The role of sleep hygiene in the risk of Shift Work Disorder in nurses

Lauren A. Booker · Maree Barnes · Pasquale K. Alvaro · Allison Collins · Ching Li Chai‐Coetzer · Marcus McMahon +4 more

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Sleep and Work-Related Fatigue Sleep and related disorders Circadian rhythm and melatonin

Abstract

A high proportion (20%-30%) of shift workers experience Shift Work Disorder (SWD), characterized by chronic sleepiness and/or insomnia associated with work schedules. The reasons for individual variation in shift work tolerance are not well understood, however. The aim of this study was to identify individual factors that contribute to the risk of SWD. Nurses (n = 202) were categorized as low or high risk of SWD based on the Shift Work Disorder Questionnaire. Participants provided demographic and lifestyle information and completed the Sleep Hygiene Index (SHI) and Morningness-Eveningness Questionnaire (MEQ). High risk of SWD was associated with poorer sleep hygiene (SHI, 35.41 ± 6.19 vs. 31.49 ± 7.08, p < .0001) and greater eveningness (MEQ, 34.73 ± 6.13 vs. 37.49 ± 6.45, p = .005) compared to low risk. No other factors, including body mass index, marital status, having children, or caffeine or alcohol intake were significant. Logistic regression showed that SHI was the most significant contributing factor to SWD risk (odds ratio [OR] = 1.09, 95% confidence interval [CI] = 1.04 to 1.14). Standardized odds ratio further revealed that with every unit increase on the SHI score, the odds of being at high risk of SWD increased by 80% (OR = 1.84). Most individuals at high risk of SWD reported "always" or "frequently" going to bed at different times (79%) and waking at different times (83%; compared to 58%, p = .017, and 61%, p = .002, respectively for the low-risk group), as well as going to bed stressed/angry (67% vs. 41%, p < .0001) and/or planning/worrying in bed (54% vs. 22%, p < .0001). Interventions aimed at improving sleep hygiene practices and psychological health of shift workers may help reduce the risk of SWD.

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References

2001Validation of the Insomnia Severity Index as an outcome measure for insomnia research 2014The role of sleep hygiene in promoting public health: A review of empirical evidence 2004Shift Work Sleep Disorder: Prevalence and Consequences Beyond that of Symptomatic Day Workers 2006Assessment of Sleep Hygiene Using the Sleep Hygiene Index 2012Shift work and the assessment and management of shift work disorder (SWD)2010Shift work, sleep, and sleepiness - differences between shift schedules and systems 2012Shift Work Disorder in Nurses – Assessment, Prevalence and Related Health Problems 2014The effect of the work environment on future sleep disturbances: a systematic review

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