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.     

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.     

The Effect of One Night's Sleep Deprivation on Temperature,Mood, and Physical Performance in Subjects with Different Amounts of Habitual Physical Activity

Eleven healthy males were studied twice. On one occasion (control, C), they slept (night 1) and then underwent a battery of tests at 4h intervals from 06: 00 day 1 to 02: 00 day 2; then, after a normal sleep (night 2), they were tested from 10: 00 to 22: 00 on day 2. On the second occasion (sleep deprivation, SD), the subjects remained awake during night 1. Each battery of tests consisted of measurements of tympanic membrane temperature, profile of mood states (POMS), muscle strength, self-chosen work rate (SCWR), perceived exertion, and heart rate (HR) while exercising on a stationary cycle ergometer. Subjects also kept a diary of their activities during the two days and answered a questionnaire about their habitual physical activity. Results showed a significant negative effect of sleep deprivation on most mood states on day 1, but no effect on the other variables. By day 2, mood had tended to recover, though muscle strength tended to be worse in both control and sleep-deprivation experiments. There was also a more general tendency for negative effects to be present at the end of day 1 (02: 00) or at the beginning of day 2 (10: 00). There was limited support for the view that subjects who were habitually more active showed less negative effects after sleep deprivation and responded less adversely to the poor sleep achieved on the university premises (night 2). These results stress the considerable interindividual variation in the responses to sleep loss and, therefore, the difficulty associated with giving general advice to individuals about work or training capability after sleep loss.     

Sleep on the job partially compensates for sleep loss in night-shift nurses

Nursing personnel in Brazil are usually submitted to fixed 12 h shifts with no consecutive working days or nights. Moonlighting is common in this group, with a consequent increase in the number of working hours. The possibility of sleeping on the job during the night shift in the studied hospitals had already been described. The present study aims to analyze whether the time devoted to daily activities (sleep, rest, leisure, housework, commuting, personal needs, care of children or other people, non-paid work, and study) is related to the number of worked hours and to nap-taking during the night shift. The field study took place at two public hospitals in Rio de Janeiro, Brazil. Workers filled out a structured form on time devoted to the above-mentioned activities for at least four consecutive days. The time devoted to sleep was analyzed according to its occurrence at home or on the job. Workers were classified according to the number of jobs (one job/two jobs) and the time dedicated to work according to the median of the whole series (below the median/above the median). All workers who had at least one working night were analyzed as to nap-taking on the job. They were classified according to the sleep occurrence during the night shift-the sleep group and the non-sleep group, both of which were compared to daytime workers. Statistical treatment of data included non-parametrical procedures. The study group comprised 144 workers (mean age: 35.7+/-10.5 years old; 91% women; 78% nurse assistants, the remainder registered nurses). They recorded their daily activities for 4-11 days; 829 cumulative days were analyzed for the whole group. A total of 165 working nights were analyzed; sleep or rest occurred during 112 (68%) of them, with mean sleep/rest duration of 141+/-86 min. Time devoted to sleep and leisure varied according to the number of working hours, being significantly reduced in those submitted to longer work hours (p < 0.001 and p = 0.002, respectively). Results close to significance point to a reduction in the time dedicated to housework among workers with long work hours (p = 0.053). The time spent on sleep/rest per working night did not differ according to the number of worked hours (p = 0.490). A tendency was observed for those who have two jobs to devote more time to sleep/rest on the job (p = 0.058). The time of personal needs was significantly lower among those who did not sleep on the job as compared to day workers (p = 0.036). The total sleep time was significantly lower among those who did not sleep on the job, as compared to day workers and to those who slept on the job (p = 0.004 and p = 0.05, respectively). As to home sleep length, workers who slept and those who did not sleep on the job were similar and slept significantly less than exclusively daytime workers (p < 0.001 and p = 0.002, respectively). Sleeping on the job during the night shift seems to partially compensate for the shorter sleep at home among night workers and may play a beneficial effect in coping with two jobs.     

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.     

Disturbed Sleep in Shift Workers,Day Workers,and Insomniacs

Very little is known about differences in sleep between day and shift workers in representative samples of the population. This study compared a national representative sample (N=3400) of shift (with night shifts) and day workers regarding the different types of sleep disturbances and also the level of sleep symptoms with that of insomnia patients. The results showed very few differences between shift and day workers; only “too little sleep” and “nodding off at work” were marginally higher among shift workers. The results also showed that the complaints of insomnia patients for most sleep disturbances corresponded to the 2nd–16th percentile of the shift workers' levels of complaints. The results suggest, at least with the present questionnaire methodology, that shift work does not appear to be a major source of sleep disturbances and that their complaint levels bear no resemblance to those seen in insomniac patients.     

