Association between long working hours and sleep problems in white-collar workers.

PubMed

Nakashima, Motoko; Morikawa, Yuko; Sakurai, Masaru; Nakamura, Koshi; Miura, Katsuyuki; Ishizaki, Masao; Kido, Teruhiko; Naruse, Yuchi; Suwazono, Yasushi; Nakagawa, Hideaki

2011-03-01

The purpose of this study is to examine the association between long work hours and sleep disturbance among white-collar workers. We evaluated 1510 male white-collar full-time employees, between the ages of 18 and 59 years, using a comprehensive sleep quality questionnaire, the Pittsburgh Sleep Quality Index (PSQI). All subjects worked in a light metal products factory in Japan. The mean number of monthly overtime work hours was determined using data from the previous 6 months from timecard records. Subjects were divided into five groups based on quintiles of the mean number of monthly overtime work hours: <26 h month(-1); ≥26 but <40; ≥40 but <50; ≥50 but <63; and >63. Leisure time physical activity, drinking habits just before sleep, presence of family/partner and health status were used as confounding factors in the multiple regression model. The prevalence of short sleep hours, impairment of sleep efficiency and daytime dysfunction among seven components of PSQI increased, in a dose-response relationship, with overtime work hours. The prevalence of high global score (>5.5 points) was highest in workers with overtime hours ≥50 h week(-1). The odds ratios after adjustment for confounding factors for high global score using less than 26 h as a reference group were 1.67 for workers with ≥50 h and <63 h, and 1.87 for workers with 63 h and more. To conclude, the present results suggest that long work hours correlate with reduced sleep quality in a dose-response manner. © 2010 European Sleep Research Society.

A systematic review of the sleep, sleepiness, and performance implications of limited wake shift work schedules.

PubMed

Short, Michelle A; Agostini, Alexandra; Lushington, Kurt; Dorrian, Jillian

2015-09-01

The aim of this review was to identify which limited wake shift work schedules (LWSW) best promote sleep, alertness, and performance. LWSW are fixed work/rest cycles where the time-at-work does is ≤8 hours and there is >1 rest period per day, on average, for ≥2 consecutive days. These schedules are commonly used in safety-critical industries such as transport and maritime industries. Literature was sourced using PubMed, Embase, PsycInfo, Scopus, and Google Scholar databases. We identified 20 independent studies (plus a further 2 overlapping studies), including 5 laboratory and 17 field-based studies focused on maritime watch keepers, ship bridge officers, and long-haul train drivers. The measurement of outcome measures was varied, incorporating subjective and objective measures of sleep: sleep diaries (N=5), actigraphy (N=4), and polysomnography, (N=3); sleepiness: Karolinska Sleepiness Scale (N=5), visual analog scale (VAS) alertness (N=2) and author-derived measures (N=2); and performance: Psychomotor Vigilance Test (PVT) (N=5), Reaction Time or Vigilance tasks (N=4), Vector and Letter Cancellation Test (N=1), and subjective performance (N=2). Of the three primary rosters examined (6 hours-on/6 hours-off, 8 hours-on/8 hours-off and 4 hours-on/8 hours-off), the 4 hours-on/8 hours-off roster was associated with better sleep and lower levels of sleepiness. Individuals working 4 hours-on/8 hours-off rosters averaged 1 hour more sleep per night than those working 6 hours-on/6 hours-off and 1.3 hours more sleep than those working 8 hours-on/8 hours-off (P<0.01). More broadly, findings indicate that LWSW schedules were associated with better sleep and lower sleepines in the case of (i) shorter time-at-work, (ii) more frequent rest breaks, (iii) shifts that start and end at the same clock time every 24 hours, and (iv) work shifts commencing in the daytime (as opposed to night). The findings for performance remain incomplete due to the small number of studies containing a performance measure and the heterogeneity of performance measures within those that did. The literature supports the utility of LWSW in industries where individuals sleep at or near the workplace as they facilitate at least some sleep during the biological night and minimize deficits associated with time-on-shift with shorter shifts. Overall, the 4 hour-on/8 hour-off roster best promoted sleep and minimized sleepiness compared to other LWSW schedules. Nevertheless, and considering the safety-critical nature of industries which employ LWSW, the limited literature needs to be greatly expanded with specific focus on the consequences for performance and comparison to mainstream rosters.

5 CFR 550.112 - Computation of overtime work.

Code of Federal Regulations, 2010 CFR

2010-01-01

... meal time. (1) Bona fide sleep and meal periods may not be considered hours of work, except as provided... a call to duty, the time spent on duty is hours of work. (2) Sleep and meal periods during regularly....C. 5545(c)(1), the amount of bona fide sleep and meal time excluded from hours of work may not...

5 CFR 550.112 - Computation of overtime work.

Code of Federal Regulations, 2011 CFR

2011-01-01

... meal time. (1) Bona fide sleep and meal periods may not be considered hours of work, except as provided... a call to duty, the time spent on duty is hours of work. (2) Sleep and meal periods during regularly....C. 5545(c)(1), the amount of bona fide sleep and meal time excluded from hours of work may not...

Sleep quality, but not quantity, is associated with self-perceived minor error rates among emergency department nurses.

PubMed

Weaver, Amy L; Stutzman, Sonja E; Supnet, Charlene; Olson, DaiWai M

2016-03-01

The emergency department (ED) is demanding and high risk. The impact of sleep quantity has been hypothesized to impact patient care. This study investigated the hypothesis that fatigue and impaired mentation, due to sleep disturbance and shortened overall sleeping hours, would lead to increased nursing errors. This is a prospective observational study of 30 ED nurses using self-administered survey and sleep architecture measured by wrist actigraphy as predictors of self-reported error rates. An actigraphy device was worn prior to working a 12-hour shift and nurses completed the Pittsburgh Sleep Quality Index (PSQI). Error rates were reported on a visual analog scale at the end of a 12-hour shift. The PSQI responses indicated that 73.3% of subjects had poor sleep quality. Lower sleep quality measured by actigraphy (hours asleep/hours in bed) was associated with higher self-perceived minor errors. Sleep quantity (total hours slept) was not associated with minor, moderate, nor severe errors. Our study found that ED nurses' sleep quality, immediately prior to a working 12-hour shift, is more predictive of error than sleep quantity. These results present evidence that a "good night's sleep" prior to working a nursing shift in the ED is beneficial for reducing minor errors. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sleep Duration Modifies the Association of Overtime Work With Risk of Developing Type 2 Diabetes: Japan Epidemiology Collaboration on Occupational Health Study.

PubMed

Kuwahara, Keisuke; Imai, Teppei; Miyamoto, Toshiaki; Kochi, Takeshi; Eguchi, Masafumi; Nishihara, Akiko; Nakagawa, Tohru; Yamamoto, Shuichiro; Honda, Toru; Kabe, Isamu; Mizoue, Tetsuya; Dohi, Seitaro

2018-02-03

Evidence linking working hours and the risk of type 2 diabetes mellitus (T2DM) is limited and inconsistent in Asian populations. No study has addressed the combined association of long working hours and sleep deprivation on T2DM risk. We investigated the association of baseline overtime work with T2DM risk and assessed whether sleep duration modified the effect among Japanese. Participants were Japanese employees (28,489 men and 4,561 women) aged 30-64 years who reported overtime hours and had no history of diabetes at baseline (mostly in 2008). They were followed up until March 2014. New-onset T2DM was identified using subsequent checkup data, including measurement of fasting/random plasma glucose, glycated hemoglobin, and self-report of medical treatment. Hazard ratios (HRs) of T2DM were estimated using Cox regression analysis. The combined association of sleep duration and working hours was examined in a subgroup of workers (n = 27,590). During a mean follow-up period of 4.5 years, 1,975 adults developed T2DM. Overtime work was not materially associated with T2DM risk. In subgroup analysis, however, long working hours combined with insufficient sleep were associated with a significantly higher risk of T2DM (HR 1.42; 95% CI, 1.11-1.83), whereas long working hours with sufficient sleep were not (HR 0.99; 95% CI, 0.88-1.11) compared with the reference (<45 hours of overtime with sufficient sleep). Sleep duration modified the association of overtime work with the risk of developing T2DM. Further investigations to elucidate the long-term effect of long working hours on glucose metabolism are warranted.

Sunlight Exposure, Work Hours, Caffeine Consumption, and Sleep Duration in the Naval Environment.

PubMed

Shattuck, Nita L; Matsangas, Panagiotis

2017-06-01

Sailors in the U.S. Navy are habitual shiftworkers, often experiencing circadian misalignment due to their irregular work/rest schedules. This study assessed the effect of sunlight exposure, work hours, and caffeinated beverage consumption on the daily sleep duration of crewmembers of a U.S. Navy ship during a 2-wk underway period. Working in an artificially lit area with no access to sunlight during work hours, U.S. Navy crew members (N = 91) used daily logs to report their daily activity, caffeinated beverage consumption, and exposure to sunlight while off-duty; sleep was assessed by wrist-worn actigraphy. Hours of sunlight exposure, work duration, and the amount of coffee/tea/soft drinks were statistically significant predictors of sleep duration. On average, crewmembers who reported more than one half-hour of sunlight each day slept on average ∼40 min (10%) less than their peers working the same shifts who received less than one half-hour of sunlight (on average 6.05 ± 0.90 h vs. 6.71 ± 0.91 h, respectively). Exposure to sunlight, work hours, and consumption of caffeinated beverages are important factors when planning watchstanding schedules at sea. Even though further research is needed, our results suggest that even brief exposure to sunlight may contribute to circadian misalignment that negatively affects sleep in the operational environment. Educating crewmembers about sleep hygiene, especially the important roles played by sunlight and caffeine, could potentially improve the sleep and fatigue levels of this population of maritime shiftworkers.Shattuck NL, Matsangas P. Sunlight exposure, work hours, caffeine consumption, and sleep duration in the naval environment. Aerosp Med Hum Perform. 2017; 88(6):579-585.

The impact of long work hours and shift work on cognitive errors in nurses.

PubMed

Rhéaume, Ann; Mullen, Jane

2018-01-01

Pilot study to examine the impact of long work hours and shift work on cognitive errors in nurses. Twelve-hour shifts are more commonly used in hospital settings and there is growing concern over the impact that extended and irregular work hours have on nurses' well-being and performance. Twenty-eight nurses working different shifts (8-hr days and 12-hr rotation) participated in this study. Nurses were assessed at the beginning of four consecutive shifts using actigraphy, a sleep diary and an after work questionnaire. Nurses working 12-hr rotations had less total sleep time and less sleep efficiency than 8-hr day nurses. Twelve-hour rotation nurses also napped more than their counterparts. There were no differences between the two groups with respect to cognitive errors. Twelve-hour rotations have a negative effect on nurses' sleep patterns. There is no evidence indicating 12-hr rotations increased errors. Nurse managers can implement specific strategies, such as greater shift work flexibility and designated quiet time, to reduce the effects of disturbed sleep patterns in nurses. © 2017 John Wiley & Sons Ltd.

Shift Schedules and Intern Work Hours, Patient Numbers, Conference Attendance, and Sleep at a Single Pediatric Residency Program.

PubMed

Kocolas, Irene; Day, Kristen; King, Marta; Stevenson, Adam; Sheng, Xiaoming; Hobson, Wendy; Bruse, Jaime; Bale, James

2017-03-01

The effects of 2011 Accreditation Council on Graduate Medical Education (ACGME) duty hour standards on intern work hours, patient load, conference attendance, and sleep have not been fully determined. We prospectively compared intern work hours, patient numbers, conference attendance, sleep duration, pattern, and quality in a 2011 ACGME duty hour-compliant shift schedule with a 2003 ACGME duty hour-compliant call schedule at a single pediatric residency program. Interns were assigned to shift or call schedules during 4 alternate months in the winter of 2010-2011. Work hours, patient numbers, conference attendance, sleep duration, pattern, and quality were tracked. Interns worked significantly fewer hours per week on day (73.2 hours) or night (71.6 hours) shifts than during q4 call (79.6 hours; P < .01). During high census months, shift schedule interns cared for significantly more patients/day (8.1/day shift vs 6.2/call; P < .001) and attended significantly fewer conferences than call schedule interns. Night shift interns slept more hours per 24-hour period than call schedule interns (7.2 ± 0.5 vs 6.3 ± 0.9 hours; P < .05) and had more consistent sleep patterns. A shift schedule resulted in reduced intern work hours and improved sleep duration and pattern. Although intern didactic conference attendance declined significantly during high census months, opportunities for experiential learning remained robust with unchanged or increased intern patient numbers. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

Sleep and Alertness in Medical Interns and Residents: An Observational Study on the Role of Extended Shifts.

PubMed

Basner, Mathias; Dinges, David F; Shea, Judy A; Small, Dylan S; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian J; Novak, Cristina; Bellini, Lisa M; Volpp, Kevin G

2017-04-01

Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Sleep-wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy. Alertness was assessed daily with a brief Psychomotor Vigilance Test (PVT) and the Karolinska Sleepiness Scale. Interns averaged 6.93 hours (95% confidence interval [CI] 6.84-7.03 hours) sleep per 24 hours across shifts, significantly less than residents not working overnight shifts (7.18 hours, 95% CI 7.06-7.30 hours, p = .007). Interns obtained on average 2.19 hours (95% CI 2.02-2.36 hours) sleep during on-call nights (17.5% obtained no sleep). Alertness was significantly lower on mornings after on-call nights compared to regular shifts (p < .001). Naps between 9 am and 6 pm on the first day post-call were frequent (90.8%) and averaged 2.84 hours (95% CI 2.69-3.00 hours), but interns still slept 1.66 hours less per 24 hours (95% CI 1.56-1.76 hours) compared to regular shift days (p < .001). Sleep inertia significantly affected alertness in the 60 minutes after waking on-call. Extended overnight shifts increase the likelihood of chronic sleep restriction in interns. Reduced levels of alertness after on-call nights need to be mitigated. A systematic comparison of sleep, alertness, and safety outcomes under current and past duty hour rules is encouraged. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Shift work and sleep disorder among textile mill workers in Bahir Dar, northwest Ethiopia.

PubMed

Abebe, Y; Fantahun, M

1999-07-01

To assess the length and quality of sleep among shift workers at Bahir Dar textile mill. A cross sectional study using structured questionnaire that contained sociodemographic variables, duration of work, work schedule, number of sleeping hours, sleep disorders, and associated reasons for such disorders. A textile mill in Bahir Dar, northwest Ethiopia. Three-hundred ninety four random sample of production workers of the mill. Sleep disorders, and the impact of external and home environment on sleep. The mean duration of work in the factory was 25.4 +/- 7.1 years. Ninety-seven per cent of the study population work in a rotating eight hourly shift system. The mean number of hours a worker sleeps after a worked shift was 5.1 +/- 2.3. Two hundred thirty (58.4%) claimed to experience a sleep disorder. Sleep disturbance was significantly associated with rotating shift work, external environmental noise, and working in the spinning department. The majority of the workers in Bahir Dar textile mill experienced sleep disturbances as detailed in the study methodology.

The association between working hours and sleep disturbances according to occupation and gender.

PubMed

Kim, Bo Hwan; Lee, Hye-Eun

2015-01-01

We attempted to explore the relationship between working hours and sleep disturbance according to occupation and gender among Korean workers. Data were derived from the third Korean Working Conditions Survey, conducted in 2011 by the Korea Occupational Safety and Health Agency. From a total of 50,032 workers, 34,783 salaried contract workers were selected. Work hours were categorized as <40, 40-48 (reference), 49-60, and >60 h/week. The outcome variable was sleep disturbance, which was assessed by a single question item (During the past 12 months, have you experienced sleep disturbance or insomnia?). Multiple survey logistic regression models were performed after adjusting with age, education level, marital status, self-rated health, salary, shift work, smoking and alcohol drinking. Gender and occupation were stratified in these models. The adjusted odds ratio (OR) for sleep disturbance in male non-manual workers with long work hours (>60 h/week) was 3.017 [95% confidence interval (CI) 1.956-4.653]. In female non-manual workers who work 49-60 working hour per week, the OR was 1.525 (95% CI 1.034-2.249). Long working hours can be a risk factor for sleep disturbance in Korean workers. The association was especially prominent in male non-manual workers.

Sleep disturbances among offshore fleet workers: a questionnaire-based survey.

PubMed

Hansen, Jakob Hønborg; Holmen, Ingunn Marie

2011-01-01

BACKGROUND. Shift work is related to fatigue and desynchronization with the external environment. This study investigates how 6-h shifts and 12-h shifts affects sleep and safety in workers onboard offshore supply vessels, and if any differences exist between the two working schedules. MATERIAL AND METHODS. A questionnaire study was carried out in the North Sea, Australia, Africa, South America, and the Far East, with 577 participants. The offshore fleet workers gave information on parameters related to sleep disturbances, causes of sleep disturbances, and safety. Regional differences in these parameters were also investigated. RESULTS. Workers on 6-hour shifts reported significantly more sleep problems than 12-hour shift workers did (p 〈 0.01). The 6-hour workers were more affected by noise (p 〈 0.01) and shift-work itself (p 〈 0.01). CONCLUSIONS. Those working 6-hour shifts suffer more from sleep disturbances than those on 12-hour shifts, but this is not reflected in the perception of safety within the individual. Noise and shift-work itself is more of a problem in the 12-hour workers. Differences in safety culture and work morale are likely to cause the differences between regions.

Relationship between sleeping on the night shift and recovery from work among nursing workers - the influence of domestic work.

PubMed

Silva-Costa, Aline; Rotenberg, Lúcia; Griep, Rosane Harter; Fischer, Frida Marina

2011-05-01

This paper is a report of a study on the association between sleep patterns during work nights and recovery from work among nursing workers, considering domestic work hours. Several hospitals allow nursing workers to sleep during the night shift, but this is rarely evaluated from the workers' health perspective. The need for recovery from work concept can be useful for testing the impact of night work on sleep. Recovery is not a problem if workers have enough time to recover between periods of work. Therefore, domestic work would be likely to interfere in the recovery process. This cross-sectional study was carried out at three hospitals in 2005-2006, through a comprehensive questionnaire. All nursing teams engaged in assistance to patients were invited to participate. Analyses included female night workers with no incidence of insomnia. Participants (n = 396) were classified into those who did not sleep during night shifts, those who slept for up to 2 hours and those who slept for 2-3 hours. Binomial logistic regression analysis showed that sleeping on the job for 2-3 hours during night shifts is related to a better recovery from work provided the workers do not undergo long domestic work hours. Being allowed to sleep at work during night shifts seemed to contribute to, but was not enough to guarantee, a good recovery from work in the studied population. Recommendations to deal with sleep-deprivation among night workers should consider the complexity of gender roles on the recovery process. © 2011 Blackwell Publishing Ltd.

Sleep patterns of offshore day-workers in relation to overtime work and age.

PubMed

Parkes, Katharine R

2015-05-01

In addition to long contractual hours during offshore weeks (14 × 12 h shifts), many personnel on North Sea oil/gas installations also work overtime, but little is known about the implications of overtime for sleep patterns offshore. In this study, the additive and interactive effects of overtime and age were analysed as predictors of sleep duration and sleep quality among offshore day-workers (N = 551), 54% of whom reported overtime. Sleep duration and quality were impaired among personnel who worked overtime, relative to those who worked only standard shifts; there was also an inverse dose-response relationship between overtime hours and sleep duration. Although the sleep measures were more favourable during shore leave than during offshore weeks, there was little evidence of compensatory sleep patterns. These findings are discussed with reference to known performance and health effects of short sleep hours; formal guidance on overtime work offshore is noted; and methodological issues are considered. Copyright © 2014 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Negative impacts of shiftwork and long work hours.

PubMed

Caruso, Claire C

2014-01-01

Healthcare organizations often have to provide patient care around the clock. Shift work (any shift outside of 7 a.m. to 6 p.m) and long work hours increase the risk for short sleep duration and sleep disturbances. Thirty-two percent of healthcare workers report they do not get enough sleep. The purpose of the article is to give an overview of the wide range of risks to nurses, patients, and employers that are linked to shift work, long work hours, and poor sleep from other sources. Shift work and long work hours increase the risk for reduced performance on the job, obesity, injuries, and a wide range of chronic diseases. In addition, fatigue-related errors could harm patients. Fatigued nurses also endanger others during their commute to and from work. The key strategy to reduce these risks is making sleep a priority in the employer's systems for organizing work and in the nurse's personal life. © 2013 Association of Rehabilitation Nurses.

Surveying the Impact of Work Hours and Schedules on Commercial Motor Vehicle Driver Sleep.

PubMed

Hege, Adam; Perko, Michael; Johnson, Amber; Yu, Chong Ho; Sönmez, Sevil; Apostolopoulos, Yorghos

2015-06-01

Given the long hours on the road involving multiple and interacting work stressors (i.e., delivery pressures, irregular shifts, ergonomic hazards), commercial drivers face a plethora of health and safety risks. Researchers goal was to determine whether and to what extent long-haul trucker work schedules influence sleep duration and quality. Survey and biometric data collected from male long-haul truck drivers at a major truckstop in central North Carolina over a six month period. Daily hours worked (mean = 11 hours, 55 minutes) and frequency of working over government-mandated daily HOS regulations (23.8% "frequently or always") were statistically significant predictors of sleep duration. Miles driven per week (mean = 2,812.61), irregular daily hours worked (63.8%), and frequency of working over the daily hour limit (23.8% "frequently or always") were statistically significant predictors of sleep quality. Implications of findings suggest a comprehensive review of the regulations and operational conditions for commercial motor vehicle drivers be undertaken.

Working hours, sleep duration and the risk of acute coronary heart disease: a case-control study of middle-aged men in Taiwan.

PubMed

Cheng, Yawen; Du, Chung-Li; Hwang, Juey-Jen; Chen, I-Shin; Chen, Ming-Fong; Su, Ta-Chen

2014-02-15

This study aimed to examine whether long working hours and short sleep duration were associated with an increased risk of acute myocardial infarction (AMI) or severe coronary heart diseases (SCHD), independent of established psychosocial work-related factors. A case-control study was conducted. Cases were 322 men, aged <60 years and economically active, who were admitted to hospital with a first diagnosed AMI or SCHD during 2008-2011, of whom 134 were confirmed AMI and the other 188 were angiography-confirmed SCHD. Controls were 644 men who were drawn from a national survey and were matched to the cases on age, education and area of residence. Odds ratios of total CHD and confirmed AMI in relation to average weekly working hours and daily hours of sleep were calculated. Men with average working hours longer than 60 h/week were found to have significantly increased risks for total CHD (OR=2.2) as compared to those with weekly working hours in 40-48 h, and those with daily hours of sleep fewer than 6 h were found to have increased risks for CHD (OR=3.0) as compared to those with sleeping hours in 6-9 h. Restriction to confirmed AMI yielded a greater risk and these associations remained consistent with adjustment of smoking status, body mass index and psychosocial work factors including job demands, job control, workplace justice, job insecurity and shift work. The results support the hypothesis that long working hours and short sleep duration contribute independently to the risk of cardiovascular diseases in men. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Working multiple jobs over a day or a week: Short-term effects on sleep duration

PubMed Central

Marucci-Wellman, Helen R.; Lombardi, David A.; Willetts, Joanna L.

2016-01-01

ABSTRACT Approximately 10% of the employed population in the United States works in multiple jobs. They are more likely to work long hours and in nonstandard work schedules, factors known to impact sleep duration and quality, and increase the risk of injury. In this study we used multivariate regression models to compare the duration of sleep in a 24-hour period between workers working in multiple jobs (MJHs) with single job holders (SJHs) controlling for other work schedule and demographic factors. We used data from the Bureau of Labor Statistics US American Time Use Survey (ATUS) pooled over a 9-year period (2003–2011). We found that MJHs had significantly reduced sleep duration compared with SJHs due to a number of independent factors, such as working longer hours and more often late at night. Male MJHs, working in their primary job or more than one job on the diary day, also had significantly shorter sleep durations (up to 40 minutes less on a weekend day) than male SJHs, even after controlling for all other factors. Therefore, duration of work hours, time of day working and duration of travel for work may not be the only factors to consider when understanding if male MJHs are able to fit in enough recuperative rest from their busy schedule. Work at night had the greatest impact on sleep duration for females, reducing sleep time by almost an hour compared with females who did not work at night. We also hypothesize that the high frequency or fragmentation of non-leisure activities (e.g. work and travel for work) throughout the day and between jobs may have an additional impact on the duration and quality of sleep for MJHs. PMID:27092404

Working multiple jobs over a day or a week: Short-term effects on sleep duration.

PubMed

Marucci-Wellman, Helen R; Lombardi, David A; Willetts, Joanna L

Approximately 10% of the employed population in the United States works in multiple jobs. They are more likely to work long hours and in nonstandard work schedules, factors known to impact sleep duration and quality, and increase the risk of injury. In this study we used multivariate regression models to compare the duration of sleep in a 24-hour period between workers working in multiple jobs (MJHs) with single job holders (SJHs) controlling for other work schedule and demographic factors. We used data from the Bureau of Labor Statistics US American Time Use Survey (ATUS) pooled over a 9-year period (2003-2011). We found that MJHs had significantly reduced sleep duration compared with SJHs due to a number of independent factors, such as working longer hours and more often late at night. Male MJHs, working in their primary job or more than one job on the diary day, also had significantly shorter sleep durations (up to 40 minutes less on a weekend day) than male SJHs, even after controlling for all other factors. Therefore, duration of work hours, time of day working and duration of travel for work may not be the only factors to consider when understanding if male MJHs are able to fit in enough recuperative rest from their busy schedule. Work at night had the greatest impact on sleep duration for females, reducing sleep time by almost an hour compared with females who did not work at night. We also hypothesize that the high frequency or fragmentation of non-leisure activities (e.g. work and travel for work) throughout the day and between jobs may have an additional impact on the duration and quality of sleep for MJHs.

Sleep, sleepiness and health complaints in police officers: the effects of a flexible shift system.

PubMed

Eriksen, Claire Anne; Kecklund, Göran

2007-04-01

The aim of the study was to study the effects of a flexible shift system (based on self-determined work hours) with respect to sleep/wake complaints and subjective health. The comparison group was a rapidly rotating shift system, with frequently occurring quick returns. A secondary aim was to examine the relation between work hour characteristics indicating compressed or difficult rosters (e.g. number of workdays in a row, frequency of quick returns and long work shifts) and subjective sleep and sleepiness, within the flexible shift system group. The sample of the analysis included 533 randomly selected police officers, of which 26% were females. The participants answered a questionnaire. The results showed that the flexible shift system group did not differ with respect to sleep/wake complaints and subjective health. However, the flexible shift group obtained more sleep in connection with the shifts, probably because of longer rest time between shifts. Thus, they worked less quick returns and long work shifts. The association between work hour characteristics and sleep/wake complaints was weak in the flexible shift group. Instead, sleep/wake problems were mainly associated with the attitude to work hours.

Sleep and Alertness in Medical Interns and Residents: An Observational Study on the Role of Extended Shifts

PubMed Central

Dinges, David F.; Shea, Judy A.; Small, Dylan S.; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian J.; Novak, Cristina; Bellini, Lisa M.; Volpp, Kevin G.

2017-01-01

Abstract Study Objectives: Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Methods: Sleep–wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy. Alertness was assessed daily with a brief Psychomotor Vigilance Test (PVT) and the Karolinska Sleepiness Scale. Results: Interns averaged 6.93 hours (95% confidence interval [CI] 6.84–7.03 hours) sleep per 24 hours across shifts, significantly less than residents not working overnight shifts (7.18 hours, 95% CI 7.06–7.30 hours, p = .007). Interns obtained on average 2.19 hours (95% CI 2.02–2.36 hours) sleep during on-call nights (17.5% obtained no sleep). Alertness was significantly lower on mornings after on-call nights compared to regular shifts (p < .001). Naps between 9 am and 6 pm on the first day post‐call were frequent (90.8%) and averaged 2.84 hours (95% CI 2.69–3.00 hours), but interns still slept 1.66 hours less per 24 hours (95% CI 1.56–1.76 hours) compared to regular shift days (p < .001). Sleep inertia significantly affected alertness in the 60 minutes after waking on-call. Conclusions: Extended overnight shifts increase the likelihood of chronic sleep restriction in interns. Reduced levels of alertness after on-call nights need to be mitigated. A systematic comparison of sleep, alertness, and safety outcomes under current and past duty hour rules is encouraged. PMID:28329124

Working hours associated with unintentional sleep at work among airline pilots

PubMed Central

Marqueze, Elaine Cristina; Nicola, Ana Carolina B; Diniz, Dag Hammarskjoeld M D; Fischer, Frida Marina

2017-01-01

ABSTRACT OBJECTIVE Tto identify factors associated with unintentional sleep at work of airline pilots. METHODS This is a cross-sectional epidemiological study conducted with 1,235 Brazilian airline pilots, who work national or international flights. Data collection has been performed online. We carried out a bivariate and multiple logistic regression analysis, having as dependent variable unintentional sleep at work. The independent variables were related to biodemographic data, characteristics of the work, lifestyle, and aspects of sleep. RESULTS The prevalence of unintentional sleep while flying the airplane was 57.8%. The factors associated with unintentional sleep at work were: flying for more than 65 hours a month, frequent technical delays, greater need for recovery after work, work ability below optimal, insufficient sleep, and excessive sleepiness. CONCLUSIONS The occurrence of unintentional sleep at work of airline pilots is associated with factors related to the organization of the work and health. PMID:28678902

Napping on the Night Shift: A Study of Sleep, Performance, and Learning in Physicians-in-Training.

PubMed

McDonald, Jennifer; Potyk, Darryl; Fischer, David; Parmenter, Brett; Lillis, Teresa; Tompkins, Lindsey; Bowen, Angela; Grant, Devon; Lamp, Amanda; Belenky, Gregory

2013-12-01

Physicians in training experience fatigue from sleep loss, high workload, and working at an adverse phase of the circadian rhythm, which collectively degrades task performance and the ability to learn and remember. To minimize fatigue and sustain performance, learning, and memory, humans generally need 7 to 8 hours of sleep in every 24-hour period. In a naturalistic, within-subjects design, we studied 17 first- and second-year internal medicine residents working in a tertiary care medical center, rotating between day shift and night float every 4 weeks. We studied each resident for 2 weeks while he/she worked the day shift and for 2 weeks while he/she worked the night float, objectively measuring sleep by wrist actigraphy, vigilance by the Psychomotor Vigilance Task test, and visual-spatial and verbal learning and memory by the Brief Visuospatial Memory Test-Revised and the Rey Auditory-Verbal Learning Test. Residents, whether working day shift or night float, slept approximately 7 hours in every 24-hour period. Residents, when working day shift, consolidated their sleep into 1 main sleep period at night. Residents working night float split their sleep, supplementing their truncated daytime sleep with nighttime on-duty naps. There was no difference in vigilance or learning and memory, whether residents worked day shift or night float. Off-duty sleep supplemented with naps while on duty appears to be an effective strategy for sustaining vigilance, learning, and memory when working night float.

Effect of reducing interns' weekly work hours on sleep and attentional failures.

PubMed

Lockley, Steven W; Cronin, John W; Evans, Erin E; Cade, Brian E; Lee, Clark J; Landrigan, Christopher P; Rothschild, Jeffrey M; Katz, Joel T; Lilly, Craig M; Stone, Peter H; Aeschbach, Daniel; Czeisler, Charles A

2004-10-28

Knowledge of the physiological effects of extended (24 hours or more) work shifts in postgraduate medical training is limited. We aimed to quantify work hours, sleep, and attentional failures among first-year residents (postgraduate year 1) during a traditional rotation schedule that included extended work shifts and during an intervention schedule that limited scheduled work hours to 16 or fewer consecutive hours. Twenty interns were studied during two three-week rotations in intensive care units, each during both the traditional and the intervention schedule. Subjects completed daily sleep logs that were validated with regular weekly episodes (72 to 96 hours) of continuous polysomnography (r=0.94) and work logs that were validated by means of direct observation by study staff (r=0.98). Seventeen of 20 interns worked more than 80 hours per week during the traditional schedule (mean, 84.9; range, 74.2 to 92.1). All interns worked less than 80 hours per week during the intervention schedule (mean, 65.4; range, 57.6 to 76.3). On average, interns worked 19.5 hours per week less (P<0.001), slept 5.8 hours per week more (P<0.001), slept more in the 24 hours preceding each working hour (P<0.001), and had less than half the rate of attentional failures while working during on-call nights (P=0.02) on the intervention schedule as compared with the traditional schedule. Eliminating interns' extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours. Copyright 2004 Massachusetts Medical Society.

29 CFR 553.222 - Sleep time.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 29 Labor 3 2011-07-01 2011-07-01 false Sleep time. 553.222 Section 553.222 Labor Regulations... Enforcement Employees of Public Agencies Tour of Duty and Compensable Hours of Work Rules § 553.222 Sleep time... may exclude sleep time from hours worked if all the conditions in § 785.22 of this title are met. (b...

29 CFR 553.222 - Sleep time.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 29 Labor 3 2013-07-01 2013-07-01 false Sleep time. 553.222 Section 553.222 Labor Regulations... Enforcement Employees of Public Agencies Tour of Duty and Compensable Hours of Work Rules § 553.222 Sleep time... may exclude sleep time from hours worked if all the conditions in § 785.22 of this title are met. (b...

29 CFR 553.222 - Sleep time.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 29 Labor 3 2012-07-01 2012-07-01 false Sleep time. 553.222 Section 553.222 Labor Regulations... Enforcement Employees of Public Agencies Tour of Duty and Compensable Hours of Work Rules § 553.222 Sleep time... may exclude sleep time from hours worked if all the conditions in § 785.22 of this title are met. (b...

29 CFR 553.222 - Sleep time.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 29 Labor 3 2014-07-01 2014-07-01 false Sleep time. 553.222 Section 553.222 Labor Regulations... Enforcement Employees of Public Agencies Tour of Duty and Compensable Hours of Work Rules § 553.222 Sleep time... may exclude sleep time from hours worked if all the conditions in § 785.22 of this title are met. (b...

Surveying the Impact of Work Hours and Schedules on Commercial Motor Vehicle Driver Sleep

PubMed Central

Hege, Adam; Perko, Michael; Johnson, Amber; Yu, Chong Ho; Sönmez, Sevil; Apostolopoulos, Yorghos

2015-01-01

Background Given the long hours on the road involving multiple and interacting work stressors (i.e., delivery pressures, irregular shifts, ergonomic hazards), commercial drivers face a plethora of health and safety risks. Researchers goal was to determine whether and to what extent long-haul trucker work schedules influence sleep duration and quality. Methods Survey and biometric data collected from male long-haul truck drivers at a major truckstop in central North Carolina over a six month period. Results Daily hours worked (mean = 11 hours, 55 minutes) and frequency of working over government-mandated daily HOS regulations (23.8% “frequently or always”) were statistically significant predictors of sleep duration. Miles driven per week (mean = 2,812.61), irregular daily hours worked (63.8%), and frequency of working over the daily hour limit (23.8% “frequently or always”) were statistically significant predictors of sleep quality. Conclusion Implications of findings suggest a comprehensive review of the regulations and operational conditions for commercial motor vehicle drivers be undertaken. PMID:26106509

29 CFR 785.21 - Less than 24-hour duty.

Code of Federal Regulations, 2014 CFR

2014-07-01

... be on duty for less than 24 hours is working even though he is permitted to sleep or engage in other... specified hours is working even though she is permitted to sleep when not busy answering calls. It makes no...

29 CFR 785.21 - Less than 24-hour duty.

Code of Federal Regulations, 2012 CFR

2012-07-01

... be on duty for less than 24 hours is working even though he is permitted to sleep or engage in other... specified hours is working even though she is permitted to sleep when not busy answering calls. It makes no...

29 CFR 785.21 - Less than 24-hour duty.

Code of Federal Regulations, 2011 CFR

2011-07-01

... be on duty for less than 24 hours is working even though he is permitted to sleep or engage in other... specified hours is working even though she is permitted to sleep when not busy answering calls. It makes no...

29 CFR 785.21 - Less than 24-hour duty.

Code of Federal Regulations, 2010 CFR

2010-07-01

... be on duty for less than 24 hours is working even though he is permitted to sleep or engage in other... specified hours is working even though she is permitted to sleep when not busy answering calls. It makes no...

29 CFR 785.21 - Less than 24-hour duty.

Code of Federal Regulations, 2013 CFR

2013-07-01

... be on duty for less than 24 hours is working even though he is permitted to sleep or engage in other... specified hours is working even though she is permitted to sleep when not busy answering calls. It makes no...

Amount and quality of sleep: exploring the role of stress and work experience in a sample of obstetrician-gynecologists.

PubMed

Taouk, Laura; Farrow, Victoria A; Schulkin, Jay

2017-05-02

Sufficient sleep is necessary for optimal performance and the delivery of safe and effective health care. To establish an empirical understanding of physician fatigue, the present study investigated the factors that contributed to the amount and the quality of sleep among obstetricians and gynecologists (ob-gyns). A survey of personal and work experiences was sent to 495 eligible physicians belonging to the American College of Obstetricians and Gynecologists (ACOG). Data were obtained from 287 ob-gyns for a response rate of 58.0%. Associations between sleep-related items and measures of stress and work-related factors were explored. Ob-gyns in our sample reported sleeping an average of 6.5 hours a night with 29.2% indicating that they received very or fairly bad quality of sleep. Average amount and quality of sleep were found to be independently related to the hours worked weekly, colleague support for a work-home balance, practice setting, perceived work-control, physician-specific stressors and perceived stress. In summary models, hours worked and perceived stress scores consistently emerged as predictors of amount of sleep. Overall, findings explained a small portion of the variance in sleep. Considering the multitude of factors that contribute to sleep, subtle associations warrant further investigation.

Changes in Sleep Duration During Transition to Statutory Retirement: A Longitudinal Cohort Study.

PubMed

Myllyntausta, Saana; Salo, Paula; Kronholm, Erkki; Aalto, Ville; Kivimäki, Mika; Vahtera, Jussi; Stenholm, Sari

2017-07-01

This study examined whether sleep duration changes during the transition from full-time work to statutory retirement and, if this were the case, which preretirement factors, including sociodemographic, work, lifestyle, and health factors, predict these changes. Data from repeated surveys of the Finnish Public Sector study, linked to records of retirement, were used. The study population consisted of 5785 participants who retired on a statutory basis in 2000-2011 and who had responded to surveys on sleep duration at least once immediately before and after their retirement (mean number of repeat study waves 3.6). Linear regression analyses with generalized estimating equations were used to examine changes in sleep duration around retirement. Before retirement there was a slight decrease in sleep duration. During the 4-year retirement transition, sleep duration increased from 7 hours 0 minutes (95% confidence interval [CI] 6 hours 54 minutes to 7 hours 6 minutes) to 7 hours and 22 minutes (95% CI 7 hours 16 minutes to 7 hours 27 minutes); thus, mean increase being 22 minutes. Increase in sleep duration was greatest in those who were short sleepers, heavy drinkers, or had sleep difficulties. After the retirement transition, sleep duration remained at approximately the same level, as no significant changes were observed. This longitudinal study suggests that transition from full-time work to statutory retirement is associated with an increase in sleep duration. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Napping on the Night Shift: A Study of Sleep, Performance, and Learning in Physicians-in-Training

PubMed Central

McDonald, Jennifer; Potyk, Darryl; Fischer, David; Parmenter, Brett; Lillis, Teresa; Tompkins, Lindsey; Bowen, Angela; Grant, Devon; Lamp, Amanda; Belenky, Gregory

2013-01-01

Background Physicians in training experience fatigue from sleep loss, high workload, and working at an adverse phase of the circadian rhythm, which collectively degrades task performance and the ability to learn and remember. To minimize fatigue and sustain performance, learning, and memory, humans generally need 7 to 8 hours of sleep in every 24-hour period. Methods In a naturalistic, within-subjects design, we studied 17 first- and second-year internal medicine residents working in a tertiary care medical center, rotating between day shift and night float every 4 weeks. We studied each resident for 2 weeks while he/she worked the day shift and for 2 weeks while he/she worked the night float, objectively measuring sleep by wrist actigraphy, vigilance by the Psychomotor Vigilance Task test, and visual-spatial and verbal learning and memory by the Brief Visuospatial Memory Test-Revised and the Rey Auditory-Verbal Learning Test. Results Residents, whether working day shift or night float, slept approximately 7 hours in every 24-hour period. Residents, when working day shift, consolidated their sleep into 1 main sleep period at night. Residents working night float split their sleep, supplementing their truncated daytime sleep with nighttime on-duty naps. There was no difference in vigilance or learning and memory, whether residents worked day shift or night float. Conclusions Off-duty sleep supplemented with naps while on duty appears to be an effective strategy for sustaining vigilance, learning, and memory when working night float. PMID:24455014

Sleep-related factors and work-related injuries among farmers in Heilongjiang Province, People's Republic of China.

PubMed

Zhu, Huiping; Han, Yunfeng; Sun, Yaowu; Xie, Zhiping; Qian, Xueyan; Stallones, Lorann; Xiang, Huiyun; Wang, Limin

2014-09-11

The association between sleep and work-related injuries among Chinese farmers has not been well studied. This study examined the impact of lack of sleep on agricultural work-related injuries among farmers in China. Data were from a cross-sectional survey of farm-workers in northeastern China. Information was obtained on injuries that occurred in 12 months prior to the survey, on eight sleep-related variables, and on socio-demographic variables. Logistic regression analyses were conducted to test the hypothesis that lack of sleep significantly increased the risk of work-related injuries after controlling for other injury-related risk- factors. Farmers who slept less than six hours per night were 59% more likely to be injured than those who slept more than eight hours per night (OR = 1.59; 95% CI = 1.04, 2.41). The odds of a work-related injury was 2.46 (1.56-3.89) for farmers who reported going to sleep after midnight at least once a week compared with farmers who reported going to sleep after midnight once a month. Farmers who reported having difficulty falling asleep or waking frequently during the night, who often having nightmares, or who experienced daytime sleepiness were at higher injury risk compared with the reference group after controlling for age, gender and alcohol consumption. Reduced sleep hours and poor sleep quality significantly increased the risk of work-related injuries in Chinese farmers. Sleep hours and sleep quality should be considered when assessing occupational safety among farmers.

Daily antecedents and consequences of nightly sleep.

PubMed

Lee, Soomi; Crain, Tori L; McHale, Susan M; Almeida, David M; Buxton, Orfeu M

2017-08-01

Sleep can serve as both cause and consequence of individuals' everyday experiences. We built upon prior studies of the correlates of sleep, which have relied primarily on cross-sectional data, to examine the antecedents and consequences of sleep using a daily diary design. Specifically, we assessed the temporal sequence between nightly sleep and daily psychosocial stressors. Parents employed in a US information technology company (n = 102) completed eight consecutive daily diaries at both baseline and 1 year later. In telephone interviews each evening, participants reported on the previous night's sleep hours, sleep quality and sleep latency. They also reported daily work-to-family conflict and time inadequacy (i.e. perceptions of not having enough time) for their child and for themselves to engage in exercise. Multi-level models testing lagged and non-lagged effects simultaneously revealed that sleep hours and sleep quality were associated with next-day consequences of work-to-family conflict and time inadequacy, whereas psychosocial stressors as antecedents did not predict sleep hours or quality that night. For sleep latency, the opposite temporal order emerged: on days with more work-to-family conflict or time inadequacy for child and self than usual, participants reported longer sleep latencies than usual. An exception to this otherwise consistent pattern was that time inadequacy for child also preceded shorter sleep hours and poorer sleep quality that night. The results highlight the utility of a daily diary design for capturing the temporal sequences linking sleep and psychosocial stressors. © 2016 European Sleep Research Society.

Work time control and sleep disturbances: prospective cohort study of Finnish public sector employees.

PubMed

Salo, Paula; Ala-Mursula, Leena; Rod, Naja Hulvej; Tucker, Philip; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi

2014-07-01

Employee control over work times has been associated with favorable psychosocial and health-related outcomes, but the evidence regarding sleep quality remains inconclusive. We examined cross-sectional and prospective associations between work time control and sleep disturbances in a large working population, taking into account total hours worked. The data were from a full-panel longitudinal cohort study of Finnish public sector employees who responded to questions on work time control and sleep disturbances in years 2000-2001, 2004-2005, 2008-2009, and 2012. The analysis of cross-sectional associations was based on 129,286 person measurements from 68,089 participants (77% women) aged 17-73 years (mean 43.1). Data from 16,503 participants were used in the longitudinal analysis. Log-binomial regression analysis with the generalized estimating equations method was used. Consistently in both cross-sectional and longitudinal models, less control over work time was associated with greater sleep disturbances in the total population and among those working normal 40-hour weeks. Among participants working more than 40 hours a week, work time that was both very high (cross-sectional prevalence ratio compared to intermediate work time control [PR] 1.32, 95% confidence interval [CI] 1.05-1.65) and very low (PR 1.23, 95% CI 1.08-1.39) was associated with sleep disturbances, after adjustment for potential confounding factors. These data suggest that having few opportunities to influence the duration and positioning of work time may increase the risk of sleep disturbances among employees. For persons working long hours, very high levels of control over working times were also associated with increased risk of sleep disturbances. Salo P, Ala-Mursula L, Rod NH, Tucker P, Pentti J, Kivimäki M, Vahtera J. Work time control and sleep disturbances: prospective cohort study of Finnish public sector employees. SLEEP 2014;37(7):1217-1225.

