Sleep patterns and sleep disorders among female shift workers in a computer factory of Japan

Using a repeated questionnaire survey for female workers in a computer factory of Japan, consisting of 45 daytime workers and 84 weekly rotating shift workers (of whom 40 and 44 were respectively engaged in early-shift work and late-shift work during the survey week), the present study aimed to clarify the effects of shift work on their sleep patterns and sleep disorders. The time of retiring, time of rising, duration of sleep, and self-evaluated sleep quality based on four sleep-related problems were investigated for four days (Sunday-Monday, Tuesday-Wednesday, Thursday-Friday, and Saturday-Sunday) in a week. The intergroup comparison revealed that the earlier the rising time and the shorter the duration of sleep, the lower the sleep quality; the lowest sleep quality was observed in the early-shift workers.     

Can we consider medical residents as shift workers?

Although medical residents are characterized by long working hours, night shifts and high levels of work load, it is unclear if their work schedule can be classified as shift work, or if it has a similar impact on residents' well-being. The present paper compared the profile of complaints about sleep or daytime functioning of medical residents to that of rotating shift workers and day workers, of similar ages. Sixty-one residents (aged: 32.2 +/- 2.2 years), after 2 years of residency, participated in the study. The two control groups with a similar age range (26-40 years) were chosen, and included 94 rotating shift workers and 146 day workers. All subjects completed self-administered questionnaires on their sleep habits, and their sleep-wake cycle was monitored by a wrist-worn actigraph. Ten percent of the residents complained about difficulties falling asleep, 34% complained about morning tiredness, 14% complained about mid-sleep awakening, and 20% about prolonged fatigue. The residents slept significantly less than the day workers, and their sleep efficiency was significantly higher. When examining their subjective complaints profile, residents complained more than day workers and their answers were more similar to those of rotating shift workers, therefore they can be considered to be characterized as shift workers.     

Effects of Ramadan upon fluid and food intake, fatigue, and physical, mental, and social activities: a comparison between the UK and Libya

Two studies were performed during Ramadan, one in the UK (N=31) and the other in Libya (N=33). The aims were to assess some changes to lifestyle that are produced by fasting as well as effects due to culture. Subjects were studied on eight separate occasions: four control days (two before and two after Ramadan) and four days during the four weeks of Ramadan itself. A questionnaire was answered that asked about naps and fluid and food intake. The questions elicited if an individual had slept, drank, or eaten, plus the reasons for doing or not doing so. Also, subjects were asked to describe their physical, mental, and social activities, their fatigue, and their perceived abilities to perform physical or mental work. The questionnaire was answered five times per day: at sunrise, at 10:00 h, at 14:00 h, at sunset, and on retiring to sleep at night. Urine samples were collected at sunset and measured for osmolality. Differences between control and Ramadan days, as well as between subjects studied in UK and Libya, were assessed by analysis of variance. Correlations between fatigue and physical, mental, and social activities were also assessed, as were differences in urine osmolality. Fasting during Ramadan resulted in fewer activities and increased fatigue and frequency of napping during daytime. Changes in fluid and food intake indicated some degree of preparation for fasting before sunrise and a marked "recuperation" from fasting after sunset. The reasons given for napping in the daytime, for drinking or not drinking, and for eating or not eating, changed during Ramadan compared with control days; as a result, links between fatigue and activities, and fatigue and fluid and food intake, were all altered during Ramadan, particularly after sunset. Subjects become dehydrated during the daytime, but this was not reduced when females who were menstruating drank during this time. Several differences between the two studies were found. There was a greater frequency of napping during the daytime in the Libya study, and evidence for the conservation of energy during the daytime and reduced physical, mental, and social activities. Subjects' preparations for fasting and recovering from it--their fluid and food intakes and associated reasons for these--also differed. Possible explanations of these differences are discussed.     

