~85 min (p < 0.0001), melatonin levels were higher (p < 0.0001) and post-prandial glucose levels were higher (p < 0.05) after one day of simulated early morning shiftwork compared with habitual wake time. REE was lower after simulated early morning shiftwork; however, TEF after breakfast was similar to habitual wake time. Insufficient sleep and caloric intake during a circadian phase of high melatonin levels may contribute to metabolic dysregulation in early morning shift workers.
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Epstein M, Söderström M, Jirwe M, Tucker P, Dahlgren A. Sleep and fatigue in newly graduated nurses-Experiences and strategies for handling shiftwork. J Clin Nurs 2019; 29:184-194. [PMID: 31609523 DOI: 10.1111/jocn.15076] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 08/30/2019] [Accepted: 09/29/2019] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore newly graduated nurses' strategies for, and experiences of, sleep problems and fatigue when starting shiftwork. A more comprehensive insight into nurses' strategies, sleep problems, fatigue experiences and contributing factors is needed to understand what support should be provided. BACKGROUND For graduate nurses, the first years of practice are often stressful, with many reporting high levels of burnout symptoms. Usually, starting working as a nurse also means an introduction to shiftwork, which is related to sleep problems. Sleep problems may impair stress management and, at the same time, stress may cause sleep problems. Previously, sleep problems and fatigue have been associated with burnout, poor health and increased accident risk. DESIGN AND METHODS Semi-structured interviews were conducted with nurses (N = 11) from four different Swedish hospitals, and qualitative inductive content analysis was used. The study was approved by the Regional Ethical Review Board in Stockholm. The COREQ checklist was followed. RESULTS Many nurses lacked effective strategies for managing sleep and fatigue in relation to shiftwork. Various strategies were used, of which some might interfere with factors regulating and promoting sleep such as the homeostatic drive. Sleep problems were common during quick returns, often due to difficulties unwinding before sleep, and high workloads exacerbated the problems. The described consequences of fatigue in a clinical work context indicated impaired executive and nonexecutive cognitive function. CONCLUSION The findings indicate that supporting strategies and behaviours for sleep and fatigue in an intervention for newly graduated nurses starting shiftwork may be of importance to improve well-being among nurses and increase patient safety. RELEVANCE TO CLINICAL PRACTICE This study highlights the importance of addressing sleep and fatigue issues in nursing education and work introduction programmes to increase patient safety and improve well-being among nurses.
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Affiliation(s)
- Majken Epstein
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Marie Söderström
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,Stressmottagningen/Stress clinic, Stockholm, Sweden
| | - Maria Jirwe
- Department for health promoting science, Sophiahemmet University, Stockholm, Sweden.,Division of Nursing, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden
| | - Philip Tucker
- Stress Research Institute, Stockholm University, Stockholm, Sweden.,Department of Psychology, Swansea University, Swansea, UK
| | - Anna Dahlgren
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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41
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Chellappa SL, Vujovic N, Williams JS, Scheer FAJL. Impact of Circadian Disruption on Cardiovascular Function and Disease. Trends Endocrinol Metab 2019; 30:767-779. [PMID: 31427142 PMCID: PMC6779516 DOI: 10.1016/j.tem.2019.07.008] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 07/07/2019] [Accepted: 07/08/2019] [Indexed: 10/26/2022]
Abstract
The circadian system, that is ubiquitous across species, generates ∼24 h rhythms in virtually all biological processes, and allows them to anticipate and adapt to the 24 h day/night cycle, thus ensuring optimal physiological function. Epidemiological studies show time-of-day variations in adverse cardiovascular (CV) events, and controlled laboratory studies demonstrate a circadian influence on key markers of CV function and risk. Furthermore, circadian misalignment, that is typically experienced by shift workers as well as by individuals who experience late eating, (social) jet lag, or circadian rhythm sleep-wake disturbances, increases CV risk factors. Therefore, understanding the mechanisms by which the circadian system regulates CV function, and which of these are affected by circadian disruption, may help to develop intervention strategies to mitigate CV risk.