Work Time Control and Sleep Disturbances: Prospective Cohort Study of Finnish Public Sector Employees

PubMed Central

Salo, Paula; Ala-Mursula, Leena; Rod, Naja Hulvej; Tucker, Philip; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi

2014-01-01

Objectives: Employee control over work times has been associated with favorable psychosocial and health-related outcomes, but the evidence regarding sleep quality remains inconclusive. We examined cross-sectional and prospective associations between work time control and sleep disturbances in a large working population, taking into account total hours worked. Methods: The data were from a full-panel longitudinal cohort study of Finnish public sector employees who responded to questions on work time control and sleep disturbances in years 2000-2001, 2004-2005, 2008-2009, and 2012. The analysis of cross-sectional associations was based on 129,286 person measurements from 68,089 participants (77% women) aged 17-73 years (mean 43.1). Data from 16,503 participants were used in the longitudinal analysis. Log-binomial regression analysis with the generalized estimating equations method was used. Results: Consistently in both cross-sectional and longitudinal models, less control over work time was associated with greater sleep disturbances in the total population and among those working normal 40-hour weeks. Among participants working more than 40 hours a week, work time that was both very high (cross-sectional prevalence ratio compared to intermediate work time control [PR] 1.32, 95% confidence interval [CI] 1.05-1.65) and very low (PR 1.23, 95% CI 1.08-1.39) was associated with sleep disturbances, after adjustment for potential confounding factors. Conclusions: These data suggest that having few opportunities to influence the duration and positioning of work time may increase the risk of sleep disturbances among employees. For persons working long hours, very high levels of control over working times were also associated with increased risk of sleep disturbances. Citation: Salo P, Ala-Mursula L, Rod NH, Tucker P, Pentti J, Kivimäki M, Vahtera J. Work time control and sleep disturbances: prospective cohort study of Finnish public sector employees. SLEEP 2014;37(7):1217-1225. PMID:25061250

A work-life perspective on sleep and fatigue--looking beyond shift workers.

PubMed

Skinner, Natalie; Dorrian, Jill

2015-01-01

This study examines sleep and fatigue through a work-life lens. Whilst most often thought of as an issue for shift workers, this study observed that self-reported insufficient sleep and fatigue were prevalent for workers on standard daytime schedules. Using a representative sample of 573 daytime workers (51.3% men; 70.7% aged 25-54 yr) from one Australian state, it was observed that 26.4% of daytime workers never or rarely get the seven hours of sleep a night that is recommended for good health. Those with parenting responsibilites (29.4%) or working long (45+) hours (37.4%) were most likely to report insufficient sleep. Whereas mothers in full-time work were most likely to report frequent fatigue (42.5%). This study highlights the common experience of insufficient sleep and fatigue in a daytime workforce, with significant implications for health and safety at work and outside of work. Stronger and more effective legislation addressing safe and 'decent' working time is clearly needed, along with greater awareness and acceptance within workplace cultures of the need to support reasonable workloads and working hours.

24-hour care: Work and sleep conditions of migrant Filipino live-in caregivers in Los Angeles.

PubMed

Riley, Kevin; Nazareno, Jennifer; Malish, Sterling

2016-12-01

Live-in formal caregivers spend consecutive days in patients' homes, raising questions about their ability to secure adequate sleep while on duty. Few studies have examined sleeping conditions and outcomes for this growing workforce. We collected weeklong sleep logs and interview data from 32 Filipino caregivers in Los Angeles who provide live-in services at least 3 consecutive days per week. Respondents recorded a total average of 6.4 sleep hours during workdays divided over 2.4 sleep periods. Caregivers rated sleep quality as lower while at work; over 40% indicated excessive daytime sleepiness. Female caregivers reported worse sleep outcomes than their male counterparts. Some variations in sleep outcomes were found by employment arrangements. Live-in caregivers experience frequent sleep interruptions at all hours of the day and night to attend to patients' needs. The resulting impacts on sleep quality pose risks for both work-related injury and errors in patient care. Am. J. Ind. Med. 59:1120-1129, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Sleep and fatigue countermeasures for the neurology resident and physician.

PubMed

Avidan, Alon Y

2013-02-01

Fragmented sleep, prolonged work hours, misalignment of sleep-wake cycles, and an expectation to make medical decisions when alertness levels are reduced are pervasive in neurology residency training. Sleep loss in residency training can lead to cognitive and psychosocial impairment and accidents, compromise patient care, and reduce the trainee's quality of life. Neurology residents experience levels of hypersomnolence similar to residents in surgical specialties and have comparable subjective levels of sleepiness as persons with pathologic sleep disorders such as narcolepsy and obstructive sleep apnea. Over the past 2 decades, work-hour limitations were established to alleviate fatigue and sleepiness. However, the implementation of work-hour limitations alone does not guarantee alleviation of fatigue and may be insufficient without additional key measures to prevent, counteract, and control sleepiness when it strikes. This article provides effective strategies to combat sleepiness, such as modification of the on-call structure (night float), power naps, and caffeine, in neurologists in training and those who are at risk for excessive sleepiness. Despite two specific work-hour restrictions set by the Accreditation Council for Graduate Medical Education, the most recent in July 2011, little data exist about the efficacy of work-hour restrictions alone in improving fatigue and sleepiness. Curtailed work hours, while appearing attractive on the surface, have important financial, educational, and patient care imperfections and fail to address the core issue--sleepiness. Historically, sleepiness and fatigue place both residents and patients at risk. Excessive sleepiness in residency training occurs because of sleep deprivation and a spectrum of other factors, such as mood disorders or even the anxiety of anticipating being woken up. An effective model to counteract sleep deprivation and its consequences is a multiplayer approach that uniquely targets and addresses the needs of all the stakeholders. A sleep medicine perspective is proposed along with other interventions to prevent adverse consequences.

Association Between Employee Sleep With Workplace Health and Economic Outcomes.

PubMed

Burton, Wayne N; Chen, Chin-Yu; Schultz, Alyssa B; Li, Xingquan

2017-02-01

Poor sleep can impact occupational functioning. The current study examines health risks, medical conditions, and workplace economic outcomes associated with self-reported hours of sleep among employees. Employees of a global financial services corporation were categorized on the basis of their self-reported average hours of sleep. Differences in health care costs, productivity measures, health risks, and medical conditions were analyzed by hours of sleep while controlling for confounding variables. A strong U-shaped relationship between health care costs, short-term disability, absenteeism, and presenteeism (on-the-job work loss) and the hours of sleep was found among employees. The nadir of the "U" occurs for 7 or 8 hours of sleep per night. Worksite wellness programs often address health risks and medical conditions and may benefit from incorporating sleep education.

Medical and Genetic Differences in the Adverse Impact of Sleep Loss on Performance: Ethical Considerations for the Medical Profession

PubMed Central

Czeisler, Charles A.

2009-01-01

The Institute of Medicine recently concluded that-on average-medical residents make more serious medical errors and have more motor vehicle crashes when they are deprived of sleep. In the interest of public safety, society has required limitations on work hours in many other safety sensitive occupations, including transportation and nuclear power generation. Those who argue in favor of traditional extended duration resident work hours often suggest that there are inter- individual differences in response to acute sleep loss or chronic sleep deprivation, implying that physicians may be more resistant than the average person to the detrimental effects of sleep deprivation on performance, although there is no evidence that physicians are particularly resistant to such effects. Indeed, recent investigations have identified genetic polymorphisms that may convey a relative resistance to the effects of prolonged wakefulness on a subset of the healthy population, although there is no evidence that physicians are over-represented in this cohort. Conversely, there are also genetic polymorphisms, sleep disorders and other inter-individual differences that appear to convey an increased vulnerability to the performance-impairing effects of 24 hours of wakefulness. Given the magnitude of inter-individual differences in the effect of sleep loss on cognitive performance, and the sizeable proportion of the population affected by sleep disorders, hospitals face a number of ethical dilemmas. How should the work hours of physicians be limited to protect patient safety optimally? For example, some have argued that, in contrast to other professions, work schedules that repeatedly induce acute and chronic sleep loss are uniquely essential to the training of physicians. If evidence were to prove this premise to be correct, how should such training be ethically accomplished in the quartile of physicians and surgeons who are most vulnerable to the effects of sleep loss on performance without unacceptably compromising patient safety? Moreover, once it is possible to identify reliably those most vulnerable to the adverse effects of sleep loss on performance, will academic medical centers have an obligation to evaluate the proficiency of both residents and staff physicians under conditions of acute and chronic sleep deprivation? Should work-hour policy limits be modified to ensure that they are not hazardous for the patients of the most vulnerable quartile of physicians, or should the limits be personalized to enable the most resistant quartile to work longer hours? Given that the prevalence of sleep disorders has increased in our society overall, and increases markedly with age, how should fitness for extended duration work hours be monitored over a physician's career? In the spirit of the dictum to do no harm, advances in understanding the medical and genetic basis of inter-individual differences in the performance vulnerability to sleep loss should be incorporated into the development of work-hour policy limits for both physicians and surgeons. PMID:19768182

Medical and genetic differences in the adverse impact of sleep loss on performance: ethical considerations for the medical profession.

PubMed

Czeisler, Charles A

2009-01-01

The Institute of Medicine recently concluded that-on average-medical residents make more serious medical errors and have more motor vehicle crashes when they are deprived of sleep. In the interest of public safety, society has required limitations on work hours in many other safety sensitive occupations, including transportation and nuclear power generation. Those who argue in favor of traditional extended duration resident work hours often suggest that there are inter- individual differences in response to acute sleep loss or chronic sleep deprivation, implying that physicians may be more resistant than the average person to the detrimental effects of sleep deprivation on performance, although there is no evidence that physicians are particularly resistant to such effects. Indeed, recent investigations have identified genetic polymorphisms that may convey a relative resistance to the effects of prolonged wakefulness on a subset of the healthy population, although there is no evidence that physicians are over-represented in this cohort. Conversely, there are also genetic polymorphisms, sleep disorders and other inter-individual differences that appear to convey an increased vulnerability to the performance-impairing effects of 24 hours of wakefulness. Given the magnitude of inter-individual differences in the effect of sleep loss on cognitive performance, and the sizeable proportion of the population affected by sleep disorders, hospitals face a number of ethical dilemmas. How should the work hours of physicians be limited to protect patient safety optimally? For example, some have argued that, in contrast to other professions, work schedules that repeatedly induce acute and chronic sleep loss are uniquely essential to the training of physicians. If evidence were to prove this premise to be correct, how should such training be ethically accomplished in the quartile of physicians and surgeons who are most vulnerable to the effects of sleep loss on performance without unacceptably compromising patient safety? Moreover, once it is possible to identify reliably those most vulnerable to the adverse effects of sleep loss on performance, will academic medical centers have an obligation to evaluate the proficiency of both residents and staff physicians under conditions of acute and chronic sleep deprivation? Should work-hour policy limits be modified to ensure that they are not hazardous for the patients of the most vulnerable quartile of physicians, or should the limits be personalized to enable the most resistant quartile to work longer hours? Given that the prevalence of sleep disorders has increased in our society overall, and increases markedly with age, how should fitness for extended duration work hours be monitored over a physician's career? In the spirit of the dictum to do no harm, advances in understanding the medical and genetic basis of inter-individual differences in the performance vulnerability to sleep loss should be incorporated into the development of work-hour policy limits for both physicians and surgeons.

Physicians' attentional performance following a 24-hour observation period: do we need to regulate sleep prior to work?

PubMed

Smyth, P; Maximova, K; Jirsch, J D

2017-08-01

The tradition of physicians working while sleep deprived is increasingly criticised. Medical regulatory bodies have restricted resident physician duty-hours, not addressing the greater population of physicians. We aimed to assess factors such as sleep duration prior to a 24-hour observation period on physicians' attention. We studied 70 physicians (mean age 38 years old (SD 10.8 years)): 36 residents and 34 faculty from call rosters at the University of Alberta. Among 70 physicians, 52 (74%) performed overnight call; 18 did not perform overnight call and were recruited to control for the learning effect of repetitive neuropsychological testing. Attentional Network Test (ANT) measured physicians' attention at the beginning and end of the 24-hour observation period. Participants self-reported ideal sleep needs, sleep duration in the 24 hours prior to (ie, baseline) and during the 24-hour observation period (ie, follow-up). Median regression models examined effects on ANT parameters. Sleep deprivation at follow-up was associated with reduced attentional accuracy following the 24-hour observation period, but only for physicians more sleep deprived at baseline. Other components of attention were not associated with sleep deprivation after adjusting for repetitive testing. Age, years since medical school and caffeine use did not impact changes in ANT parameters. Our study suggests that baseline sleep before 24 hours of observation impacts the accuracy of physicians' attentional testing at 24 hours. Further study is required to determine if optimising physician sleep prior to overnight call shifts is a sustainable strategy to mitigate the effects of sleep deprivation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Sociodemographic characteristics and waking activities and their role in the timing and duration of sleep.

PubMed

Basner, Mathias; Spaeth, Andrea M; Dinges, David F

2014-12-01

Chronic sleep restriction is prevalent in the U.S. population and associated with increased morbidity and mortality. The primary reasons for reduced sleep are unknown. Using population data on time use, we sought to identify individual characteristics and behaviors associated with short sleep that could be targeted for intervention programs. Analysis of the American Time Use Survey (ATUS). Cross-sectional annual survey conducted by the U.S. Bureau of Labor Statistics. Representative cohort (N = 124,517) of Americans 15 years and older surveyed between 2003 and 2011. None. Telephone survey of activities over 24 hours. Relative to all other waking activities, paid work time was the primary waking activity exchanged for sleep. Time spent traveling, which included commuting to/ from work, and immediate pre- and post-sleep activities (socializing, grooming, watching TV) were also reciprocally related to sleep duration. With every hour that work or educational training started later in the morning, sleep time increased by approximately 20 minutes. Working multiple jobs was associated with the highest odds for sleeping ≤6 hours on weekdays (adjusted OR 1.61, 95% CI 1.44; 1.81). Self-employed respondents were less likely to be short sleepers compared to private sector employees (OR 0.83, 95% CI 0.72; 0.95). Sociodemographic characteristics associated with paid work (age 25-64, male sex, high income, and employment per se) were consistently associated with short sleep. U.S. population time use survey findings suggest that interventions to increase sleep time should concentrate on delaying the morning start time of work and educational activities (or making them more flexible), increasing sleep opportunities, and shortening morning and evening commute times. Reducing the need for multiple jobs may increase sleep time, but economic disincentives from working fewer hours will need to be offset. Raising awareness of the importance of sufficient sleep for health and safety may be necessary to positively influence discretionary behaviors that reduce sleep time, including television viewing and morning grooming. © 2014 Associated Professional Sleep Societies, LLC.

A work-life perspective on sleep and fatigue—looking beyond shift workers

PubMed Central

SKINNER, Natalie; DORRIAN, Jill

2015-01-01

This study examines sleep and fatigue through a work-life lens. Whilst most often thought of as an issue for shift workers, this study observed that self-reported insufficient sleep and fatigue were prevalent for workers on standard daytime schedules. Using a representative sample of 573 daytime workers (51.3% men; 70.7% aged 25−54 yr) from one Australian state, it was observed that 26.4% of daytime workers never or rarely get the seven hours of sleep a night that is recommended for good health. Those with parenting responsibilites (29.4%) or working long (45+) hours (37.4%) were most likely to report insufficient sleep. Whereas mothers in full-time work were most likely to report frequent fatigue (42.5%). This study highlights the common experience of insufficient sleep and fatigue in a daytime workforce, with significant implications for health and safety at work and outside of work. Stronger and more effective legislation addressing safe and ‘decent’ working time is clearly needed, along with greater awareness and acceptance within workplace cultures of the need to support reasonable workloads and working hours. PMID:26027709

Assessing Individual Differences in Adaptation to Extreme Environments: A 36-Hour Sleep Deprivation Study

NASA Technical Reports Server (NTRS)

Martinez, Jacqueline; Cowings, Patricia S.; Toscano, William B.

2012-01-01

In space, astronauts may experience effects of cumulative sleep loss due to demanding work schedules that can result in cognitive performance impairments, mood state deteriorations, and sleep-wake cycle disruption. Individuals who experience sleep deprivation of six hours beyond normal sleep times experience detrimental changes in their mood and performance states. Hence, the potential for life threatening errors increases exponentially with sleep deprivation. We explored the effects of 36-hours of sleep deprivation on cognitive performance, mood states, and physiological responses to identify which metrics may best predict fatigue induced performance decrements of individuals.

USN Manpower Determination Decision Making: A Case Study Using Imprint Pro to Validate the LCS Core Crew Manning Solution

DTIC Science & Technology

2014-12-01

available time consists of 56 hours of sleep (8 hours per 24 hour period), 14 hours for eating (messing), and 17 hours of free time (which includes 3 hours...experiences changes to their sleeping, eating , and working habits that then changes their body temperature peak times, respiratory rate, and hormone...training, personal hygiene, sleeping, and eating . The unplanned events are represented by the yellow tags in Figure 11 and represent emergencies that

[Association of Japanese doctors' sleep habits with working environments and lifestyle].

PubMed

Tamura, Yoshiyuki; Chiba, Shigeru

2011-01-01

To clarify the association of Japanese doctors' sleep habits with working environments and lifestyle, a survey was performed using a self-administered questionnaire in February 2002, targeting a population of 2,455 Asahikawa Medical University alumni. A total of 881 subjects completed questionnaires, yielding a response rate of 35.9%. The mean+/-SD sleep duration on workdays was 410.4+/-60.5 minutes, approximately 30 minutes shorter than that of the general Japanese population. The prevalence of subjective insufficient sleep (SIS) on workdays was 64.5%, significantly higher than that in the general Japanese population. The estimated overall prevalences of various sleep problems are as follows: difficulty initiating sleep, 14.7%; difficulty maintaining sleep, 15.3%; poor perceived quality of sleep, 15.6%; waking without feeling refreshed (WWFR), 30.0%; and excessive daytime sleepiness (EDS), 30.8%. SIS had a significant positive association with WWFR and EDS. Doctors' sleeplessness differed depending on their working style. The prevalence of SIS among doctors working at hospitals and clinics with inpatient wards was significantly higher than that among those working in environments without inpatient wards. The prevalence of SIS was significantly associated with the number of working hours, fatigue, and an irregular lifestyle. Habitual exercise did not appear to affect SIS. A multiple logistic regression model revealed that working in hospitals, long working hours (more than 9 hours a day), fatigue, and an irregular lifestyle were independently associated with SIS [OR=2.19 (95% CI=1.29-3.70); OR=1.95 (95% CI=1.37-2.77); OR=1.93 (95% CI=1.38-2.69); OR=3.27 (95% CI=2.21-4.84)]. Sleep duration on holidays was approximately 60 minutes longer than that on workdays, and the prevalence of SIS decreased to 32.3%. These results demonstrate that the prevalence of SIS is higher among doctors working at hospitals and clinics with inpatient wards, who tend to have long working hours and irregular lifestyles.

Relationship between subjective fatigue, physical activity, and sleep indices in nurses working 16-hour night shifts in a rotating two-shift system

PubMed Central

Kagamiyama, Hiromi; Yano, Rika

2018-01-01

Objective: We clarified the relationship between the degree of subjective fatigue, sleep, and physical activity among nurses working 16-hour night shifts in a rotating two-shift system. Materials and Methods: We investigated 15 nurses who were surveyed regarding their individual attributes, physical activity level (consumed calories), hours of sleep, sleep efficiency, sleep onset latency, sleep diary, and subjective symptoms. Nurses wore a Fitbit One (Fitbit Inc., San Francisco, CA, USA) for 7 consecutive days to measure sleep and physical activity. Results: Results were analyzed for nine participants, excluding those who withdrew or had missing data. The years of nursing experience, nurses’ age, and the length of nocturnal awakening time of the high fatigue group were significantly longer than of the low fatigue group (p < .05). Years of nursing experience in the affiliated department of the high fatigue group was significantly shorter than of low fatigue group (p < .05). The number of nightshifts during the survey period was significantly higher in the high fatigue group than in the low fatigue group. Fatigue after work and body mass index (r = 0.46, p < .001), consumed calories (r = 0.30, p < .05), bedtime (r = –0.36, p < .05), and hours of sleep (r = –0.37, p < .01) were significantly correlated; however, the sleep indices were not correlated. Conclusion: We clarified that the degree of fatigue in nurses working 16-hour night shifts in a rotating two-shift system was related to individual factors, such as age, years of nursing experience, years of nursing experience in the affiliated department, number of nightshifts, and length of nocturnal awakening time. Nurses with greater fatigue had significant differences in their bedtime on days off and work days, which suggests that sleep rhythm may also affect fatigue.

Reduced sleep duration and history of work-related injuries among Washington State adolescents with a history of working.

PubMed

Graves, Janessa M; Miller, Mary E

2015-04-01

The relationship between sleep and occupational injury risk has not been adequately explored for working adolescents. Data were analyzed from the 2010 Washington State Healthy Youth Survey of 8th, 10th, and 12th grade public school students. Teens reported average school and weekend night sleep hours and history of work-related injury that received medical treatment. Multivariable logistic regression evaluated the association between sleep duration and occupational injury. Of 4,144 working teens, 6.4% reported ever having an occupational injury. Teens who sleep ≤5 hr/school night had greater odds of a history of occupational injury than those sleeping 8 hr (OR:2.91, 95% CI:1.85-4.57). No significant association was observed for weekend night sleep duration. Reduced school night sleep was associated with increased odds of work-related injury in adolescents. Long hours and late night schedules may contribute to decreased sleep time and potentially have other health and developmental impacts for youth. © 2015 Wiley Periodicals, Inc.

Short sleep duration among workers--United States, 2010.

PubMed

2012-04-27

Insufficient sleep can have serious and sometimes fatal consequences for fatigued workers and others around them. For example, an estimated 20% of vehicle crashes are linked to drowsy driving. The National Sleep Foundation recommends that healthy adults sleep 7-9 hours per day. To assess the prevalence of short sleep duration among workers, CDC analyzed data from the 2010 National Health Interview Survey (NHIS). The analysis compared sleep duration by age group, race/ethnicity, sex, marital status, education, and employment characteristics. Overall, 30.0% of civilian employed U.S. adults (approximately 40.6 million workers) reported an average sleep duration of ≤6 hours per day. The prevalence of short sleep duration (≤6 hours per day) varied by industry of employment (range: 24.1%-41.6%), with a significantly higher rate of short sleep duration among workers in manufacturing (34.1%) compared with all workers combined. Among all workers, those who usually worked the night shift had a much higher prevalence of short sleep duration (44.0%, representing approximately 2.2 million night shift workers) than those who worked the day shift (28.8%, representing approximately 28.3 million day shift workers). An especially high prevalence of short sleep duration was reported by night shift workers in the transportation and warehousing (69.7%) and health-care and social assistance (52.3%) industries. Targeted interventions, such as evidence-based shift system designs that improve sleep opportunities and evidence-based training programs on sleep and working hours tailored for managers and employees, should be implemented to protect the health and safety of workers, their coworkers, and the public.

Sociodemographic Characteristics and Waking Activities and their Role in the Timing and Duration of Sleep

PubMed Central

Basner, Mathias; Spaeth, Andrea M.; Dinges, David F.

2014-01-01

Study Objectives: Chronic sleep restriction is prevalent in the U.S. population and associated with increased morbidity and mortality. The primary reasons for reduced sleep are unknown. Using population data on time use, we sought to identify individual characteristics and behaviors associated with short sleep that could be targeted for intervention programs. Design: Analysis of the American Time Use Survey (ATUS). Setting: Cross-sectional annual survey conducted by the U.S. Bureau of Labor Statistics. Participants: Representative cohort (N = 124,517) of Americans 15 years and older surveyed between 2003 and 2011. Interventions: None. Measurements and Results: Telephone survey of activities over 24 hours. Relative to all other waking activities, paid work time was the primary waking activity exchanged for sleep. Time spent traveling, which included commuting to/from work, and immediate pre- and post-sleep activities (socializing, grooming, watching TV) were also reciprocally related to sleep duration. With every hour that work or educational training started later in the morning, sleep time increased by approximately 20 minutes. Working multiple jobs was associated with the highest odds for sleeping ≤ 6 hours on weekdays (adjusted OR 1.61, 95% CI 1.44; 1.81). Self-employed respondents were less likely to be short sleepers compared to private sector employees (OR 0.83, 95% CI 0.72; 0.95). Sociodemographic characteristics associated with paid work (age 25-64, male sex, high income, and employment per se) were consistently associated with short sleep. Conclusions: U.S. population time use survey findings suggest that interventions to increase sleep time should concentrate on delaying the morning start time of work and educational activities (or making them more flexible), increasing sleep opportunities, and shortening morning and evening commute times. Reducing the need for multiple jobs may increase sleep time, but economic disincentives from working fewer hours will need to be offset. Raising awareness of the importance of sufficient sleep for health and safety may be necessary to positively influence discretionary behaviors that reduce sleep time, including television viewing and morning grooming. Citation: Basner M, Spaeth AM, Dinges DF. Sociodemographic characteristics and waking activities and their role in the timing and duration of sleep. SLEEP 2014;37(12):1889-1906. PMID:25325472

Sleep and recovery in physicians on night call: a longitudinal field study.

PubMed

Malmberg, Birgitta; Kecklund, Göran; Karlson, Björn; Persson, Roger; Flisberg, Per; Ørbaek, Palle

2010-08-15

It is well known that physicians' night-call duty may cause impaired performance and adverse effects on subjective health, but there is limited knowledge about effects on sleep duration and recovery time. In recent years occupational stress and impaired well-being among anaesthesiologists have been frequently reported for in the scientific literature. Given their main focus on handling patients with life-threatening conditions, when on call, one might expect sleep and recovery to be negatively affected by work, especially in this specialist group. The aim of the present study was to examine whether a 16-hour night-call schedule allowed for sufficient recovery in anaesthesiologists compared with other physician specialists handling less life-threatening conditions, when on call. Sleep, monitored by actigraphy and Karolinska Sleep Diary/Sleepiness Scale on one night after daytime work, one night call, the following first and second nights post-call, and a Saturday night, was compared between 15 anaesthesiologists and 17 paediatricians and ear, nose, and throat surgeons. Recovery patterns over the days after night call did not differ between groups, but between days. Mean night sleep for all physicians was 3 hours when on call, 7 h both nights post-call and Saturday, and 6 h after daytime work (p < 0.001). Scores for mental fatigue and feeling well rested were poorer post-call, but returned to Sunday morning levels after two nights' sleep. Despite considerable sleep loss during work on night call, and unexpectedly short sleep after ordinary day work, the physicians' self-reports indicate full recovery after two nights' sleep. We conclude that these 16-hour night duties were compatible with a short-term recovery in both physician groups, but the limited sleep duration in general still implies a long-term health concern. These results may contribute to the establishment of safe working hours for night-call duty in physicians and other health-care workers.

Sleep and recovery in physicians on night call: a longitudinal field study

PubMed Central

2010-01-01

Background It is well known that physicians' night-call duty may cause impaired performance and adverse effects on subjective health, but there is limited knowledge about effects on sleep duration and recovery time. In recent years occupational stress and impaired well-being among anaesthesiologists have been frequently reported for in the scientific literature. Given their main focus on handling patients with life-threatening conditions, when on call, one might expect sleep and recovery to be negatively affected by work, especially in this specialist group. The aim of the present study was to examine whether a 16-hour night-call schedule allowed for sufficient recovery in anaesthesiologists compared with other physician specialists handling less life-threatening conditions, when on call. Methods Sleep, monitored by actigraphy and Karolinska Sleep Diary/Sleepiness Scale on one night after daytime work, one night call, the following first and second nights post-call, and a Saturday night, was compared between 15 anaesthesiologists and 17 paediatricians and ear, nose, and throat surgeons. Results Recovery patterns over the days after night call did not differ between groups, but between days. Mean night sleep for all physicians was 3 hours when on call, 7 h both nights post-call and Saturday, and 6 h after daytime work (p < 0.001). Scores for mental fatigue and feeling well rested were poorer post-call, but returned to Sunday morning levels after two nights' sleep. Conclusions Despite considerable sleep loss during work on night call, and unexpectedly short sleep after ordinary day work, the physicians' self-reports indicate full recovery after two nights' sleep. We conclude that these 16-hour night duties were compatible with a short-term recovery in both physician groups, but the limited sleep duration in general still implies a long-term health concern. These results may contribute to the establishment of safe working hours for night-call duty in physicians and other health-care workers. PMID:20712854

The effects of double-shifts (15.5 hours) on sleep, fatigue and health.

PubMed

Kecklund, G; Ekstedt, M; Akerstedt, T; Dahlgren, A; Samuelson, B

2001-12-01

The aim of the present study was to investigate how "double-shifts" (15.5 hours) affects sleep, fatigue and self-rated health. The study was carried out on male construction workers of which 80% were long-distance commuters. The schedule involved two work periods and each work period involved two double shifts in a row. The subjects filled in a sleep/wake diary at 8 times across a year and a questionnaire at 3 times. They also wore an actigraph during one shift cycle. The results showed that sleepiness, and to a certain extent, mental fatigue increased during double shifts and accumulated across days. The short rest time (8.5 hours) between days caused insufficient sleep and approximately 5.5 hours of sleep was obtained between double shifts. Questionnaire data showed that complaints of insufficient sleep, exhaustion on awakening and pain symptoms increased across the year. It was concluded that a shift system involving double shifts has a negative effect on fatigue, recovery and health-related well-being.

Quick returns and night work as predictors of sleep quality, fatigue, work-family balance and satisfaction with work hours.

PubMed

Dahlgren, Anna; Tucker, Philip; Gustavsson, Petter; Rudman, Ann

2016-01-01

Quick returns (intervals of <11 h between the end of one shift and the start of the next) are associated with short sleeps and fatigue on the subsequent shift. Recent evidence suggests that shift workers regard quick returns as being more problematic than night work. The current study explored quick returns and night work in terms of their impact on sleep, unwinding, recovery, exhaustion, satisfaction with work hours and work-family interference. Data from the 2006 cohort of Swedish nursing students within the national Longitudinal Analysis of Nursing Education (LANE) study were analysed (N = 1459). Respondents completed a questionnaire prior to graduation (response rate 69.2%) and 3 years after graduation (65.9%). The analyses examined associations between frequency of quick returns and night work and measures taken in year three, while adjusting for confounding factors (in year three and prior graduation). Frequency of quick returns was a significant predictor of poor sleep quality, short sleeps, unwinding, exhaustion, satisfaction with work hours and work-to-family interference, with higher frequency predicting more negative outcomes. Quick returns did not predict recovery after rest days. Frequency of night work did not predict any of the outcomes. In conclusion, quick returns were an important determinant of sleep, recovery and wellbeing, whereas night work did not show such an association.

Work environment, overtime and sleep among offshore personnel.

PubMed

Parkes, Katharine R

2017-02-01

Personnel working on North Sea oil/gas installations are exposed to remote and potentially hazardous environments, and to extended work schedules (typically, 14×12h shifts). Moreover, overtime (additional to the standard 84-h week) is not uncommon among offshore personnel. Evidence from onshore research suggests that long work hours and adverse environmental characteristics are associated with sleep impairments, and consequently with health and safety risks, including accidents and injuries. However, little is known about the extent to which long hours and a demanding work environment combine synergistically in relation to sleep. The present study sought to address this issue, using survey data collected from offshore day-shift personnel (N=551). The multivariate analysis examined the additive and interactive effects of overtime and measures of the psychosocial/physical work environment (job demands, job control, supervisor support, and physical stressors) as predictors of sleep outcomes during offshore work weeks. Control variables, including age and sleep during leave weeks, were also included in the analysis model. Sleep duration and quality were significantly impaired among those who worked overtime (54% of the participants) relative to those who worked only 12-h shifts. A linear relationship was found between long overtime hours and short sleep duration; personnel who worked >33h/week overtime reported <6h/day sleep. Significant interactions were also found; sleep duration was negatively related to job demands, and positively related to supervisor support, only among personnel who worked overtime. Poor sleep quality was predicted by the additive effects of overtime, low support and an adverse physical environment. These findings highlight the need to further examine the potential health and safety consequences of impaired sleep associated with high overtime rates offshore, and to identify the extent to which adverse effects of overtime can be mitigated by favourable physical and psychosocial work environment characteristics. Copyright © 2015 Elsevier Ltd. All rights reserved.

[Sleep habits of medical students, physicians and nurses regarding age, sex, shift work and caffein consumption].

PubMed

Pecotić, Renata; Valić, Maja; Kardum, Goran; Sevo, Vana; Dogas, Zoran

2008-01-01

The aim of this study was to evaluate sleep habits of nurses, medical students, and physicians and to explore whether they are influenced by age, sex, shift work, and caffeine consumption. The questionnaire was derived from the MEDSleep Survey. A total of 453 respondents were surveyed: second-year medical students (130); physicians at the postgraduate study program (68); specialists (162); nurses (93). Results of our study indicate that hours of sleep needed for feeling rested depends on age and gender. Younger respondents and women in the study need longer sleep to feel rested (7.5 hours and more) than older ones and males who need less than 7.5 hours of sleep. Among medical professionals a need for sleep differs related to work demands and work schedule. Nurses need more sleep than physicians (chi2 = 38.57, p < 0.001). Female nurses need more sleep for feeling rested than female physicians (chi2 = 18.18, p < 0.001), and sleep longer during the weeknights (chi2 = 33.78, p < 0.001) and weekends (chi2 = 28.06, p < 0.001). The respondents that consume caffeine have more trouble staying awake while listening to lectures or learning (chi2 = 9.37, p = 0.009), and while driving a car (chi2 = 14.56, p = 0.001). The results indicate that sleep habits are related to age, sex and caffeine consumption.

Sleep problems and computer use during work and leisure: Cross-sectional study among 7800 adults.

PubMed

Andersen, Lars Louis; Garde, Anne Helene

2015-01-01

Previous studies linked heavy computer use to disturbed sleep. This study investigates the association between computer use during work and leisure and sleep problems in working adults. From the 2010 round of the Danish Work Environment Cohort Study, currently employed wage earners on daytime schedule (N = 7883) replied to the Bergen insomnia scale and questions on weekly duration of computer use. Results showed that sleep problems for three or more days per week (average of six questions) were experienced by 14.9% of the respondents. Logistic regression analyses, controlled for gender, age, physical and psychosocial work factors, lifestyle, chronic disease and mental health showed that computer use during leisure for 30 or more hours per week (reference 0-10 hours per week) was associated with increased odds of sleep problems (OR 1.83 [95% CI 1.06-3.17]). Computer use during work and shorter duration of computer use during leisure were not associated with sleep problems. In conclusion, excessive computer use during leisure - but not work - is associated with sleep problems in adults working on daytime schedule.

Shift work, night work and sleep disorders among pastry cookers and shopkeepers in France: a cross-sectional survey

PubMed Central

Pepin, Emilie; Gillet, Pascal; Sauvet, Fabien; Gomez-Merino, Danielle; Thaon, Isabelle; Chennaoui, Mounir; Leger, Damien

2018-01-01

Objective Most research on night and shift work focuses on employee health in large companies, primarily in the healthcare and transportation sectors. However, many night workers work on their own or in small businesses related to services or food. This survey focuses on sleep habits and disorders concerning night work in pastry production and sales. Methods An epidemiological telephone cross-sectional survey of night shift workers and their sleep habits was proposed to all employers and employees in the French pastry industry via their insurance health prevention company. Sleep logs allow us to estimate the total sleep time (TST) on workdays and enquire on napping episodes and length. In order to estimate the ideal TST, we added a question on the ideal amount of sleep the subjects need to be in good shape in the morning. We also define sleep debt as the difference between the ideal TST and TST on workdays, and considered a sleep debt when the difference was above 60 min and severe sleep debt above 90 min. Finally we retained subjects as long sleepers for those with a TSTof more than 7 hours and short sleepers when TST was under 5 hours. Insomnia, sleepiness and sleep apnoea have been defined based on the International Classification of Sleep Disorders-Third Edition and the classification of mental disorders (Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition). Bivariate and multivariate logistic regression models were applied to investigate the association with short TST, long TST, sleep debt and napping. Results We analysed 2622 complete questionnaires from 1313 men and 1309 women aged 22–50 years old. 1397 workers began work before 07:00, whereas 1225 began later. The 24-hour TST was 6.7±1.4 hours, whereas the ideal TST was 7.0±1.2 hours. Severe sleep debt (>90 min) was reported by 6% women versus 5% men, whereas moderate sleep debt (>60 min) was reported by 11.5% women versus 9.3% men. Napping is one way to improve 24-hour TST for 58% of pastry producers (75±13 min) and 23% of shopkeepers (45±8 min). Nevertheless, 26.2% of the respondents complained of chronic insomnia, especially women aged 45–54 years old (31%). Finally, 29.6% had evocative criteria for obstructive sleep apnoea, although only 9.1% had a high score on the Berlin Questionnaire. Conclusion Our study demonstrates that both pastry producers and shopkeepers can have disturbed sleep schedules and a high prevalence of sleep disorders, although many have used napping as a behavioural countermeasure to fight sleep debt. The results of our survey lead us to conclude that, besides the need to take care of night workers in big industries, more information and occupational prevention must be focused on night workers in individual and small businesses. PMID:29743318

Need for recovery from work and sleep-related complaints among nursing professionals.

PubMed

Silva-Costa, Aline; Griep, Rosane Harter; Fischer, Frida Marina; Rotenberg, Lúcia

2012-01-01

The concept of need for recovery from work (NFR) was deduced from the effort recuperation model. In this model work produces costs in terms of effort during the working day. When there is enough time and possibilities to recuperate, a worker will arrive at the next working day with no residual symptoms of previous effort. NFR evaluates work characteristics such as psychosocial demands, professional work hours or schedules. However, sleep may be an important part of the recovery process. The aim of the study was to test the association between sleep-related complaints and NFR. A cross-sectional study was carried out at three hospitals. All females nursing professionals engaged in assistance to patients were invited to participate (N = 1,307). Participants answered a questionnaire that included four sleep-related complaints (insomnia, unsatisfactory sleep, sleepiness during work hours and insufficient sleep), work characteristics and NRF scale. Binomial logistic regression analysis showed that all sleep-related complaints are associated with a high need for recovery from work. Those who reported insufficient sleep showed a greater chance of high need for recovery; OR=2.730 (CI 95% 2.074 - 3.593). These results corroborate the hypothesis that sleep is an important aspect of the recovery process and, therefore, should be thoroughly investigated.

Working hours and roster structures of surgical trainees in Australia and New Zealand.

PubMed

O'Grady, Gregory; Loveday, Benjamin; Harper, Simon; Adams, Brandon; Civil, Ian D; Peters, Matthew

2010-12-01

The working hours of surgical trainees are a subject of international debate. Excessive working hours are fatiguing, and compromise performance, learning and work-life balance. However, reducing hours can impact on continuity of care, training experience and service provision. This study defines the current working hours of Australasian trainees, to inform the working hours debate in our regions. An online survey was conducted of all current Australasian trainees. Questions determined hours spent at work (AW) and off-site on-call (OC) per week, and roster structures were evaluated by training year, specialty and location. The response rate was 55.3%. Trainees averaged 61.4 ± 11.7 h/week AW, with 5% working ≥80 h. OC shifts were worked by 73.5%, for an average of 27.8 ± 14.3 h/week. Trainees of all levels worked similar hours (P= 0.10); however, neurosurgical trainees worked longer hours than most other specialties (P < 0.01). Tertiary centre rotations involved longer AW hours (P= 0.01) and rural rotations more OC (P < 0.001). Long days (>12 h) were worked by 86%; median frequency 1:4.4 days; median duration 15 h. OC shifts of 24-h duration were worked by 75%; median frequency 1:4.2 days; median sleep: 5-7 h/shift; median uninterrupted sleep: 3-5 h/shift. This study has quantified the working hours and roster structures of Australasian surgical trainees. By international standards, Australasian trainee working hours are around average. However, some rosters demand long hours and/or induce chronic sleep loss, placing some trainees at risk of fatigue. Ongoing efforts are needed to promote safe rostering practices. © 2010 The Authors. ANZ Journal of Surgery © 2010 Royal Australasian College of Surgeons.

Registrar sleep patterns and supervision during two different rosters in a tertiary Australasian intensive care unit.

PubMed

Poynter, Chris J; Garden, Alexander; Young, Paul J

2012-03-01

To compare registrar sleep and supervision hours before and after a change in roster to accommodate more senior registrar (SR) positions, and to identify risky patterns of sleep on night shifts. Prospective study of 21 registrars on two different roster templates from September 2010 to May 2011 in the intensive care unit of Wellington Regional Hospital, Wellington, New Zealand. Roster change from 13 registrars and one SR to 10 registrars and four SRs. Mean sleep and supervision hours by shift; episodes of sleep ≤ 5 hours, wakefulness ≥17 hours, sleep during shift, waking before 16:00 before night shifts. 990 sleep surveys were analysed. There was no significant difference between groups in mean sleep or supervision hours for any shift. Two hundred and thirty-six night shifts were analysed. Registrars slept ≤5 hours before 19/236 (8.1%) night shifts; had ≥17 hours wakefulness before 79/236 night shifts (33.5%); woke by 16:00 107/ 236 (45.3%) times; and slept during 86/236 (36.4%) night shifts. Registrars arrived at work having either woken before 16:00 or had ≤5 hours of sleep on 114/236 (48.3%) night shifts. Changing the registrar roster to meet the training demands of our senior trainees did not adversely affect registrar sleep or supervision. Registrars may be taking on unnecessary risk due to poor sleep hygiene around night shifts. We suggest sleep education and scheduled sleep time during night shifts.

Sleep quality and the risk of work injury: a Swiss case-control study.

PubMed

Uehli, Katrin; Miedinger, David; Bingisser, Roland; Dürr, Selina; Holsboer-Trachsler, Edith; Maier, Sabrina; Mehta, Amar J; Müller, Roland; Schindler, Christian; Zogg, Stefanie; Künzli, Nino; Leuppi, Jörg D

2014-10-01

Sleep problems are a well-known risk factor for work injuries, but less is known about which vulnerable populations are most at risk. The aims of this study were to investigate the association between sleep quality and the risk of work injury and to identify factors that may modify the association. A case-control study including 180 cases and 551 controls was conducted at the University Hospital in Basel, Switzerland, from 1 December 2009 to 30 June 2011. Data on work injuries and sleep quality were collected. Adjusted odds ratios and 95% confidence intervals of the association between sleep quality and work injury were estimated in multivariable logistic regression analyses and were stratified by hypothesized effect modifiers (age, gender, job risk, shift work, sleep duration and working hours). Poor sleep quality was associated significantly with work injury of any type (P < 0.05) and with being caught in particular (P < 0.05). The association between poor sleep quality and work injury was significantly higher for workers older than 30 years (odds ratio>30 1.30 versus odds ratio≤30 0.91, P < 0.01), sleeping 7 h or less per night (odds ratio≤7 1.17 versus odds ratio>7 0.79, P < 0.05) and working 50 h or more per week (odds ratio≥50 1.79 versus odd ratio<50 1.10, P < 0.01). Work injury risk increased with increasing severity of sleep problems (P < 0.05). Prior work injury frequency increased with decreasing sleep quality (P < 0.05). Older age, short sleep duration and long working hours may enhance the risk of work injuries associated with sleep quality. © 2014 European Sleep Research Society.

Associations of excessive sleepiness on duty with sleeping hours and number of days of overnight work among medical residents in Japan.

PubMed

Wada, Koji; Sakata, Yumi; Theriault, Gilles; Narai, Rie; Yoshino, Yae; Tanaka, Katsutoshi; Aizawa, Yoshiharu

2007-11-01

Despite long-standing concerns regarding the effects of working hours on the performance and health of medical residents, and the patients' safety, prior studies have not shown an association of excessive sleepiness with the number of sleeping hours and days of overnight work among medical residents. In August 2005, a questionnaire was mailed to 227 eligible participants at 16 teaching hospitals. The total number of sleeping hours in the last 30 d was estimated from the average number of sleeping hours during regular days and during days with overnight work, and the number of days of overnight work. Multiple logistic regression analysis was used to adjust for potentially associated variables. A total of 149 men and 47 women participated in this study. The participation rate was 86.3%. Among the participants, 55 (28.1%) suffered from excessive sleepiness. Excessive sleepiness was associated with sleeping for less than 150 h in the last 30 d (corrected odds ratio [cOR]=1.57; 95% confidence interval [CI], 1.02-2.16). The number of days of overnight work in the last 30 d showed no association with excessive sleepiness. Excessive sleepiness was also associated with smoking (cOR, 1.65; 95%CI, 1.01-2.32). Medical residents who slept for less than 150 h in the last 30 d and smoked had a significantly higher risk of excessive sleepiness on duty.

Interns' compliance with accreditation council for graduate medical education work-hour limits.

