Factors Associated With Shift Work Disorder in Nurses Working With Rapid-Rotation Schedules in Japan: The Nurses’ Sleep Health Project

Abstract

Workers who meet the criteria for shift work disorder (SWD) have elevated levels of risk for various health and behavioral problems. However, the impact of having SWD on shiftworkers engaged in rapid-rotation schedules is unknown. Moreover, the risk factors for the occurrence of SWD remain unclear. To clarify these issues, we conducted a questionnaire-based, cross-sectional survey on a sample of shiftworking nurses. Responses were obtained from 1202 nurses working at university hospitals in Tokyo, Japan, including 727 two-shift workers and 315 three-shift workers. The questionnaire included items relevant to age, gender, family structure, work environment, health-related quality of life (QOL), diurnal type, depressive symptoms, and SWD. Participants who reported insomnia and/or excessive sleepiness for at least 1 mo that was subjectively relevant to their shiftwork schedules were categorized as having SWD. The prevalence of SWD in the sampled shiftworking nurses was 24.4%; shiftworking nurses with SWD showed lower health-related QOL and more severe depressive symptoms, with greater rates of both actual accidents/errors and near misses, than those without SWD. The results of logistic regression analyses showed that more time spent working at night, frequent missing of nap opportunities during night work, and having an eveningness-oriented chronotype were significantly associated with SWD. The present study indicated that SWD might be associated with reduced health-related QOL and decreased work performance in shiftworking nurses on rapid-rotation schedules. The results also suggested that missing napping opportunities during night work, long nighttime working hours, and the delay of circadian rhythms are associated with the occurrence of SWD among shiftworking nurses on rapid-rotation schedules.

The Relationship Between Sleep Disorders and Quality of Life in Rotating Shift Workers at a Textile Factory

“…In another study by Asaoka et al conducted on 1202 nurses, the prevalence of insomnia was 24.4%, they had lower healthrelated QOL, more severe depressive symptoms, and more errors than those without insomnia. In their study, working at night was associated with the occurrence of insomnia among shift working nurses on rapid rotation schedules (24). In Anbazhagan study, the prevalence of insomnia among nurses was 43.07%.…”

Shift-Work Disorder and Sleep-Related Environmental Factors in the Manufacturing Industry

“…The international classification of sleep disorders (ICSD-2) issued the following diagnostic criteria for SWD: 1) complaints of insomnia or excessive sleepiness that are temporally associated with a recurring work schedule that overlaps with the usual time for sleep, 2) symptoms must be associated with the shiftwork schedule over the course of at least 1 month, 3) circadian and sleep-time misalignment, as demonstrated by sleep logs or actigraphical monitoring for 7 days or more and 4) the sleep disturbance cannot be explained by another sleep disorder, a medical disorder, neurological disorder, mental disorder, or medication, or use of other substances. Several studies of the prevalence of SWD in shift workers have been conducted [4][5][6][7][8]. Drake CL et al [4] and Di Milia L et al [5] reported that the prevalence of SWD was 26.1% and 32.1%, respectively, in mixed samples of different types of shift work schedules.…”

“…Waage S et al [6] found that the prevalence of SWD was 23.3% in shift workers following a slow rotating shift-work schedule that involved repeatedly working in the same factory during either the day or the night every 1 or 2 weeks. In Japan, the prevalence of SWD among nurses working in shift was 24.4% [7]. However, these nurses did not engage in continuous night work and could take a nap during night shifts.…”

Sleep Patterns, Sleep Instability, and Health Related Quality of Life in Parents of Ventilator-Assisted Children

“…52,53 Further, health outcomes have been shown to be negatively affected by night work and rotating shift work in nurses. 28,54 Thus, further research is needed with parental caregivers to examine the role of variable sleep schedules and nighttime caregiving on medical decision making, fulfillment of responsibilities, and parent health outcomes. 28,[55][56][57] Notable strengths of this study compared to previous research include the relatively large sample size, the inclusion of both mothers and fathers (n = 30 families), and the use of a control group.…”

“…[26][27][28] Notably, a study of caregivers of dementia patients found greater objective nightto-night instability in sleep duration and quality compared to non-car egivers. 29 Objective night-to-night sleep instability, however, has not been previously examined in pediatric parental caregivers.…”