Associations of a Short Sleep Duration,Insufficient Sleep,and Insomnia with Self-Rated Health among Nurses

Epidemiological evidence suggests that sleep duration and poor sleep are associated with mortality, as well as with a wide range of negative health outcomes. However, few studies have examined the association between sleep and self-rated health, particularly through the combination of sleep complaints. The objective of this study was to examine whether self-rated health is associated with sleep complaints, considering the combination of sleep duration, insomnia, and sleep sufficiency. This cross-sectional study was performed in the 18 largest public hospitals in the city of Rio de Janeiro, Brazil. A total of 2518 female nurses answered a self-filled multidimensional questionnaire. The adjusted odds ratios and 95% confidence intervals (CIs) estimated the chance of poor self-rated health in the presence of different combinations of sleep duration and quality. Compared with women who reported adequate sleep duration with no sleep quality complaints (reference group), the odds ratios (95% CI) for poor self-rated health were 1.79 (1.27–2.24) for those who reported only insufficient sleep, 1.85 (0.94–3.66) for only a short sleep duration, and 3.12 (1.94–5.01) for only insomnia. Compared with those who expressed all three complaints (short sleep duration, insomnia, and insufficient sleep), the odds ratio for poor self-rated health was 4.49 (3.25–6.22). Differences in the magnitude of the associations were observed, depending on the combination of sleep complaints. Because self-rated health is a consistent predictor of morbidity, these results reinforce the increasing awareness of the role of sleep in health and disease. Our findings contribute to the recognition of sleep as a public health matter that deserves to be better understood and addressed by policymakers.     

Relationship of Chronotype to Sleep,Light Exposure,and Work-Related Fatigue in Student Workers

Students who work during the school year face the potential of sleep deprivation and its effects, since they have to juggle between school and work responsibilities along with social life. This may leave them with less time left for sleep than their nonworking counterparts. Chronotype is a factor that may exert an influence on the sleep of student workers. Also, light and social zeitgebers may have an impact on the sleep-related problems of this population. This study aimed to document sleep, light exposure patterns, social rhythms, and work-related fatigue of student workers aged 19–21 yrs and explore possible associations with chronotype. A total of 88 student workers (mean?±?SD: 20.18?±?.44 yrs of age; 36 males/52 females) wore an actigraph (Actiwatch-L; Mini-Mitter/Respironics,Bend, OR) and filled out the Social Rhythm Metric for two consecutive weeks during the school year. Also, they completed the Morningness-Eveningness Questionnaire (MEQ), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and Occupational Fatigue Exhaustion/Recovery Scale (OFER). Repeated and one-way analyses of variance (ANOVAs), Pearson's chi-square tests, and correlation coefficients were used for statistical comparisons. Subjects slept an average of 06:28?h/night. Actigraphic sleep parameters, such as sleep duration, sleep efficiency, wake after sleep onset, and sleep latency, did not differ between chronotypes. Results also show that evening types (n?=?17) presented lower subjective sleep quality than intermediate types (n?=?58) and morning types (n?=?13). Moreover, evening types reported higher levels of chronic work-related fatigue, exhibited less regular social rhythms, and were exposed to lower levels of light during their waking hours (between 2 and 11 h after wake time) as compared to intermediate types and morning types. In addition, exposure to light intensities between 100 and 500 lux was lower in evening types than in intermediate types and morning types. However, bright light exposure (≥1000 lux) did not differ between chronotypes. In conclusion, results suggest that student workers may constitute a high-risk population for sleep deprivation. Evening types seemed to cope less well with sleep deprivation, reporting poorer sleep quality and higher levels of work-related fatigue than intermediate types and morning types. The higher chronic work-related fatigue of evening types may be linked to their attenuated level of light exposure and weaker social zeitgebers. These results add credence to the hypothesis that eveningness entails a higher risk of health-impairing behaviors. (Author correspondence: luc.laberge@uqac.ca)     