PubMed

Landrigan, Christopher P; Barger, Laura K; Cade, Brian E; Ayas, Najib T; Czeisler, Charles A

2006-09-06

Sleep deprivation is associated with increased risk of serious medical errors and motor vehicle crashes among interns. The Accreditation Council for Graduate Medical Education (ACGME) introduced duty-hour standards in 2003 to reduce work hours. To estimate compliance with the ACGME duty-hour standards among interns. National prospective cohort study with monthly Web-based survey assessment of intern work and sleep hours using a validated instrument, conducted preimplementation (July 2002 through May 2003) and postimplementation (July 2003 through May 2004) of ACGME standards. Participants were 4015 of the approximately 37 253 interns in US residency programs in all specialties during this time; they completed 29 477 reports of their work and sleep hours. Overall and monthly rates of compliance with the ACGME standards. Postimplementation, 1068 (83.6%; 95% confidence interval [CI], 81.4%-85.5%) of 1278 of interns reported work hours in violation of the standards during 1 or more months. Working shifts greater than 30 consecutive hours was reported by 67.4% (95% CI, 64.8%-70.0%). Averaged over 4 weeks, 43.0% (95% CI, 40.3%-45.7%) reported working more than 80 hours weekly, and 43.7% (95% CI, 41.0%-46.5%) reported not having 1 day in 7 off work duties. Violations were reported during 3765 (44.0%; 95% CI, 43.0%-45.1%) of the 8553 intern-months assessed postimplementation (including vacation and ambulatory rotations), and during 2660 (61.5%; 95% CI, 60.0%-62.9%) of 4327 intern-months during which interns worked exclusively in inpatient settings. Postimplementation, 29.0% (95% CI, 28.7%-29.7%) of reported work weeks were more than 80 hours per week, 12.1% (95% CI, 11.8%-12.6%) were 90 or more hours per week, and 3.9% (95% CI, 3.7%-4.2%) were 100 or more hours per week. Comparing preimplementation to postimplementation responses, reported mean work duration decreased 5.8% from 70.7 (95% CI, 70.5-70.9) hours to 66.6 (95% CI, 66.3-66.9) hours per week (P<.001), and reported mean sleep duration increased 6.1% (22 minutes) from 5.91 (95% CI, 5.88-5.94) hours to 6.27 (95% CI, 6.23-6.31) hours per night (P<.001). However, reported mean sleep during extended shifts decreased 4.5%, from 2.69 (95% CI, 2.66-2.73) hours to 2.57 (95% CI, 2.52-2.62) hours (P<.001). In the first year following implementation of the ACGME duty-hour standards, interns commonly reported noncompliance with these requirements.

Sleep and Wakefulness Handbook for Flight Medical Officers,

DTIC Science & Technology

1982-01-01

hours, but routine monotonous tasks show a rapid and severe decrement after 24 hours without sleep. Motivation may counteract some of the sequelae of...repeated partial sleep loss will lead to impaired performance. IRREGULARITY OF WORK AND REST Irregularity of work and rest over several days is also...movements, each of several seconds duration, which are usually most prominent during the early part of the stage. Rapid eye movements are absent, and the

Sleep restriction during simulated wildfire suppression: effect on physical task performance.

PubMed

Vincent, Grace; Ferguson, Sally A; Tran, Jacqueline; Larsen, Brianna; Wolkow, Alexander; Aisbett, Brad

2015-01-01

To examine the effects of sleep restriction on firefighters' physical task performance during simulated wildfire suppression. Thirty-five firefighters were matched and randomly allocated to either a control condition (8-hour sleep opportunity, n = 18) or a sleep restricted condition (4-hour sleep opportunity, n = 17). Performance on physical work tasks was evaluated across three days. In addition, heart rate, core temperature, and worker activity were measured continuously. Rate of perceived and exertion and effort sensation were evaluated during the physical work periods. There were no differences between the sleep-restricted and control groups in firefighters' task performance, heart rate, core temperature, or perceptual responses during self-paced simulated firefighting work tasks. However, the sleep-restricted group were less active during periods of non-physical work compared to the control group. Under self-paced work conditions, 4 h of sleep restriction did not adversely affect firefighters' performance on physical work tasks. However, the sleep-restricted group were less physically active throughout the simulation. This may indicate that sleep-restricted participants adapted their behaviour to conserve effort during rest periods, to subsequently ensure they were able to maintain performance during the firefighter work tasks. This work contributes new knowledge to inform fire agencies of firefighters' operational capabilities when their sleep is restricted during multi-day wildfire events. The work also highlights the need for further research to explore how sleep restriction affects physical performance during tasks of varying duration, intensity, and complexity.

Sleep Restriction during Simulated Wildfire Suppression: Effect on Physical Task Performance

PubMed Central

Vincent, Grace; Ferguson, Sally A.; Tran, Jacqueline; Larsen, Brianna; Wolkow, Alexander; Aisbett, Brad

2015-01-01

Objectives To examine the effects of sleep restriction on firefighters’ physical task performance during simulated wildfire suppression. Methods Thirty-five firefighters were matched and randomly allocated to either a control condition (8-hour sleep opportunity, n = 18) or a sleep restricted condition (4-hour sleep opportunity, n = 17). Performance on physical work tasks was evaluated across three days. In addition, heart rate, core temperature, and worker activity were measured continuously. Rate of perceived and exertion and effort sensation were evaluated during the physical work periods. Results There were no differences between the sleep-restricted and control groups in firefighters’ task performance, heart rate, core temperature, or perceptual responses during self-paced simulated firefighting work tasks. However, the sleep-restricted group were less active during periods of non-physical work compared to the control group. Conclusions Under self-paced work conditions, 4 h of sleep restriction did not adversely affect firefighters’ performance on physical work tasks. However, the sleep-restricted group were less physically active throughout the simulation. This may indicate that sleep-restricted participants adapted their behaviour to conserve effort during rest periods, to subsequently ensure they were able to maintain performance during the firefighter work tasks. This work contributes new knowledge to inform fire agencies of firefighters’ operational capabilities when their sleep is restricted during multi-day wildfire events. The work also highlights the need for further research to explore how sleep restriction affects physical performance during tasks of varying duration, intensity, and complexity. PMID:25615988

Effect of working hours on cardiovascular-autonomic nervous functions in engineers in an electronics manufacturing company.

PubMed

Sasaki, T; Iwasaki, K; Oka, T; Hisanaga, N; Ueda, T; Takada, Y; Fujiki, Y

1999-01-01

A field survey of 147 engineers (23-49 years) in an electronics manufacturing company was conducted to investigate the effect of working hours on cardiovascular-autonomic nervous functions (urinary catecholamines, heart rate variability and blood pressure). The subjects were divided into 3 groups by age: 23-29 (n = 49), 30-39 (n = 74) and 40-49 (n = 24) year groups. Subjects in each age group were further divided into shorter (SWH) and longer (LWH) working hour subgroups according to the median of weekly working hours. In the 30-39 year group, urinary noradrenaline in the afternoon for LWH was significantly lower than that for SWH and a similar tendency was found in the LF/HF ratio of heart rate variability at rest. Because these two autonomic nervous indices are related to sympathetic nervous activity, the findings suggested that sympathetic nervous activity for LWH was lower than that for SWH in the 30-39 year group. Furthermore, there were significant relationships both between long working hours and short sleeping hours, and between short sleeping hours and high complaint rates of "drowsiness and dullness" in the morning in this age group. Summarizing these results, it appeared that long working hours might lower sympathetic nervous activity due to chronic sleep deprivation.

Dubious bargain: trading sleep for Leno and Letterman.

PubMed

Basner, Mathias; Dinges, David F

2009-06-01

Sleeping less than 7 hours daily impairs alertness and is associated with increased obesity, morbidity, and mortality; yet up to 40% of US adults do so. Population data indicate work time is the primary activity reciprocally related to sleep time in the United States. Reducing work time and its economic benefits to increase sleep time may not be feasible for most of the population. We sought to identify waking activities under discretionary control and adjacent to the sleep period that would be a more feasible source for increasing sleep time. American Time Use Survey data from 21,475 respondents aged > or = 15 years were pooled for the years 2003-2006 to explore activities in 2-hour periods prior to going to bed and past getting up on weekdays. N/A. Long workers (> or = 8 hours) terminated bed time an average of 0.68 h earlier than short workers (< 8 hours, P < 0.0001) and 1.31 h earlier than respondents not working on the interview day (P < 0.001), but time of going to bed did not differ among groups (22:37 vs. 22:42 vs. 22:37, respectively, P = 0.385). Watching television was the primary activity people engaged in before going to bed, accounting for 55.6 min (46.3%) of the 2-h pre-bed period. In the morning, travel time and work time increased steadily toward the end of the post-awakening 2-h period, accounting for 14.8% and 12.3%, respectively. Watching television may be an important social Zeitgeber for the time of going to bed. Watching less television in the evening and postponing work start time in the morning appear to be the candidate behavioral changes for achieving additional sleep. While the timing of work may not be flexible, giving up some TV viewing in the evening should be possible to reduce chronic sleep debt and promote adequate sleep in those who need it.

Circadian rhythm adaptation to simulated night shift work: effect of nocturnal bright-light duration.

PubMed

Eastman, C I; Liu, L; Fogg, L F

1995-07-01

We compared bright-light durations of 6, 3 and 0 hours (i.e. dim light) during simulated night shifts for phase shifting the circadian rectal temperature rhythm to align with a 12-hour shift of the sleep schedule. After 10 baseline days there were 8 consecutive night-work, day-sleep days, with 8-hour sleep (dark) periods. The bright light (about 5,000 lux, around the baseline temperature minimum) was used during all 8 night shifts, and dim light was < 500 lux. This was a field study in which subjects (n = 46) went outside after the night shifts and slept at home. Substantial circadian adaptation (i.e. a large cumulative temperature rhythm phase shift) was produced in many subjects in the bright light groups, but not in the dim light group. Six and 3 hours of bright light were each significantly better than dim light for phase shifting the temperature rhythm, but there was no significant difference between 6 and 3 hours. Thus, durations > 3 hours are probably not necessary in similar shift-work situations. Larger temperature rhythm phase shifts were associated with better subjective daytime sleep, less subjective fatigue and better overall mood.

Shift work, night work and sleep disorders among pastry cookers and shopkeepers in France: a cross-sectional survey.

PubMed

Pepin, Emilie; Gillet, Pascal; Sauvet, Fabien; Gomez-Merino, Danielle; Thaon, Isabelle; Chennaoui, Mounir; Leger, Damien

2018-05-09

Most research on night and shift work focuses on employee health in large companies, primarily in the healthcare and transportation sectors. However, many night workers work on their own or in small businesses related to services or food. This survey focuses on sleep habits and disorders concerning night work in pastry production and sales. An epidemiological telephone cross-sectional survey of night shift workers and their sleep habits was proposed to all employers and employees in the French pastry industry via their insurance health prevention company. Sleep logs allow us to estimate the total sleep time (TST) on workdays and enquire on napping episodes and length. In order to estimate the ideal TST, we added a question on the ideal amount of sleep the subjects need to be in good shape in the morning. We also define sleep debt as the difference between the ideal TST and TST on workdays, and considered a sleep debt when the difference was above 60 min and severe sleep debt above 90 min. Finally we retained subjects as long sleepers for those with a TSTof more than 7 hours and short sleepers when TST was under 5 hours. Insomnia, sleepiness and sleep apnoea have been defined based on the International Classification of Sleep Disorders-Third Edition and the classification of mental disorders (Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition). Bivariate and multivariate logistic regression models were applied to investigate the association with short TST, long TST, sleep debt and napping. We analysed 2622 complete questionnaires from 1313 men and 1309 women aged 22-50 years old. 1397 workers began work before 07:00, whereas 1225 began later. The 24-hour TST was 6.7±1.4 hours, whereas the ideal TST was 7.0±1.2 hours. Severe sleep debt (>90 min) was reported by 6% women versus 5% men, whereas moderate sleep debt (>60 min) was reported by 11.5% women versus 9.3% men. Napping is one way to improve 24-hour TST for 58% of pastry producers (75±13 min) and 23% of shopkeepers (45±8 min). Nevertheless, 26.2% of the respondents complained of chronic insomnia, especially women aged 45-54 years old (31%). Finally, 29.6% had evocative criteria for obstructive sleep apnoea, although only 9.1% had a high score on the Berlin Questionnaire. Our study demonstrates that both pastry producers and shopkeepers can have disturbed sleep schedules and a high prevalence of sleep disorders, although many have used napping as a behavioural countermeasure to fight sleep debt. The results of our survey lead us to conclude that, besides the need to take care of night workers in big industries, more information and occupational prevention must be focused on night workers in individual and small businesses. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Impacts of shift work on sleep and circadian rhythms.

PubMed

Boivin, D B; Boudreau, P

2014-10-01

Shift work comprises work schedules that extend beyond the typical "nine-to-five" workday, wherein schedules often comprise early work start, compressed work weeks with 12-hour shifts, and night work. According to recent American and European surveys, between 15 and 30% of adult workers are engaged in some type of shift work, with 19% of the European population reportedly working at least 2 hours between 22:00 and 05:00. The 2005 International Classification of Sleep Disorders estimates that a shift work sleep disorder can be found in 2-5% of workers. This disorder is characterized by excessive sleepiness and/or sleep disruption for at least one month in relation with the atypical work schedule. Individual tolerance to shift work remains a complex problem that is affected by the number of consecutive work hours and shifts, the rest periods, and the predictability of work schedules. Sleepiness usually occurs during night shifts and is maximal at the end of the night. Impaired vigilance and performance occur around times of increased sleepiness and can seriously compromise workers' health and safety. Indeed, workers suffering from a shift work sleep-wake disorder can fall asleep involuntarily at work or while driving back home after a night shift. Working on atypical shifts has important socioeconomic impacts as it leads to an increased risk of accidents, workers' impairment and danger to public safety, especially at night. The aim of the present review is to review the circadian and sleep-wake disturbances associated with shift work as well as their medical impacts. Copyright © 2014. Published by Elsevier SAS.

Appropriate working hours for surgical training according to Australasian trainees.

PubMed

O'Grady, Gregory; Harper, Simon; Loveday, Benjamin; Adams, Brandon; Civil, Ian D; Peters, Matthew

2012-04-01

The demands of surgical training, learning and service delivery compete with the need to minimize fatigue and maintain an acceptable lifestyle. The optimal balance of working hours is uncertain. This study aimed to define the appropriate hours to meet these requirements according to trainees. All Australian and New Zealand surgical trainees were surveyed. Roster structures, weekly working hours and weekly 'sleep loss hours' (<8 per night) because of 24-h calls were defined. These work practices were then correlated with sufficiency of training time, time for study, fatigue and its impacts, and work-life balance preferences. Multivariate and univariate analyses were performed. The response rate was 55.3% with responders representative of the total trainee body. Trainees who worked median 60 h/week (interquartile range: 55-65) considered their work hours to be appropriate for 'technical' and 'non-technical' training needs compared with 55 h/week (interquartile range: 50-60) regarded as appropriate for study/research needs. Working ≥65 h/week, or accruing ≥5.5 weekly 'sleep loss hours', was associated with increased fatigue, reduced ability to study, more frequent dozing while driving and impaired concentration at work. Trainees who considered they had an appropriate work-life balance worked median 55 h/week. Approximately, 60 h/week proved an appropriate balance of working hours for surgical training, although study and lifestyle demands are better met at around 55 h/week. Sleep loss is an important determinant of fatigue and its impacts, and work hours should not be considered in isolation. © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

New Zealanders working non-standard hours also have greater exposure to other workplace hazards.

PubMed

Jay, Sarah M; Gander, Philippa H; Eng, Amanda; Cheng, Soo; Douwes, Jeroen; Ellison-Loschmann, Lis; McLean, Dave; Pearce, Neil; 'tMannetje, Andrea

2017-01-01

Exposure to workplace hazards, such as dust, solvents, and fumes, has the potential to adversely affect the health of people. However, the effects of workplace hazards on health may differ when exposure occurs at different times in the circadian cycle, and among people who work longer hours or who do not obtain adequate sleep. The aim of the present study was to document exposures to workplace hazards across a national sample of New Zealanders, comparing people who work a standard 08:00 -17:00 h Monday-to-Friday working week (Std hours) and those who do not (N-Std hours). New Zealanders (n = 10 000) aged 20-64 yrs were randomly selected from the Electoral Roll to take part in a nationwide survey of workplace exposures. Telephone interviews were conducted between 2004 and 2006, using a six-part questionnaire addressing demographics, detailed information on the current or most recent job (including exposures to a range of workplace hazards), sleep, sleepiness, and health status. N-Std hours were categorised on the basis of: being required to start work prior to 07:00 h or finish work after 21:00 h and/or; having a regular on-call commitment (at least once per week) and/or; working rotating shifts and/or; working night shift(s) in the last month. The response rate was 37% (n = 3003), with 22.2% of participants (n = 656) categorised as working N-Std hours. Industry sectors with the highest numbers of participants working N-Std hours were manufacturing, health and community services, and agriculture, fishing, and forestry. Response rate was 37% (n = 3003) with 22.2% (n = 656) categorised as working N-Std hours. Participants working N-Std hours were more likely to be exposed to all identified hazards, including multiple hazards (OR = 2.45, 95% CI = 2.01-3.0) compared to those working Std hours. Participants working N-Std hours were also more likely to report 'never/rarely' getting enough sleep (OR = 1.38, 95% CI = 1.15-1.65), 'never/rarely' waking refreshed (OR = 1.23, 95% CI = 1.04-1.47), and excessive sleepiness (OR = 1.77, 95% CI = 1.29-2.42). New Zealanders working N-Std hours are more likely to be exposed to hazards in the workplace, to be exposed to multiple hazards, and to report inadequate sleep and excessive sleepiness than their colleagues working a standard 08:00-17:00 h Monday-to-Friday working week. More research is needed on the effects of exposure to hazardous substances outside the usual waking day, on the effects of exposure to multiple hazards, and on the combination of hazard exposure and sleep restriction as a result of shift work.

Dubious Bargain: Trading Sleep for Leno and Letterman

PubMed Central

Basner, Mathias; Dinges, David F.

2009-01-01

Study Objectives: Sleeping less than 7 hours daily impairs alertness and is associated with increased obesity, morbidity, and mortality; yet up to 40% of US adults do so. Population data indicate work time is the primary activity reciprocally related to sleep time in the United States. Reducing work time and its economic benefits to increase sleep time may not be feasible for most of the population. We sought to identify waking activities under discretionary control and adjacent to the sleep period that would be a more feasible source for increasing sleep time. Design/Participants: American Time Use Survey data from 21,475 respondents aged ≥ 15 years were pooled for the years 2003–2006 to explore activities in 2-hour periods prior to going to bed and past getting up on weekdays. Interventions: N/A Results: Long workers (≥ 8 hours) terminated bed time an average of 0.68 h earlier than short workers (< 8 hours, P < 0.0001) and 1.31 h earlier than respondents not working on the interview day (P < 0.001), but time of going to bed did not differ among groups (22:37 vs. 22:42 vs. 22:37, respectively, P = 0.385). Watching television was the primary activity people engaged in before going to bed, accounting for 55.6 min (46.3%) of the 2-h pre-bed period. In the morning, travel time and work time increased steadily toward the end of the post-awakening 2-h period, accounting for 14.8% and 12.3%, respectively. Conclusions: Watching television may be an important social Zeitgeber for the time of going to bed. Watching less television in the evening and postponing work start time in the morning appear to be the candidate behavioral changes for achieving additional sleep. While the timing of work may not be flexible, giving up some TV viewing in the evening should be possible to reduce chronic sleep debt and promote adequate sleep in those who need it. Citation: Basner M; Dinges DF. Dubious bargain: trading sleep for Leno and Letterman. SLEEP 2009;32(6):747–752. PMID:19544750

HEALTH EFFECTS OF SLEEP DEPRIVATION ON NURSES WORKING SHIFTS.

PubMed

Stanojevic, Cedomirka; Simic, Svetlana; Milutinovic, Dragana

2016-10-01

Atypical work schedules cause reduced sleep, leading to drowsiness, fatigue, decline of cognitive performance and health problems among the members of the nursing staff. The study was aimed at reviewing current knowledge and attitudes concerning the impact of sleep disorders on health and cognitive functions among the members of the nursing staff. Sleep and Interpersonal Relations in Modern Society. The modern 24-hour society involves more and more employees (health services, police departments, public transport) in non-standard forms of work. In European Union countries, over 50% of the nursing staff work night shifts, while in the United States of America 55% of nursing staff work more than 40 hours a week, and 30-70% of nurses sleep less than six hours before their shift. Cognitive Effects of Sleep Deprivation. Sleep deprivation impairs the performance of tasks that require intensive and prolonged attention which increases the number of errors in patients care, and nurses are subject to incre- ased risk of traffic accidents. Sleep Deprivation and Health Disorders. Sleep deprived members of the nursing staff are at risk of obesity, diabetes, gastrointestinal disorders and cardiovascular disease. The risk factors for breast cancer are increased by 1.79 times. and there is a significantly higher risk for colorectal carcinoma. Too long or repeated shifts reduce the opportunity for sleep, shorten recovery time in nurses, thus endangering their safety and health as well as the quality of care and patients' safety. Bearing in mind the significance of the problerm it is necessary to conduct the surveys of sleep quality and health of nurses in the Republic of Serbia as well in order to tackle this issue which is insufficiently recognized.

Normative data on the diurnal pattern of the Karolinska Sleepiness Scale ratings and its relation to age, sex, work, stress, sleep quality and sickness absence/illness in a large sample of daytime workers.

PubMed

Åkerstedt, Torbjorn; Hallvig, David; Kecklund, Göran

2017-10-01

Self-rated sleepiness responds to sleep loss, time of day and work schedules. There is, however, a lack of a normative reference showing the diurnal pattern during a normal working day, compared with a day off, as well as differences depending on stress, sleep quality, sex, age and being sick listed. The present study sought to provide such data for the Karolinska Sleepiness Scale. Participants were 431 individuals working in medium-sized public service units. Sleepiness (Karolinska Sleepiness Scale, scale 1-9) was rated at six times a day for a working week and 2 days off (>90.000 ratings). The results show a clear circadian pattern, with high values during the morning (4.5 at 07:00 hours) and evening (6.0 at 22:00 hours), and with low values (3-4) during the 10:00-16:00 hours span. Women had significantly higher (0.5 units) Karolinska Sleepiness Scale values than men, as did younger individuals (0.3 units), those with stress (1.3 units above the low-stress group) and those with poor sleep quality (1.0 units above those with qood sleep quality). Days off showed reduced sleepiness (0.7 units), while being sick listed was associated with an increased sleepiness (0.8 units). Multiple regression analysis of mean sleepiness during the working week yielded mean daytime stress, mean sleep quality, age, and sex as predictors (not sleep duration). Improved sleep quality accounted for the reduced sleepiness during days off, but reduced stress was a second factor. Similar results were obtained in a longitudinal mixed-model regression analysis across the 7 days of the week. The percentage of ratings at Karolinska Sleepiness Scale risk levels (8 + 9) was 6.6%, but most of these were obtained at 22:00 hours. It was concluded that sleepiness ratings are strongly associated with time of day, sleep quality, stress, work day/day off, being ill, age, and sex. © 2017 European Sleep Research Society.

National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study

PubMed Central

2010-01-01

Background Physicians' mental health may be adversely affected by the number of days of work and time spent on-call, and improved by sleep and days-off. The aim of this study was to determine the associations of depressive symptoms with taking days of off duty, hours of sleep, and the number of days of on-call and overnight work among physicians working in Japanese hospitals. Methods A cross-sectional study as a national survey was conducted by mail. The study population was 10,000 randomly selected physicians working in hospitals who were also members of the Japan Medical Association (response rate 40.5%). Self-reported anonymous questionnaire was sent to assess the number of days off-duty, overnight work, and on-calls, and the average number of sleep hours on days not working overnight in the previous one month. Depressive state was determined by the Japanese version of the Quick Inventory of Depressive Symptomatology. Logistic regression analysis was used to explore the associations between depressive symptoms and the studied variables. Results Among the respondents, 8.3% of men and 10.5% of women were determined to be depressed. For both men and women, depressive state was associated with having no off-duty days and averaging less than 5 hours of sleep on days not doing overnight work. Depressive state was positively associated with being on-call more than 5 days per month for men, and more than 8 days per month for women, and was negatively associated with being off-duty more than 8 days per month for men. Conclusion Some physicians need some support to maintain their mental health. Physicians who do not take enough days-off, who reduced sleep hours, and who have certain number of days on-calls may develop depressive symptoms. PMID:20222990

National survey of the association of depressive symptoms with the number of off duty and on-call, and sleep hours among physicians working in Japanese hospitals: a cross sectional study.

PubMed

Wada, Koji; Yoshikawa, Toru; Goto, Takahisa; Hirai, Aizan; Matsushima, Eisuke; Nakashima, Yoshifumi; Akaho, Rie; Kido, Michiko; Hosaka, Takashi

2010-03-12

Physicians' mental health may be adversely affected by the number of days of work and time spent on-call, and improved by sleep and days-off. The aim of this study was to determine the associations of depressive symptoms with taking days of off duty, hours of sleep, and the number of days of on-call and overnight work among physicians working in Japanese hospitals. A cross-sectional study as a national survey was conducted by mail. The study population was 10,000 randomly selected physicians working in hospitals who were also members of the Japan Medical Association (response rate 40.5%). Self-reported anonymous questionnaire was sent to assess the number of days off-duty, overnight work, and on-calls, and the average number of sleep hours on days not working overnight in the previous one month. Depressive state was determined by the Japanese version of the Quick Inventory of Depressive Symptomatology. Logistic regression analysis was used to explore the associations between depressive symptoms and the studied variables. Among the respondents, 8.3% of men and 10.5% of women were determined to be depressed. For both men and women, depressive state was associated with having no off-duty days and averaging less than 5 hours of sleep on days not doing overnight work. Depressive state was positively associated with being on-call more than 5 days per month for men, and more than 8 days per month for women, and was negatively associated with being off-duty more than 8 days per month for men. Some physicians need some support to maintain their mental health. Physicians who do not take enough days-off, who reduced sleep hours, and who have certain number of days on-calls may develop depressive symptoms.

EFFECTS OF LONG-TIME COMMUTING AND LONG-HOUR WORKING ON LIFESTYLE AND MENTAL HEALTH AMONG SCHOOL TEACHERS IN TOKYO, JAPAN.

PubMed

Nomoto, Marino; Hara, Akiko; Kikuchi, Kimiyo

2015-06-01

The objective of this study was to investigate the effects of long-time commuting and long-hour working on lifestyle including sleeping, physical exercise, breakfast, smoking, alcohol intake and mental health. In this cross-sectional study, data were collected from 146 school teachers in Tokyo. The binary associations of commuting time and working hours with lifestyle, mental stress measured by the General Health Questionnaire (GHQ) and stress coping measured by the Sense of Coherence (SOC) scores were examined. The Chi-square test was used for statistical analyses. Our results indicated that the mean commuting time and working hours per week of the respondents were 42.1 (SD 22.5) minutes and 50.4 (SD 8.6) hours, respectively. Longer commuting time was significantly associated with shorter working hours (p = 0.023), less physical exercise (p < 0.001) and shorter sleeping hours (p = 0.001). Longer working hours were significantly associated with more frequent working on holidays (p = 0.001), higher SOC scores (p = 0.001) and more smoking (p = 0.028). The negative association between GHQ and SOC scores was also significant (p < 0.001). Our findings revealed that long-time commuters were more likely to sleep less, exercise less and work less long. Long-hour workers were more likely to commute shorter, work on holidays more frequently, smoke more and their stress coping potentials were higher. Some kinds of strategies are required to improve the healthy lifestyle for long-time com- muters or long-hour workers. Key words: stress; stress coping; general health questionnaire; sense of coherence

Regulating danger on the highways: hours of service regulations.

PubMed

Mansfield, Daniel; Kryger, Meir

2015-12-01

Current hours of service regulations governing commercial truck drivers in place in the United States, Canada, Australia, and the European Union are summarized and compared to facilitate the assessment of the effectiveness of such provisions in preventing fatigue and drowsiness among truck drivers. Current hours of service provisions governing commercial truck drivers were derived from governmental sources. The commercial truck driver hours of service provisions in the United States, Canada, and the European Union permit drivers to work 14 hours and those of Australia permit drivers to work 12 hours a day on a regular basis. The regulations do not state what a driver may do with time off. They are consistent with a driver being able to drive after 24 hours without sleep. They do not take into account circadian rhythm by linking driving or rest to time of day. Current hours of service regulations governing commercial truck drivers leave gaps--permitting drivers to work long hours on a regular basis, permitting driving after no sleep for 24 hours, and failing to take into account the importance of circadian rhythm, endangering the public safety and the truck drivers themselves. Copyright © 2015 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Work and family characteristics as determinants of socioeconomic and sex inequalities in sleep: The Japanese Civil Servants Study.

PubMed

Sekine, Michikazu; Chandola, Tarani; Martikainen, Pekka; Marmot, Michael; Kagamimori, Sadanobu

2006-02-01

To clarify whether socioeconomic and sex inequalities in poor sleep quality are explained by socioeconomic and sex differences in work and family characteristics. A cross-sectional study. Three thousand five hundred fifty-six employees (2397 men and 1159 women) aged 20 to 65 years in local government in Japan. Respondents completed a self-administered questionnaire that asked about sleep quality, as measured by the Pittsburgh Sleep Quality Index; work characteristics, as measured by the job-demand-control-support model, work hours, and shift work; and family characteristics, such as family structure and family-work conflicts. Lower control at work, higher work demands, lower social support, shorter and longer working hours, shift work, being single, higher family-to-work conflict, and higher work-to-family conflict were independently associated with poorer sleep quality in both men and women. In men, the age-adjusted odds ratio (OR) of low-grade employees for poor sleep quality was 1.64 (95% confidence interval: 1.14-2.36) in comparison with high-grade employees. The difference in sleep was attenuated when work and family characteristics were adjusted for (OR=1.25 [0.84-1.86]). Among women, there was no significant grade difference in sleep. Women tended to have poorer sleep quality than men (the age-adjusted OR=1.75 [1.49-2.06]). The sex difference was attenuated and no longer significant when adjustments were made for work and family characteristics (OR=1.04 [0.85-1.27]). The results of this study suggest that work and family characteristics may be important for reducing socioeconomic and sex inequalities in sleep. Sex differences in the pattern of socioeconomic inequalities in sleep deserve further research.

The effects of two types of sleep deprivation on visual working memory capacity and filtering efficiency.

PubMed

Drummond, Sean P A; Anderson, Dane E; Straus, Laura D; Vogel, Edward K; Perez, Veronica B

2012-01-01

Sleep deprivation has adverse consequences for a variety of cognitive functions. The exact effects of sleep deprivation, though, are dependent upon the cognitive process examined. Within working memory, for example, some component processes are more vulnerable to sleep deprivation than others. Additionally, the differential impacts on cognition of different types of sleep deprivation have not been well studied. The aim of this study was to examine the effects of one night of total sleep deprivation and 4 nights of partial sleep deprivation (4 hours in bed/night) on two components of visual working memory: capacity and filtering efficiency. Forty-four healthy young adults were randomly assigned to one of the two sleep deprivation conditions. All participants were studied: 1) in a well-rested condition (following 6 nights of 9 hours in bed/night); and 2) following sleep deprivation, in a counter-balanced order. Visual working memory testing consisted of two related tasks. The first measured visual working memory capacity and the second measured the ability to ignore distractor stimuli in a visual scene (filtering efficiency). Results showed neither type of sleep deprivation reduced visual working memory capacity. Partial sleep deprivation also generally did not change filtering efficiency. Total sleep deprivation, on the other hand, did impair performance in the filtering task. These results suggest components of visual working memory are differentially vulnerable to the effects of sleep deprivation, and different types of sleep deprivation impact visual working memory to different degrees. Such findings have implications for operational settings where individuals may need to perform with inadequate sleep and whose jobs involve receiving an array of visual information and discriminating the relevant from the irrelevant prior to making decisions or taking actions (e.g., baggage screeners, air traffic controllers, military personnel, health care providers).

A regular yoga intervention for staff nurse sleep quality and work stress: a randomised controlled trial.

PubMed

Fang, Ronghua; Li, Xia

2015-12-01

Although many studies have assessed the efficacy of yoga in older individuals, minimal research has focused on how nurses use yoga to improve sleep quality and to reduce work stress after work hours. We used the Pittsburgh Sleep Quality Index in Chinese and the Questionnaire on Medical Worker's Stress in Chinese to determine the impact of yoga on the quality of sleep and work stress of staff nurses employed by a general hospital in China. Disturbances in the circadian rhythm interrupt an individual's pattern of sleep. Convenient sampling method. One hundred and twenty nurses were randomised into two groups: a yoga group and a non-yoga group. The yoga group performed yoga more than two times every week for 50-60 minutes each time after work hours. The NG group did not participate in yoga. After six months, self-reported sleep quality and work stress were compared between the two groups, and then we used linear regression to confirm the independent factors related to sleep quality. Nurses in the yoga group had better sleep quality and lower work stress compared with nurses in the non-yoga group. The linear regression model indicated that nursing experience, age and yoga intervention were significantly related to sleep quality. Regular yoga can improve sleep quality and reduce work stress in staff nurses. This study provides evidence that hospital management should pay attention to nurse sleep quality and work stress, thereby taking corresponding measures to reduce work pressure and improve health outcomes. © 2015 John Wiley & Sons Ltd.

Myths and realities of the 80-hour work week.

PubMed

Schenarts, Paul J; Anderson Schenarts, Kimberly D; Rotondo, Michael F

2006-01-01

Myths are so ingrained into cultural traditions that emotion frequently overshadows a rational evaluation of the facts. The reduction in resident work hours has resulted in the formation of several myths. The purpose of this review is to examine the published data on resident work hours to separate out myth from reality. An electronic database was searched for publications related to resident training, work-hours, continuity of care, sleep deprivation, quality of life, patient safety, clinical/operative experience, faculty work hours, and surgical education. Sleep deprivation has been shown to be harmful, and residents played a role in advocating for work-hour limits. Surgical residents have seen a less dramatic improvement in quality of life compared with other disciplines. Work-hour reductions have decreased participation in clinic but have not resulted in a significant decline in clinical or operative exposure. Limiting resident work hours will unlikely result in a decrease health-care cost. Reduction in resident work hours has not resulted in an improvement or deterioration in patient outcome. Reduction of work hours has not increased faculty work hours nor made surgery a more attractive career choice. Despite strongly held opinions, resident work-hour reduction has resulted in little significant change in lifestyle, clinical exposure, patient well-being, faculty work hours, or medical student recruitment.

Sleep quality in long haul truck drivers: A study on Iranian national data.

PubMed

Sadeghniiat-Haghighi, Khosro; Yazdi, Zohreh; Kazemifar, Amir-Mohammad

2016-08-01

Iran has a high rate of road traffic accidents. Poor quality of sleep brings about loss of attention, which is an important cause of road traffic accidents particularly in monotonous roads. The causes of poor quality of sleep in occupational drivers are multifactorial. The objective of the present study was to assess the prevalence of poor sleep quality among occupational drivers with rotating work schedules and analyze its different risk factors. 2200 professional long-haul truck drivers who had been referred to the Occupational Health Clinic for routine education course were invited. We obtained data from eight provinces from various parts of Iran during 2012-2013. Data were collected using a questionnaire including questions about demographic and job characteristics. Pittsburg Sleep Quality Index (PSQI) was used to assess drivers' sleep quality. Mean working (driving) time was (9.3±2.5) hours daily and (55.5 ± 18.29) hours weekly. About 23.5% of the drivers reported history of smoking, 14.5% had low job satisfaction and 60% had irregular work schedule. 16.4% of drivers had an accidents leading to injury during the past five years. The mean PSQI score was 4.2 ± 2.7; 54% had a PSQI>5 (poor quality of sleep). Multivariate logistic regression showed that smoking, job satisfaction, history of accidents, shift work and work hours per day were the most important risk factors for poor sleep quality. Results obtained from the current study showed a high prevalence of poor quality of sleep among professional drivers. It warrants more attention to this significant problem using some measures to improve working conditions in professional drivers, as well as health promotion interventions.

Effects of Sleep Deprivation on U.S. Navy Surface Ship Watchstander Performance using Alternative Watch Schedules

DTIC Science & Technology

2012-09-01

75  xi LIST OF TABLES Table 1.  Allocation of Hours per Sailor per Week Based on the Navy Standard Workweek ...sleep than allotted by the Navy Standard Workweek (NSWW). On average, personnel onboard cruisers achieve two- hours less sleep per week and personnel on...fact that the Navy adopted the 168- hour Navy Standard Workweek (NSWW), multiple studies have shown the amount of work conducted by personnel onboard

Factors associated with intern fatigue.

PubMed

Friesen, Lindsay D; Vidyarthi, Arpana R; Baron, Robert B; Katz, Patricia P

2008-12-01

Prior data suggest that fatigue adversely affects patient safety and resident well-being. ACGME duty hour limitations were intended, in part, to reduce resident fatigue, but the factors that affect intern fatigue are unknown. To identify factors associated with intern fatigue following implementation of duty hour limitations. Cross-sectional confidential survey of validated questions related to fatigue, sleep, and stress, as well as author-developed teamwork questions. Interns in cognitive specialties at the University of California, San Francisco. Univariate statistics characterized the distribution of responses. Pearson correlations elucidated bivariate relationships between fatigue and other variables. Multivariate linear regression models identified factors independently associated with fatigue, sleep, and stress. Of 111 eligible interns, 66 responded (59%). In a regression analysis including gender, hours worked in the previous week, sleep quality, perceived stress, and teamwork, only poorer quality of sleep and greater perceived stress were significantly associated with fatigue (p < 0.001 and p = 0.02, respectively). To identify factors that may affect sleep, specifically duty hours and stress, a secondary model was constructed. Only greater perceived stress was significantly associated with diminished sleep quality (p = 0.04), and only poorer teamwork was significantly associated with perceived stress (p < 0.001). Working >80 h was not significantly associated with perceived stress, quality of sleep, or fatigue. Simply decreasing the number of duty hours may be insufficient to reduce intern fatigue. Residency programs may need to incorporate programmatic changes to reduce stress, improve sleep quality, and foster teamwork in order to decrease intern fatigue and its deleterious consequences.

An Integrated Survey System for Addressing Abuse and Misconduct Toward Air Force Trainees During Basic Military Training

DTIC Science & Technology

2015-01-01

guidance, lack of time off, long work hours ) and asks MTIs to indicate the extent to which each has caused stress over the past six months (five-point...questions also ask MTIs about their work and sleep habits. Although the section on specific stressors includes items that assess MTI stress related to...single question on the average number of hours worked in a 30 day, as well as a single item on the number of hours of sleep the MTI is able to

Sleep Detriments Associated With Quick Returns in Rotating Shift Work: A Diary Study.

PubMed

Vedaa, Øystein; Mørland, Erik; Larsen, Marit; Harris, Anette; Erevik, Eilin; Sivertsen, Børge; Bjorvatn, Bjørn; Waage, Siri; Pallesen, Ståle

2017-06-01

We aimed to compared sleep characteristics associated with quick returns (QRs, <11 hours between shift intervals) with those associated with other common shift transitions. Sixty-seven nurses completed a 2-week work and sleep diary (94.0% female, mean age 47.7 years). A multilevel fixed effects model was used to examine the sleep in QRs compared with two consecutive night shifts, two consecutive evening shifts, and two consecutive day shifts, respectively. None of the other shift transitions studied encumbered as many detriments as QRs, which included short sleep duration (5.6 hours), slightly prolonged sleep onset latency, more abrupt ending of main sleep period, increased sleepiness, and higher level of perceived stress on the following shift. The study emphasizes the need for sufficient time for rest and recuperation between shifts.

The Impact of Work and Volunteer Hours on the Health of Undergraduate Students.

PubMed

Lederer, Alyssa M; Autry, Dana M; Day, Carol R T; Oswalt, Sara B

2015-01-01

To examine the impact of work and volunteer hours on 4 health issues among undergraduate college students. Full-time undergraduate students (N = 70,068) enrolled at 129 institutions who participated in the Spring 2011 American College Health Association-National College Health Assessment II survey. Multiple linear regression and binary logistic regression were used to examine work and volunteer hour impact on depression, feelings of being overwhelmed, sleep, and physical activity. The impact of work and volunteer hours was inconsistent among the health outcomes. Increased work hours tended to negatively affect sleep and increase feelings of being overwhelmed. Students who volunteered were more likely to meet physical activity guidelines, and those who volunteered 1 to 9 hours per week reported less depression. College health professionals should consider integrating discussion of students' employment and volunteering and their intersection with health outcomes into clinical visits, programming, and other services.

Work organisation and unintentional sleep: results from the WOLF study

PubMed Central

Akerstedt, T; Knutsson, A; Westerholm, P; Theorell, T; Alfredsson, L; Kecklund, G

2002-01-01

Background: Falling asleep at work is receiving increasing attention as a cause of work accidents. Aims: To investigate which variables (related to work, lifestyle, or background) are related to the tendency to fall asleep unintentionally, either during work hours, or during leisure time. Methods: 5589 individuals (76% response rate) responded to a questionnaire. A multiple logistic regression analysis of the cross sectional data was used to estimate the risk of falling asleep. Results: The prevalence for falling asleep unintentionally at least once a month was 7.0% during work hours and 23.1% during leisure time. The risk of unintentional sleep at work was related to disturbed sleep, having shift work, and higher socioeconomic group. Being older, being a woman, and being a smoker were associated with a reduced risk of unintentionally falling asleep at work. Work demands, decision latitude at work, physical load, sedentary work, solitary work, extra work, and overtime work were not related to falling asleep at work. Removing "disturbed sleep" as a predictor did not change the odds ratios of the other predictors in any significant way. With respect to falling asleep during leisure time, disturbed sleep, snoring, high work demands, being a smoker, not exercising, and higher age (>45 years) became risk indicators. Conclusion: The risk of involuntary sleep at work is increased in connection with disturbed sleep but also with night work, socioeconomic group, low age, being a male, and being a non-smoker. PMID:12205231

5 CFR 550.112 - Computation of overtime work.

Code of Federal Regulations, 2014 CFR

2014-01-01

... arrangements for another person to perform any work that may arise during the on-call period. (m) Sleep and meal time. (1) Bona fide sleep and meal periods may not be considered hours of work, except as provided in paragraphs (m)(2), (m)(3), and (m)(4) of this section. If a sleep or meal period is interrupted by...

5 CFR 550.112 - Computation of overtime work.

Code of Federal Regulations, 2013 CFR

2013-01-01

... arrangements for another person to perform any work that may arise during the on-call period. (m) Sleep and meal time. (1) Bona fide sleep and meal periods may not be considered hours of work, except as provided in paragraphs (m)(2), (m)(3), and (m)(4) of this section. If a sleep or meal period is interrupted by...

5 CFR 550.112 - Computation of overtime work.

Code of Federal Regulations, 2012 CFR

2012-01-01

... arrangements for another person to perform any work that may arise during the on-call period. (m) Sleep and meal time. (1) Bona fide sleep and meal periods may not be considered hours of work, except as provided in paragraphs (m)(2), (m)(3), and (m)(4) of this section. If a sleep or meal period is interrupted by...

Subjective alertness and sleep quality in connection with permanent 12-hour day and night shifts.

PubMed

Gillberg, M

1998-01-01

The aim of this study was to compare permanent 12-hour day and night shifts (shift change over times at 0500 and 1700) in a shift system with 3 work periods followed by 4 free days. Sleep diaries were collected after main periods of sleep, and sleepiness ratings [Karolinska sleepiness scale (KSS)] were obtained 4 times during the last free day and also during the following 3 workshifts. Eighteen to twenty night workers and 8-10 day workers (depending on the instrument) participated. The day workers were significantly sleepier during their workdays. Times for going to bed and for rising differed between the groups. The amount of sleep per week did not differ between groups, but the pattern across days did in that the day workers had a short sleep (5 hours) before the first day and 6 hours of sleep after the other two. Night workers slept long (9 hours) before the first shift and had 6.5-hour sleep periods after the other shifts. During free time the day workers slept around 9 hours and the night workers around 8 hours. Sleep quality and ease of awakening showed no group differences in overall levels, but the day workers had difficulties awakening before their shifts. The night workers had little variation in sleep quality or difficulties awakening. The suggested explanation for the greater sleepiness and difficulties awakening among the day workers was the early start of the shift and the difficulties the workers had with phase advancing their sleep-wake rhythm.

Effect of a Protected Sleep Period on Hours Slept During Extended Overnight In-hospital Duty Hours Among Medical Interns

PubMed Central

Volpp, Kevin G.; Shea, Judy A.; Small, Dylan S.; Basner, Mathias; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian; Novak, Cristina; Bellini, Lisa M.; Dine, C. Jessica; Mollicone, Daniel J.; Dinges, David F.