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Affiliation(s)
- Sarah L Chellappa
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Nina Vujovic
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Jonathan S Williams
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Frank A J L Scheer
- Medical Chronobiology Program, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA 02115, USA; Division of Sleep Medicine, Department of Medicine, Harvard Medical School, Boston, MA 02115, USA.
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Walbeek TJ, Harrison EM, Soler RR, Gorman MR. Enhanced Circadian Entrainment in Mice and Its Utility under Human Shiftwork Schedules. Clocks Sleep 2019; 1:394-413. [PMID: 33089177 PMCID: PMC7445835 DOI: 10.3390/clockssleep1030032] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2019] [Accepted: 08/20/2019] [Indexed: 12/21/2022] Open
Abstract
The circadian system is generally considered to be incapable of adjusting to rapid changes in sleep/work demands. In shiftworkers this leads to chronic circadian disruption and sleep loss, which together predict underperformance at work and negative health consequences. Two distinct experimental protocols have been proposed to increase circadian flexibility in rodents using dim light at night: rhythm bifurcation and T-cycle (i.e., day length) entrainment. Successful translation of such protocols to human shiftworkers could facilitate alignment of internal time with external demands. To assess entrainment flexibility following bifurcation and exposure to T-cycles, mice in Study 1 were repeatedly phase-shifted. Mice from experimental conditions rapidly phase-shifted their activity, while control mice showed expected transient misalignment. In Study 2 and 3, mice followed a several weeks-long intervention designed to model a modified DuPont or Continental shiftwork schedule, respectively. For both schedules, bifurcation and nocturnal dim lighting reduced circadian misalignment. Together, these studies demonstrate proof of concept that mammalian circadian systems can be rendered sufficiently flexible to adapt to multiple, rapidly changing shiftwork schedules. Flexible adaptation to exotic light-dark cycles likely relies on entrainment mechanisms that are distinct from traditional entrainment.
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Affiliation(s)
- Thijs J. Walbeek
- Department of Psychology, University of California San Diego, La Jolla, CA 92093, USA
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA
- Correspondence: (T.J.W.); (M.R.G.); Tel.: +1-858-822-2466 (M.R.G.)
| | - Elizabeth M. Harrison
- Department of Psychology, University of California San Diego, La Jolla, CA 92093, USA
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA
| | - Robert R. Soler
- Department of Psychology, University of California San Diego, La Jolla, CA 92093, USA
| | - Michael R. Gorman
- Department of Psychology, University of California San Diego, La Jolla, CA 92093, USA
- Center for Circadian Biology, University of California San Diego, La Jolla, CA 92093, USA
- Correspondence: (T.J.W.); (M.R.G.); Tel.: +1-858-822-2466 (M.R.G.)
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Peter L, Reindl R, Zauter S, Hillemacher T, Richter K. Effectiveness of an Online CBT-I Intervention and a Face-to-Face Treatment for Shift Work Sleep Disorder: A Comparison of Sleep Diary Data. Int J Environ Res Public Health 2019; 16:ijerph16173081. [PMID: 31450619 PMCID: PMC6747089 DOI: 10.3390/ijerph16173081] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 08/15/2019] [Accepted: 08/18/2019] [Indexed: 12/28/2022]
Abstract
In western societies, about one in six employees works in shifts. Shiftwork is associated with a number of poor somatic and psychological health outcomes, especially sleep issues. Higher rates of absenteeism and accidents in the workplace are possible consequences. Still, prevention programs and treatment options that are specifically tailored to shift-workers’ needs are rare. We devised a 4-week online cognitive behavioral therapy for insomnia (CBT-I) intervention (n = 21) and compared sleep outcomes to a face-to-face outpatient treatment for shift-workers (n = 12) using a sleep diary and the Epworth Sleepiness Scale (ESS). In the online sample, measures also included the World Health Organization wellbeing questionnaire (WHO-5) and the Insomnia Severity Index (ISI). In the outpatient sample, the Beck Depression Inventory (BDI-II), the Montgomery–Åsberg Depression Rating Scale (MADRS), and the Pittsburgh Sleep Quality Index (PSQI) were administered. Results showed significant improvements in sleep efficiency by 7.2% in the online sample and 7.7% in the outpatient sample. However, no significant difference was found in the rate of improvement in sleep efficiency across four weeks of treatment between the samples. In the online sample, the wellbeing (WHO-5) and insomnia symptoms (ISI) scores were significantly improved following the CBT-I intervention (p < 0.004 and p < 0.002 respectively). In the outpatient sample, symptoms of depression (BDI-II and MADRS scores) and insomnia symptoms (PSQI scores) improved significantly following the CBT-I intervention. In summary, CBT-I significantly improved sleep efficiency in both the online and outpatient samples, in addition to wellbeing, symptoms of insomnia, and depression. The findings of this study demonstrate online CBT-I as a feasible approach for treating insomnia in shift-workers. Future randomized controlled trials are needed.
