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      Insomnia, Excessive Sleepiness, Excessive Fatigue, Anxiety, Depression and Shift Work Disorder in Nurses Having Less than 11 Hours in-Between Shifts

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          Abstract

          Study objective

          To assess if less than 11 hours off work between work shifts (quick returns) was related to insomnia, sleepiness, fatigue, anxiety, depression and shift work disorder among nurses.

          Methods

          A questionnaire including established instruments measuring insomnia (Bergen Insomnia Scale), sleepiness (Epworth Sleepiness Scale), fatigue (Fatigue Questionnaire), anxiety/depression (Hospital Anxiety and Depression Scale) and shift work disorder was administered. Among the 1990 Norwegian nurses who participated in the study; 264 nurses had no quick returns, 724 had 1–30 quick returns and 892 had more than 30 quick returns during the past year. 110 nurses did not report the number of quick returns during the past year. The prevalence of insomnia, excessive sleepiness, excessive fatigue, anxiety, depression and shift work disorder was calculated within the three groups of nurses. Crude and adjusted logistic regression analyses were performed to assess the relation between quick returns and such complaints.

          Results

          We found a significant positive association between quick returns and insomnia, excessive sleepiness, excessive fatigue and shift work disorder. Anxiety and depression were not related to working quick returns.

          Conclusions

          There is a health hazard associated with quick returns. Further research should aim to investigate if workplace strategies aimed at reducing the number of quick returns may reduce complaints among workers.

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          Most cited references18

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          Health disorders of shift workers.

          Anders Knutsson (2003)
          The effects of shift work on physiological function through disruption of circadian rhythms are well described. However, shift work can also be associated with specific pathological disorders. This article reviews the evidence for a relationship between specific medical disorders and working at night or on shift systems. The strongest evidence exists for an association with peptic ulcer disease, coronary heart disease and compromised pregnancy outcome.
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            A new scale for measuring insomnia: the Bergen Insomnia Scale.

            Inger Nordhus, Mari Hjørnevik, Børge Sivertsen … (2008)
            A new scale for the measurement of insomnia, the Bergen Insomnia Scale, was constructed on the basis of current formal and clinical diagnostic criteria for insomnia. There are six items, of which the first three pertain to sleep onset, maintenance, and early morning wakening insomnia, respectively. The last three items refer to not feeling adequately rested, experiencing daytime impairment, and being dissatisfied with current sleep. This scale was validated in three samples, 320 students, 2645 community persons, and 225 patients. Cronbach alphas in the three samples were .79, .87, and .80, respectively. The 2-wk. test-retest reliability for students was .77. In the student and the patient samples, a two-factor solution was found, nocturnal symptoms and daytime symptoms, but in the community sample, a one-factor solution was found. The Bergen Insomnia Scale discriminated well between the patient sample and the other two. In all three, values of convergent and discriminative validity in relation to other self-report measures were good, as well as in relation to polysomnographic data for patients. It is concluded that the Bergen Insomnia Scale has good psychometric properties. It is one of very few insomnia scales which provide normative data for comparisons and which has been validated against subjective as well as polysomnographic data.
            Article 0 comments Cited 131 times – based on 0 reviews     Review now
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              Shift work, sleep, and sleepiness - differences between shift schedules and systems.

              Göran Kecklund, Mikael Sallinen (2010)
              In this narrative review, we examined what level of research evidence is available that shift workers' sleep-wake disturbances can be minimized through ergonomic shift scheduling. We classified the pertinent studies conducted on real shift workers in field conditions by the type of shift system and study design (ie, whether the shift systems were modified or not - "treatment" versus "no treatment"). The results of the observational studies in which no changes to the shift system were made (ie, no treatment) showed that, irrespective of the shift system, night and early-morning shifts and quick returns are associated with short sleep and increases in sleepiness. The same is true for very long shifts (>16 hours) and extremely long weekly working hours (>55 hours). For all categories of shift systems, there was a lack of controlled intervention studies, limiting the possibility to provide solution-focused recommendations for shift scheduling. Most of the controlled intervention studies had been conducted on workers under regular 3-shift systems. These studies suggested that a change from slowly backward-rotating shifts to rapidly forward-rotating shifts is advantageous for alertness and, to some degree, sleep. We also found that a change from an 8- to 12-hour shift system does not necessarily result in impairments in the sleep-wake pattern. The level of research evidence was affected by many of the studies' frequent methodological limitations in measuring sleep and sleepiness. In all, to have reliable and solution-focused recommendations for shift scheduling, methodologically sound controlled intervention studies are required in different categories of shift systems.
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                Author and article information

                Contributors
                Karen L. Gamble: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, USA )
                ISSN (Electronic): 1932-6203
                Publication date Collection: 2013
                Publication date (Electronic): 15 August 2013
                Volume: 8
                Issue: 8
                Electronic Location Identifier: e70882
                Affiliations
                [1 ]Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway
                [2 ]Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
                [3 ]Department of Psychosocial Science, University of Bergen, Bergen, Norway
                [4 ]Department of Occupational Medicine, Haukeland University Hospital, Bergen, Norway
                University of Alabama at Birmingham, United States of America
                Author notes

                Competing Interests: The authors have the following interest: Bjorvatn B has been paid for speaking engagements for different businesses (Glaxo, Nycomed, ResMed, Confex, Medi3). This does not alter the authors' adherence to all the PLOS ONE policies on sharing data and materials.

                Conceived and designed the experiments: MFE EF BEM SP BB. Performed the experiments: MFE EF BEM SP BB. Analyzed the data: MFE EF SP BB. Wrote the paper: MFE EF BEM SP BB.

                Article
                Publisher ID: PONE-D-13-06025
                DOI: 10.1371/journal.pone.0070882
                PMC ID: 3744484
                PubMed ID: 23976964
                SO-VID: 08d78dc1-26ba-4704-8335-c3074a52a2d3
                Copyright statement: Copyright @ 2013
                License:

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 8 February 2013
                Date accepted : 24 June 2013
                Page count
                Pages: 9
                Funding
                The project generating the data analyzed in the present study received a grant for practical administration and data collection from The Western Norway Regional Health Authority (no personal payment/salary). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Medicine
                Subject: Anatomy and Physiology
                Subject: Physiological Processes
                Subject: Sleep
                Subject: Clinical Research Design
                Subject: Survey Research
                Subject: Mental Health
                Subject: Psychiatry
                Subject: Anxiety Disorders
                Subject: Psychology
                Subject: Psychological Stress
                Subject: Psychometrics
                Subject: Neurology
                Subject: Sleep Disorders
                Subject: Non-Clinical Medicine
                Subject: Health Care Providers
                Subject: Nurses
                Subject: Health Services Research
                Subject: Public Health
                Subject: Environmental Health
                Subject: Occupational and Industrial Health
                Subject: Preventive Medicine
                Subject: Social and Behavioral Sciences
                Subject: Psychology
                Subject: Psychological Stress
                Subject: Psychometrics

                ScienceOpen disciplines: Uncategorized
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                ScienceOpen disciplines: Uncategorized

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