2013-01-01

Context A 2009 Institute of Medicine report recommended protected sleep periods for medicine trainees on extended overnight shifts, a position reinforced by new Accreditation Council for Graduate Medical Education requirements. Objective To evaluate the feasibility and consequences of protected sleep periods during extended duty. Design, Setting, and Participants Randomized controlled trial conducted at the Philadelphia VA Medical Center medical service and Oncology Unit of the Hospital of the University of Pennsylvania (2009–2010). Of the 106 interns and senior medical students who consented, 3 were not scheduled on any study rotations. Among the others, 44 worked at the VA center, 16 at the university hospital, and 43 at both. Intervention Twelve 4-week blocks were randomly assigned to either a standard intern schedule (extended duty overnight shifts of up to 30 hours; equivalent to 1200 overnight intern shifts at each site), or a protected sleep period (protected time from 12:30 AM to 5:30 AM with handover of work cell phone; equivalent to 1200 overnight intern shifts at each site). Participants were asked to wear wrist actigraphs and complete sleep diaries. Main Outcome Measures Primary outcome was hours slept during the protected period on extended duty overnight shifts. Secondary outcome measures included hours slept during a 24-hour period (noon to noon) by day of call cycle and Karolinska sleepiness scale. Results For 98.3% of on-call nights, cell phones were signed out as designed. At the VA center, participants with protected sleep had a mean 2.86 hours (95% CI, 2.57–3.10 hours) of sleep vs 1.98 hours (95% CI, 1.68–2.28 hours) among those who did not have protected hours of sleep (P < .001). At the university hospital, participants with protected sleep had a mean 3.04 hours (95% CI, 2.77–3.45 hours) of sleep vs 2.04 hours (95% CI, 1.79–2.24) among those who did not have protected sleep (P <.001). Participants with protected sleep were significantly less likely to have call nights with no sleep: 5.8% (95% CI, 3.0%–8.5%) vs 18.6% (95% CI, 13.9%–23.2%) at the VA center (P <.001) and 5.9% (95% CI, 3.1%–8.7%) vs 14.2% (95% CI, 9.9%–18.4%) at the university hospital (P=.001). Participants felt less sleepy after on-call nights in the intervention group, with Karolinska sleepiness scale scores of 6.65 (95% CI, 6.35–6.97) vs 7.10 (95% CI, 6.85–7.33; P=.01) at the VA center and 5.91 (95% CI, 5.64–6.16) vs 6.79 (95% CI, 6.57–7.04; P <.001) at the university hospital. Conclusions For internal medicine services at 2 hospitals, implementation of a protected sleep period while on call resulted in an increase in overnight sleep duration and improved alertness the next morning. Trial Registration clinicaltrials.gov Identifier: NCT00874510. PMID:23212498

Effective implementation of work-hour limits and systemic improvements.

PubMed

Landrigan, Christopher P; Czeisler, Charles A; Barger, Laura K; Ayas, Najib T; Rothschild, Jeffrey M; Lockley, Steven W

2007-11-01

Sleep deprivation, ubiquitous among nurses and physicians, recently has been shown to greatly increase rates of serious medical errors and occupational injuries among health care workers in the United States. The Accreditation Council for Graduate Medical Education's current work-hour limits for physicians-in-training allow work hours well in excess of those proven safe. No regulations limit the work hours of other groups of health care providers in the United States. Consequently, nursing work shifts exceeding 12 hours remain common. Physician-in-training shifts of 30 consecutive hours continue to be endorsed officially, and data demonstrate that even the 30-hour limit is exceeded routinely. By contrast, European health care workers are limited by law to 13 consecutive hours of work and to 48-56 hours of work per week. Except for a few institutions that have eliminated 24-hour shifts, as a whole, the United States lags far behind other industrialized nations in ensuring safe work hours. Preventing health care provider sleep deprivation could be an extremely powerful means of addressing the epidemic of medical errors in the United States. Implementation of evidence-based work-hour limits, scientifically designed work schedules, and infrastructural changes, such as the development of standardized handoff systems, are urgently needed.

[Relationship between Working Schedule and Sleeping Hours with Overweight and Obesity in Spanish Adult Population According to Data from the National Health Survey 2012].

PubMed

Marqueta de Salas, María; Rodríguez Gómez, Lorena; Enjuto Martínez, Diego; Juárez Soto, José Juan; Martín-Ramiro, José Javier

2017-03-01

Obesity is a public health problem worldwide. The aim of the present study was to determine the association between the type of working schedule and the sleeping hours per day with obesity and overweight. Cross-sectional study of the National Health Survey in 2012. We conducted an analysis of multinomial logistic regression and estimated the rates of possible risk of obesity and overweight versus the normal weight in relation to the type of working schedule and sleeping hours. Obesity among those who worked at night was 17,50% and those who had irregular works was 17,92%. Overweight among those who performed part-time works was 40,81% and 39,17% in night works. The obesity and overweight among those who slept less than six hours a day were 24,42% and 40,99% respectively. Regression analysis logistic showed OR=1,83 (IC95% 1,15-1,75) in irregular works and OR= 1,83 (IC95% 1,59-2,11) in people who slept less than six hours. Whenever overweight and obesity are present, a positive association between irregular jobs and short patterns of rest has been found, but stadistical significance is lost when estimating the OR adjusting the confounding factors.

Executive Functions are not Affected by 24 Hours of Sleep Deprivation: A Color-Word Stroop Task Study.

PubMed

Dixit, Abhinav; Mittal, Tushar

2015-01-01

Sleep is an important factor affecting cognitive performance. Sleep deprivation results in fatigue, lack of concentration, confusion and sleepiness along with anxiety, depression and irritability. Sleep deprivation can have serious consequences in professions like armed forces and medicine where quick decisions and actions need to be taken. Color-Word Stroop task is one of the reliable tests to assess attention and it analyzes the processing of information in two dimensions i.e., reading of words and naming of colour. The evidence regarding the effect of sleep deprivation on Stroop interference is conflicting. The present study evaluated the effect of 24 hours of sleep deprivation on reaction time and interference in Stroop task. The present study was done on 30 healthy male medical student volunteers in the age group of 18-25 years after taking their consent and clearance from Institute Ethics Committee. Recordings of Stroop task were at three times: baseline (between 7-9 am), after 12 hours (7-9 pm) and after 24 hours (7-9 am, next day). The subjects were allowed to perform normal daily activities. The study revealed a significant increase in reaction time after 24 hours of sleep deprivation in comparison to baseline and after 12 hours of sleep deprivation. There was no significant change in interference and facilitation after sleep deprivation in comparison to baseline. The number of errors also did not show any significant change after sleep deprivation. The study indicated that there was slowing of responses without change in executive functions after 24 hours of sleep deprivation. It is probable that 24 hours of sleep deprivation does not bring about change in areas of brain affecting executive functions in healthy individuals who have normal sleep cycle. The present study indicated that in professions like armed forces and medicine working 24 hours at a stretch can lead to decrease in motor responses without affecting information processing and judgment ability.

Factors associated with sleep duration in Brazilian high school students.

PubMed

Gomes Felden, Érico Pereira; Barbosa, Diego Grasel; Junior, Geraldo Jose Ferrari; Santos, Manoella De Oliveira; Pelegrini, Andreia; Silva, Diego Augusto Santos

2017-01-01

The aim of this study was to investigate the factors associated with short sleep duration on southern Brazilian high school students. Our study was comprised of 1,132 adolescents aged 14 to 19 years, enrolled in public high schools in São José, Brazil. The students answered a questionnaire about working (work and workload), health perception, smoking, school schedule, sleep (duration and daytime sleepiness), and socio-demographics data. The results showed that more than two thirds of adolescent workers had short sleep duration (76.7%), and those with a higher workload (more than 20 hours) had a shorter sleep duration (7.07 hours) compared to non-workers (7.83 hours). In the analysis of factors associated with short sleep duration, adolescents who worked (OR = 2.12, 95% CI 1.53 to 2.95) were more likely to have short sleep duration compared to those who did not work. In addition, older adolescents (17-19 years) and students with poor sleep quality were 40% and 55% more likely to have short sleep duration compared to younger adolescents (14-16 years) and students with good sleep quality, respectively. Adolescents with daytime sleepiness were more likely to have short sleep duration (OR = 1.49, 95% CI 1.06 to 2.07) compared to those without excessive daytime sleepiness. In addition students of the morning shift (OR = 6.02, 95% CI 4.23 to 8.57) and evening shift (OR = 2.16, 95% CI 1.45 to 3.22) were more likely to have short sleep duration compared to adolescents of the afternoon shift. Thereby adolescents who are workers, older, attended morning and evening classes and have excessive daytime sleepiness showed risk factors for short sleep duration. In this sense, it is pointed out the importance of raising awareness of these risk factors for short sleep duration of students from public schools from São José, located in southern Brazil.

Relationship between Long Working Hours and Suicidal Thoughts: Nationwide Data from the 4th and 5th Korean National Health and Nutrition Examination Survey.

PubMed

Yoon, Jin-Ha; Jung, Pil Kyun; Roh, Jaehoon; Seok, Hongdeok; Won, Jong-Uk

2015-01-01

Long working hours are a worldwide problem and may increase the risk of various health issues. However, the health effects of long working hours on suicidal thoughts have not been frequently studied. Our goal was to investigate the relationship between long working hours and suicidal thoughts in the rapidly developing country of Korea. Data from 12,076 participants (7,164 men, 4,912 women) from the 4th and 5th Korean National Health and Nutrition Examination Surveys were used for the current analysis. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals for suicidal thoughts. Combined effects of long working hours and lower socioeconomic status or sleep disturbance were also estimated. Compared to groups who worked less than 52 hours per week, odds ratios (95% confidence intervals) for suicidal thoughts in groups who worked 60 hours or more per week were 1.36 (1.09-1.70) for males and 1.38 (1.11-1.72) for females, even after controlling for household income, marital status, history of hypertension or diabetes mellitus, health-related behaviors, and past two weeks' experience of injury, intoxication, or acute or chronic diseases, as well as type of work. The combined effects of long working hours with lower socioeconomic status, or with sleep disturbance, were also significantly higher compared to participants who worked less than 52 hours per week with higher socioeconomic status, or with 6-8 hours of nighttime sleep. In this study, long working hours were linked to suicidal thoughts for both genders. Additionally, the odds of those suicidal thoughts were higher for lower socioeconomic groups. To prevent adverse psychological health problems such as suicidal thoughts, a strategy regarding long working hours should be investigated.

Relationship between Long Working Hours and Suicidal Thoughts: Nationwide Data from the 4th and 5th Korean National Health and Nutrition Examination Survey

PubMed Central

Yoon, Jin-Ha; Jung, Pil Kyun; Roh, Jaehoon; Seok, Hongdeok; Won, Jong-Uk

2015-01-01

Background Long working hours are a worldwide problem and may increase the risk of various health issues. However, the health effects of long working hours on suicidal thoughts have not been frequently studied. Our goal was to investigate the relationship between long working hours and suicidal thoughts in the rapidly developing country of Korea. Methods Data from 12,076 participants (7,164 men, 4,912 women) from the 4th and 5th Korean National Health and Nutrition Examination Surveys were used for the current analysis. Multivariate logistic regression models were used to estimate odds ratios and 95% confidence intervals for suicidal thoughts. Combined effects of long working hours and lower socioeconomic status or sleep disturbance were also estimated. Results Compared to groups who worked less than 52 hours per week, odds ratios (95% confidence intervals) for suicidal thoughts in groups who worked 60 hours or more per week were 1.36 (1.09–1.70) for males and 1.38 (1.11–1.72) for females, even after controlling for household income, marital status, history of hypertension or diabetes mellitus, health-related behaviors, and past two weeks’ experience of injury, intoxication, or acute or chronic diseases, as well as type of work. The combined effects of long working hours with lower socioeconomic status, or with sleep disturbance, were also significantly higher compared to participants who worked less than 52 hours per week with higher socioeconomic status, or with 6–8 hours of nighttime sleep. Conclusion In this study, long working hours were linked to suicidal thoughts for both genders. Additionally, the odds of those suicidal thoughts were higher for lower socioeconomic groups. To prevent adverse psychological health problems such as suicidal thoughts, a strategy regarding long working hours should be investigated. PMID:26080022

Sex differences in factors contributing to family-to-work and work-to-family conflict in Japanese civil servants.

PubMed

Fujimura, Yuko; Sekine, Michikazu; Tatsuse, Takashi

2014-01-01

As the number of dual-earner couples in Japan has increased, work-life balance has become important. This study aimed to examine the factors that contribute to work-family conflict. The participants included 3,594 (2,332 men and 1,262 women) civil servants aged 20-59 working for local government on the west coast of Japan. Logistic regression analysis was used to evaluate whether work, family, or lifestyle characteristics were associated with work-family conflict. For men, family-to-work conflict was associated with being elderly, having low-grade employment, working long hours, raising children, and sleeping shorter hours. For women, being married and raising children were strong determinants of family-to-work conflict, and being middle-aged, working long hours, and sleeping shorter hours were also associated with this type of conflict. Regarding work-to-family conflict, working long hours was the strongest determinant of conflict in both sexes. In men, being elderly, living with family, eating dinner late, and sleeping shorter hours were also associated with work-to-family conflict. In women, having high-grade employment, being married, raising children, and eating dinner late were associated with work-to-family conflict. This study showed that working long hours was the primary determinant of work-to-family conflict in both sexes and that being married and raising children were strong factors of family-to-work conflict in women only. Sex differences may reflect divergence of the social and domestic roles of men and women in Japanese society. To improve the work-life balance, general and sex-specific health policies may be required.

Shift work with and without night work as a risk factor for fatigue and changes in sleep length: A cohort study with linkage to records on daily working hours.

PubMed

Härmä, Mikko; Karhula, Kati; Puttonen, Sampsa; Ropponen, Annina; Koskinen, Aki; Ojajärvi, Anneli; Kivimäki, Mika

2018-01-31

We examined shift work with or without night work as a risk factor for fatigue and short or long sleep. In a prospective cohort study with 4- and 6-year follow-ups (the Finnish Public Sector study), we linked survey responses of 3,679 full-time hospital employees on sleep duration and fatigue to records on daily working hours in 2008 (baseline), 2012 and 2014. We used logistic regression to estimate risk ratios and their confidence intervals to examine whether continuous exposure to shift work or changes between shift work and day work were associated with short (≤6.5 hr) or long (≥9.0 hr) sleep over 24 hr and fatigue at work and during free days. Compared with continuous day work and adjusting for age, gender, education and fatigue/sleep duration at baseline, continuous shift work with night shifts was associated with increased fatigue during free days (risk ratio = 1.38, 95% confidence interval 1.17-1.63) and long sleep (risk ratio = 8.04, 95% confidence interval 2.88-22.5, without adjustment for education) after 6-year follow-up. Exposure to shift work without night shifts increased only long sleep after 6 years (risk ratio = 5.87, 95% confidence interval 1.94-17.8). A change from day work to shift work with or without night shifts was associated with an increased risk for long sleep, and a change from shift work to day work with a decreased risk for long sleep and fatigue. This study suggests that irregular shift work is a modifiable risk factor for long sleep and increased fatigue, probably reflecting a higher need for recovery. © 2018 European Sleep Research Society.

Factors Associated with Intern Fatigue

PubMed Central

Vidyarthi, Arpana R.; Baron, Robert B.; Katz, Patricia P.

2008-01-01

ABSTRACT BACKGROUND Prior data suggest that fatigue adversely affects patient safety and resident well-being. ACGME duty hour limitations were intended, in part, to reduce resident fatigue, but the factors that affect intern fatigue are unknown. OBJECTIVE To identify factors associated with intern fatigue following implementation of duty hour limitations. DESIGN Cross-sectional confidential survey of validated questions related to fatigue, sleep, and stress, as well as author-developed teamwork questions. SUBJECTS Interns in cognitive specialties at the University of California, San Francisco. MEASUREMENTS Univariate statistics characterized the distribution of responses. Pearson correlations elucidated bivariate relationships between fatigue and other variables. Multivariate linear regression models identified factors independently associated with fatigue, sleep, and stress. RESULTS Of 111 eligible interns, 66 responded (59%). In a regression analysis including gender, hours worked in the previous week, sleep quality, perceived stress, and teamwork, only poorer quality of sleep and greater perceived stress were significantly associated with fatigue (p < 0.001 and p = 0.02, respectively). To identify factors that may affect sleep, specifically duty hours and stress, a secondary model was constructed. Only greater perceived stress was significantly associated with diminished sleep quality (p = 0.04), and only poorer teamwork was significantly associated with perceived stress (p < 0.001). Working >80 h was not significantly associated with perceived stress, quality of sleep, or fatigue. CONCLUSIONS Simply decreasing the number of duty hours may be insufficient to reduce intern fatigue. Residency programs may need to incorporate programmatic changes to reduce stress, improve sleep quality, and foster teamwork in order to decrease intern fatigue and its deleterious consequences. PMID:18807096

[Sleep, work, and study: sleep duration in working and non-working students].

PubMed

Pereira, Erico Felden; Bernardo, Maria Perpeto Socorro Leite; D'Almeida, Vânia; Louzada, Fernando Mazzilli

2011-05-01

The aim of this study was to investigate the duration of sleep and associated factors in working and non-working students. Data were analyzed on the sleep-wake cycle in 863 teenage students in São Paulo, Brazil. Adjusted analyses were performed to compare sleep duration in working and non-working students. 18.4% of the group worked, and 52% of the working students slept eight hours or less per night. Prevalence of short sleep duration was higher in working students of both sexes (males, p = 0.017; females, p < 0.001). Working students showed short sleep duration in the analysis adjusted for socioeconomic status, but short sleep was more frequent in older adolescents (p = 0.004) and in lower (p = 0.001) and middle (p = 0.011) socioeconomic classes. Although more working students were in night school, in the model adjusted for gender and socioeconomic status, working students in afternoon courses showed higher prevalence of short sleep duration (PR = 2.53; 95%CI: 1.68-4.12).

The Effects of the Mars Exploration Rovers (MER) Work Schedule Regime on Locomotor Activity Circadian Rhythms, Sleep and Fatigue

NASA Technical Reports Server (NTRS)

DeRoshia, Charles W.; Colletti, Laura C.; Mallis, Melissa M.

2008-01-01

This study assessed human adaptation to a Mars sol by evaluating sleep metrics obtained by actigraphy and subjective responses in 22 participants, and circadian rhythmicity in locomotor activity in 9 participants assigned to Mars Exploration Rover (MER) operational work schedules (24.65 hour days) at the Jet Propulsion Laboratory in 2004. During MER operations, increased work shift durations and reduced sleep durations and time in bed were associated with the appearance of pronounced 12-hr (circasemidian) rhythms with reduced activity levels. Sleep duration, workload, and circadian rhythm stability have important implications for adaptability and maintenance of operational performance not only of MER operations personnel but also in space crews exposed to a Mars sol of 24.65 hours during future Mars missions.

[Work schedules in the Hungarian health care system and the sleep quality of nurses].

PubMed

Fusz, Katalin; Pakai, Annamária; Kívés, Zsuzsanna; Szunomár, Szilvia; Regős, Annamária; Oláh, András

2016-03-06

One way of ensuring the continuity of health care is the shift work, which is burdensome and it can lead to sleep disturbances. The aim of the study was to measure the typical Hungarian nursing shift systems in hospitals, to analyse the causes of irregular work schedules, and to compare the sleep quality of nurses in different work schedules. 236 head nurses filled out the national online survey, and 217 nurses in clinics of the University of Pécs filled the Hungarian version of Bergen Shift Work Sleep Questionnaire. The head nurses provided data of 8697 nurses's schedules. 51.89% of nurses work in flexible shift system. 1944 employees work in regular shift system, most of them in the following order: 12-hour day shift and 12-hour night shift, followed by a one- or two-day rest. Where there is no system of shifts, the most frequent causes are the needs of nurses and the nurse shortage. Nurses who are working in irregular shift system had worse sleep quality than nurses who are working in flexible and regular shift system (p = 0.044). It would be helpful if the least burdensome shift system could be established.

[24-hour work: the interaction of stress and changes in the sleep-wake cycle in the police force].

PubMed

Garbarino, Sergio

2014-01-01

Disruption in police officers. In recent years there has been a widespread growth in services, available regardless of time or day organization (24/7 service) and a diffuse increase in their use, both in work and private lives, generally ignoring the importance of a regular sleep organization. Police officers - often need to work extended shifts and long hours under highly stressful conditions, which results in reduced levels of safety and operational effectiveness. In numerous studies, perceived stress has been found to correlate with both subjective and objective disturbances in sleep. Consequently, excessive daytime sleepiness is one of the most frequent health and safety hazards that police officers have to deal with. Sleep deprivation affects performance outcomes through a wide range of cognitive domains. Sleepiness and fatigue, caused by sleep loss, extended work and wakefulness, circadian misalignment and sleep disorders are major causes of workplace human errors, incidents, and accidents. Therefore, prevention of sleep loss, high levels of stress and fatigue is a key factor to consider when assessing emergency intervention. In order to combat fatigue and sleepiness, a 30-90 minutes nap before night shift could be a viable option.

Sleep duration, subjective sleep need, and sleep habits of 40- to 45-year-olds in the Hordaland Health Study.

PubMed

Ursin, Reidun; Bjorvatn, Bjørn; Holsten, Fred

2005-10-01

To report the distribution of various sleep parameters in a population-based study. Population-based cross-sectional study with self-administered questionnaires. Conducted as part of the Hordaland Health Study '97-'99 in collaboration with the Norwegian National Health Screening Service. 8860 subjects, aged 40 to 45 years, answered the sleep questionnaire part of the study. N/A. Reports on habitual bedtimes, rise times, subjective sleep need, and various sleep characteristics were used in this study. Mean (+/- SD) nocturnal sleep duration during weekdays in men was 6 hours 52 minutes (+/- 55 minutes); in women 7 hours 11 minutes (+/- 57 minutes). Mean subjective sleep need was 7 hours 16 minutes (+/- 52 minutes) in men; 7 hours 45 minutes (+/- 52 minutes) in women. Sleep duration was shorter in shift workers and longer in married subjects and in those living in rural areas. Subjective sleep need was higher in subjects reporting poor subjective health and in subjects living in rural areas. In total, these variables accounted for only around 3% of the variance in sleep duration and sleep need. Ten percent of the men and 12.2% of the women reported frequent insomnia. The wide distribution of sleep duration and subjective sleep need indicate large interindividual variations in these parameters. There were pronounced sex differences in these variables and in most of the sleep characteristics studied. Shift work, urban-rural living, marital status, and education in men were sources of significant, but small, variations in sleep duration.

Sleep duration, life satisfaction and disability.

PubMed

Pagan, Ricardo

2017-04-01

Although sleep is considered an essential part of individuals' lives, there are no previous studies analysing how sleep duration affects the levels of life satisfaction reported by males and females with disabilities. To analyse and compare the impact of hours of sleep on life satisfaction scores reported by people without and with disabilities (stratified by sex) in Germany. Using data taken from the German Socio-Economic Panel for the period 2008-2013, we estimate life satisfaction equations for males and females (running a fixed-effects model) which include a set of variables measuring the number of sleep hours on workdays and weekends. A higher number of sleep hours on workdays increase life satisfaction for all males and females. However, the contribution of each hour of sleep on workdays is greater for males with disabilities in terms of life satisfaction, whereas for females no significant differences by disability status have been found. Although sleep hours on weekends also increase life satisfaction, the magnitude of the coefficients is relatively higher than that found for the corresponding hours of sleep on workdays, but only for the male sample (disabled or not). The participation and commitment of policymakers, governments, trade unions, employers, and health care professionals are key aspects for developing and formulating new guidelines and specific measures that promote a healthy lifestyle and increase sleep duration. Such guidelines and measures are of essence for people with disabilities who are employed (e.g. using brief sleep opportunities during prolonged work periods, which can contribute to reducing fatigue, stress and anxiety). Copyright © 2016 Elsevier Inc. All rights reserved.

Non-24-Hour Sleep-Wake Rhythm Disorder and Melatonin Secretion Impairment in a Patient With Pineal Cyst

PubMed Central

Ferri, Lorenzo; Filardi, Marco; Moresco, Monica; Pizza, Fabio; Vandi, Stefano; Antelmi, Elena; Toni, Francesco; Zucchelli, Mino; Pierangeli, Giulia; Plazzi, Giuseppe

2017-01-01

We report the case of a 14-year-old girl with a wide non-compressive pineal cyst, associated with the inability to control her sleep-wake schedule. Actigraphic monitoring showed a 24-hour free-running disorder (tau 26.96 hours). A 24-hour serum melatonin curve assay, with concomitant video-polysomnographic and body-core temperature monitoring, was performed. Melatonin curve showed a blunted nocturnal peak, lower total quantity of melatonin, and prolonged melatonin secretion in the morning, with normal temperature profile and sleep parameters. Treatment with melatonin up to 14 mg at bedtime was initiated with complete realignment of the sleep-wake rhythm (tau 23.93 hours). The role of the pineal cyst in the aforementioned alteration of melatonin secretion and free-running disorder remains controversial, but our case supports the utility of monitoring sleep/wake, temperature, and melatonin rhythms in the diagnostic work-up of pineal cysts associated with free-running disorder. Citation: Ferri L, Filardi M, Moresco M, Pizza F, Vandi S, Antelmi E, Toni F, Zucchelli M, Pierangeli G, Plazzi G. Non-24-hour sleep-wake rhythm disorder and melatonin secretion impairment in a patient with pineal cyst. J Clin Sleep Med. 2017;13(11):1355–1357. PMID:28992833

Excessive Video Game Use, Sleep Deprivation, and Poor Work Performance Among U.S. Marines Treated in a Military Mental Health Clinic: A Case Series.

PubMed

Eickhoff, Erin; Yung, Kathryn; Davis, Diane L; Bishop, Frank; Klam, Warren P; Doan, Andrew P

2015-07-01

Excessive use of video games may be associated with sleep deprivation, resulting in poor job performance and atypical mood disorders. Three active duty service members in the U.S. Marine Corps were offered mental health evaluation for sleep disturbance and symptoms of blunted affect, low mood, poor concentration, inability to focus, irritability, and drowsiness. All three patients reported insomnia as their primary complaint. When asked about online video games and sleep hygiene practices, all three patients reported playing video games from 30 hours to more than 60 hours per week in addition to maintaining a 40-hour or more workweek. Our patients endorsed sacrificing sleep to maintain their video gaming schedules without insight into the subsequent sleep deprivation. During the initial interviews, they exhibited blunted affects and depressed moods, but appeared to be activated with enthusiasm and joy when discussing their video gaming with the clinical provider. Our article illustrates the importance of asking about online video gaming in patients presenting with sleep disturbances, poor work performance, and depressive symptoms. Because excessive video gaming is becoming more prevalent worldwide, military mental health providers should ask about video gaming when patients report problems with sleep. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Relationship between shift work schedule and self-reported sleep quality in Chinese employees.

PubMed

Ma, Yifei; Wei, Fu; Nie, Guanghui; Zhang, Li'e; Qin, Jian; Peng, Suwan; Xiong, Feng; Zhang, Zhiyong; Yang, Xiaobo; Peng, Xiaowu; Wang, Mingjun; Zou, Yunfeng

2018-02-01

Few studies have reported on the effects of fixed and rotating shift systems on the prevalence of sleep disturbance. Thus, in this study, the relationships between different work schedules and sleep disturbance in Chinese workers were investigated. A total of 2180 workers aged 19-65 years responded to the self-report questionnaire on shift work schedule (fixed day-shift, fixed night-shift, two-shift or three-shift system), working hours a day, and working days a week, physical effort, subjective sleep quality and subjective mental state. It was found that the rotating shift workers, namely, two- and three-shift workers, exhibited higher risks of sleep disturbance than with the fixed day-shift workers did (OR 1.37; 95% CI 1.07to 1.74; and OR 2.19; 95% CI 1.52 to 3.15, respectively). The risk was particularly high among two- or three-shift workers who worked more than 8 hours a day or more than 5 days a week and among three-shift workers who reported both light and heavy physical effort at work. Moreover, the two- and three-shift workers (rotating shift workers) suffered from poorer sleep quality than the fixed night shift workers did (OR 1.84; 95% CI 1.01 to 3.32; and OR 2.94; 95% CI 1.53 to 5.64, respectively). Consequently, rotating shift work (two- and three-shift work) is a risk factor for sleep disturbance, and the fixed work rhythm may contribute to the quality of sleep.

Managing sleep and wakefulness in a 24-hour world

PubMed Central

Coveney, Catherine M

2014-01-01

This article contributes to literature on the sociology of sleep by exploring the sleeping practices and subjective sleep experiences of two social groups: shift workers and students. It draws on data, collected in the UK from 25 semi-structured interviews, to discuss the complex ways in which working patterns and social activities impact upon experiences and expectations of sleep in our wired awake world. The data show that, typically, sleep is valued and considered to be important for health, general wellbeing, appearance and physical and cognitive functioning. However, sleep time is often cut back on in favour of work demands and social activities. While shift workers described their efforts to fit in an adequate amount of sleep per 24-hour period, for students, the adoption of a flexible sleep routine was thought to be favourable for maintaining a work–social life balance. Collectively, respondents reported using a wide range of strategies, techniques, technologies and practices to encourage, overcome or delay sleep(iness) and boost, promote or enhance wakefulness/alertness at socially desirable times. The analysis demonstrates how social context impacts not only on how we come to think about sleep and understand it, but also how we manage or self-regulate our sleeping patterns. PMID:23957268

To Assess Sleep Quality among Pakistani Junior Physicians (House Officers): A Cross-sectional Study.

PubMed

Surani, A A; Surani, A; Zahid, S; Ali, S; Farhan, R; Surani, S

2015-01-01

Sleep deprivation among junior physicians (house officers) is of growing concern. In developed countries, duty hours are now mandated, but in developing countries, junior physicians are highly susceptible to develop sleep impairment due to long working hours, on-call duties and shift work schedule. We undertook the study to assess sleep quality among Pakistani junior physicians. A cross-sectional study was conducted at private and public hospitals in Karachi, Pakistan, from June 2012 to January 2013. The study population comprised of junior doctors (house physicians and house surgeons). A consecutive sample of 350 physicians was drawn from the above-mentioned study setting. The subject underwent two validated self-administered questionnaires, that is, Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). A total of 334 physicians completely filled out the questionnaire with a response rate of 95.4% (334/350). Of 334 physicians, 36.8% (123/334) were classified as "poor sleepers" (global PSQI score > 5). Poor sleep quality was associated with female gender (P = 0.01), excessive daytime sleepiness (P < 0.01), lower total sleep time (P < 0.001), increased sleep onset latency (P < 0.001), and increased frequency of sleep disturbances (P < 0.001). Abnormal ESS scores (ESS > 10) were more prevalent among poor sleepers (P < 0.01) signifying increased level of daytime hypersomnolence. Sleep quality among Pakistani junior physicians is significantly poor. Efforts must be directed towards proper sleep hygiene education. Regulations regarding duty hour limitations need to be considered.

Managing sleep and wakefulness in a 24-hour world.

PubMed

Coveney, Catherine M

2014-01-01

This article contributes to literature on the sociology of sleep by exploring the sleeping practices and subjective sleep experiences of two social groups: shift workers and students. It draws on data, collected in the UK from 25 semi-structured interviews, to discuss the complex ways in which working patterns and social activities impact upon experiences and expectations of sleep in our wired awake world. The data show that, typically, sleep is valued and considered to be important for health, general wellbeing, appearance and physical and cognitive functioning. However, sleep time is often cut back on in favour of work demands and social activities. While shift workers described their efforts to fit in an adequate amount of sleep per 24-hour period, for students, the adoption of a flexible sleep routine was thought to be favourable for maintaining a work-social life balance. Collectively, respondents reported using a wide range of strategies, techniques, technologies and practices to encourage, overcome or delay sleep(iness) and boost, promote or enhance wakefulness/alertness at socially desirable times. The analysis demonstrates how social context impacts not only on how we come to think about sleep and understand it, but also how we manage or self-regulate our sleeping patterns. © 2013 The Author. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Physical Activity, Energy Expenditure, Nutritional Habits, Quality of Sleep and Stress Levels in Shift-Working Health Care Personnel.

PubMed

Roskoden, Frederick Charles; Krüger, Janine; Vogt, Lena Johanna; Gärtner, Simone; Hannich, Hans Joachim; Steveling, Antje; Lerch, Markus M; Aghdassi, Ali A

2017-01-01

Among health care personnel working regular hours or rotating shifts can affect parameters of general health and nutrition. We have investigated physical activity, sleep quality, metabolic activity and stress levels in health care workers from both groups. We prospectively recruited 46 volunteer participants from the workforce of a University Medical Department of which 23 worked in rotating shifts (all nursing) and 21 non-shift regular hours (10 nursing, 13 clerical staff). All were investigated over 7 days by multisensory accelerometer (SenseWear Bodymedia® armband) and kept a detailed food diary. Physical activity and resting energy expenditure (REE) were measured in metabolic equivalents of task (METs). Quality of sleep was assessed as Pittsburgh Sleeping Quality Index and stress load using the Trier Inventory for Chronic Stress questionnaire (TICS). No significant differences were found for overall physical activity, steps per minute, time of exceeding the 3 METs level or sleep quality. A significant difference for physical activity during working hours was found between shift-workers vs. non-shift-workers (p<0.01) and for shift-working nurses (median = 2.1 METs SE = 0.1) vs. non-shift-working clerical personnel (median = 1.5 METs SE = 0.07, p<0.05). Non-shift-working nurses had a significantly lower REE than the other groups (p<0.05). The proportion of fat in the diet was significantly higher (p<0.05) in the office worker group (median = 42% SE = 1.2) whereas shift-working nurses consumed significantly more carbohydrates (median = 46% SE = 1.4) than clerical staff (median = 41% SE = 1.7). Stress assessment by TICS confirmed a significantly higher level of social overload in the shift working group (p<0.05). In this prospective cohort study shift-working had no influence on overall physical activity. Lower physical activity during working hours appears to be compensated for during off-hours. Differences in nutritional habits and stress load warrant larger scale trials to determine the effect on implicit health-associated conditions.

Physical Activity, Energy Expenditure, Nutritional Habits, Quality of Sleep and Stress Levels in Shift-Working Health Care Personnel

PubMed Central

Vogt, Lena Johanna; Gärtner, Simone; Hannich, Hans Joachim; Steveling, Antje; Lerch, Markus M.

2017-01-01

Background Among health care personnel working regular hours or rotating shifts can affect parameters of general health and nutrition. We have investigated physical activity, sleep quality, metabolic activity and stress levels in health care workers from both groups. Methods We prospectively recruited 46 volunteer participants from the workforce of a University Medical Department of which 23 worked in rotating shifts (all nursing) and 21 non-shift regular hours (10 nursing, 13 clerical staff). All were investigated over 7 days by multisensory accelerometer (SenseWear Bodymedia® armband) and kept a detailed food diary. Physical activity and resting energy expenditure (REE) were measured in metabolic equivalents of task (METs). Quality of sleep was assessed as Pittsburgh Sleeping Quality Index and stress load using the Trier Inventory for Chronic Stress questionnaire (TICS). Results No significant differences were found for overall physical activity, steps per minute, time of exceeding the 3 METs level or sleep quality. A significant difference for physical activity during working hours was found between shift-workers vs. non-shift-workers (p<0.01) and for shift-working nurses (median = 2.1 METs SE = 0.1) vs. non-shift-working clerical personnel (median = 1.5 METs SE = 0.07, p<0.05). Non-shift-working nurses had a significantly lower REE than the other groups (p<0.05). The proportion of fat in the diet was significantly higher (p<0.05) in the office worker group (median = 42% SE = 1.2) whereas shift-working nurses consumed significantly more carbohydrates (median = 46% SE = 1.4) than clerical staff (median = 41% SE = 1.7). Stress assessment by TICS confirmed a significantly higher level of social overload in the shift working group (p<0.05). Conclusion In this prospective cohort study shift-working had no influence on overall physical activity. Lower physical activity during working hours appears to be compensated for during off-hours. Differences in nutritional habits and stress load warrant larger scale trials to determine the effect on implicit health-associated conditions. PMID:28081231

5 CFR 551.432 - Sleep time.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 5 Administrative Personnel 1 2013-01-01 2013-01-01 false Sleep time. 551.432 Section 551.432... FAIR LABOR STANDARDS ACT Hours of Work Special Situations § 551.432 Sleep time. (a) Except as provided in paragraph (b) of this section, bona fide sleep time that fulfills the following conditions shall...

5 CFR 551.432 - Sleep time.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 5 Administrative Personnel 1 2014-01-01 2014-01-01 false Sleep time. 551.432 Section 551.432... FAIR LABOR STANDARDS ACT Hours of Work Special Situations § 551.432 Sleep time. (a) Except as provided in paragraph (b) of this section, bona fide sleep time that fulfills the following conditions shall...

5 CFR 551.432 - Sleep time.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 5 Administrative Personnel 1 2012-01-01 2012-01-01 false Sleep time. 551.432 Section 551.432... FAIR LABOR STANDARDS ACT Hours of Work Special Situations § 551.432 Sleep time. (a) Except as provided in paragraph (b) of this section, bona fide sleep time that fulfills the following conditions shall...

Sleep habits, insomnia, and daytime sleepiness in a large and healthy community-based sample of New Zealanders.

PubMed

Wilsmore, Bradley R; Grunstein, Ronald R; Fransen, Marlene; Woodward, Mark; Norton, Robyn; Ameratunga, Shanthi

2013-06-15

To determine the relationship between sleep complaints, primary insomnia, excessive daytime sleepiness, and lifestyle factors in a large community-based sample. Cross-sectional study. Blood donor sites in New Zealand. 22,389 individuals aged 16-84 years volunteering to donate blood. N/A. A comprehensive self-administered questionnaire including personal demographics and validated questions assessing sleep disorders (snoring, apnea), sleep complaints (sleep quantity, sleep dissatisfaction), insomnia symptoms, excessive daytime sleepiness, mood, and lifestyle factors such as work patterns, smoking, alcohol, and illicit substance use. Additionally, direct measurements of height and weight were obtained. One in three participants report < 7-8 h sleep, 5 or more nights per week, and 60% would like more sleep. Almost half the participants (45%) report suffering the symptoms of insomnia at least once per week, with one in 5 meeting more stringent criteria for primary insomnia. Excessive daytime sleepiness (evident in 9% of this large, predominantly healthy sample) was associated with insomnia (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.50 to 2.05), depression (OR 2.01, CI 1.74 to 2.32), and sleep disordered breathing (OR 1.92, CI 1.59 to 2.32). Long work hours, alcohol dependence, and rotating work shifts also increase the risk of daytime sleepiness. Even in this relatively young, healthy, non-clinical sample, sleep complaints and primary insomnia with subsequent excess daytime sleepiness were common. There were clear associations between many personal and lifestyle factors-such as depression, long work hours, alcohol dependence, and rotating shift work-and sleep problems or excessive daytime sleepiness.

The effects of anticipating a high-stress task on sleep and performance during simulated on-call work.

PubMed

Sprajcer, Madeline; Jay, Sarah M; Vincent, Grace E; Vakulin, Andrew; Lack, Leon; Ferguson, Sally A

2018-04-22

On-call work is used to manage around the clock working requirements in a variety of industries. Often, tasks that must be performed while on-call are highly important, difficult and/or stressful by nature and, as such, may impact the level of anxiety that is experienced by on-call workers. Heightened anxiety is associated with poor sleep, which affects next-day cognitive performance. Twenty-four male participants (20-35 years old) spent an adaptation, a control and two counterbalanced on-call nights in a time-isolated sleep laboratory. On one of the on-call nights they were told that they would be required to do a speech upon waking (high-stress condition), whereas on the other night they were instructed that they would be required to read to themselves (low-stress condition). Pre-bed anxiety was measured by the State Trait Anxiety Inventory form x-1, and polysomnography and quantitative electroencephalogram analyses were used to investigate sleep. Performance was assessed across each day using the 10-min psychomotor vigilance task (09:30 hours, 12:00 hours, 14:30 hours, 17:00 hours). The results indicated that participants experienced no significant changes in pre-bed anxiety or sleep between conditions. However, performance on the psychomotor vigilance task was best in the high-stress condition, possibly as a result of heightened physiological arousal caused by performing the stressful task that morning. This suggests that performing a high-stress task may be protective of cognitive performance to some degree when sleep is not disrupted. © 2018 European Sleep Research Society.

Sleep, but not other daily routines, mediates the association between maternal employment and BMI for preschool children.

PubMed

Speirs, Katherine E; Liechty, Janet M; Wu, Chi-Fang

2014-12-01

It has been established that the more time mothers spend working outside of the home, the more likely their preschool-aged children are to be overweight. However, the mechanisms explaining this relationship are not well understood. Our objective was to explore child sleep, dietary habits, TV time, and family mealtime routines as mediators of the relationship between maternal employment status (full-time, part-time, and no or minimal employment) and child body mass index (BMI) percentile. Data were drawn from waves 1 and 2 of STRONG Kids, a prospective panel study examining childhood obesity among parent-preschooler dyads (n = 247). Mothers reported their own work hours, their child's hours of nighttime sleep, dietary habits, TV time, and mealtime routines. Trained staff measured child height and weight. Compared to working 0-19 h/week, both full-time (>35 h/week) and part-time (20-34 h/week) employment predicted higher child BMI percentile 1 year later. Hours of child nighttime sleep partially mediated the association between maternal full-time employment and child BMI percentile. Adjusting for individual and family characteristics, children whose mothers were employed full time were less likely to sleep longer hours than children whose mothers were employed 0-19 h/week (b = -0.49, p < 0.04). Shorter child nighttime sleep was associated with higher BMI percentile (b = -7.31, p < 0.001). None of the other mediation pathways tested were significant. These findings add to the growing literature on the importance of adequate sleep for young children's health. Copyright © 2014 Elsevier B.V. All rights reserved.

Prevalence of Healthy Sleep Duration among Adults--United States, 2014.

PubMed

Liu, Yong; Wheaton, Anne G; Chapman, Daniel P; Cunningham, Timothy J; Lu, Hua; Croft, Janet B

2016-02-19

To promote optimal health and well-being, adults aged 18-60 years are recommended to sleep at least 7 hours each night (1). Sleeping <7 hours per night is associated with increased risk for obesity, diabetes, high blood pressure, coronary heart disease, stroke, frequent mental distress, and all-cause mortality (2-4). Insufficient sleep impairs cognitive performance, which can increase the likelihood of motor vehicle and other transportation accidents, industrial accidents, medical errors, and loss of work productivity that could affect the wider community (5). CDC analyzed data from the 2014 Behavioral Risk Factor Surveillance System (BRFSS) to determine the prevalence of a healthy sleep duration (≥ 7 hours) among 444,306 adult respondents in all 50 states and the District of Columbia. A total of 65.2% of respondents reported a healthy sleep duration; the age-adjusted prevalence of healthy sleep was lower among non-Hispanic blacks, American Indians/Alaska Natives, Native Hawaiians/Pacific Islanders, and multiracial respondents, compared with non-Hispanic whites, Hispanics, and Asians. State-based estimates of healthy sleep duration prevalence ranged from 56.1% in Hawaii to 71.6% in South Dakota. Geographic clustering of the lowest prevalence of healthy sleep duration was observed in the southeastern United States and in states along the Appalachian Mountains, and the highest prevalence was observed in the Great Plains states. More than one third of U.S. respondents reported typically sleeping <7 hours in a 24-hour period, suggesting an ongoing need for public awareness and public education about sleep health; worksite shift policies that ensure healthy sleep duration for shift workers, particularly medical professionals, emergency response personnel, and transportation industry personnel; and opportunities for health care providers to discuss the importance of healthy sleep duration with patients and address reasons for poor sleep health.

Circadian Disruptions of Heart Rate Variability among Weekly Consecutive-12-hour 2 Shift Workers in the Automobile Factory in Korea.

PubMed

Son, Mia; Sung, Juhon; Yum, Myunggul; Kong, Jung Ok; Lee, Hye Un; Kim, In A; Kim, Jung Yeon

2004-05-01

The objective of this study is to compare the circadian patterns of heart rate variability assessed by 24-hour ambulatory electrocardiographic (ECG) recordings during day shift and night shift among the workers in the 5 days-concecutive- 12-hour shift in an automobile factory in Korea. The study population consisted 300 workers, who were randomly selected among the 8700 total workers in one car factory. To analyse circadian variation, the 24-hour ECG recordings (Marquette) were measured during day shift (08: 00-20: 00 h) and night shift (20: 00-08: 00 h). Analysis was performed for all time and frequency domain measures of HRV. 233 workers completed taking 24-hour ECG recordings. This study shows that the 24 hourcircadian variation mainly follows work/sleep cycle rather than day/night cycle among shift workers. This study also shows that among the night shift, the circadian variation between work and sleep cycle decreased compared to the work/sleep cycle among day shift workers. All time and frequency domain parameters (except LF/HF ratio) show significantly different between work and sleep in the day shift and night shift. These changes in heart rate variability circadian rhythms reflect significant reductions in cardiac parasympathetic activity with the most marked reduction in normal vagal activity among the shift workers. Especially, it suggests the circadian rhytm has blunted among the night workers. The quantification of the circadian variation in HRV can be a surrogates of workers' potential health risk, as well as suggests possible mechanisms through which the shift works compromise workers' health.

Relationship between sleep loss and economic worry among farmers: a survery of 94 active saskatchewan noncorporate farms.