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Affiliation(s)
- Lukas Peter
- University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University, 90419 Nuremberg, Germany.
- Faculty for Social Sciences, University of Applied Sciences Georg Simon Ohm, 90402 Nuremberg, Germany.
| | - Richard Reindl
- Faculty for Social Sciences, University of Applied Sciences Georg Simon Ohm, 90402 Nuremberg, Germany
| | - Sigrid Zauter
- Faculty for Social Sciences, University of Applied Sciences Georg Simon Ohm, 90402 Nuremberg, Germany
| | - Thomas Hillemacher
- University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University, 90419 Nuremberg, Germany
| | - Kneginja Richter
- University Clinic for Psychiatry and Psychotherapy, Paracelsus Medical University, 90419 Nuremberg, Germany
- Faculty for Social Sciences, University of Applied Sciences Georg Simon Ohm, 90402 Nuremberg, Germany
- Faculty for Medical Sciences, University Goce Delcev, 2000 Stip, Republic of North Macedonia
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Matheson A, O'Brien L, Reid JA. Women's experience of shiftwork in nursing whilst caring for children: A juggling act. J Clin Nurs 2019; 28:3817-3826. [PMID: 31359497 DOI: 10.1111/jocn.15017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 07/04/2019] [Accepted: 07/20/2019] [Indexed: 11/30/2022]
Abstract
AIMS AND OBJECTIVES To explore women's experiences of working shiftwork in nursing whilst caring for children. BACKGROUND In nursing, almost 90% of Australia's practising nurses and midwives are women. Much of the research undertaken in the shiftwork area uses men as their sample and uses a quantitative methodology to achieve results. Little work has been undertaken that explores the experience of women working shiftwork whilst raising children. DESIGN Heideggerian Hermeneutic Phenomenological Design. METHODS Semistructured interviews were conducted with ten women who cared for children about their experience of shiftwork. Each interview was digitally audio-recorded. The interviews were transcribed verbatim and thematically analysed. The interpretation used first Heideggerian phenomenology as a lens and then second research on women's work and gender roles to resituate the experience in context. Reporting rigour has been demonstrated using the COREQ checklist. RESULTS Two major themes were derived from the data, Being Guilty and Being Juggler. Each is discussed in this paper. CONCLUSIONS This study adds a qualitative voice to the substantial quantitative shiftwork body of literature. The themes uncovered in this study have thrown light on the nature of work done by women who are nurses, particularly the work related to their home and children. RELEVANCE TO CLINICAL PRACTICE There are opportunities to increase education around the importance of sleep and shiftwork self-care in both preservice and new graduate education to assist nurses to ensure that sleep is a priority whilst working shiftwork.