Effects of Ramadan upon Fluid and Food Intake,Fatigue, and Physical,Mental, and Social Activities: A Comparison between the UK and Libya

Two studies were performed during Ramadan, one in the UK (N=31) and the other in Libya (N=33). The aims were to assess some changes to lifestyle that are produced by fasting as well as effects due to culture. Subjects were studied on eight separate occasions: four control days (two before and two after Ramadan) and four days during the four weeks of Ramadan itself. A questionnaire was answered that asked about naps and fluid and food intake. The questions elicited if an individual had slept, drank, or eaten, plus the reasons for doing or not doing so. Also, subjects were asked to describe their physical, mental, and social activities, their fatigue, and their perceived abilities to perform physical or mental work. The questionnaire was answered five times per day: at sunrise, at 10:00 h, at 14:00 h, at sunset, and on retiring to sleep at night. Urine samples were collected at sunset and measured for osmolality. Differences between control and Ramadan days, as well as between subjects studied in UK and Libya, were assessed by analysis of variance. Correlations between fatigue and physical, mental, and social activities were also assessed, as were differences in urine osmolality. Fasting during Ramadan resulted in fewer activities and increased fatigue and frequency of napping during daytime. Changes in fluid and food intake indicated some degree of preparation for fasting before sunrise and a marked “recuperation” from fasting after sunset. The reasons given for napping in the daytime, for drinking or not drinking, and for eating or not eating, changed during Ramadan compared with control days; as a result, links between fatigue and activities, and fatigue and fluid and food intake, were all altered during Ramadan, particularly after sunset. Subjects become dehydrated during the daytime, but this was not reduced when females who were menstruating drank during this time. Several differences between the two studies were found. There was a greater frequency of napping during the daytime in the Libya study, and evidence for the conservation of energy during the daytime and reduced physical, mental, and social activities. Subjects' preparations for fasting and recovering from it—their fluid and food intakes and associated reasons for these—also differed. Possible explanations of these differences are discussed. (Author correspondence: waterhouseathome@hotmail.com)     

Comparisons of psychosomatic health and unhealthy behaviors between cleanroom workers in a 12-hour shift and those in an 8-hour shift

The General Health Questionnaire (GHQ12) and physical fitness tests were administered to 338 workers in clean rooms producing electronic parts in 12-h shifts. The results were compared to those in 95 workers in 8-h shifts and 284 daytime management, clerical and engineering workers. The 12-h shift workers complained of poor health, dissatisfaction with life and poor recuperation from fatigue more than the 8-h shift workers although the rates of complaints were highest in the daytime workers. The GHQ scores were similar in the two shift groups, and much better than those in the daytime workers. However, the 12-h shift workers showed significantly lower fitness levels than the 8-h shift workers, and the levels were even worse than the daytime workers who had higher mean age and BMI levels compared with the shift workers. The tendency to have sedentary freetime activities and larger alcohol and cigarette consumption were observed in the 12-h shift workers. The 12-h shift work may have contributed to the unhealthy behaviors resulting in lower physical fitness levels. Health promotion services at the workplace should devote greater attention to long-hour shift workers, together with devising the ways to improve working conditions and environments for reducing fatigue at work.     

Building-site camps and extended work hours: A two-week monitoring of self-reported physical exertion, fatigue, and daytime sleepiness

Large-scale construction work often requires people to work longer daily hours and more than the ordinary five days in a row. In order to minimize transportation times and optimize the use of personnel, workers are sometimes asked to live in temporary building-site camps in the proximity of the work site. However, little is known about the biological and psychological effects of this experience. The objective of the present study was to investigate whether exposure to long work hours and extended workweeks while living in building-site camps in between work shifts was associated with a build-up of increased complaints of poor sleep, daytime sleepiness, physical exertion, and fatigue across a two-week work cycle. Two groups of construction workers were examined. The camp group of 13 participants (mean age: 42+/-11 S.D. yrs) lived in building-site camps and worked extended hours (between 07:00 and 18:00 h) and extended workweeks (six days in a row, one day off, five days in a row, nine days off). The home group of 16 participants (mean age 40+/-9 yrs) worked ordinary hours between 07:00 and 15:00 h and returned home after each workday. Self-ratings of daytime sleepiness (Karolinska Sleepiness Scale), physical exertion (Borg CR-10), and mood were obtained six or seven times daily during two workweeks. Fatigue ratings were obtained once daily in the evening, and ratings of sleep disturbances were obtained once daily in the morning with the Karolinska Sleep Diary. Data were evaluated in a repeated measures design. The results showed that both groups reported a similar level of daytime sleepiness, physical exertion, and mood across workdays and time points within a workday (all three-way interactions had p>0.898). Although the home group reported earlier wake-up times, the pattern of sleep disturbance ratings across the workdays did not differ between the groups. Both groups reported few sleep disturbances and good mood. However, the camp group reported higher physical exertion already at the start of work and showed a more gentle increase in ratings during the work shift and a smaller decline between the end of work and bedtime. The camp group also reported higher fatigue scores than the home group. However, none of the groups showed signs of increasing ratings in the progress of the two workweeks. For both groups, the ratings of daytime sleepiness formed a U-shaped pattern, with the highest scores at awakening and at bedtime. Yet, the camp group reported higher daytime sleepiness than the home group at lunch break and at the second break in the afternoon. In conclusion, there were no signs of fatigue build-up or accumulation of daytime sleepiness, physical exertion, or sleep disturbances in either group. Despite the fact that the camp group showed some signs of having trouble in recuperating in between work shifts, as indicated by the higher physical exertion ratings at the start of work, higher fatigue scores, and higher daytime sleepiness, the results constitute no real foundation for altering the camp group's current work schedule and living arrangements.     