Gender and sleep in nightworkers: a quantitative analysis of sleep in days off

Differences in sleep patterns between workdays and days off contribute to shiftwork effects on workers' health and well-being. But regardless of shift schedules, female workers face more difficulties in fulfilling their sleep need because of housework. This study analyzes gender differences concerning sleep in days off by comparing sleep patterns in male and female nightworkers, analyzing sleep as related to the presence of children and testing the association of sleep features between workdays and days off. Male (n = 16) and female (n = 30) workers at a plastic plant, working from 10 p.m. to 6 a.m., on weekdays, filled sleep logs for seven consecutive weeks. Male and female samples did not differ in length of night sleep or in total length of sleep. For both samples, sleep length/day in days off increased, but the difference was lager among females. Also important were the relations between sleep in workdays and days off, specially among women. Among female workers, the results indicated that workers with children tended to sleep less in Saturday mornings, suggesting a negative effect of motherhood on sleep not restricted to workdays. The general results indicate that sleep need on the one hand, and social factors on the other determine the actual amount of sleep.     

Circadian Rhythms in 6-Sulphatoxymelatonin and Nocturnal Sleep in Blind Children

This article describes the relationship between melatonin secretion and sleep quality and subjective complaints about sleep in totally blind children. Eleven boarding-school children (mean age 15.2 years) participated. The major urinary melatonin metabolite 6-sulphatoxymelatonin (aMT6s) was measured five times a day for 48 h. Sleep-wake cycles were recorded by continuous actigraphic recordings during the same time period. Results showed that delayed secretory peaks in aMT6s were significantly associated with disturbed nocturnal sleep and with complaints about morning fatigue.     

Circadian Rhythms in 6-Sulphatoxymelatonin and Nocturnal Sleep in Blind Children

This article describes the relationship between melatonin secretion and sleep quality and subjective complaints about sleep in totally blind children. Eleven boarding-school children (mean age 15.2 years) participated. The major urinary melatonin metabolite 6-sulphatoxymelatonin (aMT6s) was measured five times a day for 48 h. Sleep-wake cycles were recorded by continuous actigraphic recordings during the same time period. Results showed that delayed secretory peaks in aMT6s were significantly associated with disturbed nocturnal sleep and with complaints about morning fatigue.     

Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses

Nurses working 12-h shifts complain of fatigue and insufficient/poor-quality sleep. Objectively measured sleep times have not been often reported. This study describes sleep, sleepiness, fatigue, and neurobehavioral performance over three consecutive 12-h (day and night) shifts for hospital registered nurses. Sleep (actigraphy), sleepiness (Karolinska Sleepiness Scale [KSS]), and vigilance (Performance Vigilance Task [PVT]), were measured serially in 80 registered nurses (RNs). Occupational fatigue (Occupational Fatigue Exhaustion Recovery Scale [OFER]) was assessed at baseline. Sleep was short (mean 5.5?h) between shifts, with little difference between day shift (5.7?h) and night shift (5.4?h). Sleepiness scores were low overall (3 on a 1-9 scale, with higher score indicating greater sleepiness), with 45% of nurses having high level of sleepiness (score >?7) on at least one shift. Nurses were progressively sleepier each shift, and night nurses were sleepier toward the end of the shift compared to the beginning. There was extensive caffeine use, presumably to preserve or improve alertness. Fatigue was high in one-third of nurses, with intershift fatigue (not feeling recovered from previous shift at the start of the next shift) being most prominent. There were no statistically significant differences in mean reaction time between day/night shift, consecutive work shift, and time into shift. Lapsing was traitlike, with rare (39% of sample), moderate (53%), and frequent (8%) lapsers. Nurses accrue a considerable sleep debt while working successive 12-h shifts with accompanying fatigue and sleepiness. Certain nurses appear more vulnerable to sleep loss than others, as measured by attention lapses.     

Sleep and sleepiness among working and non-working high school evening students

The aim of this study was to evaluate patterns of sleepiness, comparing working and non-working students. The study was conducted on high school students attending evening classes (19:00-22:30 h) at a public school in S?o Paulo, Brazil. The study group consisted of working (n=51) and non-working (n=41) students, aged 14-21 yrs. The students answered a questionnaire about working and living conditions and reported health symptoms and diseases. For seven consecutive days, actigraphy measurements were recorded, and the students also filled in a sleep diary. Sleepiness ratings were given six times per day, including upon waking and at bedtime, using the Karolinska Sleepiness Scale. Statistical analyses included three-way ANOVA and t-test. The mean sleep duration during weekdays was shorter among workers (7.2 h) than non-workers (8.8 h) (t=4.34; p<.01). The mean duration of night awakenings was longer among workers on Tuesdays and Wednesdays (28.2 min) and shorter on Mondays (24.2 min) (t=2.57; p=.03). Among workers, mean napping duration was longer on Mondays and Tuesdays (89.9 min) (t=2.27; p=.03) but shorter on Fridays and Sundays (31.4 min) (t=3.13; p=.03). Sleep efficiency was lower on Fridays among non-workers. Working students were moderately sleepier than non-workers during the week and also during class on specific days: Mondays (13:00-15:00 h), Wednesdays (19:00-22:00 h), and Fridays (22:00-00:59 h). The study found that daytime sleepiness of workers is moderately higher in the evening. This might be due to a work effect, reducing the available time for sleep and shortening the sleep duration. Sleepiness and shorter sleep duration can have a negative impact on the quality of life and school development of high school students.     

