Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and impact prolactin levels during the subsequent day: a case control study

Abstract

BackgroundWe investigated circadian changes and effects on mood, sleep-related hormones and cognitive performance when nurses worked consecutive night shifts in a rapidly rotating shift system. Daytime cognitive function, sleep propensity and sleep-related hormones (growth hormone, cortisol, prolactin, thyrotropin) were compared after participants worked two and four consecutive night shifts.MethodsTwenty-three off-duty nurses, 20 nurses working two consecutive night shifts and 16 nurses working four consecutive night shifts were enrolled. All participants completed the Maintenance of Wakefulness Test, State-Trait Anxiety Inventory, Stanford Sleepiness Scale, visual attention tasks (VAT), Wisconsin Card Sorting Test, and modified Multiple Sleep Latency Test. Hormone levels were also measured four times throughout the day, at 2-h intervals.ResultsDuring the day, the participants in the night shift groups were less able to maintain wakefulness, had poor performance on VAT, and higher thyrotropin levels than did those in the off-duty group. Participants who worked two night shifts were better able to maintain wakefulness, had higher anxiety scale scores, poorer initial performance and lack of learning effect on VAT, and higher prolactin levels compared with those who worked four night shifts. There were no differences in cortisol levels between the two- and four- shift groups.ConclusionsRotating night shifts too quickly may cause anxiety and decreased attentional performance, and may impact daytime prolactin levels after night shifts. It is possible that the two-shift group had a higher cortisol level than did the four-shift group, which would be consistent with the group’s higher state anxiety scores. The negative findings may be due to the small sample size. Further studies on the effects of consecutive night shifts on mood and cortisol levels during the daytime after sleep restriction would be valuable.

Exploring the associations between shift work disorder, depression, anxiety and sick leave taken amongst nurses

“…A difference in shift schedules (permanent nights vs. rotating shift workers with fewer nights) might explain why more nights was associated with less anxiety. Rotating too quickly between shifts has been shown to increase anxiety (Chang et al., ) and nurses who changed from night work to day work reported a significant decrease in symptoms of both anxiety and depression (Bjorvatn, Torsheim, Moen, Magerøy, & Pallesen, ). In the current study, night shifts were undertaken in 2–4‐week blocks, possibly reducing the amount of rotation for that period and thus anxiety, but other factors may have contributed to this finding.…”

“…Sleep loss can affect resilience to stress, accelerating the development of cognitive consequences and the ability to utilize strategies to manage anxiety (Chang et al., ; Kalmbach et al., ). Furthermore, the more an individual is affected negatively by stress, the greater the impact on their sleep (Adriaenssens et al., ; Kalmbach et al., ).…”

Relationship between the night shift work and thyroid disorders: A systematic review and meta-analysis

“…Korompeli et al (2009) have compared the night shift workers for 9 years with the day shift workers for 17.5 years Burdelak et al (2012). andChang et al (2014) were not eligible for analysis. The two papers have assessed thyroid disorders through different variables, which are inconsistent with the other papers Burdelak et al (2012).…”

Stress and cortisol as predictors of fatigue in medical/surgical nurses and nurse leaders: A biobehavioral approach

“…[20] Another study found that nurses who worked 2 consecutive rotating 8-hour shifts had higher anxiety (stress) and poorer performance than did those who worked 4 consecutive 8-hour shifts; however, the sample size was small. [21] Chen et al [10] collected data on a very small number of nurses during 2 consecutive 12-hour shifts and reported heart rate elevations associated with increased acute fatigue with care activities such as manual patient handing versus care coordination activities. [10] In a study of nurses working 3 consecutive 12-hour days, nights, fixed, or rotating shifts, Han et al [22] reported that nurses working rotating shifts had higher levels of acute fatigue than did those on days, nights, or fixed shifts.…”