Building‐Site Camps and Extended Work Hours: A Two‐Week Monitoring of Self‐Reported Physical Exertion,Fatigue, and Daytime Sleepiness

Large‐scale construction work often requires people to work longer daily hours and more than the ordinary five days in a row. In order to minimize transportation times and optimize the use of personnel, workers are sometimes asked to live in temporary building‐site camps in the proximity of the work site. However, little is known about the biological and psychological effects of this experience. The objective of the present study was to investigate whether exposure to long work hours and extended workweeks while living in building‐site camps in between work shifts was associated with a build‐up of increased complaints of poor sleep, daytime sleepiness, physical exertion, and fatigue across a two‐week work cycle. Two groups of construction workers were examined. The camp group of 13 participants (mean age: 42±11 S.D. yrs) lived in building‐site camps and worked extended hours (between 07:00 and 18:00 h) and extended workweeks (six days in a row, one day off, five days in a row, nine days off). The home group of 16 participants (mean age 40±9 yrs) worked ordinary hours between 07:00 and 15:00 h and returned home after each workday. Self‐ratings of daytime sleepiness (Karolinska Sleepiness Scale), physical exertion (Borg CR‐10), and mood were obtained six or seven times daily during two workweeks. Fatigue ratings were obtained once daily in the evening, and ratings of sleep disturbances were obtained once daily in the morning with the Karolinska Sleep Diary. Data were evaluated in a repeated measures design. The results showed that both groups reported a similar level of daytime sleepiness, physical exertion, and mood across workdays and time points within a workday (all three‐way interactions had p>0.898). Although the home group reported earlier wake‐up times, the pattern of sleep disturbance ratings across the workdays did not differ between the groups. Both groups reported few sleep disturbances and good mood. However, the camp group reported higher physical exertion already at the start of work and showed a more gentle increase in ratings during the work shift and a smaller decline between the end of work and bedtime. The camp group also reported higher fatigue scores than the home group. However, none of the groups showed signs of increasing ratings in the progress of the two workweeks. For both groups, the ratings of daytime sleepiness formed a U‐shaped pattern, with the highest scores at awakening and at bedtime. Yet, the camp group reported higher daytime sleepiness than the home group at lunch break and at the second break in the afternoon. In conclusion, there were no signs of fatigue build‐up or accumulation of daytime sleepiness, physical exertion, or sleep disturbances in either group. Despite the fact that the camp group showed some signs of having trouble in recuperating in between work shifts, as indicated by the higher physical exertion ratings at the start of work, higher fatigue scores, and higher daytime sleepiness, the results constitute no real foundation for altering the camp group's current work schedule and living arrangements.     