Sleep Complaints and Polysomnographic Findings: A Study of Nuclear Power Plant Shift Workers

The literature widely recognizes that shift workers have more health complaints than the general population. The objective of this study was to describe the prevalence of sleep complaints and verify the polysomnographic (PSG) variables of shift workers in two Brazilian nuclear power plants. We carried out a subjective evaluation with a sleep questionnaire. Based on these results, the interviewees that reported sleep‐related complaints were referred for polysomnographic evaluation. Of the 327 volunteers initially evaluated by the sleep questionnaire, 113 (35%) reported sleep complaints; they were significantly older, had higher body mass index (BMI), and worked more years on shifts than those without sleep complaints. Of these 113, 90 met criteria for various sleep disorders: 30 (9%) showed obstructive sleep apnea (OSA), 18 (5.5%) showed limb movement, and 42 (13%) evidenced both sleep problems and had a significantly higher proportion of sleep stage 1 and arousals compared with the 23 shift workers that had no indices of sleep problems. The present study found that 90 (27.5%) of the evaluated participants met the PSG criteria of some type of clinical sleep disorder. This high proportion should be investigated for associations with other aspects of work, such as working hours, working schedule, years performing shift work, and access to health services. Due to the strong association between sleep disorders and the incidence of fatigue and sleepiness, the evaluation of the sleep patterns and complaints of shift workers is essential and should be considered to be one of the basic strategies of industry to prevent accidents.     

Sleep complaints and polysomnographic findings: a study of nuclear power plant shift workers

The literature widely recognizes that shift workers have more health complaints than the general population. The objective of this study was to describe the prevalence of sleep complaints and verify the polysomnographic (PSG) variables of shift workers in two Brazilian nuclear power plants. We carried out a subjective evaluation with a sleep questionnaire. Based on these results, the interviewees that reported sleep-related complaints were referred for polysomnographic evaluation. Of the 327 volunteers initially evaluated by the sleep questionnaire, 113 (35%) reported sleep complaints; they were significantly older, had higher body mass index (BMI), and worked more years on shifts than those without sleep complaints. Of these 113, 90 met criteria for various sleep disorders: 30 (9%) showed obstructive sleep apnea (OSA), 18 (5.5%) showed limb movement, and 42 (13%) evidenced both sleep problems and had a significantly higher proportion of sleep stage 1 and arousals compared with the 23 shift workers that had no indices of sleep problems. The present study found that 90 (27.5%) of the evaluated participants met the PSG criteria of some type of clinical sleep disorder. This high proportion should be investigated for associations with other aspects of work, such as working hours, working schedule, years performing shift work, and access to health services. Due to the strong association between sleep disorders and the incidence of fatigue and sleepiness, the evaluation of the sleep patterns and complaints of shift workers is essential and should be considered to be one of the basic strategies of industry to prevent accidents.     

Sleep,Sleepiness, Fatigue,and Performance of 12-Hour-Shift Nurses

Nurses working 12-h shifts complain of fatigue and insufficient/poor-quality sleep. Objectively measured sleep times have not been often reported. This study describes sleep, sleepiness, fatigue, and neurobehavioral performance over three consecutive 12-h (day and night) shifts for hospital registered nurses. Sleep (actigraphy), sleepiness (Karolinska Sleepiness Scale [KSS]), and vigilance (Performance Vigilance Task [PVT]), were measured serially in 80 registered nurses (RNs). Occupational fatigue (Occupational Fatigue Exhaustion Recovery Scale [OFER]) was assessed at baseline. Sleep was short (mean 5.5?h) between shifts, with little difference between day shift (5.7?h) and night shift (5.4?h). Sleepiness scores were low overall (3 on a 1–9 scale, with higher score indicating greater sleepiness), with 45% of nurses having high level of sleepiness (score ?>?7) on at least one shift. Nurses were progressively sleepier each shift, and night nurses were sleepier toward the end of the shift compared to the beginning. There was extensive caffeine use, presumably to preserve or improve alertness. Fatigue was high in one-third of nurses, with intershift fatigue (not feeling recovered from previous shift at the start of the next shift) being most prominent. There were no statistically significant differences in mean reaction time between day/night shift, consecutive work shift, and time into shift. Lapsing was traitlike, with rare (39% of sample), moderate (53%), and frequent (8%) lapsers. Nurses accrue a considerable sleep debt while working successive 12-h shifts with accompanying fatigue and sleepiness. Certain nurses appear more vulnerable to sleep loss than others, as measured by attention lapses. (Author correspondence: jgeiger@son.umaryland.edu)     

