Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society

Gurubhagavatula, Indira; Barnes, Christopher M.; Basner, Mathias; Boivin, Diane B.; Dawson, Drew; Drake, Christopher L.; Flynn‐Evans, Erin E.; Mysliwiec, Vincent; Patterson, P. Daniel; Reid, Kathryn J.; Samuels, Charles; Shattuck, Nita Lewis; Kazmi, Uzma; Carandang, Gerard; Heald, Jonathan L.; Dongen, Hans P A Van

doi:10.1093/sleep/zsab161

Cited by 33 publications

(39 citation statements)

References 219 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Neurobehavioral functioning is strongly influenced by the two processes of sleep/wake regulation: a homeostatic process (“Process S”), which degrades neurobehavioral functioning over time awake and restores it during sleep; and a circadian process (“Process C”), which cycles between promoting and depressing neurobehavioral functioning across time of day [ 1 , 2 ]. The combined effect of these two processes governs changes in waking neurobehavioral functioning over time, such that day shift-workers tend to exhibit stable, near-optimal performance through the workday [ 3 , 4 ], whereas night shift-workers typically experience a steady decline of performance through the night [ 5 , 6 ]. Inter-individual differences in the contributions of the two processes notwithstanding [ 7 , 8 ], these dynamics are well understood [ 9 , 10 ] and have led to the development of biomathematical models predicting neurobehavioral performance across a wide range of sleep/wake/work scenarios [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Working around the Clock: Is a Person’s Endogenous Circadian Timing for Optimal Neurobehavioral Functioning Inherently Task-Dependent?

et al. 2022

Self Cite

View full text Add to dashboard Cite

Neurobehavioral task performance is modulated by the circadian and homeostatic processes of sleep/wake regulation. Biomathematical modeling of the temporal dynamics of these processes and their interaction allows for prospective prediction of performance impairment in shift-workers and provides a basis for fatigue risk management in 24/7 operations. It has been reported, however, that the impact of the circadian rhythm—and in particular its timing—is inherently task-dependent, which would have profound implications for our understanding of the temporal dynamics of neurobehavioral functioning and the accuracy of biomathematical model predictions. We investigated this issue in a laboratory study designed to unambiguously dissociate the influences of the circadian and homeostatic processes on neurobehavioral performance, as measured during a constant routine protocol preceded by three days on either a simulated night shift or a simulated day shift schedule. Neurobehavioral functions were measured every 3 h using three functionally distinct assays: a digit symbol substitution test, a psychomotor vigilance test, and the Karolinska Sleepiness Scale. After dissociating the circadian and homeostatic influences and accounting for inter-individual variability, peak circadian performance occurred in the late biological afternoon (in the “wake maintenance zone”) for all three neurobehavioral assays. Our results are incongruent with the idea of inherent task-dependent differences in the endogenous circadian impact on performance. Rather, our results suggest that neurobehavioral functions are under top-down circadian control, consistent with the way they are accounted for in extant biomathematical models.

show abstract

Section: Introductionmentioning

confidence: 99%

Working around the Clock: Is a Person’s Endogenous Circadian Timing for Optimal Neurobehavioral Functioning Inherently Task-Dependent?

et al. 2022

Self Cite

View full text Add to dashboard Cite

show abstract

“…The reason for health and manufacturing industries may be due to irregular work schedules such as shift work. Unfortunately, we did not ask about shift work, however, it is well known from the literature that shift work is a risk factor for disturbing a normal sleeping pattern ( 25 ).…”