Sleep/Wake Cycle Parameters and Sleep/Fatigue Complaints in Female Night Workers

Adaptation to shift-work is influenced by the way workers schedule their lives, including allocation of sleep episodes. Female workers (n = 29) engaged at an assembly line were studied as to individual differences in sleep parameters in order to verify whether those differences could be related to the manifestation of sleep and fatigue complaints. The sample was composed of women (20–40 y) working at night from Monday to Friday. Sleep data were based on daily sleep logs which were filled out by the workers for 10 consecutive weeks. In the analyses of sleep data both diurnal episodes between consecutive night shifts and noctural sleep episodes preceding working nights were taken into account. Worker's complaints were analyzed through questions extracted from an interview form encompassing questions on fatigue associated with the work schedule and on dissatisfaction with sleep on weekdays and weekends. The analysis of diurnal episodes showed no significant correlation between the total amount of sleep per day and the total number of complaints. Nevertheless, the latter was correlated to the length of the first sleep episode on a day, which usually began in the morning. As to sleep onset times, significant correlations were not detected concerning the first diurnal episodes. The analysis of nocturnal episodes did not reveal any significant correlation between sleep parameters and complaints. Results indicate that workers whose sleep onsets were allocated to the morning and were able to sleep for many consecutive hours, tended to show less complaints, suggesting that the temporal allocation of diurnal sleep and its length are relevant in the determination of how these workers perceive fatigue and sleep quality.     

Sleep/Wake Cycle Parameters and Sleep/Fatigue Complaints in Female Night Workers

Adaptation to shift-work is influenced by the way workers schedule their lives, including allocation of sleep episodes. Female workers ( n = 29) engaged at an assembly line were studied as to individual differences in sleep parameters in order to verify whether those differences could be related to the manifestation of sleep and fatigue complaints. The sample was composed of women (20-40 y) working at night from Monday to Friday. Sleep data were based on daily sleep logs which were filled out by the workers for 10 consecutive weeks. In the analyses of sleep data both diurnal episodes between consecutive night shifts and noctural sleep episodes preceding working nights were taken into account. Worker's complaints were analyzed through questions extracted from an interview form encompassing questions on fatigue associated with the work schedule and on dissatisfaction with sleep on weekdays and weekends. The analysis of diurnal episodes showed no significant correlation between the total amount of sleep per day and the total number of complaints. Nevertheless, the latter was correlated to the length of the first sleep episode on a day, which usually began in the morning. As to sleep onset times, significant correlations were not detected concerning the first diurnal episodes. The analysis of nocturnal episodes did not reveal any significant correlation between sleep parameters and complaints. Results indicate that workers whose sleep onsets were allocated to the morning and were able to sleep for many consecutive hours, tended to show less complaints, suggesting that the temporal allocation of diurnal sleep and its length are relevant in the determination of how these workers perceive fatigue and sleep quality.     

Adaptation to night shifts and synchronisation processes of night workers

Human beings are accustomed to being active and awake during the day, and asleep and rest at night. Since we live in a society which is organised predominantly along daytime activity, therefore working in the night shift may deeply disrupt our social and family life. It is also a well-known fact that night shift causes fatigue and circadian disruption. The basic manifestation of fatigue and circadian rhythm has been linked to health and safety problems, involving decrements in psychophysical and physiological functions, plus subjective complaints. In this context quantitative relationships between shift work and circadian rhythm need to be assessed to explore suitable time schedule, and to minimise sleep depth and fatigue. There is also a great need to discuss circadian disruption, sleepiness and the increasing cost of work related illness among night workers. In this regard, some aspects of fatigue and circadian disruption caused from night shift work are revealed in this paper aiming to increase workers' health, safety and well being as well as productivity. Light/dark cycle and social stimuli issues acting on the circadian timing systems are also explored to solicit opinions and discussion on the controversy of night work. Suggestions are therefore likewise given to enhance workers' adaptation to night shift and synchronization process.     

The Amount of Diurnal Sleep,and Complaints of Fatigue and Poor Sleep,in Night-Working Women: The Effects of Having Children

This study deals with female industrial night workers. There is little scientific literature on this topic since, until recently, such shift systems have in most countries been restricted to men. The amount of diurnal sleep, as well as complaints about fatigue and poor sleep, were compared in women who were (n = 17) or were not (n = 26) caring for children. The women were engaged at an assembly line, working nights (22:00-06:00) from Monday to Friday. They filled out sleep logs for 10 consecutive weeks and were interviewed about complaints concerned with fatigue and poor sleep. A comparison of the diurnal sleeps taken between consecutive night shifts showed that the average total length of daily sleep, as well as the time of onset of the first sleep, did not differ between the groups; however, workers who had children tended to show, in comparison with their childless colleagues, more sleep episodes per day and a shorter first sleep. The total number of complaints about poor sleep and fatigue did not differ between the groups; nevertheless, workers with children complained more of difficulty in falling asleep, had a greater dissatisfaction with the amount of sleep on weekdays, and tended to show an increasing fatigue as the week progressed. We conclude that there are social pressures in women who care for children that are in addition to those that are a general consequence of night work. These results reinforce a need for the implementation of measures that organise child care, so helping a mother who wishes to work also outside the home.     