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Affiliation(s)
- Annabel Matheson
- School of Nursing, Midwifery and Indigenous Health, Charles Sturt University, Bathurst, NSW, Australia
| | - Louise O'Brien
- School of Nursing and Midwifery, University of Newcastle, Newcastle, NSW, Australia
| | - Jo-Anne Reid
- School of Teacher Education, Charles Sturt University, Bathurst, NSW, Australia
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45
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Gupta CC, Centofanti S, Dorrian J, Coates AM, Stepien JM, Kennaway D, Wittert G, Heilbronn L, Catcheside P, Noakes M, Coro D, Chandrakumar D, Banks S. Subjective Hunger, Gastric Upset, and Sleepiness in Response to Altered Meal Timing during Simulated Shiftwork. Nutrients 2019; 11:nu11061352. [PMID: 31208092 PMCID: PMC6628383 DOI: 10.3390/nu11061352] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 06/14/2019] [Accepted: 06/14/2019] [Indexed: 01/28/2023] Open
Abstract
Shiftworkers report eating during the night when the body is primed to sleep. This study investigated the impact of altering food timing on subjective responses. Healthy participants (n = 44, 26 male, age Mean ± SD = 25.0 ± 2.9 years, BMI = 23.82 ± 2.59kg/m2) participated in a 7-day simulated shiftwork protocol. Participants were randomly allocated to one of three eating conditions. At 00:30, participants consumed a meal comprising 30% of 24 h energy intake (Meal condition; n = 14, 8 males), a snack comprising 10% of 24 h energy intake (Snack condition; n = 14; 8 males) or did not eat during the night (No Eating condition; n = 16, 10 males). Total 24 h individual energy intake and macronutrient content was constant across conditions. During the night, participants reported hunger, gut reaction, and sleepiness levels at 21:00, 23:30, 2:30, and 5:00. Mixed model analyses revealed that the snack condition reported significantly more hunger than the meal group (p < 0.001) with the no eating at night group reporting the greatest hunger (p < 0.001). There was no difference in desire to eat between meal and snack groups. Participants reported less sleepiness after the snack compared to after the meal (p < 0.001) or when not eating during the night (p< 0.001). Gastric upset did not differ between conditions. A snack during the nightshift could alleviate hunger during the nightshift without causing fullness or increased sleepiness.
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Affiliation(s)
- Charlotte C Gupta
- Sleep and Chronobiology Laboratory, Behaviour-Brain-Body Research Centre, School of Psychology, Social Work and Social Policy, University of South Australia, 5072 Adelaide, Australia.
| | - Stephanie Centofanti
- Sleep and Chronobiology Laboratory, Behaviour-Brain-Body Research Centre, School of Psychology, Social Work and Social Policy, University of South Australia, 5072 Adelaide, Australia.
| | - Jillian Dorrian
- Sleep and Chronobiology Laboratory, Behaviour-Brain-Body Research Centre, School of Psychology, Social Work and Social Policy, University of South Australia, 5072 Adelaide, Australia.
| | - Alison M Coates
- Sleep and Chronobiology Laboratory, Behaviour-Brain-Body Research Centre, School of Psychology, Social Work and Social Policy, University of South Australia, 5072 Adelaide, Australia.
- Division of Health Sciences, University of South Australia, 5000 Adelaide, Australia.
| | - Jacqueline M Stepien
- Sleep and Chronobiology Laboratory, Behaviour-Brain-Body Research Centre, School of Psychology, Social Work and Social Policy, University of South Australia, 5072 Adelaide, Australia.
| | - David Kennaway
- Robinson Research Institute and Adelaide School of Medicine, University of Adelaide, 5000 Adelaide, Australia.
| | - Gary Wittert
- Discipline of Medicine, Adelaide Medical School, University of Adelaide, 5000Adelaide, Australia.
| | - Leonie Heilbronn
- Discipline of Medicine, Adelaide Medical School, University of Adelaide, 5000Adelaide, Australia.