Circadian phase, sleepiness, and light exposure assessment in night workers with and without shift work disorder

Most night workers are unable to adjust their circadian rhythms to the atypical hours of sleep and wake. Between 10% and 30% of shiftworkers report symptoms of excessive sleepiness and/or insomnia consistent with a diagnosis of shift work disorder (SWD). Difficulties in attaining appropriate shifts in circadian phase, in response to night work, may explain why some individuals develop SWD. In the present study, it was hypothesized that disturbances of sleep and wakefulness in shiftworkers are related to the degree of mismatch between their endogenous circadian rhythms and the night-work schedule of sleep during the day and wake activities at night. Five asymptomatic night workers (ANWs) (3 females; [mean ± SD] age: 39.2 ± 12.5 yrs; mean yrs on shift = 9.3) and five night workers meeting diagnostic criteria (International Classification of Sleep Disorders [ICSD]-2) for SWD (3 females; age: 35.6 ± 8.6 yrs; mean years on shift = 8.4) participated. All participants were admitted to the sleep center at 16:00 h, where they stayed in a dim light (<10 lux) private room for the study period of 25 consecutive hours. Saliva samples for melatonin assessment were collected at 30-min intervals. Circadian phase was determined from circadian rhythms of salivary melatonin onset (dim light melatonin onset, DLMO) calculated for each individual melatonin profile. Objective sleepiness was assessed using the multiple sleep latency test (MSLT; 13 trials, 2-h intervals starting at 17:00 h). A Mann-Whitney U test was used for evaluation of differences between groups. The DLMO in ANW group was 04:42 ± 3.25 h, whereas in the SWD group it was 20:42 ± 2.21 h (z = 2.4; p 相似文献   

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.     

The Relationship between Sleep and Shift System, Age and Chronotype in Shift Workers

The purpose of this study was to investigate the effects of shift system, age, and chronotype on the sleep habits, sleepiness and catnaps of shift workers during night work. We administrated a Morningness-Eveningness Questionnaire and Life Habits Inventory to 561 male shift workers of three different shift systems in Korea. The mean scores on the Morningness-Eveningness Questionnaire clearly shifted toward the Morning type from the young to old groups. The waking and bedtimes during the day and evening shift were earlier for the older than for the younger groups, and these times were earlier across the Evening, Intermediate, to Morning type as well. Sleep length during the day shift was longer from the young to old, and it was shorter from the Evening, Intermediate, to Morning type. In the weekly rotation full-day 3-team 3-shift system and continuous full-day 3-team 3-shift system (which had earlier starting times for day shift) the sleep length of the younger workers was short. For the aged workers, sleep length during the night shift was short because they woke up early. In the weekly rotation full-day 2-team 2-shift system that had a short working interval, the reduction of sleep length during night shift was greater than that of the other shift systems. However, the scores on the Morningness-Eveningness Questionnaire showed a significantly negative correlation only in the bedtime during day shift among the sleep habit parameters for the independent variable by age. For the percentage of subjects that reported 'become sleepiness', the degree and time of sleepiness during the night shift were greater and earlier for the older than for the younger workers, and greater for the Morning than for the Evening type. The percentage of subjects who took a catnap during night shift, as well as the length of their catnap, were also higher and longer for the older groups, and higher and longer for the Morning type than for the Evening type. From these results, we surmised that the sleep habit parameters were influenced the age or shift systems rather than the chronotype. The sleep length during the night shift was shorter for the aged than for the young. In the shift systems that have a short working interval, the nocturnal was remarkably shorter for the young than the aged. The aged had not adapted their sleep for the night shift compared to the young, this suggested by the aged's strong complaint of sleepiness and by the fact that a larger percentage of aged subjects said they took catnaps during night shift compared to the younger workers.