PubMed

LaBrash, Leanne F; Pahwa, Punam; Pickett, William; Hagel, Louise M; Snodgrass, Phyllis R; Dosman, James A

2008-01-01

Farm work involves seasonal peak busy periods with long hours of work and potential sleep loss. Social, technological, and economic changes, and depressed commodity prices, have resulted in financial stress. There may be a relationship between sleep loss and worry about economic conditions. The objective of this study was to examine the association between hours of sleep and worry associated with cash flow shortages and worry associated with debt among a population of farmers and their family members. One hundred and ninety-five persons from 94 active farms in two rural municipalities in west central Saskatchewan were interviewed by questionnaire. Logistic regression analyses were used to quantify associations between sleep patterns and economic concerns during peak seasons and nonpeak seasons. During peak agricultural seasons, 31.6% of owners/operators reported less than 6 hours of sleep per night compared to 6.3% during the nonpeak seasons (p< .01). A significant relationship (odds ration [OR] 3.59, confidence interval [Cl] 1.58-8.13) was observed between daily cash flow worry and impaired sleep during peak busy seasons. A large proportion of farmers surveyed suffered sleep deprivation during peak seasons, and this sleep loss appeared related to worries about cash flow that were not observed during nonpeak seasons. It is possible that sleep loss during peak busy seasons may be related to impared judgment, as shown by differential worry habits, and might also be related to the high injury rates in farmers during peak busy seasons.

Lower percentage of CD56+ cells associated with long working hours.

PubMed

Yasuda, A; Iwasaki, K; Sasaki, T; Oka, T; Hisanaga, N

2001-04-01

In a study of 142 Japanese men from a cross-section of the workforce of a technology development company, we found that the percentage of CD56+ cells was inversely correlated with the number of hours worked per week. A low CD56+ cell percentage was associated with longer weekly working hours and shorter daily sleeping hours.

Occupational Health Screenings of the Virtual Warrior: Distributed Common Ground System Intelligence Operators Compared with Non-Combatant Support Personnel

DTIC Science & Technology

2014-02-01

long hours , shift work , relational conflict...reasons for an increase in medication. Such sleep problems were often explained in textual responses to be the result of long work hours , shift work ...to be operational in nature [1]. Specifically, long hours , shift work , organizational and leadership challenges, nature of work , additional

Time spent in physical activity and sedentary behaviors on the working day: the American time use survey.

PubMed

Tudor-Locke, Catrine; Leonardi, Claudia; Johnson, William D; Katzmarzyk, Peter T

2011-12-01

To determine time spent on the working day in sleep, work, sedentary behaviors, and light-, moderate-, and vigorous-intensity behaviors by occupation intensity. Data came from 30,758 working respondents to the 2003 to 2009 American Time Use Survey. Mean ± SEM time spent in work, sedentary behaviors, light-, moderate-, and vigorous-intensity activities, and sleep were computed by occupations classified as sedentary, light, moderate, and vigorous intensity. On average, approximately 32% of the 24-hour day was spent sleeping and approximately 31% was spent at work. Time spent in sedentary behaviors outside of work was higher, and light-intensity time was lower, with higher levels of intensity-defined occupation. Those employed in sedentary occupations were sedentary for approximately 11 hours per day, leaving little time to achieve recommended levels of physical activity for overall health.

Fatigue and work safety behavior in men during early fatherhood.

PubMed

Mellor, Gary; St John, Winsome

2012-01-01

This study investigated the relationship between fatigue and work safety behavior of fathers with new babies. A total of 241 fathers completed a questionnaire at 6 and 12 weeks postpartum with items on fatigue and safety behavior at work. Results revealed that fathers worked long hours, reported a moderate-to-high physical intensity of work, and experienced interrupted sleep averaging less than 6 hours. Fathers also reported moderate fatigue at both 6 and 12 weeks postbirth, which was inversely related to safety behavior. Both fatigue and sleep history made a small but statistically significant contribution to safety behavior results at 6 and 12 weeks postbirth. Findings suggest that working fathers with babies experience fatigue during early fatherhood and are unable to recover due to interrupted and poor sleep patterns. Managers should consider the potential for fatigue to compromise work safety and develop risk management strategies that target new fathers.

Understanding the role of sleep quality and sleep duration in commercial driving safety.

PubMed

Lemke, Michael K; Apostolopoulos, Yorghos; Hege, Adam; Sönmez, Sevil; Wideman, Laurie

2016-12-01

Long-haul truck drivers in the United States suffer disproportionately high injury rates. Sleep is a critical factor in these outcomes, contributing to fatigue and degrading multiple aspects of safety-relevant performance. Both sleep duration and sleep quality are often compromised among truck drivers; however, much of the efforts to combat fatigue focus on sleep duration rather than sleep quality. Thus, the current study has two objectives: (1) to determine the degree to which sleep impacts safety-relevant performance among long-haul truck drivers; and (2) to evaluate workday and non-workday sleep quality and duration as predictors of drivers' safety-relevant performance. A non-experimental, descriptive, cross-sectional design was employed to collect survey and biometric data from 260 long-haul truck drivers. The Trucker Sleep Disorders Survey was developed to assess sleep duration and quality, the impact of sleep on job performance and accident risk, and other relevant work organization characteristics. Descriptive statistics assessed work organization variables, sleep duration and quality, and frequency of engaging in safety-relevant performance while sleepy. Linear regression analyses were conducted to evaluate relationships between sleep duration, sleep quality, and work organization variables with safety composite variables. Drivers reported long work hours, with over 70% of drivers working more than 11h daily. Drivers also reported a large number of miles driven per week, with an average of 2,812.61 miles per week, and frequent violations of hours-of-service rules, with 43.8% of drivers "sometimes to always" violating the "14-h rule." Sleep duration was longer, and sleep quality was better, on non-workdays compared on workdays. Drivers frequently operated motor vehicles while sleepy, and sleepiness impacted several aspects of safety-relevant performance. Sleep quality was better associated with driving while sleepy and with job performance and concentration than sleep duration. Sleep duration was better associated with accidents and accident risk than sleep quality. Sleep quality appears to be better associated with safety-relevant performance among long-haul truck drivers than sleep duration. Comprehensive and multilevel efforts are needed to meaningfully address sleep quality among drivers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Work-Family Conflict, Sleep, and Mental Health of Nursing Assistants Working in Nursing Homes.

PubMed

Zhang, Yuan; Punnett, Laura; Nannini, Angela

2017-07-01

Work-family conflict is challenging for workers and may lead to depression, anxiety, and overall poor health. Sleep plays an important role in the maintenance of mental health; however, the role of sleep in the association between work-family conflict and mental health is not well-studied. Questionnaires were collected from 650 nursing assistants in 15 nursing homes. Multivariate linear regression modeling demonstrated that increased work-family conflict was associated with lower mental health scores (β = -2.56, p < .01). More work-family conflict was correlated with more job demands, less job control, less social support, and longer work hours. Poor sleep quality, but not short sleep duration, mediated the association between work-family conflict and mental health. Workplace interventions to improve nursing assistants' mental health should increase their control over work schedules and responsibilities, provide support to meet their work and family needs, and address healthy sleep practices.

Sitting Time, Physical Activity and Sleep by Work Type and Pattern—The Australian Longitudinal Study on Women’s Health

PubMed Central

Clark, Bronwyn K.; Kolbe-Alexander, Tracy L.; Duncan, Mitch J.; Brown, Wendy

2017-01-01

Data from the Australian Longitudinal Study on Women’s Health were used to examine how work was associated with time spent sleeping, sitting and in physical activity (PA), in working women. Young (31–36 years; 2009) and mid-aged (59–64 years; 2010) women reported sleep (categorised as shorter ≤6 h/day and longer ≥8 h/day) and sitting time (work, transport, television, non-work computer, and other; summed for total sitting time) on the most recent work and non-work day; and moderate and vigorous PA (categorised as meeting/not meeting guidelines) in the previous week. Participants reported occupation (manager/professional; clerical/sales; trades/transport/labourer), work hours (part-time; full-time) and work pattern (shift/night; not shift/night). The odds of shorter sleep on work days was higher in both cohorts for women who worked shift or night hours. Longer sitting time on work days, made up primarily of sitting for work, was found for managers/professionals, clerical/sales and full-time workers. In the young cohort, clerical/sales workers and in the mid-aged cohort, full-time workers were less likely to meet PA guidelines. These results suggest multiple behaviour interventions tailored to work patterns and occupational category may be useful to improve the sleep, sitting and activity of working women. PMID:28287446

Sitting Time, Physical Activity and Sleep by Work Type and Pattern-The Australian Longitudinal Study on Women's Health.

PubMed

Clark, Bronwyn K; Kolbe-Alexander, Tracy L; Duncan, Mitch J; Brown, Wendy

2017-03-10

Data from the Australian Longitudinal Study on Women's Health were used to examine how work was associated with time spent sleeping, sitting and in physical activity (PA), in working women. Young (31-36 years; 2009) and mid-aged (59-64 years; 2010) women reported sleep (categorised as shorter ≤6 h/day and longer ≥8 h/day) and sitting time (work, transport, television, non-work computer, and other; summed for total sitting time) on the most recent work and non-work day; and moderate and vigorous PA (categorised as meeting/not meeting guidelines) in the previous week. Participants reported occupation (manager/professional; clerical/sales; trades/transport/labourer), work hours (part-time; full-time) and work pattern (shift/night; not shift/night). The odds of shorter sleep on work days was higher in both cohorts for women who worked shift or night hours. Longer sitting time on work days, made up primarily of sitting for work, was found for managers/professionals, clerical/sales and full-time workers. In the young cohort, clerical/sales workers and in the mid-aged cohort, full-time workers were less likely to meet PA guidelines. These results suggest multiple behaviour interventions tailored to work patterns and occupational category may be useful to improve the sleep, sitting and activity of working women.

Work shift duration: a review comparing eight hour and 12 hour shift systems.

PubMed

Smith, L; Folkard, S; Tucker, P; Macdonald, I

1998-04-01

Shiftwork is now a major feature of working life across a broad range of industries. The features of the shift systems operated can impact on the wellbeing, performance, and sleep of shiftworkers. This paper reviews the current state of knowledge on one major characteristic of shift rotas-namely, shift duration. Evidence comparing the relative effects of eight hour and 12 hour shifts on fatigue and job performance, safety, sleep, and physical and psychological health are considered. At the organisational level, factors such as the mode of system implementation, attitudes towards shift rotas, sickness absence and turnover, overtime, and moonlighting are discussed. Manual and electronic searches of the shiftwork research literature were conducted to obtain information on comparisons between eight hour and 12 hour shifts. The research findings are largely equivocal. The bulk of the evidence suggests few differences between eight and 12 hour shifts in the way they affect people. There may even be advantages to 12 hour shifts in terms of lower stress levels, better physical and psychological wellbeing, improved durations and quality of off duty sleep as well as improvements in family relations. On the negative side, the main concerns are fatigue and safety. It is noted that a 12 hour shift does not equate with being active for only 12 hours. There can be considerable extension of the person's time awake either side of the shift. However, the effects of longer term exposure to extended work days have been relatively uncharted in any systematic way. Longitudinal comparative research into the chronic impact of the compressed working week is needed.

Increased energy intake following sleep restriction in men and women: A one-size-fits-all conclusion?

PubMed

McNeil, Jessica; St-Onge, Marie-Pierre

2017-06-01

This study assessed the degree of interindividual responses in energy intake (EI) to an imposed sleep restriction versus habitual sleep duration protocol. It also investigated participant (age, sex, ethnicity, and BMI) and study (study site and protocol order) characteristics as potential contributors to the variance in EI responses to sleep restriction between individuals. Data from two randomized crossover trials were combined. All participants (n = 43; age: 31 ± 7 years, BMI: 23 ± 2 kg/m 2 ) were free of medical/sleep conditions, were nonsmokers, reported not performing shift work, and had an average sleep duration of 7 to 9 hours per night. Ad libitum, 24-hour EI was objectively assessed following sleep restriction (3.5-4 hours in bed per night) and habitual sleep (7-9 hours in bed per night) conditions. Large interindividual variations in EI change (ΔEI) between restricted and habitual sleep conditions were noted (-813 to 1437 kcal/d). Only phase order was associated with ΔEI (β = -568 kcal/d, 95% confidence interval for β = -921 to -215 kcal/d; P = 0.002); participants randomized to the habitual sleep condition first had greater increases in EI when sleep was restricted (P = 0.01). Large interindividual variations in ΔEI following sleep restriction were noted, suggesting that not all participants were negatively impacted by the effects of sleep restriction. © 2017 The Obesity Society.

Sleep-deprived motor vehicle operators are unfit to drive: a multidisciplinary expert consensus statement on drowsy driving.

PubMed

Czeisler, Charles A; Wickwire, Emerson M; Barger, Laura K; Dement, William C; Gamble, Karen; Hartenbaum, Natalie; Ohayon, Maurice M; Pelayo, Rafael; Phillips, Barbara; Strohl, Kingman; Tefft, Brian; Rajaratnam, Shantha M W; Malhotra, Raman; Whiton, Kaitlyn; Hirshkowitz, Max

2016-06-01

This article presents the consensus findings of the National Sleep Foundation Drowsy Driving Consensus Working Group, which was an expert panel assembled to establish a consensus statement regarding sleep-related driving impairment. The National Sleep Foundation assembled a expert panel comprised of experts from the sleep community and experts appointed by stakeholder organizations. A systematic literature review identified 346 studies that were abstracted and provided to the panelists for review. A modified Delphi RAND/UCLA Appropriateness Method with 2 rounds of voting was used to reach consensus. A final consensus was reached that sleep deprivation renders motorists unfit to drive a motor vehicle. After reviewing growing evidence of impairment and increased crash risk among drivers who obtained less than optimal sleep duration in the preceding 24 hours, the panelists recognized the need for public policy guidance as to when it is certainly unsafe to drive. Toward this end, the panelists agreed upon the following expert consensus statement: "Drivers who have slept for two hours or less in the preceding 24 hours are not fit to operate a motor vehicle." Panelists further agreed that most healthy drivers would likely be impaired with only 3 to 5 hours of sleep during the prior 24 hours. There is consensus among experts that healthy individuals who have slept for 2 hours or less in the preceding 24 hours are too impaired to safely operate a motor vehicle. Prevention of drowsy driving will require sustained and collaborative effort from multiple stakeholders. Implications and limitations of the consensus recommendations are discussed. Copyright © 2016. Published by Elsevier Inc.

29 CFR 553.222 - Sleep time.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 29 Labor 3 2010-07-01 2010-07-01 false Sleep time. 553.222 Section 553.222 Labor Regulations... Enforcement Employees of Public Agencies Tour of Duty and Compensable Hours of Work Rules § 553.222 Sleep time... enforcement personnel in accordance with section 7(a)(1) of the Act, the public agency may exclude sleep time...

The association between long working hours and health: a systematic review of epidemiological evidence.

PubMed

Bannai, Akira; Tamakoshi, Akiko

2014-01-01

Many studies have investigated the association between long working hours and health. By focusing on differences in the definition of long working hours and the influence of shift work, we attempt to explain why the results of these studies remain inconclusive. We defined long working hours as working time greater than around 40 hours per week or 8 hours per day. Since previous studies have indicated that shift work is detrimental to health, we minimized the influence of shift work in the studies. We also placed importance on the existence of reference groups since this made the results clearer. Based on these points, we analyzed previous studies to clarify the epidemiological evidence regarding the association between long working hours and health. We established inclusion criteria and carried out a systematic search for articles published in the Medline and PsycINFO databases between 1995-2012. We identified a total of 17 articles and 19 studies (12 prospective cohort and 7 cross-sectional studies). The outcomes were all-cause mortality, circulatory disease, diabetes mellitus, metabolic syndrome, depressive state, anxiety, other psychological disorders, sleep condition, cognitive function, and health-related behavior. Long working hours had significant adverse effects on most health outcomes. We concluded that working long hours is associated with depressive state, anxiety, sleep condition, and coronary heart disease. However, further studies that appropriately deal with the definition of long working hours and shift work are needed.

Work hours, workload, sleep and fatigue in Australian Rail Industry employees.

PubMed

Dorrian, Jillian; Baulk, Stuart D; Dawson, Drew

2011-01-01

Research suggests that less than 5 h sleep in the 24 h prior to work and/or more than 16 h of wakefulness can significantly increase the likelihood of fatigue-related impairment and error at work. Studies have also shown exponential safety declines with time on shift, with roughly double the likelihood of accident or injury after 10 h relative to the first 8h. While it is acknowledged that reduced sleep, increased wakefulness and longer work hours produce work-related fatigue, few studies have examined the impact of workload on this relationship. Studies in the rail industry have focused on drivers. This study investigated fatigue in a large sample of Australian Rail Industry Employees. Participants were from four companies (n = 90: 85m, 5f; mean age 40.2 ± 8.6 y). Data was analysed for a total of 713 shifts. Subjects wore wrist actigraphs and completed sleep and work diaries for 14-days. They also completed the Samn-Perelli Fatigue Scale at the beginning and end of shifts, and the NASA-TLX workload scale at least twice during each shift. Average (±SD) sleep length (7.2 ± 2.6h), prior wake at shift end (12.0 ± 4.7h), shift duration (8.0 ± 1.3) and fatigue (4.1 ± 1.3, "a little tired, less than fresh") were within limits generally considered acceptable from a fatigue perspective. However, participants received 5 h or less sleep in the prior 24 h on 13%, were awake for at least 16 h at the end of 16% and worked at least 10 h on 7% of shifts. Subjects reported that they felt "extremely tired, very difficult to concentrate," or "completely exhausted, unable to function effectively" on 13% of shifts. Sleep length (OR = 0.88, p < 0.01), shift duration (OR = 1.18, p < 0.05), night shift (REF = morning shift, OR = 2.12, p < 0.05) and workload ratings (OR = 1.2, p < 0.05) were significant predictors of ratings of extreme tiredness/exhaustion (yes/no). While on average, sleep loss, extended wakefulness, longer work hours and work-related fatigue do not appear problematic in this sample, there is still a notable percentage of shifts that are likely to be associated with high levels of work-related fatigue. Given the size of the Australian Rail Industry, with thousands of shifts occurring each day, this is potentially of operational concern. Further, results indicate that, in addition to sleep length, wakefulness and work hours, workload significantly influences fatigue. This has possible implications for bio-mathematical predictions of fatigue and for fatigue management more generally. Copyright © 2010. Published by Elsevier Ltd.

Effects of work hour reduction on residents' lives: a systematic review.

PubMed

Fletcher, Kathlyn E; Underwood, Willie; Davis, Steven Q; Mangrulkar, Rajesh S; McMahon, Laurence F; Saint, Sanjay

2005-09-07

The Accreditation Council for Graduate Medical Education implemented mandatory work hour limitations in July 2003, partly out of concern for residents' well-being in the setting of sleep deprivation. These limitations are likely to also have an impact on other aspects of the lives of residents. To summarize the literature regarding the effect of interventions to reduce resident work hours on residents' education and quality of life. We searched the English-language literature about resident work hours from 1966 through April 2005 using MEDLINE, EMBASE, and Current Contents, supplemented with hand-search of additional journals, reference list review, and review of abstracts from national meetings. Studies were included that assessed a system change designed to counteract the effects of resident work hours, fatigue, or sleep deprivation; included an outcome directly related to residents; and were conducted in the United States. For each included study, 2 investigators independently abstracted data related to study quality, subjects, interventions, and findings using a standard data abstraction form. Fifty-four articles met inclusion criteria. The interventions used to decrease resident work hours varied but included night and day float teams, extra cross-coverage, and physician extenders. Outcomes included measures of resident education (operative experience, test scores, satisfaction) and quality of residents' lives (amount of sleep, well-being). Interventions to reduce resident work hours resulted in mixed effects on both operative experience and on perceived educational quality but generally improved residents' quality of life. Many studies had major limitations in their design or conduct. Past interventions suggest that residents' quality of life may improve with work hour limitations, but interpretation of the outcomes of these studies is hampered by suboptimal study design and the use of nonvalidated instruments. The long-term impact of reducing resident work hours on education remains unknown. Current and future interventions should be evaluated with more rigorous methods and should investigate links between residents' quality of life and quality of patient care.

Joint associations of sleep duration and insomnia symptoms with subsequent sickness absence: the Helsinki Health Study.

PubMed

Lallukka, Tea; Haaramo, Peija; Rahkonen, Ossi; Sivertsen, Børge

2013-07-01

We aimed to examine the joint associations of sleep duration and insomnia symptoms with subsequent sickness absence of various lengths while considering several covariates. Baseline surveys among 40-60-year-old employees of the City of Helsinki, Finland, (N = 6535) were prospectively linked with employer's personnel register data comprising short self-certified (1-3 days), medically-certified intermediate (4-14 days) and long (15 days or more) sickness absence spells. Average follow-up time was 4.1 years. Sleep duration, insomnia symptoms, sociodemographics, working conditions, health behaviours and health were self-reported in the surveys. Poisson regression analysis was used. Insomnia symptoms were associated with sickness absence at all levels of sleep duration. Adjusting for gender and age, U-shaped associations regarding sleep hours were found. Thus, those reporting short or long sleep and reporting insomnia symptoms had a higher risk for medically-certified intermediate and long sickness absence as compared to those reporting 7 hours of sleep without insomnia symptoms. Also, those reporting 6, 7, and 8 hours of sleep had a higher risk for such sickness absence, if they reported insomnia. Weak associations were also found for self-certified sickness absence, and for those reporting short and long sleep without insomnia. Adjustments attenuated the associations, but they mainly remained. These results suggest primacy of the effects of insomnia symptoms over sleep duration on sickness absence. Although insomnia dominated the joint association, U-shaped associations suggest that both sleep duration and insomnia symptoms need to be considered to promote work ability.

5 CFR 551.501 - Overtime pay.

Code of Federal Regulations, 2010 CFR

2010-01-01

... status or while sleeping or eating; (4) On the basis of hours of work in excess of 8 hours in a day for... shall compensate an employee who is not exempt under subpart B of this part for all hours of work in... for that duty under 5 U.S.C. 5545(c)(1) or (2) or 5545b; (2) On the basis of hours of work in excess...

The relationship between nurse work schedules, sleep duration, and drowsy driving.

PubMed

Scott, Linda D; Hwang, Wei-Ting; Rogers, Ann E; Nysse, Tami; Dean, Grace E; Dinges, David F

2007-12-01

Recent studies have shown that extended shifts worked by hospital staff nurses are associated with significantly higher risk of errors, yet little information is available about the ability to remain alert during the nurses' commutes following the completion of an extended work shift. The purpose of this study is to describe the prevalence of drowsy driving episodes and the relationship between drowsy driving and nurse work hours, alertness on duty, working at night, and sleep duration. Data were collected from 2 national random samples of registered nurses (n=895). Full-time hospital staff nurses (n=895) completed logbooks on a daily basis for 4 weeks providing information concerning work hours, sleep duration, drowsy and sleep episodes at work, and drowsy driving occurrences. Almost 600 of the nurses (596/895) reported at least 1 episode of drowsy driving, and 30 nurses reported experiencing drowsy driving following every shift worked. Shorter sleep durations, working at night, and difficulties remaining awake at work significantly increased the likelihood of drowsy driving episodes. Given the large numbers of nurses who reported struggling to stay awake when driving home from work and the frequency with which nurses reported drowsy driving, greater attention should be paid to increasing nurse awareness of the risks and to implementing strategies to prevent drowsy driving episodes to ensure public safety. Without mitigation, fatigued nurses will continue to put the public and themselves at risk.

Relationship between napping during night shift work and household obligations of female nursing personnel.

PubMed

Silva-Costa, Aline; Fischer, Frida Marina; Griep, Rosane Harter; Rotenberg, Lúcia

2013-01-01

Night shift employment involves displacing sleep to the daytime. For female workers, the opportunity for daytime sleep is influenced by routine housework demands, which aggravates sleep deprivation. Allowing naps to be taken during the night shift of work is a frequent practice at some hospitals and can help reduce the effects of sleep deprivation. We hypothesize that an association between domestic work and the length of naps during night work exists for nursing professionals. To test this hypothesis, two cross-sectional studies were conducted in two different hospitals. In Study 1, female workers answered questionnaires regarding sleeping habits, professional work, and housework demands. In Study 2, data regarding napping during shifts was obtained by actigraphy, a noninvasive method of monitoring the human sleep-wake cycle. The demand for the performance of housework was measured by (i) domestic work hours (total time spent performing domestic work per week), and (ii) domestic workload, which considers the degree of sharing domestic tasks and the number of people living at home. The populations from the two studies were subdivided into groups, based on the duration of napping at work. Data on naps were analyzed according to domestic demands, using the Mann-Whitney and Chi-squared tests. Among the two study populations (Studies 1 and 2), those in Study 2 were older, had shorter professional weekly work hours, worked more night shifts, and dedicated more time to housework. significant associations were only found in Study 2, where greater time napping at work was associated with both greater time spent doing housework and greater domestic workload. The known benefits of napping during night shifts seem to be especially relevant for female workers who are more sleep-deprived from working more night shifts and who have higher demands for housework.

Self-Reported Recovery from 2-Week 12-Hour Shift Work Schedules: A 14-Day Follow-Up.

PubMed

Merkus, Suzanne L; Holte, Kari Anne; Huysmans, Maaike A; van de Ven, Peter M; van Mechelen, Willem; van der Beek, Allard J

2015-09-01

Recovery from fatigue is important in maintaining night workers' health. This study compared the course of self-reported recovery after 2-week 12-hour schedules consisting of either night shifts or swing shifts (i.e., 7 night shifts followed by 7 day shifts) to such schedules consisting of only day work. Sixty-one male offshore employees-20 night workers, 16 swing shift workers, and 25 day workers-rated six questions on fatigue (sleep quality, feeling rested, physical and mental fatigue, and energy levels; scale 1-11) for 14 days after an offshore tour. After the two night-work schedules, differences on the 1(st) day (main effects) and differences during the follow-up (interaction effects) were compared to day work with generalized estimating equations analysis. After adjustment for confounders, significant main effects were found for sleep quality for night workers (1.41, 95% confidence interval 1.05-1.89) and swing shift workers (1.42, 95% confidence interval 1.03-1.94) when compared to day workers; their interaction terms were not statistically significant. For the remaining fatigue outcomes, no statistically significant main or interaction effects were found. After 2-week 12-hour night and swing shifts, only the course for sleep quality differed from that of day work. Sleep quality was poorer for night and swing shift workers on the 1(st) day off and remained poorer for the 14-day follow-up. This showed that while working at night had no effect on feeling rested, tiredness, and energy levels, it had a relatively long-lasting effect on sleep quality.

Effects on employees of controlling working hours and working schedules.

PubMed

Kubo, T; Takahashi, M; Togo, F; Liu, X; Shimazu, A; Tanaka, K; Takaya, M

2013-03-01

High levels of control over working time and low variability in working hours have been associated with improved health-related outcomes. The potential mechanisms for this association remain unclear. To examine how work-time control and variability of working times are associated with fatigue recovery, sleep quality, work-life balance, and 'near misses' at work. Manufacturing sector employees completed a questionnaire that assessed work-time control, work-time variability, fatigue recovery, sleep quality, work-life balance and the frequency of near misses in the past 6 months. Mixed model analysis of covariance and multiple logistic regression analysis tested the main effects of work-time control and variability and their interaction, while adjusting for age, sex, work schedules, and overtime work in the past month. Subscales of work-time control were also investigated (control over daily working hours and over days off). One thousand three hundred and seventy-two completed questionnaires were returned, a response rate of 69%. A significantly higher quality of sleep and better work-life balance were found in the 'high control with low variability' reference group than in the other groups. Significantly better recovery of fatigue was also observed in the group having control over days off with low variability. While near misses were more frequent in the group with high control over daily working hours coupled with high variability compared with the reference group this was not significant. High work-time control and low variability were associated with favourable outcomes of health and work-life balance. This combined effect was not observed for the safety outcome addressed here.

Sleep medicine content in dental hygiene education.

PubMed

Minichbauer, Brittany C; Sheats, Rose D; Wilder, Rebecca S; Phillips, Ceib L; Essick, Gregory K

2015-05-01

According to the National Research Council, 70 million Americans chronically suffer from approximately 60 medically recognized sleep disorders. With most clinicians unaware of these disorders, many individuals remain undiagnosed. To effectively address this issue, health care professionals must work collaboratively to educate, identify, and treat patients with sleep disorders. However, medical and dental clinicians do not receive adequate education in sleep medicine. On the frontline regarding prevention and counseling, dental hygienists play an important role in patient education, screening, and management of sleep disorders. The aim of this study was to assess the amount of sleep medicine content in U.S. dental hygiene programs. An electronic survey was emailed to all 334 accredited U.S. dental hygiene programs. The 18-question survey assessed the sleep medicine content presented during the 2012-13 academic year. A total of 35.3% (n=118) of the programs responded. The mean number of hours devoted to sleep medicine in their curricula was 1.55 hours (SD=1.37). Although 69% (n=79) of the responding programs reported spending time on sleep bruxism (mean=1.38 hours, SD=0.85), only 28% (n=32) reported spending time on other topics such as snoring and obstructive sleep apnea (mean=1.39 hours, SD=0.72). These results suggest that sleep medicine is included in the majority of U.S. dental hygiene programs, but the content is limited and focused on sleep bruxism. This level of training is inadequate to prepare dental hygienists for their potential role in patient education, screening, and management of sleep-related breathing disorders.

Work shift duration: a review comparing eight hour and 12 hour shift systems

PubMed Central

Smith, L.; Folkard, S.; Tucker, P.; Macdonald, I.

1998-01-01

OBJECTIVES: Shiftwork is now a major feature of working life across a broad range of industries. The features of the shift systems operated can impact on the wellbeing, performance, and sleep of shiftworkers. This paper reviews the current state of knowledge on one major characteristic of shift rotas-namely, shift duration. Evidence comparing the relative effects of eight hour and 12 hour shifts on fatigue and job performance, safety, sleep, and physical and psychological health are considered. At the organisational level, factors such as the mode of system implementation, attitudes towards shift rotas, sickness absence and turnover, overtime, and moonlighting are discussed. METHODS: Manual and electronic searches of the shiftwork research literature were conducted to obtain information on comparisons between eight hour and 12 hour shifts. RESULTS: The research findings are largely equivocal. The bulk of the evidence suggests few differences between eight and 12 hour shifts in the way they affect people. There may even be advantages to 12 hour shifts in terms of lower stress levels, better physical and psychological wellbeing, improved durations and quality of off duty sleep as well as improvements in family relations. On the negative side, the main concerns are fatigue and safety. It is noted that a 12 hour shift does not equate with being active for only 12 hours. CONCLUSIONS: There can be considerable extension of the person's time awake either side of the shift. However, the effects of longer term exposure to extended work days have been relatively uncharted in any systematic way. Longitudinal comparative research into the chronic impact of the compressed working week is needed.   PMID:9624275

24 hours on-call and acute fatigue no longer worsen resident mood under the 80-hour work week regulations.

PubMed

Kiernan, Michael; Civetta, Joseph; Bartus, Christine; Walsh, Stephen

2006-01-01

Studies in on-call residents have shown that mood is worsened by fatigue as indicated by increased scores on measures of depression, anxiety, confusion, and anger using the Profile of Mood States (POMS). In prior sleep deprivation studies, mood has been shown to be more affected than either cognitive or motor performances. The purpose of this study was to examine the effect of the 80-hour work week regulations on resident mood in general and in a post-call period (PC). Institutional Review Board approval was obtained to survey the residents and publish the results. POMS is a 65-item adjective questionnaire that includes subscales for measuring tension-anxiety, anger-hostility, depression-dejection, vigor-activity, fatigue-inertia, and confusion-bewilderment, with the summation of the scales forming a total mood disturbance score. Surgical residents were tested at a 9 am didactic curriculum session (9 am has been shown to correlate with the nadir of performance). Residents were tested after nights off call (NOC) or after PC. Time asleep in the preceding 24 hours and other demographic data were also collected. Acute fatigue (AF) was defined as <4 hours sleep. The two-sample t-test and linear regression were used to assess differences between groups. A total of 123 standardized POMS mood questionnaires were administered on 4 occasions to 51 surgical residents, 35 men and 16 women at levels PGY-1 through PGY-5. Overall, 33 tests (27%) were taken after PC and 90 (73%) were taken after NOC. Acute fatigue residents had a mean sleep time of 2.2 (+/-1.5) hours, whereas rested (R) residents had a mean sleep time of 6.7 (+/-2.2) hours (whether PC or NOC). No statistical differences in mean values of vigor, anger, depression, concentration, fatigue, tension, or total score were observed between PC and NOC or between AF and R residents. There was no significant relationship between acute sleep deprivation and total mood disturbance, whether PC or NOC. In linear relationships, NOC total score and hours slept had r2 = 0.01 (p = 0.44), whereas PC total score and hours slept had r2 = 0.07 (p = 0.14). Although POMS was given 4 times, only 27% were PC, which reflects our 1 in 4 night in-house coverage. In contrast to earlier studies, resident mood, as measured by POMS, is no longer related to PC/NOC or acute fatigue. Previous studies have shown that loss of sleep was associated with declining mood. The lack of such a relationship in this study may be related to the new regulations. It has been assumed that people can adapt to chronic sleep loss but have a harder time coping with the effects of acute sleep deprivation. If, however, the new regulations have relieved chronic sleep deprivation, then a well-rested resident can periodically cope with the effects of acute sleep deprivation. Perhaps by eliminating chronic sleep debt, work hour restrictions seem to have removed the negative impact of PC seen in the prior era. Further studies should increase the number of residents studied, have numerous repeat NOC and PC pairs in same subjects, compare different services with different workloads, junior and senior residents, and in-house and at-home call schedules.

Napping during the night shift and recovery after work among hospital nurses1

PubMed Central

Palermo, Thaís Aparecida de Castro; Rotenberg, Lúcia; Zeitoune, Regina Célia Gollner; Silva-Costa, Aline; Souto, Ester Paiva; Griep, Rosane Härter

2015-01-01

OBJECTIVE: To analyze the association between the length of napping during the night shift and the recovery after work among nurses. METHOD: Cross-sectional epidemiological study involving 1940 nurses from 18 public hospitals in the City of Rio de Janeiro. A multidimensional and self-applied questionnaire was used with information about health, sociodemographic and occupational characteristics, health-related behaviors and housework. Multiple logistic regression was applied to identify the association, adjusted for confounding variables. RESULTS: The gross analyses showed 44%, 127% and 66% higher chances of a high level of recovery after work for nurses who sleep up to two hours, between 2.1 and 3 hours and 3.1 hours or more, respectively, when compared to the nurses who do not sleep. After adjusting for confounding variables, the association only continues significant for the group that sleeps 2.1 to 3 hours during the night shift (OR=1.79; 95%CI=1.33-2.41). CONCLUSION: The association between the length of napping and the high level of recovery after work, confirmed in the present results, can be included in the studies that aim to support more appropriate policies aimed at improving the workers' work, life and health conditions, not only in nursing, but night-shift workers in general. PMID:25806639

The effects of sleep duration on the incidence of cardiovascular events among middle-aged male workers in Japan.

PubMed

Hamazaki, Yuko; Morikawa, Yuko; Nakamura, Koshi; Sakurai, Masaru; Miura, Katsuyuki; Ishizaki, Masao; Kido, Teruhiko; Naruse, Yuchi; Suwazono, Yasushi; Nakagawa, Hideaki

2011-09-01

Although previous epidemiological studies have investigated the relationship between sleep duration and various cardiovascular events, the results have been inconsistent. Accordingly, we conducted a follow-up survey to investigate the relationship between sleep duration and cardiovascular events among male workers, accounting for occupational factors that might confound the true relationship. A total of 2282 male employees aged 35-54 years based in a factory in Japan were followed for 14 years. The risk of cardiovascular events was compared among 4 groups stratified based on sleep duration at baseline (<6, 6-6.9, 7-7.9, and ≥8 hours). Cardiovascular events included stroke, coronary events and sudden cardiac death. The hazard ratios for events were calculated using a Cox proportional hazards model, with the 7-7.9-hour group serving as a reference. The model was adjusted for potential confounders including traditional cardiovascular risk factors and working characteristics. During 14 years of follow-up, 64 cardiovascular events were recorded including 30 strokes, 27 coronary events and 7 sudden cardiac deaths. After adjustment for possible confounders, the hazard ratios for cardiovascular and coronary events in the <6-hour group were 3.49 [95% confidence interval (95% CI) 1.30-9.40] and 4.95 (95% CI 1.31-18.73), respectively. There was no significant increment in the risk of stroke for any sleep duration groups. Short sleep duration (<6 hours) was a significant risk factor for coronary events in a Japanese male working population.

Effects of health care provider work hours and sleep deprivation on safety and performance.

PubMed

Lockley, Steven W; Barger, Laura K; Ayas, Najib T; Rothschild, Jeffrey M; Czeisler, Charles A; Landrigan, Christopher P

2007-11-01

There has been increasing interest in the impact of resident-physician and nurse work hours on patient safety. The evidence demonstrates that work schedules have a profound effect on providers' sleep and performance, as well as on their safety and that of their patients. Nurses working shifts greater than 12.5 hours are at significantly increased risk of experiencing decreased vigilance on the job, suffering an occupational injury, or making a medical error. Physicians-in-training working traditional > 24-hour on-call shifts are at greatly increased risk of experiencing an occupational sharps injury or a motor vehicle crash on the drive home from work and of making a serious or even fatal medical error. As compared to when working 16-hours shifts, on-call residents have twice as many attentional failures when working overnight and commit 36% more serious medical errors. They also report making 300% more fatigue-related medical errors that lead to a patient's death. The weight of evidence strongly suggests that extended-duration work shifts significantly increase fatigue and impair performance and safety. From the standpoint of both providers and patients, the hours routinely worked by health care providers in the United States are unsafe. To reduce the unacceptably high rate of preventable fatigue-related medical error and injuries among health care workers, the United States must establish and enforce safe work-hour limits.

Associations Among Rotating Night Shift Work, Sleep, and Skin Cancer in Nurses’ Health Study II Participants

PubMed Central

Heckman, Carolyn J.; Kloss, Jacqueline D.; Feskanich, Diane; Culnan, Elizabeth; Schernhammer, Eva S.

2016-01-01

Background Night shift work and sleep duration have been associated with breast and other cancers. Results from the few prior studies of night shift work and skin cancer risk have been mixed and not fully accounted for other potentially important health-related variables (e.g., sleep characteristics). This study evaluated the relationship between rotating night shift work and skin cancer risk and included additional skin cancer risk factors and sleep-related variables. Methods The current study used data from 74,323 Nurses’ Health Study (NHS) II participants. Cox proportional hazards models were used to estimate multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for skin cancers across categories of shift work and sleep duration. Results Over 10 years of follow-up, 4308 BCC, 334 SCC and 212 melanoma cases were identified. Longer duration of rotating night shifts was associated with a linear decline in risk of BCC (HR=0.93, 95% CI: 0.90-0.97 per 5-year increase). Shift work was not significantly associated with either melanoma (HR=1.02, 95% CI: 0.86-1.21) or SCC (HR=0.92, 95% CI: 0.80-1.06). A short sleep duration (≤6 hours per day) was associated with lower risks of melanoma (HR=0.68, 95% CI: 0.46-0.98) and BCC (HR=0.93, 95% CI: 0.86-1.00) compared with the most common report of 7 hours. SCC was not associated with duration of sleep (HR=0.94, 95% CI: 0.83-1.06). Conclusions Longer duration of rotating night shift work and shorter sleep duration were associated with lower risk of some skin cancers. Further research is needed to confirm and identify the mechanisms underlying these associations. PMID:27663986

Reducing Risks to Women Linked to Shift Work, Long Work Hours, and Related Workplace Sleep and Fatigue Issues.

PubMed

Caruso, Claire C

2015-10-01

In the United States, an estimated 12% to 28% of working women are on shift work schedules, and 12% work more than 48 hours per week. Shift work and long work hours are associated with many health and safety risks, including obesity, injuries, and negative reproductive outcomes. Over time, the worker is at risk for developing a wide range of chronic diseases. These work schedules can also strain personal relationships, owing to fatigue and poor mood from sleep deprivation and reduced quality time to spend with family and friends. Worker errors from fatigue can lead to reduced quality of goods and services, negatively impacting the employer. In addition, mistakes by fatigued workers can have far-reaching negative effects on the community, ranging from medical care errors to motor vehicle crashes and industrial disasters that endanger others. To reduce the many risks that are linked to these demanding work hours, the National Institute for Occupational Safety and Health (NIOSH) conducts research, develops guidance and authoritative recommendations, and translates and disseminates scientific information to protect workers, their families, employers, and the community. The key message to reduce these risks is making sleep a priority in the employer's systems for organizing work and in the worker's personal life. The NIOSH website has freely available online training programs with suggestions for workers and their managers to help them better cope with this workplace hazard.

Stress and sleep quality in doctors working on-call shifts are associated with functional gastrointestinal disorders.

PubMed

Lim, Soo-Kyung; Yoo, Seung Jin; Koo, Dae Lim; Park, Chae A; Ryu, Han Jun; Jung, Yong Jin; Jeong, Ji Bong; Kim, Byeong Gwan; Lee, Kook Lae; Koh, Seong-Joon

2017-05-14

To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call shifts. In this cross-sectional observation study, using the Rome III Questionnaire and Pittsburgh Sleep Quality Index (PSQI), we analyzed 170 doctors with 24 hour-on-call shifts. Among the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48 (28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores (PSQI) (8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm (83.3% vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work (81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD (OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality (PSQI ≥ 6) was a predictor of IBS (OR = 4.17, 95%CI: 1.92-19.02, P = 0.016). Physicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs.

Change from an 8-hour shift to a 12-hour shift, attitudes, sleep, sleepiness and performance.

PubMed

Lowden, A; Kecklund, G; Axelsson, J; Akerstedt, T

1998-01-01

The present study sought to evaluate the effect of a change from a rotating 3-shift (8-hour) to a 2-shift shift (12 hour) schedule on sleep, sleepiness, performance, perceived health, and well-being. Thirty-two shift workers at a chemical plant (control room operators) responded to a questionnaire a few months before a change was made in their shift schedule and 10 months after the change. Fourteen workers also filled out a diary, carried activity loggers, and carried out reaction-time tests (beginning and end of shift). Fourteen day workers served as a reference group for the questionnaires and 9 were intensively studied during a week with workdays and a free weekend. The questionnaire data showed that the shift change increased satisfaction with workhours, sleep, and time for social activities. Health, perceived accident risk, and reaction-time performance were not negatively affected. Alertness improved and subjective recovery time after night work decreased. The quick changes in the 8-hour schedule greatly increased sleep problems and fatigue. Sleepiness integrated across the entire shift cycle showed that the shift workers were less alert than the day workers, across workdays and days off (although alertness increased with the 12-hour shift). The change from 8-hour to 12-hour shifts was positive in most respects, possibly due to the shorter sequences of the workdays, the longer sequences of consecutive days off, the fewer types of shifts (easier planning), and the elimination of quick changes. The results may differ in groups with a higher work load.

A unique, fast-forwards rotating schedule with 12-h long shifts prevents chronic sleep debt.

PubMed

Fischer, Dorothee; Vetter, Céline; Oberlinner, Christoph; Wegener, Sven; Roenneberg, Till

2016-01-01

Sleep debt--together with circadian misalignment--is considered a central factor for adverse health outcomes associated with shift work. Here, we describe in detail sleep-wake behavior in a fast-forward rotating 12-h shift schedule, which involves at least 24 hours off after each shift and thus allows examining the role of immediate recovery after shift-specific sleep debt. Thirty-five participants at two chemical plants in Germany were chronotyped using the Munich ChronoType Questionnaire for Shift-Workers (MCTQ(Shift)) and wore actimeters throughout the two-week study period. From these actimetry recordings, we computed sleep and nap duration, social jetlag (a measure of circadian misalignment), and the daily timing of activity and sleep (center of gravity and mid-sleep, respectively). We observed that the long off-work periods between each shift create a fast alternation between shortened (mean ± standard deviation, 5h 17min ± 56min) and extended (8h 25min ± 72min) sleep episodes resulting in immanent reductions of sleep debt. Additionally, extensive napping of early chronotypes (up to 3 hours before the night shift) statistically compensated short sleep durations after the night shift. Partial rank correlations showed chronotype-dependent patterns of sleep and activity that were similar to those previously described in 8-h schedules; however, sleep before the day shift did not differ between chronotypes. Our findings indicate that schedules preventing a build-up of chronic sleep debt may reduce detrimental effects of shift work irrespective of shift duration. Prospective studies are needed to further elucidate the relationship between sleep, the circadian system, and health and safety hazards.

Psychosocial work factors and sleep problems: findings from the French national SIP survey.

PubMed

Chazelle, Emilie; Chastang, Jean-François; Niedhammer, Isabelle

2016-04-01

This study aimed at exploring the cross-sectional and prospective associations between psychosocial work factors and sleep problems. The study population consisted of a national representative sample of the French working population (SIP survey). The sample sizes were 7506 and 3555 for the cross-sectional and prospective analyses. Sleep problems were defined by either sleep disturbances or insufficient sleep duration at least several times a week. Psychosocial work factors included classical (job strain model factors) and emergent factors (recognition, insecurity, role/ethical conflict, emotional demands, work-life imbalance, etc.). Occupational factors related to working time/hours and physical work environment were also included as well as covariates related to factors outside work. Statistical analyses were performed using weighted Poisson regression analysis. In the cross-sectional analyses, psychological demands, low social support, low recognition, emotional demands, perception of danger, work-life imbalance and night work were found to be associated with sleep problems. In the prospective analyses, psychological demands and night work were predictive of sleep problems. Using a less conservative method, more factors were found to be associated with sleep problems. Dose-response associations were observed, showing that the more frequent the exposure to these factors, the higher the risk of sleep problems. No effect of repeated exposure was found on sleep problems. Classical and emergent psychosocial work factors were associated with sleep problems. More prospective studies and prevention policies may be needed.