- South Australia Medical Research Institute (SAHMRI), 5000 Adelaide, Australia.
| | - Peter Catcheside
- Adelaide Institute for Sleep Health, College of Medicine and Public Health, Flinders University, 5042 Adelaide, Australia.
| | - Manny Noakes
- Commonwealth Scientific and Industrial Research Organisation - Food and Nutrition Flagship, 5000 Adelaide, Australia.
| | - Daniel Coro
- Sleep and Chronobiology Laboratory, Behaviour-Brain-Body Research Centre, School of Psychology, Social Work and Social Policy, University of South Australia, 5072 Adelaide, Australia.
| | - Dilushi Chandrakumar
- Cognitive Ageing Impairment Neurosciences Laboratory, Behaviour-Brain-Body Research Centre, School of Psychology, Social Work and Social Policy, University of South Australia, 5072 Adelaide, Australia.
| | - Siobhan Banks
- Sleep and Chronobiology Laboratory, Behaviour-Brain-Body Research Centre, School of Psychology, Social Work and Social Policy, University of South Australia, 5072 Adelaide, Australia.
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Holst MM, Wirth MD, Mnatsakanova A, Burch JB, Charles LE, Tinney-Zara C, Fekedulegn D, Andrew ME, Hartley TA, Violanti JM. Shiftwork and Biomarkers of Subclinical Cardiovascular Disease: The BCOPS Study. J Occup Environ Med 2019; 61:391-396. [PMID: 30649009 PMCID: PMC6610651 DOI: 10.1097/jom.0000000000001541] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To assess the association of shiftwork with biomarkers of subclinical cardiovascular disease and examine the moderating role of body mass index (BMI) in a police cohort. METHODS A cross-sectional analysis was conducted among officers who were categorized as working the day, evening, or night shift. Comparisons with inflammatory biomarkers were performed among shifts using analysis of variance/covariance and further stratified by BMI to assess potential effect modification. RESULTS Associations were observed between day and night shiftworkers for leukocytes, tumor necrosis factor alpha, and homocysteine. After BMI stratification, higher c-reactive protein (CRP) levels were observed among evening shiftworkers with a BMI more than or equal to 30 kg/m versus the day shift. CONCLUSIONS Future studies examining prospective changes in these markers will allow for more comprehensive evaluation of their association with shiftwork.
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Affiliation(s)
- Meghan M. Holst
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Michael D. Wirth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC USA
- College of Nursing, University of South Carolina, Columbia, SC, USA
| | - Anna Mnatsakanova
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - James B. Burch
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
- Cancer Prevention and Control Program, University of South Carolina, Columbia, SC USA
- WJB Dorn VA Medical Center, Columbia, SC, USA
| | - Luenda E. Charles
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Cathy Tinney-Zara
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Desta Fekedulegn
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Michael E. Andrew
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - Tara A. Hartley
- Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA
| | - John M. Violanti
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University of Buffalo, The State University of New York, Buffalo, NY, USA
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Ferguson SA, Appleton SL, Reynolds AC, Gill TK, Taylor AW, McEvoy RD, Adams RJ. Making errors at work due to sleepiness or sleep problems is not confined to non-standard work hours: results of the 2016 Sleep Health Foundation national survey. Chronobiol Int 2019; 36:758-769. [PMID: 31017005 DOI: 10.1080/07420528.2019.1578969] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Almost one-third of Australians report having made errors at work that are related to sleep issues. While there is significant literature investigating the role of sleep in workplace health and safety in shiftworking and nightwork operations, long working hours, work-family conflict, and commute times getting longer also impact day workers' sleep behaviors and opportunities. The aim of this study was to examine the relationship between sleep duration and disorders, sleep health and hygiene factors, work-related factors and errors at work in Australian workers. From a sample of 1011 Australian adults, age-adjusted binary logistic regression analyses were conducted in 512 workers who provided responses to the question "Thinking about the past three months, how many days did you make errors at work because you were too sleepy or you had a sleep problem?" A number of sleep behaviors and poor sleep hygiene factors were linked with work errors related to sleepiness or sleep problems, with age-adjusted odds of errors (confidence intervals) up to 11.6 times higher (5.4-25.1, p < 0.001) in those that snored, 7.7 (4.6-12.9) times higher in those reporting more than three sleep issues (p < 0.001), 7.0 times higher (3.4-14.8) in short (≤5 hours/night) sleepers (p < 0.021), 6.1 times higher (2.9-12.7) in those staying up later than planned most nights of the week (p< 0.001) and 2.4 times higher (1.6-3.7) in those drinking alcohol ≥3 nights/week before bed (p < 0.001). More than 40% of participants working non-standard hours reported making errors at work, and they were more likely to be young (compared to the main sample of workers) and more likely to engage in work activities in the hour before bed. Sleep factors (other than clinical sleep disorders) were associated with an increased likelihood of sleep-related work errors. Both day workers and those working non-standard hours engage in work, sleep and health behaviors that do not support good sleep health, which may be impacting safety and productivity in the workplace through increased sleepiness-related errors.