Self-Reported Health and Sleep Complaints Among Nursing Personnel Working Under 12 h Night and Day Shifts

This cross-sectional exploratory study involved health care workers of various skill types and levels. We tested the hypothesis that the prevalence of diseases, sleep complaints, and insufficient time for nonprofessional activities (family, leisure, and rest) are higher among night than day workers. Data collection was carried out in two public hospitals using questionnaires and other forms. Night work was explored as a risk factor, considering a night worker as one who had at least one night job on the occasion of the research. Data were assessed by a univariate analysis. The association between work schedule and the dependent variables—health conditions, sleep complaints, and insufficient time for nonprofessional activities—was evaluated through the estimation of the prevalence ratio, with a confidence interval of 95%. Two hundred and fifty-eight female nursing personnel participated; 41.5% were moonlighters, and only 20 worked a shift of less than 12 h in length. Reports of migraine and need of medical care the 2 weeks before the survey were more prevalent among day than night workers (PR = 0.71; CI = 0.55–0.92 and PR = 0.71; CI = 0.52–0.95, respectively). Migraine headaches occurred less frequently among night than day workers as confirmed by comparing the reports of the night workers and day workers whose work history was always day shifts (PR = 0.74; CI = 0.57–0.96). Reports of mild emotional disorders (mild depression, tension, anxiety, or insomnia) were less frequent among night (PR = 0.76; CI = 0.59–0.98) and ex-night workers (PR = 0.68; CI = 0.50–0.91) than day workers who never had worked a night job. The healthy worker effect does not seem to explain the results of the comparisons between day and night workers. The possible role of exposure by day workers to some risk factors, such as stress, was suggested as an explanation for these results. No significant difference was observed between night and day workers as to sleep complaints, a result that may have been influenced by the nature of the shift-work schedule (no successive night shifts) and possibly nap taking during the night shift. Moreover, the long work hours and moonlighting of the healthcare workers, which is common in Brazil, may have masked other possible differences between the day and night workers. Among night workers, a significant relation was found between years working nights (more than 10 yrs) and high cholesterol values (PR = 2.58; CI = 1.07–6.27), a result that deserves additional study. Working nights more than four times per 2-week span was related to complaints about insufficient time for children (PR = 1.96; CI = 1.38–2.78) and rest/leisure (PR = 1.54; CI = 1.20–1.99). These results can be related to the “social value of time,” as evenings and nights are when families usually spend time together. The complexity of the professional life and the consequent heterogeneity of the group of workers under shift-work schemes confound the results. More in-depth study of the questions raised here demands a more sophisticated epidemiological treatment and larger sample size.     

The Amount of Diurnal Sleep, and Complaints of Fatigue and Poor Sleep, in Night-Working Women: The Effects of Having Children

This study deals with female industrial night workers. There is little scientific literature on this topic since, until recently, such shift systems have in most countries been restricted to men. The amount of diurnal sleep, as well as complaints about fatigue and poor sleep, were compared in women who were (n = 17) or were not (n = 26) caring for children. The women were engaged at an assembly line, working nights (22:00-06:00) from Monday to Friday. They filled out sleep logs for 10 consecutive weeks and were interviewed about complaints concerned with fatigue and poor sleep. A comparison of the diurnal sleeps taken between consecutive night shifts showed that the average total length of daily sleep, as well as the time of onset of the first sleep, did not differ between the groups; however, workers who had children tended to show, in comparison with their childless colleagues, more sleep episodes per day and a shorter first sleep. The total number of complaints about poor sleep and fatigue did not differ between the groups; nevertheless, workers with children complained more of difficulty in falling asleep, had a greater dissatisfaction with the amount of sleep on weekdays, and tended to show an increasing fatigue as the week progressed. We conclude that there are social pressures in women who care for children that are in addition to those that are a general consequence of night work. These results reinforce a need for the implementation of measures that organise child care, so helping a mother who wishes to work also outside the home.     