Farm work-related injury among middle school students in rural China.

PubMed

Postel, M W; Jaung, M S; Chen, G; Yu, S; Stallones, L; Xiang, H

2009-04-01

Farm work-related injuries are considered an important issue facing rural area adolescents. However, little research has been done in developing countries, including China. This study evaluated agricultural work-related injuries among Chinese middle school adolescents, focusing on the potential association between farm work hours, sleep patterns, school-related stress, and farm work-related injuries. This cross-sectional study surveyed 1,551 middle school students in Hunan Province who reported working on farms. The surveys assessed their involvement in farm work, sleep patterns, school activities, and farm work-related injuries during a three-month recall period. The cumulative incidence of farm work-related injury was 15.6% among the 1187 students who reported working on a farm. Average days per month farming, number of pesticide applications per month, sleep disturbances, and school-related stress were significantly associated with farm work-related injuries (p < 0.05). Multivariable logistic regression analysis revealed that after adjusting for possible confounding effects of age, gender, and farm work days per month, sleep disturbance (less than 7 hours of sleep: OR = 2.36, 95% CI = 1.07-5.22; awakening at night and having trouble falling back to sleep: OR = 2.70, 95% CI = 1.36-5.37; having nightmares: OR = 2.24, 95% CI = 1.18-4.24) and school-related stress (difficult homework: OR = 2.45, 95% CI = 1.21-4.99; extra homework assigned often by parents: OR = 3.62, 95% CI = 1.88-6.97; and scolded/chastised by parents for poor school performance: OR = 2.53, 95% CI = 1.75-3.65) were statistically significant risk factors for farm work-related injuries (p < 0.05).

[Sleep patterns and fatigue of nursing students who work].

PubMed

Ferreira, Luciane Ruiz Carmona; de Martino, Milva Maria Figueiredo

2012-10-01

It has been observed there is currently a growing interest in developing research regarding the sleep patterns of workers who must wake up very early or who work nights. Therefore, the objective of this study was to identify the levels of fatigue and the sleep patterns of nursing students who study during the day and work at night. Participants were thirty students who completed the Epworth Sleepiness Scale and Sleep Journal for thirty days. It was found that sleep duration was longer among men compared to women on days off work, and when on vacation from school compared to the regular school period. Participants showed high levels of fatigue and sleepiness, characterized by the incidence of excessive daytime sleepiness. In conclusion, night workers who endure sleep deprivation have additional wake hours due to studying, thus causing high levels of fatigue, which may harm their performance at school and at work.

Work time control, sleep & accident risk: A prospective cohort study.

PubMed

Tucker, Philip; Albrecht, Sophie; Kecklund, Göran; Beckers, Debby G J; Leineweber, Constanze

We examined whether the beneficial impact of work time control (WTC) on sleep leads to lower accident risk, using data from a nationally representative survey conducted in Sweden. Logistic regressions examined WTC in 2010 and 2012 as predictors of accidents occurring in the subsequent 2 years (N = 4840 and 4337, respectively). Sleep disturbance and frequency of short sleeps in 2012 were examined as potential mediators of the associations between WTC in 2010 and subsequent accidents as reported in 2014 (N = 3636). All analyses adjusted for age, sex, education, occupational category, weekly work hours, shift work status, job control and perceived accident risk at work. In both waves, overall WTC was inversely associated with accidents (p = 0.048 and p = 0.038, respectively). Analyses of the sub-dimensions of WTC indicated that Control over Daily Hours (influence over start and finish times, and over length of shift) did not predict accidents in either wave, while Control over Time-off (CoT; influence over taking breaks, running private errands during work and taking paid leave) predicted fewer accidents in both waves (p = 0.013 and p = 0.010). Sleep disturbance in 2012 mediated associations between WTC/CoT in 2010 and accidents in 2014, although effects' sizes were small (effectWTC = -0.006, 95% confidence interval [CI] = -0.018 to -0.001; effectCoT = -0.009, 95%CI = -0.022 to -0.001; unstandardized coefficients), with the indirect effects of sleep disturbance accounting for less than 5% of the total direct and indirect effects. Frequency of short sleeps was not a significant mediator. WTC reduces the risk of subsequently being involved in an accident, although sleep may not be a strong component of the mechanism underlying this association.

Self-Reported Recovery from 2-Week 12-Hour Shift Work Schedules: A 14-Day Follow-Up

PubMed Central

Merkus, Suzanne L.; Holte, Kari Anne; Huysmans, Maaike A.; van de Ven, Peter M.; van Mechelen, Willem; van der Beek, Allard J.

2015-01-01

Background Recovery from fatigue is important in maintaining night workers' health. This study compared the course of self-reported recovery after 2-week 12-hour schedules consisting of either night shifts or swing shifts (i.e., 7 night shifts followed by 7 day shifts) to such schedules consisting of only day work. Methods Sixty-one male offshore employees—20 night workers, 16 swing shift workers, and 25 day workers—rated six questions on fatigue (sleep quality, feeling rested, physical and mental fatigue, and energy levels; scale 1–11) for 14 days after an offshore tour. After the two night-work schedules, differences on the 1st day (main effects) and differences during the follow-up (interaction effects) were compared to day work with generalized estimating equations analysis. Results After adjustment for confounders, significant main effects were found for sleep quality for night workers (1.41, 95% confidence interval 1.05–1.89) and swing shift workers (1.42, 95% confidence interval 1.03–1.94) when compared to day workers; their interaction terms were not statistically significant. For the remaining fatigue outcomes, no statistically significant main or interaction effects were found. Conclusion After 2-week 12-hour night and swing shifts, only the course for sleep quality differed from that of day work. Sleep quality was poorer for night and swing shift workers on the 1st day off and remained poorer for the 14-day follow-up. This showed that while working at night had no effect on feeling rested, tiredness, and energy levels, it had a relatively long-lasting effect on sleep quality. PMID:26929834

Recent temporal trends in sleep duration, domain-specific sedentary behaviour and physical activity. A survey among 25-79-year-old Danish adults.

PubMed

Aadahl, Mette; Andreasen, Anne Helms; Hammer-Helmich, Lene; Buhelt, Lone; Jørgensen, Torben; Glümer, Charlotte

2013-11-01

Prevalence of sedentary behaviour is high in many countries, but little is known about temporal trends in sitting time. To examine temporal changes in sleep and domain-specific sedentary behaviour and moderate to vigorous leisure time physical activity (MVPA). Two cross-sectional population-based surveys of 25-79-year-old inhabitants were conducted in The Capital Region of Denmark in 2007 (N = 69.800, response rate 52.3%) and 2010 (N = 77.517, response rate 54.8%). Information on sedentary behaviour and physical activity was obtained from self-report questionnaire and sociodemographic information from central registers. Data were weighted for survey design and for non-response and were analysed by multiple regression analyses. In 2007, the entire survey population reported a mean daily sleeping duration of 7.4 hours, leisure time sitting of 3.4 hours per day, occupational sitting of 4.4 hours per day, MVPA of 0.87 hours per day and a total 24-hour energy expenditure of 40.12 METs per day. In 2010, duration of sleep was unaltered (p = 0.1), sedentary leisure time and sedentary work time had increased by 12.6 minutes (p < 0.0001) and 13.2 minutes (p < 0.0001) per day, respectively. Time spent on MVPA had increased by 2.9 minutes per day (p < 0.0001). The 24-hour energy expenditure had decreased by 0.41 METs (p < 0.0001). Adult Danish men and women spend an increased amount of time sitting down at work and during leisure time, but also on leisure time MVPA. As duration of sleep is unaltered findings suggest that low intensity physical activity may be displaced in everyday life.

Differences in time use and activity patterns when adding a second job: implications for health and safety in the United States.

PubMed

Marucci-Wellman, Helen R; Lin, Tin-Chi; Willetts, Joanna L; Brennan, Melanye J; Verma, Santosh K

2014-08-01

We compared work and lifestyle activities for workers who work in 1 job with those who work in multiple jobs during a 1-week period. We used information from the 2003-2011 American Time Use Survey to classify workers into 6 work groups based on whether they were a single (SJH) or multiple (MJH) job holder and whether they worked their primary, other, multiple, or no job on the diary day. The MJHs often worked 2 part-time jobs (20%), long weekly hours (27% worked 60+ hours), and on weekends. The MJHs working multiple jobs on the diary day averaged more than 2 additional work hours (2.25 weekday, 2.75 weekend day; P < .05), odd hours (more often between 5 pm and 7 am), with more work travel time (10 minutes weekday, 9 minutes weekend day; P < .05) and less sleep (-45 minutes weekday, -62 minutes weekend day; P < .05) and time for other household (P < .05) and leisure (P < .05) activities than SJHs. Because of long work hours, long daily commutes, multiple shifts, and less sleep and leisure time, MJHs may be at heightened risk of fatigue and injury.

Differences in Time Use and Activity Patterns When Adding a Second Job: Implications for Health and Safety in the United States

PubMed Central

Willetts, Joanna L.; Brennan, Melanye J.; Verma, Santosh K.

2014-01-01

Objectives. We compared work and lifestyle activities for workers who work in 1 job with those who work in multiple jobs during a 1-week period. Methods. We used information from the 2003–2011 American Time Use Survey to classify workers into 6 work groups based on whether they were a single (SJH) or multiple (MJH) job holder and whether they worked their primary, other, multiple, or no job on the diary day. Results. The MJHs often worked 2 part-time jobs (20%), long weekly hours (27% worked 60+ hours), and on weekends. The MJHs working multiple jobs on the diary day averaged more than 2 additional work hours (2.25 weekday, 2.75 weekend day; P < .05), odd hours (more often between 5 pm and 7 am), with more work travel time (10 minutes weekday, 9 minutes weekend day; P < .05) and less sleep (–45 minutes weekday, −62 minutes weekend day; P < .05) and time for other household (P < .05) and leisure (P < .05) activities than SJHs. Conclusions. Because of long work hours, long daily commutes, multiple shifts, and less sleep and leisure time, MJHs may be at heightened risk of fatigue and injury. PMID:24922135

5 CFR 550.1303 - Hourly rates of basic pay.

Code of Federal Regulations, 2010 CFR

2010-01-01

... generally consist of 24-hour shifts with a significant amount of designated standby and sleep time), the... annual rate in effect at the time the hour was actually worked. [63 FR 64593, Nov. 23, 1998, as amended...

5 CFR 550.1303 - Hourly rates of basic pay.

Code of Federal Regulations, 2012 CFR

2012-01-01

... generally consist of 24-hour shifts with a significant amount of designated standby and sleep time), the... annual rate in effect at the time the hour was actually worked. [63 FR 64593, Nov. 23, 1998, as amended...

5 CFR 550.1303 - Hourly rates of basic pay.

Code of Federal Regulations, 2013 CFR

2013-01-01

... generally consist of 24-hour shifts with a significant amount of designated standby and sleep time), the... annual rate in effect at the time the hour was actually worked. [63 FR 64593, Nov. 23, 1998, as amended...

5 CFR 550.1303 - Hourly rates of basic pay.

Code of Federal Regulations, 2011 CFR

2011-01-01

... generally consist of 24-hour shifts with a significant amount of designated standby and sleep time), the... annual rate in effect at the time the hour was actually worked. [63 FR 64593, Nov. 23, 1998, as amended...

5 CFR 550.1303 - Hourly rates of basic pay.

Code of Federal Regulations, 2014 CFR

2014-01-01

... generally consist of 24-hour shifts with a significant amount of designated standby and sleep time), the... annual rate in effect at the time the hour was actually worked. [63 FR 64593, Nov. 23, 1998, as amended...

Effort-reward imbalance and social support are associated with chronic fatigue among medical residents in Japan.

PubMed

Wada, Koji; Sakata, Yumi; Theriault, Gilles; Aratake, Yutaka; Shimizu, Midori; Tsutsumi, Akizumi; Tanaka, Katsutoshi; Aizawa, Yoshiharu

2008-01-01

The purpose of this study was to determine the associations of effort-reward imbalance and social support with chronic fatigue among medical residents in Japan. A total of 104 men and 42 women at 14 teaching hospitals participated in this study. Chronic fatigue was measured by the checklist individual strength questionnaire. Effort, reward and overcommitment were determined by the effort-reward questionnaire developed by Siegrist. Social support was determined by a visual analog scale. Sleeping hours for the last 30 days were estimated based on the number of overnight shifts worked, the average number of sleeping hours, and the number of hours of napping during overnight work. Multiple regression analysis was used to examine the multivariate relationship between these variables and chronic fatigue. In both men and women, effort-reward imbalance was positively associated, and higher social support was negatively associated with chronic fatigue. In men, higher overcommitment was positively associated with chronic fatigue. In women, longer sleeping hours was negatively associated with chronic fatigue and an interaction between sleeping hours and social support was found. The adjusted variance in fatigue explained by the exposure variables was 34% in men and 51% in women. The result of this study suggested that it is desirable to take these factors into consideration in the management of chronic fatigue among medical residents.

Sleep duration and its correlates in middle-aged and elderly Chinese women: the Shanghai Women’s Health Study

PubMed Central

Tu, Xiangdong; Cai, Hui; Gao, Yu-Tang; Wu, Xiaoyan; Ji, Bu-Tian; Yang, Gong; Li, Honglan; Zheng, Wei; Shu, Xiao Ou

2012-01-01

Background Abnormal sleep duration, either long or short, is associated with disease risk and mortality. Little information is available on sleep duration and its correlates among Chinese women. Methods Using information collected from 68,832 women who participated in the Shanghai Women’s Health Study (SWHS), we evaluated sleep duration and its correlations with sociodemographic and lifestyle factors, health status, and anthropometric measurements and their indexes using polynomial logistic regression. Results The mean age of the study population was 59.6 years (SD=9.0; range: 44.6–79.9 years) at time of sleep duration assessment. Approximately 80% of women reported sleeping 6–8 hours per day, 11.5% slept five hours or less, and 8.7% slept nine hours or more. As expected, age was the strongest predictor for sleep duration and was negatively correlated with sleep duration. In general, sleep duration was positively associated with energy intake, intakes of total meat and fruits, body mass index (BMI), waist-hip ratio (WHR), and waist circumference (WC) after adjustment for age and other factors. Both short and long sleep duration were negatively associated with education level, family income, and leisure-time physical activity and positively associated with number of live births, history of night shift work, and certain chronic diseases, compared to sleep duration around seven hours/day (6.5–7.4 hours/day). Short sleep duration was related to tea consumption and passive smoking. Long sleep duration was related to menopausal status and marital status. Conclusions In this large, population-based study, we found that sleep duration among middle-aged and elderly Chinese women was associated with several sociodemographic and lifestyle factors and with disease status. The main limitation of the study is the cross-sectional design that does not allow us to draw any causal inference. However, this study provides information for future investigation into the nature of these associations so that recommendations can be developed to reduce sleep problems in middle-aged and elderly Chinese women. It also provides important information on potential confounders for investigation of sleep duration on health outcomes in this population. PMID:22938861

Sleep Habits, Insomnia, and Daytime Sleepiness in a Large and Healthy Community-Based Sample of New Zealanders

PubMed Central

Wilsmore, Bradley R.; Grunstein, Ronald R.; Fransen, Marlene; Woodward, Mark; Norton, Robyn; Ameratunga, Shanthi

2013-01-01

Study Objectives: To determine the relationship between sleep complaints, primary insomnia, excessive daytime sleepiness, and lifestyle factors in a large community-based sample. Design: Cross-sectional study. Setting: Blood donor sites in New Zealand. Patients or Participants: 22,389 individuals aged 16-84 years volunteering to donate blood. Interventions: N/A. Measurements: A comprehensive self-administered questionnaire including personal demographics and validated questions assessing sleep disorders (snoring, apnea), sleep complaints (sleep quantity, sleep dissatisfaction), insomnia symptoms, excessive daytime sleepiness, mood, and lifestyle factors such as work patterns, smoking, alcohol, and illicit substance use. Additionally, direct measurements of height and weight were obtained. Results: One in three participants report < 7-8 h sleep, 5 or more nights per week, and 60% would like more sleep. Almost half the participants (45%) report suffering the symptoms of insomnia at least once per week, with one in 5 meeting more stringent criteria for primary insomnia. Excessive daytime sleepiness (evident in 9% of this large, predominantly healthy sample) was associated with insomnia (odds ratio [OR] 1.75, 95% confidence interval [CI] 1.50 to 2.05), depression (OR 2.01, CI 1.74 to 2.32), and sleep disordered breathing (OR 1.92, CI 1.59 to 2.32). Long work hours, alcohol dependence, and rotating work shifts also increase the risk of daytime sleepiness. Conclusions: Even in this relatively young, healthy, non-clinical sample, sleep complaints and primary insomnia with subsequent excess daytime sleepiness were common. There were clear associations between many personal and lifestyle factors—such as depression, long work hours, alcohol dependence, and rotating shift work—and sleep problems or excessive daytime sleepiness. Citation: Wilsmore BR; Grunstein RR; Fransen M; Woodward M; Norton R; Ameratunga S. Sleep habits, insomnia, and daytime sleepiness in a large and healthy community-based sample of New Zealanders. J Clin Sleep Med 2013;9(6):559-566. PMID:23772189

A pilot study of the safety implications of Australian nurses' sleep and work hours.

PubMed

Dorrian, Jillian; Lamond, Nicole; van den Heuvel, Cameron; Pincombe, Jan; Rogers, Ann E; Dawson, Drew

2006-01-01

The frequency and severity of adverse events in Australian healthcare is under increasing scrutiny. A recent state government report identified 31 events involving "death or serious [patient] harm" and 452 "very high risk" incidents. Australia-wide, a previous study identified 2,324 adverse medical events (AME) in a single year, with more than half considered preventable. Despite the recognized link between fatigue and error in other industries, to date, few studies of medical errors have assessed the fatigue of the healthcare professionals involved. Nurses work extended and unpredictable hours with a lack of regular breaks and are therefore likely to experience elevated fatigue. Currently, there is very little available information on Australian nurses' sleep or fatigue levels, nor is there any information about whether this affects their performance. This study therefore aims to examine work hours, sleep, fatigue and error occurrence in Australian nurses. Using logbooks, 23 full-time nurses in a metropolitan hospital completed daily recordings for one month (644 days, 377 shifts) of their scheduled and actual work hours, sleep length and quality, sleepiness, and fatigue levels. Frequency and type of nursing errors, near errors, and observed errors (made by others) were recorded. Nurses reported struggling to remain awake during 36% of shifts. Moderate to high levels of stress, physical exhaustion, and mental exhaustion were reported on 23%, 40%, and 36% of shifts, respectively. Extreme drowsiness while driving or cycling home was reported on 45 occasions (11.5%), with three reports of near accidents. Overall, 20 errors, 13 near errors, and 22 observed errors were reported. The perceived potential consequences for the majority of errors were minor; however, 11 errors were associated with moderate and four with potentially severe consequences. Nurses reported that they had trouble falling asleep on 26.8% of days, had frequent arousals on 34.0% of days, and that work-related concerns were either partially or fully responsible for their sleep disruption on 12.5% of occasions. Fourteen out of the 23 nurses reported using a sleep aid. The most commonly reported sleep aids were prescription medications (62.7%), followed by alcohol (26.9%). Total sleep duration was significantly shorter on workdays than days off (p < 0.01). In comparison to other workdays, sleep was significantly shorter on days when an error (p < 0.05) or a near error (p < 0.01) was recorded. In contrast, sleep was higher on workdays when someone else's error was recorded (p = 0.08). Logistic regression analysis indicated that sleep duration was a significant predictor of error occurrence (chi2 = 6.739, p = 0.009, e beta = 0.727). The findings of this pilot study suggest that Australian nurses experience sleepiness and related physical symptoms at work and during their trip home. Further, a measurable number of errors occur of various types and severity. Less sleep may lead to the increased likelihood of making an error, and importantly, the decreased likelihood of catching someone else's error. These pilot results suggest that further investigation into the effects of sleep loss in nursing may be necessary for patient safety from an individual nurse perspective and from a healthcare team perspective.

75 FR 285 - Hours of Service

Federal Register 2010, 2011, 2012, 2013, 2014

2010-01-05

... period long enough to provide restorative sleep regardless of the number of hours worked prior to the... No. FMCSA-2004-19608] RIN 2126-AB26 Hours of Service AGENCY: Federal Motor Carrier Safety... hold three public listening sessions to solicit comments and information on potential hours-of- service...

Sleep loss and accidents--work hours, life style, and sleep pathology.

PubMed

Akerstedt, Torbjörn; Philip, Pierre; Capelli, Aurore; Kecklund, Göran

2011-01-01

A very important outcome of reduced sleep is accidents. The present chapter will attempt to bring together some of the present knowledge in this area. We will focus on the driving situation, for which the evidence of the link between sleep loss and accidents is quite well established, but we will also bring up working life in general where evidence is more sparse. It should be emphasized that reduced sleep as a cause of accidents implies that the mediating factor is sleepiness (or fatigue). This link is discussed elsewhere in this volume, but here we will bring in sleepiness (subjective or physiological) as an explanatory factor of accidents. Another central observation is that many real life accident studies do not link accidents to reduced sleep, but infer reduced sleep and/or sleepiness from the context, like, for example, from work schedules, life styles, or sleep pathology. Reduced sleep is mainly due to suboptimal work schedules (or to a suboptimal life style) or to sleep pathology. We have divided the present chapter into two areas. Copyright © 2011 Elsevier B.V. All rights reserved.

Relationship of Work Hours with Selected Health Behaviors and Academic Progress among a College Student Cohort

ERIC Educational Resources Information Center

Miller, Kim; Danner, Fred; Staten, Ruth

2008-01-01

Approximately 57% of college students work while attending school. Health risks related to working while in college have not been widely studied. Objective: The authors' purpose in this study was to determine associations between hours worked, binge drinking, sleep habits, and academic performance among a college student cohort. Participants and…

Stress and sleep quality in doctors working on-call shifts are associated with functional gastrointestinal disorders

PubMed Central

Lim, Soo-Kyung; Yoo, Seung Jin; Koo, Dae Lim; Park, Chae A; Ryu, Han Jun; Jung, Yong Jin; Jeong, Ji Bong; Kim, Byeong Gwan; Lee, Kook Lae; Koh, Seong-Joon

2017-01-01

AIM To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call shifts. METHODS In this cross-sectional observation study, using the Rome III Questionnaire and Pittsburgh Sleep Quality Index (PSQI), we analyzed 170 doctors with 24 hour-on-call shifts. RESULTS Among the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48 (28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores (PSQI) (8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm (83.3% vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work (81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD (OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality (PSQI ≥ 6) was a predictor of IBS (OR = 4.17, 95%CI: 1.92-19.02, P = 0.016). CONCLUSION Physicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs. PMID:28566894

Sleep Duration and Media Time Have a Major Impact on Insulin Resistance and Metabolic Risk Factors in Obese Children and Adolescents.

PubMed

Sayin, Fatma Kubra; Buyukinan, Muammer

2016-08-01

Lifestyle factors sleep duration and media time during childhood differ between countries. This study examined whether sleep duration and media time affect metabolic risk factors insulin resistance (IR), blood lipid profile, and liver enzymes, and whether there is a relationship between sleep time and media time in Turkish obese children and adolescents. Subjects included 108 obese children and adolescents (aged 10-15 years) whose lifestyle factors were assessed using a survey containing questions about sleep durations, television viewing, media use, and demographic factors. Metabolic risk factors were compared among groups categorized according to sleep and media duration. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), and triglyceride (TG) levels and homeostasis model assessment of insulin resistance (HOMA-IR) values were higher in subjects who spent >5 hours/day on media. Children 10-13 years old who slept <9 hours/day were more likely to have higher insulin and HOMA-IR (p < 0.05) levels and lower high-density lipoprotein cholesterol (HDL-C) levels compared with subjects who slept 9-10 hours/day and >10 hours/day. Correlation analysis revealed a negative relationship between sleep time and media time (r = -0.471, p = 0.000). Short sleep duration was associated with IR and an elevated plasma lipoprotein profile in children and adolescents. Our results suggest that insufficient sleep and excessive media exposure may contribute to metabolic risk in the context of obesity, and therefore, working to improve sleep duration and limit media time could help reduce metabolic risk in obese children and adolescents.

Change from slowly rotating 8-hour shifts to rapidly rotating 8-hour and 12-hour shifts using participative shift roster design.

PubMed

Smith, P A; Wright, B M; Mackey, R W; Milsop, H W; Yates, S C

1998-01-01

The study examined the impact of change, from slowly rotating continuous 8-hour shifts to more rapidly rotating continuous 8-hour and 12-hour shifts, on the health and quality of life of shift workers. Self-report survey data were collected from 72 shift workers at 3 sewage treatment plants before and several months after roster change. After the change 1 plant first worked a rapidly rotating, 8-hour shift roster and then worked a 12-hour shift roster, and the other 2 plants worked continuous 12-hour shift rosters. After the change the shift workers at each plant reported increased satisfaction with roster design, a decrease in physical and psychological circadian malaise associated with shift work, improved day sleep quality, less tiredness, and improvements in the quality of home, social and work life. A between-plant comparison of the rapidly rotating 8-hour and 12-hour shift rosters showed greater improvements had been obtained with the 12-hour shift roster, and no significant differences in tiredness or sleep quality between the redesigned 8- and 12-hour shift rosters. However, a within-plant matched-pairs comparison at the 1st plant of the rapidly rotating 8-hour shift roster and the 12-hour shift roster showed no significant differences. The results show that the prior level of support for change may best explain the impact of roster redesign on individual well-being. They lend further support to shift worker participation in roster design.

Fatigue mitigation with SleepTrackTXT2 in air medical emergency care systems: study protocol for a randomized controlled trial.

PubMed

Patterson, P Daniel; Moore, Charity G; Guyette, Frank X; Doman, Jack M; Sequeira, Denisse; Werman, Howard A; Swanson, Doug; Hostler, David; Lynch, Joshua; Russo, Lindsey; Hines, Linda; Swecker, Karen; Runyon, Michael S; Buysse, Daniel J

2017-06-05

Most air medical Emergency Medical Services (EMS) clinicians work extended duration shifts, and more than 50% report inadequate sleep, poor sleep quality, and/or poor recovery between shifts. The SleepTrackTXT pilot trial (ClinicalTrials.gov, NCT02063737) showed that use of mobile phone text messages could impact EMS clinician self-reported fatigue and sleepiness during long duration shifts. The purpose of the SleepTrackTXT2 trial is to leverage lessons learned from the first SleepTrackTXT study and test an enhanced intervention targeting air medical EMS clinicians. We will conduct a multi-site randomized trial with a sample of adult EMS clinicians recruited from four air medical EMS systems located in the midwest, northeastern, and southern USA. Participants will be allocated to one of two possible arms for a 4-month (120-day) study period. The intervention arm will involve text-message assessments of sleepiness, fatigue, and difficulty concentrating at the beginning, every 4 hours during, and at the end of scheduled shifts. Participants reporting high levels of sleepiness, fatigue, or difficulty with concentration will receive one of nine randomly selected intervention messages to promote behavior change during shift work to improve alertness. Intervention participants will receive a text-message report on Friday of each week that shows their sleep debt over the previous 7 days followed by a text message to promote paying back sleep debt recovery when feasible. Participants in the control group receive text messages that only include assessments. Both arms will receive text-message assessments of perceived recovery since last shift, sleepiness, fatigue, or difficulty with concentration at noon (1200 hours) on days between scheduled shifts (off-duty days). We have two aims for this study: (1) to determine the short-term impact of the enhanced SleepTrackTXT2 intervention on air medical clinician fatigue reported in real time during and at the end of shift work, and (2) to determine the long-term impact of the SleepTrackTXT2 intervention on sleep quality and sleep health indicators including hours of sleep and recovery between shift work. The SleepTrackTXT2 trial may provide evidence of real-world effectiveness that would support widespread expansion of fatigue mitigation interventions in emergency care clinician shift workers. The trial may specifically support use of real-time assessments and interventions delivered via mobile technology such as text messaging. ClinicalTrials.gov, NCT02783027 . Registered on 23 May 2016.

29 CFR 552.102 - Live-in domestic service employees.

Code of Federal Regulations, 2010 CFR

2010-07-01

... themselves, the amount of sleeping time, meal time and other periods of complete freedom from all duties when... periods of free time (other than those relating to meals and sleeping) to be excluded from hours worked.... If the sleeping time, meal periods or other periods of free time are interrupted by a call to duty...

29 CFR 552.102 - Live-in domestic service employees.

Code of Federal Regulations, 2011 CFR

2011-07-01

... themselves, the amount of sleeping time, meal time and other periods of complete freedom from all duties when... periods of free time (other than those relating to meals and sleeping) to be excluded from hours worked.... If the sleeping time, meal periods or other periods of free time are interrupted by a call to duty...

On-call work: To sleep or not to sleep? It depends.

PubMed

Ferguson, Sally A; Paterson, Jessica L; Hall, Sarah J; Jay, Sarah M; Aisbett, Brad

On-call working time arrangements are increasingly common, involve work only in the event of an unpredictable incident and exist primarily outside of standard hours. Like other non-standard working time arrangements, on-call work disrupts sleep and can therefore have negative effects on health, safety and performance. Unlike other non-standard working time arrangements, on-call work often allows sleep opportunities between calls. Any sleep obtained during on-call periods will be beneficial for waking performance. However, there is evidence that sleep while on call may be of substantially reduced restorative value because of the expectation of receiving the call and apprehension about missing the call. In turn, waking from sleep to respond to a call may be associated with temporary increases in performance impairment. This is dependent on characteristics of both the preceding sleep, the tasks required upon waking and the availability and utility of any countermeasures to support the transition from sleep to wake. In this paper, we critically evaluate the evidence both for and against sleeping during on-call periods and conclude that some sleep, even if it is of reduced quality and broken by repeated calls, is a good strategy. We also note, however, that organisations utilising on-call working time arrangements need to systematically manage the likelihood that on-call sleep can be associated with temporary performance impairments upon waking. Given that the majority of work in this area has been laboratory-based, there is a significant need for field-based investigations of the magnitude of sleep inertia, in addition to the utility of sleep inertia countermeasures. Field studies should include working with subject matter experts to identify the real-world impacts of changes in performance associated with sleeping, or not sleeping, whilst on call.

Duty hours and incidents in flight among commercial airline pilots.

PubMed

O'Hagan, Anna Donnla; Issartel, Johann; Fletcher, Richard; Warrington, Giles

2016-01-01

Working long duty hours has often been associated with increased risk of incidents and accidents in transport industries. Despite this, information regarding the intermediate relationship between duty hours and incident risk is limited. This study aimed to test a work hours/incident model to identify the interplay of factors contributing to incidents within the aviation industry. Nine hundred and fifty-four European-registered commercial airline pilots completed a 30-item survey investigating self-report attitudes and experiences of fatigue. Path analysis was used to test the proposed model. The fit indices indicated this to be a good fit model (χ(2) = 11.066, df = 5, p = 0.05; Comparative Fit Index = 0.991; Normed Fit Index = 0.984; Tucker-Lewis Index = 0.962; Root Mean Square of Approximation = 0.036). Highly significant relationships were identified between duty hours and sleep disturbance (r = 0.18, p < 0.001), sleep disturbance and fatigue in the cockpit (r = 0.40, p < 0.001), and fatigue in the cockpit and microsleeps in the cockpit (r = 0.43, p < 0.001). A critical pathway from duty hours through to self-reported incidents in flight was identified. Further investigation employing both objective and subjective measures of sleep and fatigue is needed.

Watching television for more than two hours increases the likelihood of reporting poor sleep quality among Brazilian schoolteachers.

PubMed

de Souza, Sara Carolina Scremin; Campanini, Marcela Zambrim; de Andrade, Selma Maffei; González, Alberto Durán; de Melo, Juliana Moura; Mesas, Arthur Eumann

2017-10-01

Although time spent watching television and sleep problems have increased in the last few decades, it is unclear whether these conditions are associated in working adults after controlling for lifestyle, job characteristics and other individual aspects. The present study analyzed the association between time spent watching television and sleep quality among teachers from public schools in Londrina, Brazil. In this cross-sectional study, information from the Pittsburgh Sleep Quality Index (PSQI) and about time spent watching television was obtained during personal interviews. Logistic regression models adjusted by the main confounders (sociodemographic, occupational and lifestyle variables) were used in the analyses. Among the 959 studied teachers (68.2% women, median age: 42years), teachers who watched >120min/day had a higher likelihood of reporting poor sleep quality (PSQI>5) (odds ratio=1.41; 95% confidence interval=1.01; 1.98) compared with those who watched television for up to 60min/day, regardless of gender, age, work hours, leisure time physical activity and other lifestyle variables. This association did not remain significant after the adjustment for health conditions, i.e., obesity, anxiety, depression and chronic pain, which may act as confounding variables in the relationship between watching television and poor sleep quality. Watching television for >120min/day was independently associated with poorer sleep quality, which should be considered in the prevention and treatment of sleep disturbances among working population. Copyright © 2017 Elsevier Inc. All rights reserved.

Effect of oxcarbazepine on sleep architecture.

PubMed

Ayala-Guerrero, Fructuoso; Mexicano, Graciela; González, Valentín; Hernandez, Mario

2009-07-01

The most common side effects following administration of antiepileptic drugs involve alterations in sleep architecture and varying degrees of daytime sleepiness. Oxcarbazepine is a drug that is approved as monotherapy for the treatment of partial seizures and generalized tonic-clonic seizures. However, there is no information about its effects on sleep pattern organization; therefore, the objective of this work was to analyze such effects. Animals (Wistar rats) exhibited three different behavioral and electrophysiological states of vigilance: wakefulness, slow wave sleep (SWS), and rapid eye movement (REM) sleep. Oral treatment with oxcarbazepine (100 mg/kg) produced an increment in total sleep time throughout the recording period. This increment involved both SWS and REM sleep. Mean duration of the REM sleep phase was not affected. In contrast, the frequency of this sleep phase increased significantly across the 10-hour period. REM sleep latency shortened significantly. Results obtained in this work indicate that oxcarbazepine's acute effects point to hypnotic properties.

Canadian Plastic Surgery Resident Work Hour Restrictions: Practices and Perceptions of Residents and Program Directors.

PubMed

McInnes, Colin W; Vorstenbosch, Joshua; Chard, Ryan; Logsetty, Sarvesh; Buchel, Edward W; Islur, Avinash

2018-02-01

The impact of resident work hour restrictions on training and patient care remains a highly controversial topic, and to date, there lacks a formal assessment as it pertains to Canadian plastic surgery residents. To characterize the work hour profile of Canadian plastic surgery residents and assess the perspectives of residents and program directors regarding work hour restrictions related to surgical competency, resident wellness, and patient safety. An anonymous online survey developed by the authors was sent to all Canadian plastic surgery residents and program directors. Basic summary statistics were calculated. Eighty (53%) residents and 10 (77%) program directors responded. Residents reported working an average of 73 hours in hospital per week with 8 call shifts per month and sleep 4.7 hours/night while on call. Most residents (88%) reported averaging 0 post-call days off per month and 61% will work post-call without any sleep. The majority want the option of working post-call (63%) and oppose an 80-hour weekly maximum (77%). Surgical and medical errors attributed to post-call fatigue were self-reported by 26% and 49% of residents, respectively. Residents and program directors expressed concern about the ability to master surgical skills without working post-call. The majority of respondents oppose duty hour restrictions. The reason is likely multifactorial, including the desire of residents to meet perceived expectations and to master their surgical skills while supervised. If duty hour restrictions are aggressively implemented, many respondents feel that an increased duration of training may be necessary.

Polysomnographic Sleep and Circadian Temperature Rhythms as a Function of Prior Shift Work Exposure in Retired Seniors.

PubMed

Monk, Timothy H; Buysse, Daniel J; Billy, Bart D; Fletcher, Mary E; Kennedy, Kathy S

2013-04-29

In an earlier published telephone interview study (n > 1,000) we have shown that retired shift workers subjectively report worse sleep than retired day workers. This laboratory study sought to determine whether these findings held up when objective polysomnograhic (PSG) measures of sleep were taken and whether retirees' circadian temperature rhythms differed as a function of shift work exposure. All completers of the telephone interview were invited to attend a 36-hour laboratory study for which participants were paid. This involved continuous core body temperature measurement (using an ingestible pill-based system) and 2 nights of PSG. Shift work exposure (plus other measures) was collected by taking a detailed work history. The second laboratory night was scored into sleep stages. Post hoc, we divided participants into 4 shift work exposure groups: 0 years (ie, no exposure to shift work), 1 to 7 years, 7 to 20 years, and >20 years. Sample sizes were 11, 16, 15, and 15, respectively, with approximate equality in mean age (71.7 years of age, 69.1 years of age, 70.0 years of age, and 70.4 years of age, respectively) and percent male (63%, 50%, 67%, and 73%, respectively). Shift work exposure was associated with worse PSG sleep in a dose-related fashion. The percentages of participants with sleep efficiency, 80% for the 0 years, 1 to 7 years, 7 to 20 years, and >20 years groups were 36%, 63%, 67%, and 73%, respectively ( P < 0.01), and the percentages with total sleep time (TST), 6 hours were 36%, 56%, 53%, and 73%, respectively ( P < 0.01). From the circadian rhythm record, shift work exposure appeared to result ( P = 0.06) in an increased spread of phase angles (difference between habitual bedtime and time of temperature trough). In conclusion, it appears likely that shift work may be related to a scarring of sleep and circadian rhythms. This may be associated with a change in the relationship between habitual sleep timing and the phase of the circadian pacemaker.

Cognitive Performance Degradation on Sonar Operator and Torpedo Data Control Unit Operator after One Night of Sleep Deprivation

DTIC Science & Technology

1985-09-01

8 II. SLEEP AND SOME CHARACTERISTICS . . . . . o . . 13 A. C"YCLE AND CYCLE EFFECT ... ......... 11 B. SLEEP DEPRIVATION...17 E. NAP: RESTORATIVE POWER AND SIDE EFFECTS OF THE NAP o . . o o o o e o o . o * o e o . 19 III. SLEEP LOSS AND...war periods. The effect of this situ- ation is a requirement for long hours of physically and mentally exhausting work without sleep. The silent war

Associations among rotating night shift work, sleep and skin cancer in Nurses' Health Study II participants.

PubMed

Heckman, Carolyn J; Kloss, Jacqueline D; Feskanich, Diane; Culnan, Elizabeth; Schernhammer, Eva S

2017-03-01

Night shift work and sleep duration have been associated with breast and other cancers. Results from the few prior studies of night shift work and skin cancer risk have been mixed and not fully accounted for other potentially important health-related variables (eg, sleep characteristics). This study evaluated the relationship between rotating night shift work and skin cancer risk and included additional skin cancer risk factors and sleep-related variables. The current study used data from 74 323 Nurses' Health Study (NHS) II participants. Cox proportional hazards models were used to estimate multivariable-adjusted HRs and 95% CIs for skin cancers across categories of shift work and sleep duration. Over 10 years of follow-up, 4308 basal cell carcinoma (BCC), 334 squamous cell carcinoma (SCC) and 212 melanoma cases were identified. Longer duration of rotating night shifts was associated with a linear decline in risk of BCC (HR=0.93, 95% CI 0.90 to 0.97 per 5-year increase). Shift work was not significantly associated with either melanoma (HR=1.02, 95% CI 0.86 to 1.21) or SCC (HR=0.92, 95% CI 0.80 to 1.06). A short sleep duration (≤6 hours per day) was associated with lower risks of melanoma (HR=0.68, 95% CI 0.46 to 0.98) and BCC (HR=0.93, 95% CI 0.86 to 1.00) compared with the most common report of 7 hours. SCC was not associated with duration of sleep (HR=0.94, 95% CI 0.83 to 1.06). Longer duration of rotating night shift work and shorter sleep duration were associated with lower risk of some skin cancers. Further research is needed to confirm and identify the mechanisms underlying these associations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Sleep Deprivation.

PubMed

Abrams, Robert M

2015-09-01

Sleep deprivation occurs when inadequate sleep leads to decreased performance, inadequate alertness, and deterioration in health. It is incompletely understood why humans need sleep, although some theories include energy conservation, restoration, and information processing. Sleep deprivation has many deleterious health effects. Residency programs have enacted strict work restrictions because of medically related errors due to sleep deprivation. Because obstetrics is an unpredictable specialty with long irregular hours, enacting a hospitalist program enhances patient safety, decreases malpractice risk, and improves the physician's quality of life by allowing obstetricians to get sufficient rest. Copyright © 2015 Elsevier Inc. All rights reserved.

Sleep and Cardio-Metabolic Disease.

PubMed

Cappuccio, Francesco P; Miller, Michelle A

2017-09-19

This review summarises and discusses the epidemiological evidence suggesting a causal relationship between sleep duration and cardio-metabolic risk and outcomes in population. Sleep duration is affected by a variety of cultural, social, psychological, behavioural, pathophysiological and environmental influences. Changes in modern society-like longer working hours, more shift-work, 24/7 availability of commodities and 24-h global connectivity-have been associated with a gradual reduction in sleep duration and sleeping patterns across westernised populations. We review the evidence of an association between sleep disturbances and the development of cardio-metabolic risk and disease and discuss the implications for causality of these associations. Prolonged curtailment of sleep duration is a risk factor for the development of obesity, diabetes, hypertension, heart disease and stroke and may contribute, in the long-term, to premature death.

The influence of daily sleep patterns of commercial truck drivers on driving performance

PubMed Central

Chen, Guang Xiang; Fang, Youjia; Guo, Feng; Hanowski, Richard J.

2016-01-01

Fatigued and drowsy driving has been found to be a major cause of truck crashes. Lack of sleep is the number one cause of fatigue and drowsiness. However, there are limited data on the sleep patterns (sleep duration, sleep percentage in the duration of non-work period, and the time when sleep occurred) of truck drivers in non-work periods and the impact on driving performance. This paper examined sleep patterns of 96 commercial truck drivers during non-work periods and evaluated the influence these sleep patterns had on truck driving performance. Data were from the Naturalistic Truck Driving Study. Each driver participated in the study for approximately four weeks. A shift was defined as a non-work period followed by a work period. A total of 1397 shifts were identified. Four distinct sleep patterns were identified based on sleep duration, sleep start/end point in a non-work period, and the percentage of sleep with reference to the duration of non-work period. Driving performance was measured by safety-critical events, which included crashes, near-crashes, crash-relevant conflicts, and unintentional lane deviations. Negative binomial regression was used to evaluate the association between the sleep patterns and driving performance, adjusted for driver demographic information. The results showed that the sleep pattern with the highest safety-critical event rate was associated with shorter sleep, sleep in the early stage of a non-work period, and less sleep between 1 a.m. and 5 a.m. This study also found that male drivers, with fewer years of commercial vehicle driving experience and higher body mass index, were associated with deteriorated driving performance and increased driving risk. The results of this study could inform hours-of-service policy-making and benefit safety management in the trucking industry. PMID:26954762

Prioritizing Sleep Health: Public Health Policy Recommendations.

PubMed

Barnes, Christopher M; Drake, Christopher L

2015-11-01

The schedules that Americans live by are not consistent with healthy sleep patterns. In addition, poor access to educational and treatment aids for sleep leaves people engaging in behavior that is harmful to sleep and forgoing treatment for sleep disorders. This has created a sleep crisis that is a public health issue with broad implications for cognitive outcomes, mental health, physical health, work performance, and safety. New public policies should be formulated to address these issues. We draw from the scientific literature to recommend the following: establishing national standards for middle and high school start times that are later in the day, stronger regulation of work hours and schedules, eliminating daylight saving time, educating the public regarding the impact of electronic media on sleep, and improving access to ambulatory in-home diagnostic testing for sleep disorders. © The Author(s) 2015.

Effects of Sleep Deprivation on U.S. Navy Watchstander Performance Onboard the Independence Class Littoral Combat Ship (LCS 2)

DTIC Science & Technology

2013-09-01

obtained .........................................................................8 Table 2. NPS theses relating to work schedule, sleep , and/or fatigue ...an analysis of performance issues related to sleep deprivation and fatigue aboard the Independence Class Littoral Combat Ship (LCS 2). The unique...rotation led to “fragmented sleep of generally less than 6 hours in duration.” Efforts to correct the issue of fatigue within the Navy were at a

Association between Sleep Duration and 24-Hour Urine Free Cortisol in the MrOS Sleep Study

PubMed Central

Rao, Madhu N.; Blackwell, Terri; Redline, Susan; Punjabi, Naresh M.; Barrett-Connor, Elizabeth; Neylan, Thomas C.; Stone, Katie L.