Section: Discussionmentioning

confidence: 99%

The Interplay Between Poor Sleep and Work-Related Health

Fietze

Rosenblum

Salanitro

et al. 2022

Front. Public Health

View full text Add to dashboard Cite

ObjectivesSleep disorders can arise from work. Employees who experience work overload are more likely to develop sleep problems. Poor sleep leads to decreased performance, sick leave, and accidents. Therefore, sleep disorders may be linked to workplace hazards as well as decreased occupational health, however, the relationship remains unknown.MethodsThis relationship was examined using secondary data analysis of aggregated survey data from 97 companies based in Germany between 2003 and 2020 as part of Workplace Health Management project. Two extreme groups with respect to sleep problems were analyzed (N = 4,865 + 9,795). The survey “Diagnosis of corporate health” contained 137 individual questions which recorded all relevant working conditions, aspects of health, and one question relating to insomnia traits. A one-way analysis of variance was used to examine whether and to what extent the potentials, hazards, and health aspects differed between employees depending on their perceived sleep problems. In addition, multiple linear regressions were used to determine whether and to what extent work characteristics affect various health aspects for both good and poor sleepers.ResultsIn total, 49.7% of staff reported moderate difficulty falling and/or remaining asleep. These poor sleepers perceived all health potentials worse than good sleepers, especially on scales such as fair assessment, work climate, and learning at work. Furthermore, poor sleepers perceived health hazards (physical environmental stress, job insecurity, and time pressure) more whilst positive health indicators (joy of work and confidence) were perceived less.ConclusionOverall, the determination of sleep difficulties could be used as a substantial health indicator. Also, these sleep problems are reported more frequently in certain occupations compared to others, which could mean that the perception of sleep health varies between professions. Therefore, it is important to implement specific recommendations for each industry in order to improve working conditions for poor sleepers which in turn, improves their health.

show abstract

“…However, modifying sleep schedules may be more difficult in the context of shiftwork, requiring a consistent later sleep schedule or leaving the non-day shift; in some countries, pregnant people are prohibited from working night shifts (8), which may be viewed as controversial and infringing on personal freedoms. Therefore, developing guidelines around shiftwork during pregnancy are complicated, and a number of factors, such as those recently outlined here (55), must be taken into account in addressing related health outcomes.…”

Section: Discussionmentioning

confidence: 99%

Associations between evening shift work, irregular sleep timing, and gestational diabetes in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b)

Wallace

Reid

Grobman

et al. 2022

Preprint

View full text Add to dashboard Cite

Study Objectives: Shift work is a risk factor for cardiometabolic disease, possibly through effects on sleep-wake rhythms. We hypothesized that shift work during pregnancy is associated with increased odds of preeclampsia, preterm birth, and gestational diabetes mellitus (GDM), and that the association is mediated by irregular sleep timing. Methods: The Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b) is a prospective cohort study (n=10,038) designed to investigate risk factors for adverse pregnancy outcomes. Medical outcomes were determined with medical record abstraction and/or questionnaires; sleep midpoint was measured in a subset of participants with ≥5-day wrist actigraphy (ActiWatch). We estimated the association of shift work during pregnancy with preeclampsia, preterm birth, and GDM using logistic regression, adjusted for adversity (a cumulative variable for poverty, education, health insurance, and partner status), smoking, self-reported race/ethnicity, and age. Finally, we performed an analysis to explore the extent to which to the association between shiftwork and GDM was mediated by variability in sleep timing. Results: Evening shift work during pregnancy is associated with approximately 75% increased odds of developing GDM (adjusted OR=1.75, 95% CI:1.12-2.66); there was no association with preterm birth and no association with preeclampsia after adjustment. Pregnant evening shift workers were found to have approximately 45 minutes greater variability in sleep timing compared to day workers (p<0.005); mediation analysis estimated that 27% of the association between shift work and GDM was explained by sleep-timing variability. Conclusions: Evening shift work was associated with GDM, and this relationship may be mediated by variability in sleep timing.

show abstract

Guiding principles for determining work shift duration and addressing the effects of work shift duration on performance, safety, and health: guidance from the American Academy of Sleep Medicine and the Sleep Research Society

Cited by 33 publications

References 219 publications

Working around the Clock: Is a Person’s Endogenous Circadian Timing for Optimal Neurobehavioral Functioning Inherently Task-Dependent?

Working around the Clock: Is a Person’s Endogenous Circadian Timing for Optimal Neurobehavioral Functioning Inherently Task-Dependent?

The Interplay Between Poor Sleep and Work-Related Health

Associations between evening shift work, irregular sleep timing, and gestational diabetes in the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-be (nuMoM2b)

Contact Info

Product

Resources

About