Changes in body fat and muscle in manual workers at and after retirement

The changes in body fat and muscle in 73 men retiring from manual work have been measured in a longitudinal anthropometric study. Body fat increased by about 3% and body muscle decreased by about 1% between measurements made just before retirement and again 1 year later. The decline in muscle was even greater in a subgroup of 22 men who reported that their activity was less after retirement: but a subgroup of 11 whose activity was said to have been greater after retirement showed an increase in body muscle. A sub-sample of 26 men were measured on five further annual occasions (Fig. 1). The initial increase in body fat was reversed, and fat measurements fell back significantly to or below the pre-retirement values. Body muscle, however, continued to decline steadily at the initial rate, and the ratio of thigh muscle area to body mass fell significantly in retirement in the group as a whole. The possible contributions of ageing and of changes in energy balance and physical activity to these findings are discussed.     

Fatigue and mood correlates of sleep length in three age-social groups: School children, students, and employees

The aim of the study was to trace the consequences of insufficient sleep, in terms of chronic sleep reduction rather than acute sleep deprivation, on fatigue, mood, cognitive performance self-estimations, and daytime sleepiness in different age-social groups. The age group of the subjects reflects their social situation and their working time organization: adolescents (n = 191) obeyed the strict school schedules with starting times often before 08:00 h; university students (n = 115) had more flexible timetables; young employees (n = 126) were engaged in regular morning schedules or irregular daytime hours or day and night shifts. A questionnaire study determined the declared need of sleep, self-reported sleep length, chronic fatigue (using a scale comprised of eight fatigue symptoms and four mood and three cognitive items), and daytime sleepiness (Epworth Sleepiness Scale). The declared need for sleep decreased in subsequent age groups from 9 h 23 min in school children to 8 h 22 min in university students and to 7 h 37 min in young employees. Consequently, the discrepancy between preferred and real sleep length (sleep deficit) was the largest in adolescents: 106 min. Females showed a greater need of sleep than males (p = .025) and significantly more fatigue, mood, and cognitive problems; they also exhibited higher level of daytime sleepiness (p < .000). The sleep index (reported sleep length related to requirements) correlated significantly with all health issues in women (p < .000), while only with fatigue symptoms in men (p = .013). Actual sleep length was unrelated to mood and fatigue issues; the declared individual need of sleep and sleep index showed significant associations, especially in the group of adolescents. The most frequent complaints of adolescents included tiredness on awakening (46%), nervousness, and general weakness; university students reported excessive drowsiness (50%), tension, and nervousness; employees suffered mostly from negative moods, such as tension (49%), nervousness, and irritability. The findings of the study indicate that chronic sleep loss seems to affect females more severely than males. The associations of fatigue and mood with sleep need and sleep index were more pronounced in younger subjects. Surprisingly, fatigue symptoms in school children and university students were as frequent as in hard-working adults. Because the problem of insufficient sleep is already present in youngsters, their work time organization needs more attention.     

Psychosocial work characteristics predicting daytime sleepiness in day and shift workers

Characteristics of work organization other than working time arrangements may contribute importantly to daytime sleepiness. The present study was designed to identify the psychosocial factors at work that predict daytime sleepiness in a sample of day and shift workers. Participants working at a pulp and chemical factory completed an annual questionnaire regarding psychosocial factors at work using the U.S. National Institute for Occupational Safety and Health Generic Job Stress Questionnaire (i.e., quantitative workload, variance in workload, job control, support from supervisor, coworkers, or family/friends, job satisfaction, and depressive symptoms), as well as daytime sleepiness (through the Epworth Sleepiness Scale [ESS]) and sleep disturbances for three years starting in 2002 (response rates, 94.6-99.0%). The present analysis included 55 day workers (11 women) and 57 shift workers (all men) who participated in all three years of the study, worked under the same work schedule throughout the study period, and had no missing data on any of the daytime sleep items. A repeated-measures analysis of covariance (ANCOVA) was used to test the effects of work schedule (day vs. shift work) and psychosocial factors at work in 2002 on the ESS scores in subsequent years, with sleep duration, insomnia symptoms, chronic diseases, and sleepiness levels at baseline as covariates. Given significant and near-significant interactions of work schedules with psychosocial factor or study year, the ANCOVA, with the factors of psychosocial work characteristics and study year, was performed by type of work schedule. The results indicated a significant main effect of psychosocial work characteristics (p = 0.010, partial eng2 = 0.14) and an almost significant main effect of study year (p = 0.067, partial eng2 = 0.06) and interaction between psychosocial work characteristics and study year (p = 0.085, partial eng2 = 0.06) for variance in workload among the day work group. The day workers reporting high variance in workload in 2002 exhibited significantly higher ESS scores in 2003 and 2004 than did those reporting low variance in workload. The ANCOVA for the shift work group showed a main effect of psychosocial work characteristics for job satisfaction (p = 0.026, partial eng2 = 0.10) and depressive symptoms (p = 0.094, partial eng2 = 0.06) with the interaction between psychosocial work characteristics and study year for job satisfaction (p = 0.172, partial eng2 = 0.04) and depressive symptoms (p = 0.035, partial eng2 = 0.07). The shift workers with low job satisfaction and high symptoms of depression in 2002 showed significantly greater ESS scores in 2003 and/or 2004 than did those with opposite characteristics. These results may suggest a potential predictive value of variance in workload for day workers as well as job satisfaction and depressive symptoms for shift workers with respect to daytime sleepiness. The present findings may imply that redesigning these aspects of work environment would be of help in managing daytime sleepiness.     