2013-01-01

Context Short sleep duration is associated with adverse health outcomes, but the mechanisms involved are unknown. It has been postulated that short sleep duration may elevate cortisol levels, but studies have had conflicting results. It is unclear whether these differing findings may be due to methodological issues, such as assessment of sleep duration. Specifically, objective versus subjective methods of measuring habitual sleep duration may account for the conflicting results found in epidemiological studies. Objective Our goal was to determine whether habitual sleep duration, measured objectively (by actigraphy) and subjectively (by self-report), was associated with 24-hour urine free cortisol (UFC), a measure of integrated cortisol secretion. Our secondary goal was to determine whether slow wave sleep (SWS, determined by polysomnography) was associated with 24-hour UFC. Design/Setting Cross sectional study of community dwelling older men. Patients/Participants 325 men (mean age = 76.6 years, SD = 5.5) from the Portland site of the MrOS Sleep Study, who underwent 24-hour urine collection, polysomnography, actigraphy and sleep questionnaire. Primary Outcome 24-hour UFC. Results In this study of community dwelling older men, self-reported sleep duration was inversely related to 24-hour UFC levels. Participants reporting <5 hours of habitual sleep had an adjusted mean 24-hour UFC of 29.8 ug, compared to 28.0 ug in participants reporting >5 to <8 hours of sleep 25.5 ug in those reporting >8 hours of habitual sleep. However, sleep duration determined by actigraphy was not associated with 24-hour UFC in either univariable or multivariable regression models. SWS was not associated with 24-hour UFC. Conclusion Objectively measured (i.e., actigraphic) sleep duration is not associated with 24-hour UFC in these community dwelling older men. This finding, together with prior studies, suggests that elevated levels of integrated cortisol secretion is not the mechanisms by which short sleep duration leads to adverse health outcomes. PMID:24228086

Vestibular vertigo is associated with abnormal sleep duration.

PubMed

Albathi, Monirah; Agrawal, Yuri

2017-01-01

Several small studies in animals and humans have suggested a relationship between vestibular function and sleep. In this study, we evaluate the association between vestibular vertigo and sleep duration in a large, representative sample of US adults. We used data from the National Health Interview Survey, which administered a Balance Supplement in 2008 in a sample of 20,950 adult respondents. We evaluated the cross-sectional association between vestibular vertigo (based on a well-validated definition) and sleep duration (defined as short <6 hours, normal 6-8 hours, and long >8 hours). We performed multiple and multinomial logistic regression analyses to estimate the odds ratio and relative risk ratio (RRR) of impaired sleep duration compared to normal sleep duration associated with vestibular vertigo. Analyses were adjusted for demographic, lifestyle and health behavior characteristics as well as relevant comorbid conditions. Thirty percent of individuals with vestibular vertigo reported abnormal sleep duration (15.5% short duration and 14.8% long duration). In adjusted analyses, individuals with vestibular vertigo had a 1.75 (95% CI 1.45-2.11) RRR of having short sleep duration compared to individuals without vestibular vertigo, and a 1.55 (95% CI 1.26-1.91) RRR of having long sleep duration compared to individuals without vestibular vertigo. This study presents epidemiologic evidence to support the association between vestibular function and sleep duration. Individuals with vestibular vertigo had a higher RRR for abnormally short or long sleep duration. Further work is needed to evaluate the causal direction(s) of this association.

Resident Duty Hours: Enhancing Sleep, Supervision, and Safety

ERIC Educational Resources Information Center

Ulmer, Cheryl, Ed.; Wolman, Dianne Miller, Ed.; Johns, Michael M. E., Ed.

2009-01-01

Medical residents in hospitals are often required to be on duty for long hours. In 2003 the organization overseeing graduate medical education adopted common program requirements to restrict resident workweeks, including limits to an average of 80 hours over 4 weeks and the longest consecutive period of work to 30 hours in order to protect…

Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion.

PubMed

Paruthi, Shalini; Brooks, Lee J; D'Ambrosio, Carolyn; Hall, Wendy A; Kotagal, Suresh; Lloyd, Robin M; Malow, Beth A; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F; Rosen, Carol L; Troester, Matthew M; Wise, Merrill S

2016-11-15

Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. A commentary on this article apears in this issue on page 1439. © 2016 American Academy of Sleep Medicine

Independent effects of sleep duration and body mass index on the risk of a work-related injury: evidence from the US National Health Interview Survey (2004-2010).

PubMed

Lombardi, David A; Wirtz, Anna; Willetts, Joanna L; Folkard, Simon

2012-06-01

Fatigue has been linked to adverse safety outcomes, and poor quality or decreased sleep has been associated with obesity (higher body mass index, BMI). Additionally, higher BMI is related to an increased risk for injury; however, it is unclear whether BMI modifies the effect of short sleep or has an independent effect on work-related injury risk. To answer this question, the authors examined the risk of a work-related injury as a function of total daily sleep time and BMI using the US National Health Interview Survey (NHIS). The NHIS is an in-person household survey using a multistage, stratified, clustered sample design representing the US civilian population. Data were pooled for the 7-yr survey period from 2004 to 2010 for 101 891 "employed" adult subjects (51.7%; 41.1 ± yrs of age [mean ± SEM]) with data on both sleep and BMI. Weighted annualized work-related injury rates were estimated across a priori defined categories of BMI: healthy weight (BMI: <25), overweight (BMI: 25-29.99), and obese (BMI: ≥30) and also categories of usual daily sleep duration: <6, 6-6.99, 7-7.99, 8-8.99, and ≥9 h. To account for the complex sampling design, including stratification, clustering, and unequal weighting, weighted multiple logistic regression was used to estimate the risk of a work-related injury. The initial model examined the interaction among daily sleep duration and BMI, controlling for weekly working hours, age, sex, race/ethnicity, education, type of pay, industry, and occupation. No significant interaction was found between usual daily sleep duration and BMI (p = .72); thus, the interaction term of the final logistic model included these two variables as independent predictors of injury, along with the aforementioned covariates. Statistically significant covariates (p ≤ .05) included age, sex, weekly work hours, occupation, and if the worker was paid hourly. The lowest categories of usual sleep duration (<6 and 6-6.9 h) showed significantly (p ≤ .05) elevated injury risks than the referent category (7-8 h sleep), whereas sleeping >7-8 h did not significantly elevate risk. The adjusted injury risk odds ratio (OR) for a worker with a usual daily sleep of <6 h was 1.86 (95% confidence interval [CI]: 1.37-2.52), and for 6-6.9 h it was 1.46 (95% CI: 1.18-1.80). With regards to BMI, the adjusted injury risk OR comparing workers who were obese (BMI: ≥30) to healthy weight workers (BMI: <25) was 1.34 (95% CI: 1.09-1.66), whereas the risk in comparing overweight workers (BMI: 25-29.99) to healthy weight risk was elevated, but not statistically significant (OR = 1.08; 95% CI: .88-1.33). These results from a large representative sample of US workers suggest increase in work-related injury risk for reduced sleep regardless of worker's body mass. However, being an overweight worker also increases work-injury risk regardless of usual daily sleep duration. The independent additive risk of these factors on work-related injury suggests a substantial, but at least partially preventable, risk.

Morning Sleep Inertia in Alertness and Performance: Effect of Cognitive Domain and White Light Conditions

PubMed Central

Santhi, Nayantara; Groeger, John A.; Archer, Simon N.; Gimenez, Marina; Schlangen, Luc J. M.; Dijk, Derk-Jan

2013-01-01

The transition from sleep to wakefulness entails a temporary period of reduced alertness and impaired performance known as sleep inertia. The extent to which its severity varies with task and cognitive processes remains unclear. We examined sleep inertia in alertness, attention, working memory and cognitive throughput with the Karolinska Sleepiness Scale (KSS), the Psychomotor Vigilance Task (PVT), n-back and add tasks, respectively. The tasks were administered 2 hours before bedtime and at regular intervals for four hours, starting immediately after awakening in the morning, in eleven participants, in a four-way cross-over laboratory design. We also investigated whether exposure to Blue-Enhanced or Bright Blue-Enhanced white light would reduce sleep inertia. Alertness and all cognitive processes were impaired immediately upon awakening (p<0.01). However, alertness and sustained attention were more affected than cognitive throughput and working memory. Moreover, speed was more affected than accuracy of responses. The light conditions had no differential effect on performance except in the 3-back task (p<0.01), where response times (RT) at the end of four hours in the two Blue-Enhanced white light conditions were faster (200 ms) than at wake time. We conclude that the effect of sleep inertia varies with cognitive domain and that it’s spectral/intensity response to light is different from that of sleepiness. That is, just increasing blue-wavelength in light may not be sufficient to reduce sleep inertia. These findings have implications for critical professions like medicine, law-enforcement etc., in which, personnel routinely wake up from night-time sleep to respond to emergency situations. PMID:24260280

The impact of reduced worktime on sleep and perceived stress - a group randomized intervention study using diary data.

PubMed

Schiller, Helena; Lekander, Mats; Rajaleid, Kristiina; Hellgren, Carina; Åkerstedt, Torbjörn; Barck-Holst, Peter; Kecklund, Göran

2017-03-01

Objective Insufficient time for recovery between workdays may cause fatigue and disturbed sleep. This study evaluated the impact of an intervention that reduced weekly working hours by 25% on sleep, sleepiness and perceived stress for employees within the public sector. Method Participating workplaces (N=33) were randomized into intervention and control groups. Participants (N=580, 76% women) worked full-time at baseline. The intervention group (N=354) reduced worktime to 75% with preserved salary during 18 months. Data were collected at baseline and after 9 and 18 months follow-up. Sleep quality, sleep duration, sleepiness, perceived stress,and worries and stress at bedtime were measured with diary during one week per data collection. Result A multilevel mixed model showed that compared with the control group, at the 18-month follow-up, the intervention group had improved sleep quality and sleep duration (+23 minutes) and displayed reduced levels of sleepiness, perceived stress, and worries and stress at bedtime on workdays (P<0.002). The same effects were shown for days off (P<0.006), except for sleep length. Effect sizes were small (Cohen's f2<0.08). Adding gender, age, having children living at home, and baseline values of sleep quality and worries and stress at bedtime as additional between-group factors did not influence the results. Conclusion A 25% reduction of weekly work hours with retained salary resulted in beneficial effects on sleep, sleepiness and perceived stress both on workdays and days off. These effects were maintained over an 18-month period. This randomized intervention thus indicates that reduced worktime may improve recovery and perceived stress.

Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

NASA Technical Reports Server (NTRS)

Flynn-Evans, Erin; Gregory, Kevin; Arsintescu, Lucia; Whitmire, Alexandra

2016-01-01

Sleep loss, circadian desynchronization, and work overload occur to some extent for ground and flight crews, prior to and during spaceflight missions. Ground evidence indicates that such risk factors may lead to performance decrements and adverse health outcomes, which could potentially compromise mission objectives. Efforts are needed to identify the environmental and mission conditions that interfere with sleep and circadian alignment, as well as individual differences in vulnerability and resiliency to sleep loss and circadian desynchronization. Specifically, this report highlights a collection of new evidence to better characterize the risk and reveals new gaps in this risk as follows: Sleep loss is apparent during spaceflight. Astronauts consistently average less sleep during spaceflight relative to on the ground. The causes of this sleep loss remain unknown, however ground-based evidence suggests that the sleep duration of astronauts is likely to lead to performance impairment and short and long-term health consequences. Further research is needed in this area in order to develop screening tools to assess individual astronaut sleep need in order to quantify the magnitude of sleep loss during spaceflight; current and planned efforts in BHP's research portfolio address this need. In addition, it is still unclear whether the conditions of spaceflight environment lead to sleep loss or whether other factors, such as work overload lead to the reduced sleep duration. Future data mining efforts and continued data collection on the ISS will help to further characterize factors contributing to sleep loss. Sleep inertia has not been evaluated during spaceflight. Ground-based studies confirm that it takes two to four hours to achieve optimal performance after waking from a sleep episode. Sleep inertia has been associated with increased accidents and reduced performance in operational environments. Sleep inertia poses considerable risk during spaceflight when emergency situations necessitate that crewmembers wake from sleep and make quick decisions. A recently completed BHP investigation assesses the effects of sleep inertia upon abrupt awakening, with and without hypnotics currently used in spaceflight; results from this investigation will help to inform strategies relative to sleep inertia effects on performance. Circadian desynchrony has been observed during spaceflight. Circadian desynchrony during spaceflight develops due to schedule constraints requiring non-24 operations or 'slam-shifts' and due to insufficient or mis-timed light exposure. In addition, circadian misalignment has been associated with reduced sleep duration and increased medication use. In ground-based studies, circadian desynchrony has been associated with significant performance impairment and increased risk of accidents when operations coincide with the circadian nadir. There is a great deal of information available on how to manage circadian misalignment, however, there are currently no easily collected biomarkers that can be used during spaceflight to determine circadian phase. Current research efforts are addressing this gap. Work overload has been documented during current spaceflight operations. NASA has established work hour guidelines that limit shift duration, however, schedule creep, where duty requirements necessitate working beyond scheduled work hours, has been reported. This observation warrants the documentation of actual work hours in order to improve planning and in order to ensure that astronauts receive adequate down time. In addition to concerns about work overload, ground based evidence suggests that work underload may be a concern during deep space missions, where torpor may develop and physically demanding workload will be exchanged for monitoring of autonomous systems. Given that increased automation is anticipated for exploration vehicles, fatigue effects in the context of such systems needs to be further understood. Performance metrics are needed to evaluate fitness-for-duty during spaceflight. Although ground-based evidence supports the notion that sleep loss, circadian desynchronization and work overload lead to performance impairment, inconsistency in the measures used to evaluate performance during spaceflight make it difficult to evaluate the magnitude of performance impairment during spaceflight. Work is underway to standardize measures of performance evaluation during spaceflight. Once established, such performance indicators need to be correlated with operational performance. Individual differences in sleep need and circadian preference, phase shifting ability and period have been documented in ground-based studies. Individual differences in response to sleep loss and circadian misalignment have also been documented and are presumed to be associated with genetic polymorphisms. No studies have systematically reported individual differences in sleep or circadian-related outcomes during spaceflight. More work is needed in this area in order to identify genetic or phenotypic biomarkers that predict resilience or vulnerability to sleep loss in order to personalize countermeasure strategies and mitigate performance impairment during spaceflight. Two laboratory and field investigations specific to this topic are currently ongoing; additional efforts, including an effort to mine existing biological data from spaceflight relative to sleep and circadian outcomes, are planned. Sex differences in sleep need and circadian period and phase have been reported in ground-based studies. The impact of these sex differences on performance is unclear. Sex differences in sleep need and circadian rhythms have not been systematically studied during spaceflight, presumably due to the small number of women that have flown in space. More research is needed in this area to evaluate whether any of the observed sex differences in physiology lead to altered performance in spaceflight and on the ground.

Sleep deprivation during a specific 3-hour time window post-training impairs hippocampal synaptic plasticity and memory

PubMed Central

Prince, Toni-Moi; Wimmer, Mathieu; Choi, Jennifer; Havekes, Robbert; Aton, Sara; Abel, Ted

2014-01-01

Sleep deprivation disrupts hippocampal function and plasticity. In particular, long-term memory consolidation is impaired by sleep deprivation, suggesting that a specific critical period exists following learning during which sleep is necessary. To elucidate the impact of sleep deprivation on long-term memory consolidation and synaptic plasticity, long-term memory was assessed when mice were sleep deprived following training in the hippocampus-dependent object place recognition task. We found that 3 hours of sleep deprivation significantly impaired memory when deprivation began 1 hour after training. In contrast, 3 hours of deprivation beginning immediately post-training did not impair spatial memory. Furthermore, a 3-hour sleep deprivation beginning 1 hour after training impaired hippocampal long-term potentiation (LTP), whereas sleep deprivation immediately after training did not affect LTP. Together, our findings define a specific 3-hour critical period, extending from 1 to 4 hours after training, during which sleep deprivation impairs hippocampal function. PMID:24380868

The effect of working on-call on stress physiology and sleep: A systematic review.

PubMed

Hall, Sarah J; Ferguson, Sally A; Turner, Anne I; Robertson, Samuel J; Vincent, Grace E; Aisbett, Brad

2017-06-01

On-call work is becoming an increasingly common work pattern, yet the human impacts of this type of work are not well established. Given the likelihood of calls to occur outside regular work hours, it is important to consider the potential impact of working on-call on stress physiology and sleep. The aims of this review were to collate and evaluate evidence on the effects of working on-call from home on stress physiology and sleep. A systematic search of Ebsco Host, Embase, Web of Science, Scopus and ScienceDirect was conducted. Search terms included: on-call, on call, standby, sleep, cortisol, heart rate, adrenaline, noradrenaline, nor-adrenaline, epinephrine, norepinephrine, nor-epinephrine, salivary alpha amylase and alpha amylase. Eight studies met the inclusion criteria, with only one study investigating the effect of working on-call from home on stress physiology. All eight studies investigated the effect of working on-call from home on sleep. Working on-call from home appears to adversely affect sleep quantity, and in most cases, sleep quality. However, studies did not differentiate between night's on-call from home with and without calls. Data examining the effect of working on-call from home on stress physiology were not sufficient to draw meaningful conclusions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Emotional working memory during sustained wakefulness.

PubMed

Tempesta, Daniela; De Gennaro, Luigi; Presaghi, Fabio; Ferrara, Michele

2014-12-01

In the present study we investigated whether one night of sleep deprivation can affect working memory (WM) performance with emotional stimuli. Twenty-five subjects were tested after one night of sleep deprivation and after one night of undisturbed sleep at home. As a second aim of the study, to evaluate the cumulative effects of sleep loss and of time-of-day changes on emotional WM ability, the subjects were tested every 4 h, from 22:00 to 10:00 hours, in four testing sessions during the sleep deprivation period (deprivation sessions: D1, D2, D3 and D4). Subjects performed the following test battery: Psychomotor Vigilance Task, 0-back task, 2-back task and an 'emotional 2-back task' with neutral, positive and negative emotional pictures selected from the International Affective Picture System. Results showed lower accuracy in the emotional WM task when the participants were sleep-deprived relative to when they had slept, suggesting the crucial role of sleep for preserving WM ability. In addition, the accuracy for the negative pictures remains stable during the sessions performed from 22:00 to 06:00 hours (D1, D2 and D3), while it drops at the D4 session, when the participants had accumulated the longest sleep debt. It is suggested that, during sleep loss, attentional and WM mechanisms may be sustained by the higher arousing characteristics of the emotional (negative) stimuli. © 2014 European Sleep Research Society.

Consensus Statement of the American Academy of Sleep Medicine on the Recommended Amount of Sleep for Healthy Children: Methodology and Discussion

PubMed Central

Paruthi, Shalini; Brooks, Lee J.; D'Ambrosio, Carolyn; Hall, Wendy A.; Kotagal, Suresh; Lloyd, Robin M.; Malow, Beth A.; Maski, Kiran; Nichols, Cynthia; Quan, Stuart F.; Rosen, Carol L.; Troester, Matthew M.; Wise, Merrill S.

2016-01-01

Members of the American Academy of Sleep Medicine developed consensus recommendations for the amount of sleep needed to promote optimal health in children and adolescents using a modified RAND Appropriateness Method. After review of 864 published articles, the following sleep durations are recommended: Infants 4 months to 12 months should sleep 12 to 16 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 1 to 2 years of age should sleep 11 to 14 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 3 to 5 years of age should sleep 10 to 13 hours per 24 hours (including naps) on a regular basis to promote optimal health. Children 6 to 12 years of age should sleep 9 to 12 hours per 24 hours on a regular basis to promote optimal health. Teenagers 13 to 18 years of age should sleep 8 to 10 hours per 24 hours on a regular basis to promote optimal health. Sleeping the number of recommended hours on a regular basis is associated with better health outcomes including: improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health. Regularly sleeping fewer than the number of recommended hours is associated with attention, behavior, and learning problems. Insufficient sleep also increases the risk of accidents, injuries, hypertension, obesity, diabetes, and depression. Insufficient sleep in teenagers is associated with increased risk of self-harm, suicidal thoughts, and suicide attempts. Commentary: A commentary on this article apears in this issue on page 1439. Citation: Paruthi S, Brooks LJ, D'Ambrosio C, Hall WA, Kotagal S, Lloyd RM, Malow BA, Maski K, Nichols C, Quan SF, Rosen CL, Troester MM, Wise MS. Consensus statement of the American Academy of Sleep Medicine on the recommended amount of sleep for healthy children: methodology and discussion. J Clin Sleep Med 2016;12(11):1549–1561. PMID:27707447

Sleep and sickness absence: a nationally representative register-based follow-up study.

PubMed

Lallukka, Tea; Kaikkonen, Risto; Härkänen, Tommi; Kronholm, Erkki; Partonen, Timo; Rahkonen, Ossi; Koskinen, Seppo

2014-09-01

We aimed to examine various sleep measures as determinants of sickness absence while considering confounders. Nationally representative Health 2000 Survey linked with sickness absence data from the Finnish Social Insurance Institution. Finland. Working-aged women (n = 1,875) and men (n = 1,885). N/A. Insomnia-related symptoms, early morning awakenings, being more tired during daytime than other people of same age, use of sleeping pills, excessive daytime sleepiness, probable sleep apnea (4 items about snoring/apnea), and reporting that sleep duration varies between different seasons were examined as determinants of sickness absence over a 7.2 year follow-up. Poisson and gamma regression models were fitted. After adjusting age, all examined sleep disturbances except excessive daytime sleepiness were associated with sickness absence among men (RRs 1.3-2.5). Among women, after adjusting for age, insomnia-related symptoms, early morning awakenings, being more tired than others, and use of sleeping pills were associated with sickness absence (RRs 1.4-1.8). After further adjustments for education, working conditions, health behaviors, and objectively measured mental and somatic health, the associations somewhat attenuated but mainly remained. The optimal sleep duration with the lowest risk of sickness absence was 7.6 hours for women and 7.8 hours for men. Although persistence of other health problems could affect the estimates, direct costs due to sickness absence could decrease by up to 28% if sleep disturbances could be fully addressed. This study highlights the need for prevention of sleep disturbances and promotion of optimal sleep length to prevent sickness absence. © 2014 Associated Professional Sleep Societies, LLC.

Estimating adolescent sleep need using dose-response modeling.

PubMed

Short, Michelle A; Weber, Nathan; Reynolds, Chelsea; Coussens, Scott; Carskadon, Mary A

2018-04-01

This study will (1) estimate the nightly sleep need of human adolescents, (2) determine the time course and severity of sleep-related deficits when sleep is reduced below this optimal quantity, and (3) determine whether sleep restriction perturbs the circadian system as well as the sleep homeostat. Thirty-four adolescents aged 15 to 17 years spent 10 days and nine nights in the sleep laboratory. Between two baseline nights and two recovery nights with 10 hours' time in bed (TIB) per night, participants experienced either severe sleep restriction (5-hour TIB), moderate sleep restriction (7.5-hour TIB), or no sleep restriction (10-hour TIB) for five nights. A 10-minute psychomotor vigilance task (PVT; lapse = response after 500 ms) and the Karolinska Sleepiness Scale were administered every 3 hours during wake. Salivary dim-light melatonin onset was calculated at baseline and after four nights of each sleep dose to estimate circadian phase. Dose-dependent deficits to sleep duration, circadian phase timing, lapses of attention, and subjective sleepiness occurred. Less TIB resulted in less sleep, more lapses of attention, greater subjective sleepiness, and larger circadian phase delays. Sleep need estimated from 10-hour TIB sleep opportunities was approximately 9 hours, while modeling PVT lapse data suggested that 9.35 hours of sleep is needed to maintain optimal sustained attention performance. Sleep restriction perturbs homeostatic and circadian systems, leading to dose-dependent deficits to sustained attention and sleepiness. Adolescents require more sleep for optimal functioning than typically obtained.

Visual Display Terminal use in Iranian bank tellers: Effects on job stress and insomnia.

PubMed

Giahi, Omid; Shahmoradi, Behzad; Barkhordari, Abdullah; Khoubi, Jamshid

2015-01-01

Visual Display Terminals (VDTs) are equipments in many workplaces which their use may increase the risk of visual, musculoskeletal and mental problems including insomnia. To determine the relationship between duration of daily VDT use and insomnia among the Iranian bank tellers. We randomly selected 382 bank tellers working with VDT. Quality of sleep and stress information were collected by Athens Insomnia Scales (AIS) and Demand-Control Model (DCM) model respectively. Out of 382 participants, 127 (33.2%) had sleep complaints and 255 (66.8%) had no sleep disorders. Moreover, the insomnia symptoms' score were significantly high in the participants having more than 6 hours of daily VDT use after adjusting for multiple confounding factors (P <  0.001). There was no significant relationship between stress and insomnia. It seems that the low levels of stress and job satisfaction reduce the impact of VDT on sleep quality in tellers who worked less than 6 hours per day.

"It's tough hanging-up a call": The relationships between calling and work hours, psychological detachment, sleep quality, and morning vigor.

PubMed

Clinton, Michael E; Conway, Neil; Sturges, Jane

2017-01-01

It has been argued that when people believe that their work is a calling, it can often be experienced as an intense and consuming passion with significant personal meaning. While callings have been demonstrated to have several positive outcomes for individuals, less is known about the potential downsides for those who experience work in this way. This study develops a multiple-meditation model proposing that, while the intensity of a calling has a positive direct effect on work-related vigor, it motivates people to work longer hours, which both directly and indirectly via longer work hours, limits their psychological detachment from work in the evenings. In turn, this process reduces sleep quality and morning vigor. Survey and diary data of 193 church ministers supported all hypotheses associated with this model. This implies that intense callings may limit the process of recovery from work experiences. The findings contribute to a more balanced theoretical understanding of callings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

U-shaped associations between time in bed and the physical and mental functioning of Japanese civil servants: the roles of work, family, behavioral and sleep quality characteristics.

PubMed

Sekine, M; Tatsuse, T; Cable, N; Chandola, T; Marmot, M

2014-09-01

This study aimed to evaluate (i) whether work, family, behavioral and sleep quality characteristics differ among individuals with different time in bed (TIB), and (ii) whether and how much the U-shaped associations between TIB and health can be explained by these characteristics. Participants were 3510 employees (2371 males and 1139 females) aged 20-65 years working in local government in Japan. They completed a questionnaire regarding work, family, and behavioral characteristics. Sleep quality and physical and mental functioning were evaluated using the Pittsburgh Sleep Quality Index and the Short Form 36. High job demands, long work hours, and high work-family conflict were more prevalent among those with short TIB. Those with long TIB had daily drinking habits. Whereas those with short TIB had poor sleep, mainly due to poor subjective sleep quality and daytime dysfunction, those with long TIB had poor sleep, mainly due to long sleep latency, poor sleep efficiency and sleep disturbances. The U-shaped associations between TIB and poor physical and mental health, with the best health observed in those spending ~8 h in bed, weakened considerably after adjustment for sleep quality, followed by work and family characteristics. After adjusting for behavioral characteristics and long-standing illnesses, the associations hardly changed. The U-shaped associations between TIB and health may be explained by U-shaped associations between TIB and poor sleep and psychosocial stress in work and family life. Copyright © 2014 Elsevier B.V. All rights reserved.

The impact of sleep deprivation in military surgical teams: a systematic review.

PubMed

Parker, Rachael Sv; Parker, P

2017-06-01

Fatigue in military operations leads to safety and operational problems due to a decrease in alertness and performance. The primary method of counteracting the effects of sleep deprivation is to increase nightly sleep time, which in operational situations is not always feasible. History has taught us that surgeons and surgical teams are finite resources that cannot operate on patients indefinitely. A systematic review was conducted using the search terms ' sleep ' and ' deprivation ' examining the impact of sleep deprivation on cognitive performance in military surgical teams. Studies examining outcomes on intensive care patients and subjects with comorbidities were not addressed in this review. Sleep deprivation in any ' out-of-hours ' surgery has a significant impact on overall morbidity and mortality. Sleep deprivation in surgeons and surgical trainees negatively impacts cognitive performance and puts their own and patients' health at risk. All published research lacks consensus when defining ' sleep deprivation ' and ' rested ' states. It is recognised that it would be unethical to conduct a well-designed randomised controlled trial, to determine the effects of fatigue on performance in surgery; however, there is a paucity between surrogate markers and applying simulated results to actual clinical performance. This requires further research. Recommended methods of combating fatigue include: prophylactically ' sleep-banking ' prior to known periods of sleep deprivation, napping, use of stimulant or alerting substances such as modafinil, coordinated work schedules to reduce circadian desynchronisation and regular breaks with enforced rest periods. A forward surgical team will become combat-ineffective after 48 hours of continuous operations. This systematic review recommends implementing on-call periods of no more than 12 hours in duration, with adequate rest periods every 24 hours. Drug therapies and sleep banking may, in the short term, prevent negative effects of acute sleep deprivation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

A single night of sleep loss impairs objective but not subjective working memory performance in a sex-dependent manner.

PubMed

Rångtell, Frida H; Karamchedu, Swathy; Andersson, Peter; Liethof, Lisanne; Olaya Búcaro, Marcela; Lampola, Lauri; Schiöth, Helgi B; Cedernaes, Jonathan; Benedict, Christian

2018-01-31

Acute sleep deprivation can lead to judgement errors and thereby increases the risk of accidents, possibly due to an impaired working memory. However, whether the adverse effects of acute sleep loss on working memory are modulated by auditory distraction in women and men are not known. Additionally, it is unknown whether sleep loss alters the way in which men and women perceive their working memory performance. Thus, 24 young adults (12 women using oral contraceptives at the time of investigation) participated in two experimental conditions: nocturnal sleep (scheduled between 22:30 and 06:30 hours) versus one night of total sleep loss. Participants were administered a digital working memory test in which eight-digit sequences were learned and retrieved in the morning after each condition. Learning of digital sequences was accompanied by either silence or auditory distraction (equal distribution among trials). After sequence retrieval, each trial ended with a question regarding how certain participants were of the correctness of their response, as a self-estimate of working memory performance. We found that sleep loss impaired objective but not self-estimated working memory performance in women. In contrast, both measures remained unaffected by sleep loss in men. Auditory distraction impaired working memory performance, without modulation by sleep loss or sex. Being unaware of cognitive limitations when sleep-deprived, as seen in our study, could lead to undesirable consequences in, for example, an occupational context. Our findings suggest that sleep-deprived young women are at particular risk for overestimating their working memory performance. © 2018 The Authors. Journal of Sleep Research published by John Wiley & Sons Ltd on behalf of European Sleep Research Society.

Operational assessment of the 5-h on/10-h off watchstanding schedule on a US Navy ship: sleep patterns, mood and psychomotor vigilance performance of crewmembers in the nuclear reactor department.

PubMed

Shattuck, Nita Lewis; Matsangas, Panagiotis

2016-05-01

We assessed sleep patterns, psychomotor vigilance performance, work demands and mood of 77 crewmembers of USS NIMITZ (CVN-68) on the rotating 5-h on/10-h off (5/10) watchstanding schedule. Within the 3-day cycle of the 5/10, sleep occurred at distinctly different times each day. On two of these days, sailors typically received only brief, 4-h sleep episodes followed by periods of sustained wakefulness (approximately 22 and 20 h). Crewmembers received approximately seven hours of sleep daily, but reported excessive fatigue and dissatisfaction with their schedule. Crewmembers' mood worsened significantly over the course of the underway phase. Psychomotor vigilance performance (reaction times, lapses) was significantly degraded compared to performance when working circadian-aligned schedules. Overall, standing watch on the 5/10 schedule, combined with other work duties, resulted in poor sleep hygiene. Crewmembers on the 5/10 experienced periodic bouts of sustained wakefulness and accrued a significant sleep debt due to extended workdays and circadian-misaligned sleep. Practitioner summary: We assessed crewmembers' sleep patterns, psychomotor vigilance performance and work demands when working a rotating 5-h on/10-h off (5/10) watchstanding schedule. The 5/10, combined with other work duties, resulted in poor sleep hygiene. Crewmembers experienced periodic bouts of sustained wakefulness and accrued a significant sleep debt due to extended workdays and circadian-misaligned sleep.

Long work hours and adiposity among police officers in a US northeast city.

PubMed

Gu, Ja K; Charles, Luenda E; Burchfiel, Cecil M; Fekedulegn, Desta; Sarkisian, Khachatur; Andrew, Michael E; Ma, Claudia; Violanti, John M

2012-11-01

To investigate the associations between long work hours and adiposity measures in police officers. Participants included 408 officers from the Buffalo Cardio-Metabolic Occupational Police Stress study who were examined between 2004 and 2009. Total work hours were abstracted from payroll records and questionnaires. Analysis of variance and covariance models were used. Among male officers who worked the midnight shift, mean values of waist circumference and body mass index increased with longer work hours after adjustment for age, physical activity, energy intake, sleep duration, smoking status, police rank, activities after work (eg, child/family care, sports), and household income. Adiposity measures were not associated with work hours among women on any shift. Working longer hours was significantly associated with larger waist circumferences and higher body mass index among male police officers working the midnight shift.

Prospective relationship between poor sleep and substance-related problems in a national sample of adolescents

PubMed Central

Wong, Maria M.; Roberson, Gail; Dyson, Rachel

2014-01-01

Background Previous studies showed that poor sleep prospectively predicted alcohol related problems and illicit drug use in adolescents and young adults (Wong et al., 2010, 2012). However, more works needs to be done to elucidate the nature of these problems. The purpose of this study was to examine whether sleep difficulties and hours of sleep prospectively predicted several serious substance related problems, e.g., binge drinking, driving under the influence of alcohol, risky sexual behavior. Methods Study participants were 6504 adolescents from the National Longitudinal Study of Adolescent Health (ADD HEALTH). Data were collected from interviews and questionnaires. The current study analyzed data from the first three waves of data (T1: 1994–95; T2: 1996; T3: 2001–02). In all analyses, we used sleep difficulties at a previous wave to predict substance-related problems at a subsequent wave, while controlling for substance-related problems at a previous wave. Results Holding T1 alcohol-related problems constant, sleep difficulties at T1 significantly predicted alcohol-related interpersonal problems, binge drinking, gotten drunk or very high on alcohol, driving under the influence of alcohol, getting into a sexual situation one later regretted due to drinking, ever using any illicit drugs and drugs-related problems at T2. T1 hours of sleep negatively predicted T2 alcohol-related interpersonal problems and binge drinking. The relationship between T2 sleep variables and T3 substance-related problems were consistent with previous waves, though the effect was weaker. Conclusions Sleep difficulties and hours of sleep are a significant predictor of a number of substance-related problems. It may be useful to educate adolescents about the importance of sleep, sleep hygiene and the potential consequences of poor sleep on drinking and related behaviors. PMID:25598438

Direct Measurements of Smartphone Screen-Time: Relationships with Demographics and Sleep.

PubMed

Christensen, Matthew A; Bettencourt, Laura; Kaye, Leanne; Moturu, Sai T; Nguyen, Kaylin T; Olgin, Jeffrey E; Pletcher, Mark J; Marcus, Gregory M

2016-01-01

Smartphones are increasingly integrated into everyday life, but frequency of use has not yet been objectively measured and compared to demographics, health information, and in particular, sleep quality. The aim of this study was to characterize smartphone use by measuring screen-time directly, determine factors that are associated with increased screen-time, and to test the hypothesis that increased screen-time is associated with poor sleep. We performed a cross-sectional analysis in a subset of 653 participants enrolled in the Health eHeart Study, an internet-based longitudinal cohort study open to any interested adult (≥ 18 years). Smartphone screen-time (the number of minutes in each hour the screen was on) was measured continuously via smartphone application. For each participant, total and average screen-time were computed over 30-day windows. Average screen-time specifically during self-reported bedtime hours and sleeping period was also computed. Demographics, medical information, and sleep habits (Pittsburgh Sleep Quality Index-PSQI) were obtained by survey. Linear regression was used to obtain effect estimates. Total screen-time over 30 days was a median 38.4 hours (IQR 21.4 to 61.3) and average screen-time over 30 days was a median 3.7 minutes per hour (IQR 2.2 to 5.5). Younger age, self-reported race/ethnicity of Black and "Other" were associated with longer average screen-time after adjustment for potential confounders. Longer average screen-time was associated with shorter sleep duration and worse sleep-efficiency. Longer average screen-times during bedtime and the sleeping period were associated with poor sleep quality, decreased sleep efficiency, and longer sleep onset latency. These findings on actual smartphone screen-time build upon prior work based on self-report and confirm that adults spend a substantial amount of time using their smartphones. Screen-time differs across age and race, but is similar across socio-economic strata suggesting that cultural factors may drive smartphone use. Screen-time is associated with poor sleep. These findings cannot support conclusions on causation. Effect-cause remains a possibility: poor sleep may lead to increased screen-time. However, exposure to smartphone screens, particularly around bedtime, may negatively impact sleep.

Work, sleep, and cholesterol levels of U.S. long-haul truck drivers

PubMed Central

LEMKE, Michael K.; APOSTOLOPOULOS, Yorghos; HEGE, Adam; WIDEMAN, Laurie; SÖNMEZ, Sevil

2016-01-01

Long-haul truck drivers in the United States experience elevated cardiovascular health risks, possibly due to hypercholesterolemia. The current study has two objectives: 1) to generate a cholesterol profile for U.S. long-haul truck drivers; and 2) to determine the influence of work organization characteristics and sleep quality and duration on cholesterol levels of long-haul truck drivers. Survey and biometric data were collected from 262 long-haul truck drivers. Descriptive analyses were performed for demographic, work organization, sleep, and cholesterol measures. Linear regression and ordinal logistic regression analyses were conducted to examine for possible predictive relationships between demographic, work organization, and sleep variables, and cholesterol outcomes. The majority (66.4%) of drivers had a low HDL (<40 mg/dL), and nearly 42% of drivers had a high-risk total cholesterol to HDL cholesterol ratio. Sleep quality was associated with HDL, LDL, and total cholesterol, and daily work hours were associated with LDL cholesterol. Workday sleep duration was associated with non-HDL cholesterol, and driving experience and sleep quality were associated with cholesterol ratio. Long-haul truck drivers have a high risk cholesterol profile, and sleep quality and work organization factors may induce these cholesterol outcomes. Targeted worksite health promotion programs are needed to curb these atherosclerotic risks. PMID:28049935

Working hours of obstetrics and gynaecology trainees in Australia and New Zealand.

PubMed

Acton, Jade; Tucker, Paige E; Bulsara, Max K; Cohen, Paul A

2017-10-01

The importance of doctors' working hours has gained significant attention with evidence suggesting long hours and fatigue may compromise the safety and wellbeing of both patients and doctors. This study aims to quantify the working hours of The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) specialist trainees in order to better inform discussions of working hours and safety within our region. An anonymous, online survey of RANZCOG trainees was conducted. Demographic data were collected. The primary outcomes were: hours per week at work and hours per week on-call. Secondary outcomes included the frequency of long days (>12 h) and 24-h shifts, time spent studying, staff shortages and opinions regarding current rostering. Response rate was 49.5% (n = 259). Full-time trainees worked an average of 53.1 ± 10.0 h/week, with 11.6% working on-call. Long-day shifts were reported by 85.8% of respondents, with an average length of 14.2 h. Fifteen percent reported working 24-h shifts, with a median duration of uninterrupted sleep during this shift being 1-2 h. Trainees in New Zealand worked 7.0 h/week more than Australian trainees (P ≤0.001), but reported less on-call (P = 0.021). Trainees in Western Australia were more likely to work on-call (P ≤0.001) and 24-h shifts (P ≤0.001). While 53.1 h/week at work is similar to the average Australian hospital doctor, high rates of long days and 24-h shifts with minimal sleep were reported by RANZCOG trainees in this survey. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

[Sleepiness, safety on the road and management of risk].

PubMed

Garbarino, S; Traversa, F; Spigno, F

2012-01-01

Public health studies have shown that sleepiness at the wheel and other risks associated with sleep are responsible for 5% to 30% of road accidents, depending on the type of driver and/or road. In industrialized countries one-fifth of all traffic accidents can be ascribed to sleepiness behind the wheel. Sleep disorders and various common acute and chronic medical conditions together with lifestyles, extended work hours and prolonged wakefulness directly or indirectly affect the quality and quantity of one's sleep increasing the number of workers with sleep debt and staggered hours. These conditions may increase the risk of road accidents. Strategies to reduce this risk of both commercial and non-commercial drivers related to sleepiness include reliable diagnosis and treatment of sleep disorders, management of chronobiological conflicts, adequate catch-up sleep, and countermeasures against sleepiness at the wheel. Road transport safety requires the adoption of occupational health measures, including risk assessment, health education, technical-environmental prevention and health surveillance.

29 CFR 552.102 - Live-in domestic service employees.

Code of Federal Regulations, 2014 CFR

2014-07-01

.... But this exemption does not excuse the employer from paying the live-in worker at the applicable... employee and the employer may exclude, by agreement between themselves, the amount of sleeping time, meal... relating to meals and sleeping) to be excluded from hours worked, the periods must be of sufficient...

The influence of daily sleep patterns of commercial truck drivers on driving performance.

PubMed

Chen, Guang Xiang; Fang, Youjia; Guo, Feng; Hanowski, Richard J

2016-06-01

Fatigued and drowsy driving has been found to be a major cause of truck crashes. Lack of sleep is the number one cause of fatigue and drowsiness. However, there are limited data on the sleep patterns (sleep duration, sleep percentage in the duration of non-work period, and the time when sleep occurred) of truck drivers in non-work periods and the impact on driving performance. This paper examined sleep patterns of 96 commercial truck drivers during non-work periods and evaluated the influence these sleep patterns had on truck driving performance. Data were from the Naturalistic Truck Driving Study. Each driver participated in the study for approximately four weeks. A shift was defined as a non-work period followed by a work period. A total of 1397 shifts were identified. Four distinct sleep patterns were identified based on sleep duration, sleep start/end point in a non-work period, and the percentage of sleep with reference to the duration of non-work period. Driving performance was measured by safety-critical events, which included crashes, near-crashes, crash-relevant conflicts, and unintentional lane deviations. Negative binomial regression was used to evaluate the association between the sleep patterns and driving performance, adjusted for driver demographic information. The results showed that the sleep pattern with the highest safety-critical event rate was associated with shorter sleep, sleep in the early stage of a non-work period, and less sleep between 1 a.m. and 5 a.m. This study also found that male drivers, with fewer years of commercial vehicle driving experience and higher body mass index, were associated with deteriorated driving performance and increased driving risk. The results of this study could inform hours-of-service policy-making and benefit safety management in the trucking industry. Published by Elsevier Ltd.

Reciprocal Relations Between Objectively Measured Sleep Patterns and Diurnal Cortisol Rhythms in Late Adolescents

PubMed Central

Zeiders, Katharine H.; Doane Sampey, Leah D.; Adam, Emma K.

2011-01-01

Purpose To examine how hours of sleep and wake times relate to between-person differences and day-to-day changes in diurnal cortisol rhythms in late adolescents Methods Older adolescents (N = 119) provided six cortisol samples (wakeup, +30min, + 2 hours, +8 hours, + 12 hours, and bedtime) on each of three consecutive days while wearing an actigraph. We examined how average (across 3 days) and day-to-day changes in hours of sleep and wake times related to diurnal cortisol patterns. Results On average, greater hours of sleep related steeper decline in cortisol across the days. Day-to-day analyses revealed that prior night’s hours of sleep predicted steeper diurnal slopes the next day, while greater waking cortisol levels and steeper slopes predicted greater hours of sleep and a later wake time the next day. Conclusions Our results suggest a bidirectional relationship between sleep and HPA axis activity. PMID:21575815

Habitual sleep duration and predicted 10-year cardiovascular risk using the pooled cohort risk equations among US adults.

PubMed

Ford, Earl S

2014-12-02

The association between sleep duration and predicted cardiovascular risk has been poorly characterized. The objective of this study was to examine the association between self-reported sleep duration and predicted 10-year cardiovascular risk among US adults. Data from 7690 men and nonpregnant women who were aged 40 to 79 years, who were free of self-reported heart disease and stroke, and who participated in a National Health and Nutrition Examination Survey from 2005 to 2012 were analyzed. Sleep duration was self-reported. Predicted 10-year cardiovascular risk was calculated using the pooled cohort equations. Among the included participants, 13.1% reported sleeping ≤5 hours, 24.4% reported sleeping 6 hours, 31.9% reported sleeping 7 hours, 25.2% reported sleeping 8 hours, 4.0% reported sleeping 9 hours, and 1.3% reported sleeping ≥10 hours. After adjustment for covariates, geometric mean-predicted 10-year cardiovascular risk was 4.0%, 3.6%, 3.4%, 3.5%, 3.7%, and 3.7% among participants who reported sleeping ≤5, 6, 7, 8, 9, and ≥10 hours per night, respectively (PWald chi-square<0.001). The age-adjusted percentages of predicted cardiovascular risk ≥20% for the 6 intervals of sleep duration were 14.5%, 11.9%, 11.0%, 11.4%, 11.8%, and 16.3% (PWald chi-square=0.022). After maximal adjustment, however, sleep duration was not significantly associated with cardiovascular risk ≥20% (PWald chi-square=0.698). Mean-predicted 10-year cardiovascular risk was lowest among adults who reported sleeping 7 hours per night and increased as participants reported sleeping fewer and more hours. © 2014 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

[The productivity of female shift workers].

PubMed

Vidacek, S; Radosević-Vidacek, B; Kaliterna, L; Prizmić, Z

1990-12-01

The productivity of female shift workers, working on a weekly rotating three-shift system, was examined. The afternoon shift was found to be the most productive and the night shift the least productive one. The greatest difference in productivity between shifts was found in the first two days of the week, when the productivity on night shift was significantly lower than that on the other two shifts. From the third day on there were no longer significant differences in productivity between shifts. The most productive and the least productive workers on night shift did not significantly differ in extraversion or in sleep duration after the night shift. Family responsibility was found to be associated with the duration of sleep after the night shift: married women slept significantly shorter after the night shift than unmarried women. However, this difference in sleep duration was not associated with productivity on night shift. Sleep duration after the afternoon shift (8 hours 40 minutes) was on average two hours longer than after the other two shifts. The difference in sleep duration after different shifts, along with circadian variations in alertness, readiness for work and performance efficiency, could be responsible for differences in productivity between shifts.