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Affiliation(s)
- Sally A Ferguson
- a Appleton Institute, School of Health, Medical and Applied Sciences , CQUniversity , Adelaide , Australia.,b Deakin University , Burwood , Australia
| | - Sarah L Appleton
- c School of Exercise and Nutrition Sciences, Adelaide Institute of Sleep Health , Flinders University , Australia.,d University of Adelaide , Freemasons Foundation Centre for Men's Health , Adelaide , Australia
| | - Amy C Reynolds
- a Appleton Institute, School of Health, Medical and Applied Sciences , CQUniversity , Adelaide , Australia
| | - Tiffany K Gill
- e Population Research & Outcome Studies, Discipline of Medicine , University of Adelaide , Adelaide , Australia
| | - Anne W Taylor
- e Population Research & Outcome Studies, Discipline of Medicine , University of Adelaide , Adelaide , Australia
| | - R Douglas McEvoy
- c School of Exercise and Nutrition Sciences, Adelaide Institute of Sleep Health , Flinders University , Australia
| | - Robert J Adams
- c School of Exercise and Nutrition Sciences, Adelaide Institute of Sleep Health , Flinders University , Australia.,f Southern Adelaide Local Health Network , SA Health , Adelaide , Australia.,g Adelaide Medical School , University of Adelaide , Adelaide , Australia
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48
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Shochat T, Hadish-Shogan S, Banin Yosipof M, Recanati A, Tzischinsky O. Burnout, Sleep, and Sleepiness during Day and Night Shifts in Transition from 8- to 12-Hour Shift Rosters among Airline Ground Crew Managers. Clocks Sleep 2019; 1:226-39. [PMID: 33089166 DOI: 10.3390/clockssleep1020020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/16/2019] [Indexed: 11/25/2022] Open
Abstract
Organizational changes in shift scheduling provide rare opportunities for field studies aimed at investigating the effects of such changes on health and wellbeing. We studied the effects of a transition from 8-hour (8-h) to 12-hour (12-h) shift rosters in 39 airline ground crew managers on burnout, sleep quality, and sleepiness. Assessments were collected during the 8-h and were repeated three months after the transition to 12-h shift rosters. These assessments included the Shirom-Melamed Burnout Measure (SMBM), the Pittsburgh Sleep Quality Index (PSQI), actigraphy, the Karolinska Sleepiness Scale (KSS) completed hourly during one day and two night shifts, and caffeine intake. Findings demonstrated lower burnout, improved sleep quality, improved quality of naps, and increased afternoon sleepiness during the 12-h day shift. Napping was reported during 12-h night shifts by 36% of the sample. In nappers, increased night shift sleepiness was associated with increased caffeine intake on 8- and 12-h shifts. In non-nappers, increased night shift sleepiness was associated with decreased caffeine intake on the 8-h shift only. Change in shift length affects other structural and behavioral parameters in the workplace, making it challenging to isolate distinct characteristics of the two rosters and their relative effects on study outcomes. Individual differences in adaptation to shiftwork may also play a role.