Self-reported health and sleep complaints among nursing personnel working under 12 h night and day shifts

This cross-sectional exploratory study involved health care workers of various skill types and levels. We tested the hypothesis that the prevalence of diseases, sleep complaints, and insufficient time for nonprofessional activities (family, leisure, and rest) are higher among night than day workers. Data collection was carried out in two public hospitals using questionnaires and other forms. Night work was explored as a risk factor, considering a night worker as one who had at least one night job on the occasion of the research. Data were assessed by a univariate analysis. The association between work schedule and the dependent variables—health conditions, sleep complaints, and insufficient time for nonprofessional activities—was evaluated through the estimation of the prevalence ratio, with a confidence interval of 95%. Two hundred and fifty-eight female nursing personnel participated; 41.5% were moonlighters, and only 20 worked a shift of less than 12 h in length. Reports of migraine and need of medical care the 2 weeks before the survey were more prevalent among day than night workers (PR = 0.71; CI = 0.55-0.92 and PR = 0.71; CI = 0.52-0.95, respectively). Migraine headaches occurred less frequently among night than day workers as confirmed by comparing the reports of the night workers and day workers whose work history was always day shifts (PR = 0.74; CI = 0.57-0.96). Reports of mild emotional disorders (mild depression, tension, anxiety, or insomnia) were less frequent among night (PR = 0.76; CI = 0.59-0.98) and ex-night workers (PR = 0.68; CI = 0.50-0.91) than day workers who never had worked a night job. The healthy worker effect does not seem to explain the results of the comparisons between day and night workers. The possible role of exposure by day workers to some risk factors, such as stress, was suggested as an explanation for these results. No significant difference was observed between night and day workers as to sleep complaints, a result that may have been influenced by the nature of the shift-work schedule (no successive night shifts) and possibly nap taking during the night shift. Moreover, the long work hours and moonlighting of the healthcare workers, which is common in Brazil, may have masked other possible differences between the day and night workers. Among night workers, a significant relation was found between years working nights (more than 10 yrs) and high cholesterol values (PR = 2.58; CI = 1.07-6.27), a result that deserves additional study. Working nights more than four times per 2-week span was related to complaints about insufficient time for children (PR = 1.96; CI = 1.38-2.78) and rest/leisure (PR = 1.54; CI = 1.20-1.99). These results can be related to the “social value of time,” as evenings and nights are when families usually spend time together. The complexity of the professional life and the consequent heterogeneity of the group of workers under shift-work schemes confound the results. More in-depth study of the questions raised here demands a more sophisticated epidemiological treatment and larger sample size.     

Shift work tolerance and the importance of sleep quality: a study of police officers

The aim of this study was to examine how subjective shift work tolerance was related to general health variables, with the expectation of inter-individual differences in the nature of this relation. A total of 740 employees of the Dutch Police force completed a questionnaire, covering seven health-related domains: sleep quality, sleep duration, need for recovery, fatigue, physical health, mental health, and work–life balance. Based on subjective reports of shift work tolerance, participants were classified as intolerant, medium-tolerant, or tolerant workers. Analysis involved group comparisons, regression, and cluster analysis. Eighteen percentage of the shift workers were classified as intolerant. The intolerant and medium-tolerant workers expressed more severe complaints than the tolerant workers, for all seven health-related domains. Shift work tolerance was primarily related to sleep quality and subsequently to need for recovery, fatigue, and work–life balance. No indications were found for systematic inter-individual differences in the nature of this relationship. For all participants equally, the degree of shift work tolerance was related to the severity of health-related complaints. This study highlights the central role of sleep for tolerance to shift work and underlines the need for occupational medicine to take explicit account of sleep.     

Wearing Blue-Blockers in the Morning Could Improve Sleep of Workers on a Permanent Night Schedule: A Pilot Study

Night shiftworkers often complain of disturbed sleep during the day. This could be partly caused by morning sunlight exposure during the commute home, which tends to maintain the circadian clock on a daytime rhythm. The circadian clock is most sensitive to the blue portion of the visible spectrum, so our aim was to determine if blocking short wavelengths of light below 540 nm could improve daytime sleep quality and nighttime vigilance of night shiftworkers. Eight permanent night shiftworkers (32–56 yrs of age) of Quebec City's Canada Post distribution center were evaluated during summertime, and twenty others (24–55 yrs of age) during fall and winter. Timing, efficacy, and fragmentation of daytime sleep were analyzed over four weeks by a wrist activity monitor, and subjective vigilance was additionally assessed at the end of the night shift in the fall–winter group. The first two weeks served as baseline and the remaining two as experimental weeks when workers had to wear blue-blockers glasses, either just before leaving the workplace at the end of their shift (summer group) or 2 h before the end of the night shift (fall–winter group). They all had to wear the glasses when outside during the day until 16:00 h. When wearing the glasses, workers slept, on average ±SD, 32±29 and 34±60 more min/day, increased their sleep efficacy by 1.95±2.17% and 4.56±6.1%, and lowered their sleep fragmentation by 1.74±1.36% and 4.22±9.16% in the summer and fall–winter group, respectively. Subjective vigilance also generally improved on Fridays in the fall–winter group. Blue-blockers seem to improve daytime sleep of permanent night-shift workers.     

Fatigue and Mood Correlates of Sleep Length in Three Age‐Social Groups: School Children,Students, and Employees

The aim of the study was to trace the consequences of insufficient sleep, in terms of chronic sleep reduction rather than acute sleep deprivation, on fatigue, mood, cognitive performance self‐estimations, and daytime sleepiness in different age‐social groups. The age group of the subjects reflects their social situation and their working time organization: adolescents (n=191) obeyed the strict school schedules with starting times often before 08:00 h; university students (n=115) had more flexible timetables; young employees (n=126) were engaged in regular morning schedules or irregular daytime hours or day and night shifts. A questionnaire study determined the declared need of sleep, self‐reported sleep length, chronic fatigue (using a scale comprised of eight fatigue symptoms and four mood and three cognitive items), and daytime sleepiness (Epworth Sleepiness Scale). The declared need for sleep decreased in subsequent age groups from 9 h 23 min in school children to 8 h 22 min in university students and to 7 h 37 min in young employees. Consequently, the discrepancy between preferred and real sleep length (sleep deficit) was the largest in adolescents: 106 min. Females showed a greater need of sleep than males (p=.025) and significantly more fatigue, mood, and cognitive problems; they also exhibited higher level of daytime sleepiness (p<.000). The sleep index (reported sleep length related to requirements) correlated significantly with all health issues in women (p<.000), while only with fatigue symptoms in men (p=.013). Actual sleep length was unrelated to mood and fatigue issues; the declared individual need of sleep and sleep index showed significant associations, especially in the group of adolescents. The most frequent complaints of adolescents included tiredness on awakening (46%), nervousness, and general weakness; university students reported excessive drowsiness (50%), tension, and nervousness; employees suffered mostly from negative moods, such as tension (49%), nervousness, and irritability. The findings of the study indicate that chronic sleep loss seems to affect females more severely than males. The associations of fatigue and mood with sleep need and sleep index were more pronounced in younger subjects. Surprisingly, fatigue symptoms in school children and university students were as frequent as in hard‐working adults. Because the problem of insufficient sleep is already present in youngsters, their work time organization needs more attention.