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Abstract
BACKGROUND There is limited information on whether the prevalence of exposure to workplace carcinogens varies among shift workers and non-shift workers. METHODS This analysis used data from the Australian Work Exposures Study-Cancer, a telephone survey which examined exposure to carcinogens in the workplace. Workers were classified as shift workers if they indicated that their usual roster ever included work between the hours of midnight and 5 am. Modified Poisson regression was used to estimate the adjusted prevalence ratios (aPRs) and 95% confidence internals (CIs). RESULTS Among the 5425 workers, 6.88% reported being exposed to shift work. Overall, shift workers were more likely to be exposed to any carcinogen (aPR = 1.16; 95% 1.06-1.26) and to specific carcinogens such as asbestos (aPR = 1.93; 95% 1.33-2.83) than non-shift workers. CONCLUSIONS Our study shows that there are differences in exposure to carcinogenic agents among shift and non-shift workers, and so there is a need for prevention programs in order to reduce these discrepancies.
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Affiliation(s)
- Sonia El-Zaemey
- School of Public Health; Curtin University; Bentley Western Australia Australia
| | - Renee N. Carey
- School of Public Health; Curtin University; Bentley Western Australia Australia
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50
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Roach GD, Matthews R, Naweed A, Kontou TG, Sargent C. Flat-out napping: The quantity and quality of sleep obtained in a seat during the daytime increase as the angle of recline of the seat increases. Chronobiol Int 2018; 35:872-883. [PMID: 29889574 DOI: 10.1080/07420528.2018.1466801] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Some shiftwokers in the long-haul transportation industries (i.e. road, rail, sea, air) have the opportunity to sleep in on-board rest facilities during duty periods. These rest facilities are typically fitted with a seat with a maximum back angle to the vertical of 20°, 40°, or 90°. The aim of this study was to examine the impact of "back angle" on the quantity and quality of sleep obtained in a seat during a daytime nap. Six healthy adults (3 females aged 27.0 years and 3 males aged 22.7 years) each participated in three conditions. For each condition, participants had a 4-h sleep opportunity in a bed (02:00-06:00 h) followed by a 4-h sleep opportunity in a seat (13:00-17:00 h). The only difference between conditions was in the back angle of the seat to the vertical during the seat-based sleep periods: 20° (upright), 40° (reclined), and 90° (flat). Polysomnographic data were collected during all sleep episodes. For the seat-based sleep episodes, there was a significant effect of back angle on three of four measures of sleep quantity, i.e. total sleep time, slow-wave sleep, and rapid eye movement (REM) sleep, and three of four measures of sleep quality, i.e. latency to REM sleep, arousals, and stage shifts. In general, the quantity and quality of sleep obtained in the reclined and flat seats were better than those obtained in the upright seat. In particular, compared to the flat seat, the reclined seat resulted in similar amounts of total sleep and slow-wave sleep, but 37% less REM sleep; and the upright seat resulted in 29% less total sleep, 30% less slow-wave sleep, and 79% less REM sleep. There are two main mechanisms that may explain the results. First, it is difficult to maintain the head in a comfortable position for sleep when sitting upright, and this is likely exacerbated during REM sleep, when muscle tone is very low. Second, an upright posture increases sympathetic activity and decreases parasympathetic activity, resulting in a heightened level of physiological arousal.
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Affiliation(s)
- Gregory D Roach
- a Appleton Institute for Behavioural Science , Central Queensland University , Adelaide , Australia
| | - Raymond Matthews
- a Appleton Institute for Behavioural Science , Central Queensland University , Adelaide , Australia.,b Department of Clinical Neuroscience , Karolinska Institute , Stockholm , Sweden.,c Stress Research Institute , Stockholm University , Stockholm , Sweden
| | - Anjum Naweed
- a Appleton Institute for Behavioural Science , Central Queensland University , Adelaide , Australia
| | - Thomas G Kontou
- a Appleton Institute for Behavioural Science , Central Queensland University , Adelaide , Australia
| | - Charli Sargent
- a Appleton Institute for Behavioural Science , Central Queensland University , Adelaide , Australia
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