Evaluation of a Workplace-Based Sleep Education Program.

PubMed

Burton, Wayne N; Chen, Chin-Yu; Li, Xingquan; McCluskey, Maureen; Erickson, Denise; Barone, Daniel; Lattarulo, Charles; Schultz, Alyssa B

2016-09-01

Poor sleep is common among working adults. Chronic sleep deprivation is associated with health problems. A healthy sleep educational program (using webinars and other intranet-based resources) was offered to employees of a financial services corporation. In 2015, a total of 357 employees (50% completion rate) completed both a pre- and post-program questionnaire assessing sleep quality and workplace productivity. Many aspects of sleep statistically improved from T1 to T2 for program participants. These included improvements in hours of sleep, sleep quality, ease of getting asleep, feeling rested, nights of poor sleep, job performance, days of sleepiness, and others. Employees reporting any limitation in productivity also showed significant improvement. This workplace healthy sleep intervention was associated with significant improvements in sleep quality and quantity among program participants.

Systematic review of the relationship between quick returns in rotating shift work and health-related outcomes.

PubMed

Vedaa, Øystein; Harris, Anette; Bjorvatn, Bjørn; Waage, Siri; Sivertsen, Børge; Tucker, Philip; Pallesen, Ståle

2016-01-01

A systematic literature search was carried out to investigate the relationship between quick returns (i.e., 11.0 hours or less between two consecutive shifts) and outcome measures of health, sleep, functional ability and work-life balance. A total of 22 studies published in 21 articles were included. Three types of quick returns were differentiated (from evening to morning/day, night to evening, morning/day to night shifts) where sleep duration and sleepiness appeared to be differently affected depending on which shifts the quick returns occurred between. There were some indications of detrimental effects of quick returns on proximate problems (e.g., sleep, sleepiness and fatigue), although the evidence of associations with more chronic outcome measures (physical and mental health and work-life balance) was inconclusive. Modern societies are dependent on people working shifts. This study systematically reviews literature on the consequences of quick returns (11.0 hours or less between two shifts). Quick returns have detrimental effects on acute health problems. However, the evidence regarding effects on chronic health is inconclusive.

Working hours associated with unintentional sleep at work among airline pilots.

PubMed

Marqueze, Elaine Cristina; Nicola, Ana Carolina B; Diniz, Dag Hammarskjoeld M D; Fischer, Frida Marina

2017-06-26

Tto identify factors associated with unintentional sleep at work of airline pilots. This is a cross-sectional epidemiological study conducted with 1,235 Brazilian airline pilots, who work national or international flights. Data collection has been performed online. We carried out a bivariate and multiple logistic regression analysis, having as dependent variable unintentional sleep at work. The independent variables were related to biodemographic data, characteristics of the work, lifestyle, and aspects of sleep. The prevalence of unintentional sleep while flying the airplane was 57.8%. The factors associated with unintentional sleep at work were: flying for more than 65 hours a month, frequent technical delays, greater need for recovery after work, work ability below optimal, insufficient sleep, and excessive sleepiness. The occurrence of unintentional sleep at work of airline pilots is associated with factors related to the organization of the work and health. Identificar fatores associados aos cochilos não intencionais durante as jornadas de trabalho de pilotos da aviação regular. Estudo epidemiológico transversal conduzido com 1.235 pilotos brasileiros de avião do transporte aéreo regular, que realizavam voos nacionais ou internacionais, sendo a coleta de dados realizada on-line. Foi realizada análise de regressão logística bivariada e múltipla, tendo como variável dependente o cochilo não intencional durante o horário de trabalho. As variáveis independentes foram relacionadas a dados biodemográficos, características do trabalho, estilo de vida e aspectos do sono. A prevalência do cochilo não intencional enquanto pilotava o avião foi de 57,8%. Os fatores associados ao cochilo não intencional foram: voar por mais de 65 horas por mês, atrasos técnicos frequentes, maior necessidade de recuperação após o trabalho, capacidade para o trabalho inferior à ótima, sono insuficiente e sonolência excessiva. A ocorrência do cochilo não intencional durante a jornada de trabalho de pilotos da aviação regular está associada a fatores relacionados à organização do trabalho e à saúde.

The effect of shift rotation on variations of cortisol, fatigue and sleep in sound engineers.

PubMed

Vangelova, Katia

2008-10-01

The aim was to study the effect of rotation direction on the time-of-day variations of cortisol, fatigue and sleep in sound engineers broadcasting in a life show. The salivary cortisol and ratings of stress, sleepiness and fatigue were followed at three hour intervals in 25 sound engineers: 13 working very fast forward-rotating shifts and 12 working very fast backward-rotating shifts. Cortisol was assessed with radioimmunological kits. The participants reported for stress symptoms and filled sleep diary. Cortisol retained the typical diurnal pattern. The rotation direction interacted with the shift significantly and as a result higher cortisol values during the morning and night shifts in the backward rotating group were found as well as worse quality of sleep. Higher salivary cortisol during morning and night shifts and worse quality of sleep in engineers working very fast backward-rotating shifts may be an indication for insufficient recovery.

Sleep duration and ischemic heart disease and all-cause mortality: prospective cohort study on effects of tranquilizers/hypnotics and perceived stress.

PubMed

Garde, Anne Helene; Hansen, Åse Marie; Holtermann, Andreas; Gyntelberg, Finn; Suadicani, Poul

2013-11-01

This prospective study aimed to examine if sleep duration is a risk indicator for ischemic heart disease (IHD) and all-cause mortality, and how perceived stress during work and leisure time and use of tranquilizers/hypnotics modifies the association. A 30-year follow-up study was carried out in the Copenhagen Male Study comprising 5249 men (40-59 years old). Confounders included lifestyle factors (smoking, alcohol, and leisure-time physical activity), clinical and health-related factors (body mass index, blood pressure, diabetes, hypertension, and physical fitness) and social class. Men with a history of cardiovascular disease at baseline were excluded. During follow-up, 587 men (11.9%) died from IHD and 2663 (53.9%) due to all-cause mortality. There were 276 short (<6 hours), 3837 medium (6-7 hours), and 828 long (≥8 hours) sleepers. Men who slept <6 hours had an increased risk of IHD mortality but not all-cause mortality, when referencing medium sleepers. Perceived psychological pressure during work and leisure was not a significant effect modifier for the association between sleep duration and IHD mortality. In contrast, among men using tranquilizers/hypnotics (rarely or regularly), short sleepers had a two-to-three fold increased risk of IHD mortality compared to medium sleepers. Among those never using tranquilizers/hypnotics, no association was observed between sleep duration and IHD mortality. Short sleep duration is a risk factor for IHD mortality among middle-aged and elderly men, particularly those using tranquilizers/hypnotics on a regular or even a rare basis, but not among men not using tranquilizers/hypnotics.

Long working hours, occupational health and the changing nature of work organization.

PubMed

Johnson, Jeffrey V; Lipscomb, Jane

2006-11-01

The impact of long working hours on health has been of major concern since the late 19th Century. Working hours are again increasing in the US. An overview of historical, sociological, and health-related research presented at an international conference on long working hours is discussed as an introduction to a special section in this issue. Research indicates that long working hours are polarizing along class lines with professionals working regular though longer hours and less well-educated workers having fewer though more irregular hours. Extended and irregular hours are associated with acute reactions such as stress and fatigue, adverse health behavior such as smoking, and chronic outcomes such as cardiovascular and musculoskeletal disorders. Improved methodologies are needed to track exposure to long working hours and irregular shifts longitudinally. Research should focus on the adverse impact that sleep-deprived and stressed workers may have on the health of the public they serve. A variety of protective efforts should be undertaken and evaluated. Copyright (c) 2006 Wiley-Liss, Inc.

Time to Work or Time to Play: The Effect of Student Employment on Homework, Housework, Screen Time, and Sleep. Working Paper 423

ERIC Educational Resources Information Center

Kalenkoski, Charlene Marie; Pabilonia, Sabrina Wulff

2009-01-01

Recent research suggests that working while in high school reduces the amount of time students spend doing homework. However, an additional hour of work leads to a reduction in homework by much less than one hour, suggesting a reduction in other activities. This paper uses data from the 2003-2007 American Time Use Surveys (ATUS) to investigate the…

[Burden and health effects of shift work].

PubMed

Heitmann, Jörg

2010-10-01

In Germany aprox. 15% of all employees have irregular or flexible working hours. Disturbed sleep and/or hypersomnia are direct consequences of shift work and therefore described as shift work disorder. Beyond this, shift work can also be associated with specific pathological disorders. There are individual differences in tolerance to shift work. Optimization of both shift schedules and sleep to "non-physiological" times of the day are measures to counteract the negative effects of shift work. There is still not enough evidence to recommend drugs for routine use in shift workers. © Georg Thieme Verlag Stuttgart · New York.

Long Work Hours and Adiposity Among Police Officers in a US Northeast City

PubMed Central

Gu, Ja K.; Charles, Luenda E.; Burchfiel, Cecil M.; Fekedulegn, Desta; Sarkisian, Khachatur; Andrew, Michael E.; Ma, Claudia; Violanti, John M.

2015-01-01

Objective To investigate the associations between long work hours and adiposity measures in police officers. Methods Participants included 408 officers from the Buffalo Cardio-Metabolic Occupational Police Stress study who were examined between 2004 and 2009. Total work hours were abstracted from payroll records and questionnaires. Analysis of variance and covariance models were used. Results Among male officers who worked the midnight shift, mean values of waist circumference and body mass index increased with longer work hours after adjustment for age, physical activity, energy intake, sleep duration, smoking status, police rank, activities after work (eg, child/family care, sports), and household income. Adiposity measures were not associated with work hours among women on any shift. Conclusion Working longer hours was significantly associated with larger waist circumferences and higher body mass index among male police officers working the midnight shift. PMID:23013913

The Combined Effect of Sleep Duration and Quality on Mental Health Among Republic of Korea Armed Forces.

PubMed

Kim, Tae Kyung; Lee, Hee-Choon; Lee, Sang Gyu; Han, Kyu-Tae; Park, Eun-Cheol

2016-11-01

Sleep problems in the Republic of Korea Armed Forces have increased. This study analyzed the mental health impact of sleep duration and quality on personnel of the Republic of Korea Armed Forces. Data from the 2014 Military Health Survey were used. Degree of sleep duration and quality were measured by this self-reported questionnaire. Analysis of variance was carried out to compare Kessler Psychological Distress Scale 10 (K10) scores. Multiple logistic regression analysis identified associations between sleep duration, quality, and K10 scores. Among the personnel studied, 2.5% reported severe sleep difficulties. The average sleep duration was 6.83 ± 1.12 hours. Short sleep duration and sleep difficulty were associated with poorer K10 scores. Higher K10 scores among individuals with short sleep duration and low sleep quality were identified in the isolated military area group, the over 53 working hours/week group, and the enlisted soldier group. The factors listed were not by themselves associated with poorer mental health scores. Rather, specific workplaces and specific rank groups were more prone to poorer mental health. These results provide helpful information to minimize the negative psychological effects of sleep factors and to promote a sleep problem prevention and management policy. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Restricting resident work hours: the good, the bad, and the ugly.

PubMed

Peets, Adam; Ayas, Najib T

2012-03-01

Inadequate sleep and long work hours are long-standing traditions in the medical profession, and work schedules are especially intense in resident physicians. However, it has been increasingly recognized that the extreme hours commonly worked by residents may have substantial occupational and patient safety consequences. Largely because of these concerns, new regulations related to resident work hours came into effect July 2011, in the United States. Residents in their first year of training are now restricted to a maximum shift length of 16 hrs, with residents in subsequent years restricted to a maximum of 24 hrs. The purpose of this review is to summarize the literature regarding resident work hours in the intensive care unit, focusing on the potential positive and negative impacts of work hour limits. The authors electronically searched MEDLINE, manually searched reference lists from retrieved articles, and reviewed their own personal databases for articles relevant to resident work hour limits. To function well, humans, including physicians, require adequate sleep. Resident work hour limits will likely reduce the incidence of fatigue-related medical errors and improve resident safety and quality of life. However, a reduction in work hours may not represent the panacea for patient safety given the potential for increased errors because of discontinuity. Furthermore, there may be other substantial negative impacts, including reduced clinical exposure, erosion of professionalism, and inadequate preparation for independent practice. Costs of implementation are likely to be substantial. Currently, there is fairly limited evidence available, and a more in-depth understanding of this complex topic is required to design a residency experience that will provide the next generation of physicians the best compromise between education, experience, and quality patient care. In the end, the primary goal of the postgraduate medical education system must be to ensure the creation of healthy physicians who can provide excellent clinical care in this complex interdisciplinary medical industry and who will have long fulfilling careers providing this outstanding care to their patients.

Managing neurobehavioral capability when social expediency trumps biological imperatives

PubMed Central

Spaeth, Andrea M.; Goel, Namni; Dinges, David F.

2013-01-01

Sleep, which is evolutionarily conserved across species, is a biological imperative that cannot be ignored or replaced. However, the percentage of habitually sleep-restricted adults has increased in recent decades. Extended work hours and commutes, shift work schedules, and television viewing are particularly potent social factors that influence sleep duration. Chronic partial sleep restriction, a product of these social expediencies, leads to the accumulation of sleep debt over time and consequently increases sleep propensity, decreases alertness, and impairs critical aspects of cognitive functioning. Significant interindividual variability in the neurobehavioral responses to sleep restriction exists—this variability is stable and phenotypic—suggesting a genetic basis. Identifying vulnerability to sleep loss is essential as many adults cannot accurately judge their level of impairment in response to sleep restriction. Indeed, the consequences of impaired performance and the lack of insight due to sleep loss can be catastrophic. In order to cope with the effects of social expediencies on biological imperatives, identification of biological (including genetic) and behavioral markers of sleep loss vulnerability as well as development of technological approaches for fatigue management are critical. PMID:22877676

Pilot fatigue survey: exploring fatigue factors in air medical operations.

PubMed

Gregory, Kevin B; Winn, William; Johnson, Kent; Rosekind, Mark R

2010-01-01

Humans confront significant physiological challenges with sleep and alertness when working in 24/7 operations. A web-based national survey of air medical pilots examined issues relevant to fatigue and sleep management. Six hundred ninety-seven responses were received, with a majority of rotor wing pilots working 3/3/7 and 7/7 duty schedules. Over 84% of the pilots reported that fatigue had affected their flight performance; less than 28% reported "nodding off" during flight. More than 90% reported a separate work site "rest" room with a bed available. Over 90% reported no company policies restricting on-duty sleep. Approximately half of the pilots reported getting 4 hours or more sleep during a typical night shift. Approximately half reported that sleep inertia had never compromised flight safety. Over 90% reported that it was better to sleep during the night and overcome sleep inertia if necessary. Survey results reflected practices that can mitigate the degrading effects of fatigue, including the availability of designated work-site sleep rooms. As demands continue to evolve, the need remains for sustained efforts to address fatigue-related risks in the air medical transport industry. This includes further study of sleep inertia issues and the need for alertness management programs. Copyright © 2010 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.

29 CFR 552.102 - Live-in domestic service employees.

Code of Federal Regulations, 2013 CFR

2013-07-01

... reside in the household where employed. But this exemption does not excuse the employer from paying the... themselves, the amount of sleeping time, meal time and other periods of complete freedom from all duties when... periods of free time (other than those relating to meals and sleeping) to be excluded from hours worked...

29 CFR 552.102 - Live-in domestic service employees.

Code of Federal Regulations, 2012 CFR

2012-07-01

... reside in the household where employed. But this exemption does not excuse the employer from paying the... themselves, the amount of sleeping time, meal time and other periods of complete freedom from all duties when... periods of free time (other than those relating to meals and sleeping) to be excluded from hours worked...

The use of entertainment and communication technologies before sleep could affect sleep and weight status: a population-based study among children.

PubMed

Dube, Nomathemba; Khan, Kaviul; Loehr, Sarah; Chu, Yen; Veugelers, Paul

2017-07-19

Short sleep duration and poor sleep quality have been demonstrated to be associated with childhood obesity. It has been suggested that electronic entertainment and communication devices (EECDs) including TVs, computers, tablets, video games and cell phones interfere with sleep in children and youth. The aim of this study was to assess the impact that the use of EECDs in the hour before bedtime has on sleep and weight status to inform sleep promotion interventions and programs to prevent childhood obesity. A provincially representative sample of 2334 grade 5 children and their parents in Alberta, Canada was surveyed. Parents reported their child's bedtime and wake-up time along with how often their child snored, felt sleepy during the day, woke-up at night and woke-up in the morning feeling unrefreshed. Sleep duration, sleep quality and sleep efficiency were derived from these indicators. Parents also reported on the presence of EECDs in their child's bedroom, while children reported use of EECDs during the day and frequency of using each of these devices during the hour before sleep. The height and weight of children were measured. Multivariable mixed effect linear and logistic regression models were used to determine how sleep duration, sleep quality, sleep efficiency and weight status are influenced by (i) access to EECDs in children's bedrooms, (ii) use of EECDs during the hour before sleep, and (iii) calming activities specifically reading during the hour before sleep. Sleep duration was shorter by -10.8 min (cell phone), -10.2 min (computer) and -7.8 min (TV) for those with bedroom access to and used these EECDs during the hour before sleep compared to no access and no use. Good sleep quality was hindered by bedroom access to and use of all EECDs investigated during the hour before sleep, particularly among users of cell phones (OR = 0.64, 95% CI: 0.58-0.71) and computers (OR = 0.72, 95% CI: 0.65-0.80). Very good sleep efficiency was decreased by access to and frequent use of a TV (54%), cell phone (52%), tablet (51%) and video games (51%). Odds of obesity were doubled by bedroom access to and use of a TV and computer during the hour before sleep. Children who rarely read a printed book in the bedroom during the hour before sleep had a shorter sleep duration and poorer sleep quality and sleep efficiency compared to their peers. Having access to an EECD in the bedroom was associated with increased obesity despite frequently reading during the hour before sleep. Our findings suggest that sleep duration, sleep quality, sleep efficiency and weight status are better among children who do not have EECDs in the bedroom and frequently read a book during the hour before sleep as opposed to those who use EECDs during this hour. Education of limits against EECD use by parents may improve sleep outcomes. These findings will inform health promotion messages and may give rise to national recommendations regarding EECD use. ClinicalTrials.gov NCT01914185 . Registered 31 July 2013 Retrospectively registered.

Occupational and socioeconomic differences in actigraphically measured sleep.

PubMed

Takahashi, Masaya; Tsutsumi, Akizumi; Kurioka, Sumiko; Inoue, Akiomi; Shimazu, Akihito; Kosugi, Yuki; Kawakami, Norito

2014-08-01

Occupational conditions, together with socioeconomic status, may modulate sleep. This study examined the association of occupational conditions and socioeconomic status with actigraphic measures of sleep in workers. Fifty-five employees (40 ± 12 years) wore a wrist actigraph during sleep for seven consecutive nights. Sleep variables addressed included total sleep time, sleep efficiency, mean activity during sleep, sleep-onset latency, and wake after sleep onset. We also measured household income, occupational class, work schedule, weekly work hours, job demand, job control, worksite social support, effort-reward imbalance, organizational justice, and workplace social capital. Multiple linear regression models were used to determine the association of occupational indicators, socioeconomic status, as well as age and gender with each sleep variable. Higher workplace social capital was associated consistently with longer total sleep time (P < 0.001), higher sleep efficiency (P < 0.05) and lower mean activity during sleep (P < 0.07). Low occupational class (P < 0.01), higher job demand (P < 0.05) and lower job control (P < 0.05) were associated with longer total sleep time. No associations were significant for sleep-onset latency or wake after sleep onset. These preliminary results suggest that enhanced workplace social capital is closely associated with better quality and quantity of sleep. © 2014 European Sleep Research Society.

Scheduled evening sleep and enhanced lighting improve adaptation to night shift work in older adults.

PubMed

Chinoy, Evan D; Harris, Michael P; Kim, Min Ju; Wang, Wei; Duffy, Jeanne F

2016-12-01

We tested whether a sleep and circadian-based treatment shown to improve circadian adaptation to night shifts and attenuate negative effects on alertness, performance and sleep in young adults would also be effective in older adults. We assessed subjective alertness, sustained attention (psychomotor vigilance task, PVT), sleep duration (actigraphy) and circadian timing (salivary dim-light melatonin onset, DLMO) in 18 older adults (57.2±3.8 years; mean±SD) in a simulated shift work protocol. 4 day shifts were followed by 3 night shifts in the laboratory. Participants slept at home and were randomised to either the treatment group (scheduled evening sleep and enhanced lighting during the latter half of night shifts) or control group (ad-lib sleep and typical lighting during night shifts). Compared with day shifts, alertness and sustained attention declined on the first night shift in both groups, and was worse in the latter half of the night shifts. Alertness and attention improved on nights 2 and 3 for the treatment group but remained lower for the control group. Sleep duration in the treatment group remained similar to baseline (6-7 hours) following night shifts, but was shorter (3-5 hours) following night shifts in the control group. Treatment group circadian timing advanced by 169.3±16.1 min (mean±SEM) but did not shift (-9.7±9.9 min) in the control group. The combined treatment of scheduled evening sleep and enhanced lighting increased sleep duration and partially aligned circadian phase with sleep and work timing, resulting in improved night shift alertness and performance. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

THE SLEEP OF LONG-HAUL TRUCK DRIVERS

PubMed Central

Mitler, Merrill M.; Miller, James C.; Lipsitz, Jeffrey J.; Walsh, James K.; Wylie, C. Dennis

2008-01-01

Background Fatigue and sleep deprivation are important safety issues for long-haul truck drivers. Methods We conducted round-the-clock electrophysiologic and performance monitoring of four groups of 20 male truck drivers who were carrying revenue-producing loads. We compared four driving schedules, two in the United States (five 10-hour trips of day driving beginning about the same time each day or of night driving beginning about 2 hours earlier each day) and two in Canada (four 13-hour trips of late-night-to-morning driving beginning at about the same time each evening or of afternoon-to-night driving beginning 1 hour later each day). Results Drivers averaged 5.18 hours in bed per day and 4.78 hours of electrophysiologically verified sleep per day over the five-day study (range, 3.83 hours of sleep for those on the steady 13-hour night schedule to 5.38 hours of sleep for those on the steady 10-hour day schedule). These values compared with a mean (±SD) self-reported ideal amount of sleep of 7.1±1 hours a day. For 35 drivers (44 percent), naps augmented the sleep obtained by an average of 0.45±0.31 hour. No crashes or other vehicle mishaps occurred. Two drivers had undiagnosed sleep apnea, as detected by polysomnography. Two other drivers had one episode each of stage 1 sleep while driving, as detected by electroencephalography. Forty-five drivers (56 percent) had at least 1 six-minute interval of drowsiness while driving, as judged by analysis of video recordings of their faces; 1067 of the 1989 six-minute segments (54 percent) showing drowsy drivers involved just eight drivers. Conclusions Long-haul truck drivers in this study obtained less sleep than is required for alertness on the job. The greatest vulnerability to sleep or sleep-like states is in the late night and early morning. PMID:9287232

The effect of shift rotation on employee cortisol profile, sleep quality, fatigue, and attention level: a systematic review.

PubMed

Niu, Shu-Fen; Chung, Min-Huey; Chen, Chiung-Hua; Hegney, Desley; O'Brien, Anthony; Chou, Kuei-Ru

2011-03-01

Disrupted circadian rhythm, especially working night duty together with irregular sleep patterns, sleep deprivation, and fatigue, creates an occupational health risk associated with diminished vigilance and work performance. This study reviewed the effect of shift rotations on employee cortisol profile, sleep quality, fatigue, and attention level. Researchers conducted a systematic review of relevant articles published between 1996 and 2008 that were listed on the following databases: SCOPUS, OVID, Blackwell Science, EBSCO Host, PsycINFO, Cochrane Controlled Trials Register, and CEPS. A total of 28 articles were included in the review. Previous research into the effects of shift work on cortisol profiles, sleep quality, fatigue, and attention used data assessed at evidence Levels II to IV. Our systematic review confirmed a conflict between sleep-wake cycle and light-dark cycle in night work. Consequences of circadian rhythm disturbance include disruption of sleep, decreased vigilance, general feeling of malaise, and decreased mental efficiency. Shift workers who sleep during the day (day sleepers) experience cortisol secretion increases, which diminish the healing power of sleep and enjoy 1 to 4 hours less sleep on average than night sleepers. Sleep debt accumulation results in chronic fatigue. Prolonged fatigue and inadequate recovery result in decreased work performance and more incidents. Rotation from day shift to night shift and its effect on shift workers was a special focus of the articles retained for review. Disturbed circadian rhythm in humans has been associated with a variety of mental and physical disorders and may negatively impact on work safety, performance, and productivity.

Understanding the relationship of long working hours with health status and health-related behaviours.

PubMed

Artazcoz, L; Cortès, I; Escribà-Agüir, V; Cascant, L; Villegas, R

2009-07-01

The objectives of this study are to identify family and job characteristics associated with long work hours, to analyse the relationship between long work hours and several health indicators, and to examine whether gender differences for both objectives exist. The sample was composed of all salaried workers aged 16-64 years (3950 men and 3153 women) interviewed in the 2006 Catalonian Health Survey. Weekly work hours were categorised as less than 30 h (part-time), 30-40 (reference category), 41-50 and 51-60 h. Multiple logistic regression models separated by sex were fitted. Factors associated with long working hours differed by gender. Among men, extended work hours were related with being married or cohabiting and with being separated or divorced. In men, working 51-60 h a week was consistently associated with poor mental health status (aOR 2.06, 95% CI 1.31 to 3.24), self-reported hypertension (aOR 1.60, 95% CI 1.12 to 2.29), job dissatisfaction (aOR 2.05, 95% CI 1.49 to 2.82), smoking (aOR 1.33, 95% CI 1.03 to 1.72), shortage of sleep (aOR 1.42, 95% CI 1.09 to 1.85) and no leisure-time physical activity (aOR 2.43, 95% CI 1.64 to 3.60). Moreover, a gradient from standard working hours to 51-60 h a week was found for these six outcomes. Among women it was only related to smoking and to shortage of sleep. The association of overtime with different health indicators among men could be explained by their role as the family breadwinner: in situations of family financial stress men work overtime in order to increase the income and/or accept poor working conditions for fear of job loss, one of them being long working hours.

Overtime work and stress response in a group of Japanese workers.

PubMed

Sato, Yuji; Miyake, Hitoshi; Thériault, Gilles

2009-01-01

Working long overtime hours is considered a cause of mental health problems among workers but such a relationship has yet to be empirically confirmed. To clarify the influence of overtime work on response to stress and to assess the role of other stress-related factors on this relationship. The study was conducted among 24 685 employees of a company in Japan. Stress response, job stressors and social supports were assessed by the Brief Job Stress Questionnaire. Participants were divided into five categories of overtime (0-19, 20-39, 40-59, >or=60 h of overtime per month and exempted employees). The nonadjusted odds ratios for stress response for 40-59 and >or=60 overtime hours per month in reference to 0-19 overtime hours were 1.11 [95% confidence interval (CI) 1.03-1.19] and 1.62 (95% CI 1.50-1.76), respectively. After adjustment for self-assessed amount of work, mental workload and sleeping time, the association between overtime work and stress response disappeared. This large cross-sectional study shows that overtime work appears to influence stress response indirectly through other stress factors such as self-assessed amount of work, mental workload and sleeping time.

Armodafinil for treatment of excessive sleepiness associated with shift work disorder: a randomized controlled study.

PubMed

Czeisler, Charles A; Walsh, James K; Wesnes, Keith A; Arora, Sanjay; Roth, Thomas

2009-11-01

To assess the effect of armodafinil, 150 mg, on the physiologic propensity for sleep and cognitive performance during usual night shift hours in patients with excessive sleepiness associated with chronic (> or =3 months) shift work disorder (SWD) of moderate or greater severity. This 12-week, randomized controlled study was conducted at 42 sleep research facilities in North America from April 2 through December 23, 2004, and enrolled 254 permanent or rotating night shift workers with SWD. Entry criteria included excessive sleepiness during usual night shifts for 3 months or longer (corroborated by mean sleep latency of < or =6 minutes on a Multiple Sleep Latency Test), insomnia (sleep efficiency < or =87.5% during daytime sleep), and SWD that was judged clinically to be of moderate or greater severity. Patients received armodafinil, 150 mg, or placebo 30 to 60 minutes before each night shift. Physiologic sleep propensity during night shift hours, clinical impression of severity, patient-reported sleepiness, and cognitive function were assessed during laboratory night shifts at weeks 4, 8, and 12. Armodafinil significantly improved mean (SD) sleep latency from 2.3 (1.6) minutes at baseline to 5.3 (5.0) minutes at final visit, compared with a change from 2.4 (1.6) minutes to 2.8 (2.9) minutes in the placebo group (P<.001). Clinical condition ratings improved in more patients receiving armodafinil (79%) vs placebo (59%) (P=.001). As reported by patients' diaries, armodafinil significantly reduced sleepiness during laboratory nights (P<.001), night shifts at work (P<.001), and the commute home (P=.003). Armodafinil improved performance on standardized memory (P<.001) and attention (power, P=.001; continuity, P<.001) tests compared with placebo. Armodafinil was well tolerated and did not affect daytime sleep, as measured by polysomnography. In patients with excessive sleepiness associated with chronic SWD of moderate or greater severity, armodafinil significantly improved wakefulness during scheduled night work, raising mean nighttime sleep latency above the level considered to indicate severe sleepiness during the daytime. Armodafinil also significantly improved measures of overall clinical condition, long-term memory, and attention. clinicaltrials.gov Identifier: NCT00080288.

Association between sleep duration and sarcopenia among community-dwelling older adults: A cross-sectional study.

PubMed

Hu, Xiaoyi; Jiang, Jiaojiao; Wang, Haozhong; Zhang, Lei; Dong, Birong; Yang, Ming

2017-03-01

Both sleep disorders and sarcopenia are common among older adults. However, little is known about the relationship between these 2 conditions.This study aimed to investigate the possible association between sleep duration and sarcopenia in a population of Chinese community-dwelling older adults.Community-dwelling older adults aged 60 years or older were recruited. Self-reported sleep duration, anthropometric data, gait speed, and handgrip strength were collected by face-to-face interviews. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS).We included 607 participants aged 70.6 ± 6.6 years (range, 60-90 years) in the analyses. The prevalence of sarcopenia in the whole study population was 18.5%. In women, the prevalence of sarcopenia was significantly higher in the short sleep duration group (< 6 hours) and long sleep duration group (>8 hours) compared with women in the normal sleep duration group (6-8 hours; 27.5%, 22.2% and 13.9%, respectively; P = .014). Similar results were found in men; however, the differences between groups were not statistically significant (18.5%, 20.6%, and 13.0%, respectively; P = .356). After adjustments for the potential confounding factors, older women having short sleep duration (OR: 4.34; 95% CI: 1.74-10.85) or having long sleep duration (OR: 2.50; 95% CI: 1.05-6.99) had greater risk of sarcopenia compared with women having normal sleep duration. With comparison to men with normal sleep duration, the adjusted OR for sarcopenia was 2.12 (0.96-8.39) in the short sleep duration group and 2.25 (0.88-6.87) in the long sleep duration group, respectively.A U-shape relationship between self-reported sleep duration and sarcopenia was identified in a population of Chinese community-dwelling older adults, especially in women.

Association between sleep duration and sarcopenia among community-dwelling older adults

PubMed Central

Hu, Xiaoyi; Jiang, Jiaojiao; Wang, Haozhong; Zhang, Lei; Dong, Birong; Yang, Ming

2017-01-01

Abstract Both sleep disorders and sarcopenia are common among older adults. However, little is known about the relationship between these 2 conditions. This study aimed to investigate the possible association between sleep duration and sarcopenia in a population of Chinese community-dwelling older adults. Community-dwelling older adults aged 60 years or older were recruited. Self-reported sleep duration, anthropometric data, gait speed, and handgrip strength were collected by face-to-face interviews. Sarcopenia was defined according to the recommended algorithm of the Asian Working Group for Sarcopenia (AWGS). We included 607 participants aged 70.6 ± 6.6 years (range, 60–90 years) in the analyses. The prevalence of sarcopenia in the whole study population was 18.5%. In women, the prevalence of sarcopenia was significantly higher in the short sleep duration group (< 6 hours) and long sleep duration group (>8 hours) compared with women in the normal sleep duration group (6–8 hours; 27.5%, 22.2% and 13.9%, respectively; P = .014). Similar results were found in men; however, the differences between groups were not statistically significant (18.5%, 20.6%, and 13.0%, respectively; P = .356). After adjustments for the potential confounding factors, older women having short sleep duration (OR: 4.34; 95% CI: 1.74–10.85) or having long sleep duration (OR: 2.50; 95% CI: 1.05–6.99) had greater risk of sarcopenia compared with women having normal sleep duration. With comparison to men with normal sleep duration, the adjusted OR for sarcopenia was 2.12 (0.96–8.39) in the short sleep duration group and 2.25 (0.88–6.87) in the long sleep duration group, respectively. A U-shape relationship between self-reported sleep duration and sarcopenia was identified in a population of Chinese community-dwelling older adults, especially in women. PMID:28272238

Mortality associated with sleep duration and insomnia.

PubMed

Kripke, Daniel F; Garfinkel, Lawrence; Wingard, Deborah L; Klauber, Melville R; Marler, Matthew R

2002-02-01

Patients often complain about insufficient sleep or chronic insomnia in the belief that they need 8 hours of sleep. Treatment strategies may be guided by what sleep durations predict optimal survival and whether insomnia might signal mortality risks. In 1982, the Cancer Prevention Study II of the American Cancer Society asked participants about their sleep duration and frequency of insomnia. Cox proportional hazards survival models were computed to determine whether sleep duration or frequency of insomnia was associated with excess mortality up to 1988, controlling simultaneously for demographics, habits, health factors, and use of various medications. Participants were more than 1.1 million men and women from 30 to 102 years of age. The best survival was found among those who slept 7 hours per night. Participants who reported sleeping 8 hours or more experienced significantly increased mortality hazard, as did those who slept 6 hours or less. The increased risk exceeded 15% for those reporting more than 8.5 hours sleep or less than 3.5 or 4.5 hours. In contrast, reports of "insomnia" were not associated with excess mortality hazard. As previously described, prescription sleeping pill use was associated with significantly increased mortality after control for reported sleep durations and insomnia. Patients can be reassured that short sleep and insomnia seem associated with little risk distinct from comorbidities. Slight risks associated with 8 or more hours of sleep and sleeping pill use need further study. Causality is unproven.

Effect of the 2011 vs 2003 duty hour regulation-compliant models on sleep duration, trainee education, and continuity of patient care among internal medicine house staff: a randomized trial.

PubMed

Desai, Sanjay V; Feldman, Leonard; Brown, Lorrel; Dezube, Rebecca; Yeh, Hsin-Chieh; Punjabi, Naresh; Afshar, Kia; Grunwald, Michael R; Harrington, Colleen; Naik, Rakhi; Cofrancesco, Joseph

2013-04-22

On July 1, 2011, the Accreditation Council for Graduate Medical Education implemented further restrictions of its 2003 regulations on duty hours and supervision. It remains unclear if the 2003 regulations improved trainee well-being or patient safety. To determine the effects of the 2011 Accreditation Council for Graduate Medical Education duty hour regulations compared with the 2003 regulations concerning sleep duration, trainee education, continuity of patient care, and perceived quality of care among internal medicine trainees. Crossover study design in an academic research setting. Medical house staff. General medical teams were randomly assigned using a sealed-envelope draw to an experimental model or a control model. We randomly assigned 4 medical house staff teams (43 interns) using a 3-month crossover design to a 2003-compliant model of every fourth night overnight call (control) with 30-hour duty limits or to one of two 2011-compliant models of every fifth night overnight call (Q5) or a night float schedule (NF), both with 16-hour duty limits. We measured sleep duration using actigraphy and used admission volumes, educational opportunities, the number of handoffs, and satisfaction surveys to assess trainee education, continuity of patient care, and perceived quality of care. RESULTS The study included 560 control, 420 Q5, and 140 NF days that interns worked and 834 hospital admissions. Compared with controls, interns on NF slept longer during the on call period (mean, 5.1 vs 8.3 hours; P = .003), and interns on Q5 slept longer during the postcall period (mean, 7.5 vs 10.2 hours; P = .05). However, both the Q5 and NF models increased handoffs, decreased availability for teaching conferences, and reduced intern presence during daytime work hours. Residents and nurses in both experimental models perceived reduced quality of care, so much so with NF that it was terminated early. Compared with a 2003-compliant model, two 2011 duty hour regulation-compliant models were associated with increased sleep duration during the on-call period and with deteriorations in educational opportunities, continuity of patient care, and perceived quality of care.

Direct Measurements of Smartphone Screen-Time: Relationships with Demographics and Sleep

PubMed Central

Christensen, Matthew A.; Bettencourt, Laura; Kaye, Leanne; Moturu, Sai T.; Nguyen, Kaylin T.; Olgin, Jeffrey E.; Pletcher, Mark J.; Marcus, Gregory M.

2016-01-01

Background Smartphones are increasingly integrated into everyday life, but frequency of use has not yet been objectively measured and compared to demographics, health information, and in particular, sleep quality. Aims The aim of this study was to characterize smartphone use by measuring screen-time directly, determine factors that are associated with increased screen-time, and to test the hypothesis that increased screen-time is associated with poor sleep. Methods We performed a cross-sectional analysis in a subset of 653 participants enrolled in the Health eHeart Study, an internet-based longitudinal cohort study open to any interested adult (≥ 18 years). Smartphone screen-time (the number of minutes in each hour the screen was on) was measured continuously via smartphone application. For each participant, total and average screen-time were computed over 30-day windows. Average screen-time specifically during self-reported bedtime hours and sleeping period was also computed. Demographics, medical information, and sleep habits (Pittsburgh Sleep Quality Index–PSQI) were obtained by survey. Linear regression was used to obtain effect estimates. Results Total screen-time over 30 days was a median 38.4 hours (IQR 21.4 to 61.3) and average screen-time over 30 days was a median 3.7 minutes per hour (IQR 2.2 to 5.5). Younger age, self-reported race/ethnicity of Black and "Other" were associated with longer average screen-time after adjustment for potential confounders. Longer average screen-time was associated with shorter sleep duration and worse sleep-efficiency. Longer average screen-times during bedtime and the sleeping period were associated with poor sleep quality, decreased sleep efficiency, and longer sleep onset latency. Conclusions These findings on actual smartphone screen-time build upon prior work based on self-report and confirm that adults spend a substantial amount of time using their smartphones. Screen-time differs across age and race, but is similar across socio-economic strata suggesting that cultural factors may drive smartphone use. Screen-time is associated with poor sleep. These findings cannot support conclusions on causation. Effect-cause remains a possibility: poor sleep may lead to increased screen-time. However, exposure to smartphone screens, particularly around bedtime, may negatively impact sleep. PMID:27829040

Sleep Patterns in Chinese Preschool Children: A Population-Based Study.

PubMed

Wu, Ran; Wang, Guang-Hai; Zhu, Hong; Jiang, Fan; Jiang, Chun-Lei

2018-04-15

This study aimed to (1) provide data on normal sleep patterns in Chinese preschool children, (2) identify cross-cultural differences of sleep patterns among children from China and other countries, (3) estimate the prevalence of sleep duration not meeting the optimal amount, and (4) characterize delayed weekend sleep pattern. A population-based sample of 1,610 children aged 3-6 years was recruited from 10 cities across China. Parents completed questions about their child's sleep patterns adapted from the Children's Sleep Habits Questionnaire (CSHQ). The mean bedtime was 9:31 PM, wake time was 7:27 AM, nighttime sleep duration was 9 hours 30 minutes, daytime sleep duration was 1 hour 31 minutes, and total sleep duration was 11 hours 2 minutes. The children had a shorter nighttime sleep duration but longer daytime naps, resulting in no differences in total sleep duration compared with counterparts predominantly in the west. Of the children, 85.3% met the recommended amount of sleep of 10 to 13 hours, and 10.8% slept fewer than 10 hours. The prevalence of sleep less than 10 hours was higher in older children and children from eastern China. Children went to bed and woke up more than 30 minutes later on weekends than weekdays, accounting for 40.1% and 50%, respectively. Children in western China showed longer delay than children in eastern China ( P < .05). Age- and region-specific variability of sleep patterns are reported as well as insufficient sleep and delayed weekend sleep pattern in Chinese preschool children. The cross-cultural difference of sleep patterns was in temporal placement rather than sleep duration. © 2018 American Academy of Sleep Medicine.

US public opinion regarding proposed limits on resident physician work hours.

PubMed

Blum, Alexander B; Raiszadeh, Farbod; Shea, Sandra; Mermin, David; Lurie, Peter; Landrigan, Christopher P; Czeisler, Charles A

2010-06-01

In both Europe and the US, resident physician work hour reduction has been a source of controversy within academic medicine. In 2008, the Institute of Medicine (IOM) recommended a reduction in resident physician work hours. We sought to assess the American public perspective on this issue. We conducted a national survey of 1,200 representative members of the public via random digit telephone dialing in order to describe US public opinion on resident physician work hour regulation, particularly with reference to the IOM recommendations. Respondents estimated that resident physicians currently work 12.9-h shifts (95% CI 12.5 to 13.3 h) and 58.3-h work weeks (95% CI 57.3 to 59.3 h). They believed the maximum shift duration should be 10.9 h (95% CI 10.6 to 11.3 h) and the maximum work week should be 50 h (95% CI 49.4 to 50.8 h), with 1% approving of shifts lasting >24 h (95% CI 0.6% to 2%). A total of 81% (95% CI 79% to 84%) believed reducing resident physician work hours would be very or somewhat effective in reducing medical errors, and 68% (95% CI 65% to 71%) favored the IOM proposal that resident physicians not work more than 16 h over an alternative IOM proposal permitting 30-h shifts with > or =5 h protected sleep time. In all, 81% believed patients should be informed if a treating resident physician had been working for >24 h and 80% (95% CI 78% to 83%) would then want a different doctor. The American public overwhelmingly favors discontinuation of the 30-h shifts without protected sleep routinely worked by US resident physicians and strongly supports implementation of restrictions on resident physician work hours that are as strict, or stricter, than those proposed by the IOM. Strong support exists to restrict resident physicians' work to 16 or fewer consecutive hours, similar to current limits in New Zealand, the UK and the rest of Europe.

Epidemiological study of sleep habits among four-and-a-half-year-old children in Japan.

PubMed

Ikeda, Maki; Kaneita, Yoshitaka; Kondo, Shuji; Itani, Osamu; Ohida, Takashi

2012-08-01

To date, only limited epidemiological data on the sleep habits of young children in Japan have been available. This study used representative samples to examine the sleep habits of four-and-a-half-year-old children in Japan. We used data from a nationwide cross-sectional survey. A member of each subject's family was asked to complete the questionnaire. The questionnaire included personal characteristics, sleep habits, and lifestyle. The data for 39,813 subject children (collection rate: 74.3%) were analyzed. The mean value of total sleep duration, night-time sleep duration, and daytime napping duration was 10 h 40 min 30 s, 9 h 53 min 0 s, and 46 min 24 s, respectively. The prevalence of daytime napping was 45.8%. Those whose total sleep duration was less than 10h accounted for 13.7% of the sample. The factors associated with high odds ratios for shorter total sleep duration were: living in a less populated area, long hours spent watching television, longer maternal work hours, and attending preschool. In attempting to devise ways of improving the sleep habits of young children, the lifestyles of both the children and their parents must be considered. Copyright © 2012 Elsevier B.V. All rights reserved.

Nurses are human beings too.

PubMed

Neeson, Jimmy

2017-03-15

Your story 'Thousands of nurses leave NHS posts to maintain work-life balance' (online news, 3 March) made me think. Maybe it would be better if employers didn't break the Working Time Directive, making us swap from a 12-hour night shift to a 14-hour day with no day off in-between, or two long days in a row with not enough time to go home, shower, sleep and get ready for work between them.

Effects of Partial and Acute Total Sleep Deprivation on Performance across Cognitive Domains, Individuals and Circadian Phase

PubMed Central

Lo, June C.; Groeger, John A.; Santhi, Nayantara; Arbon, Emma L.; Lazar, Alpar S.; Hasan, Sibah; von Schantz, Malcolm; Archer, Simon N.; Dijk, Derk-Jan

2012-01-01

Background Cognitive performance deteriorates during extended wakefulness and circadian phase misalignment, and some individuals are more affected than others. Whether performance is affected similarly across cognitive domains, or whether cognitive processes involving Executive Functions are more sensitive to sleep and circadian misalignment than Alertness and Sustained Attention, is a matter of debate. Methodology/Principal Findings We conducted a 2 × 12-day laboratory protocol to characterize the interaction of repeated partial and acute total sleep deprivation and circadian phase on performance across seven cognitive domains in 36 individuals (18 males; mean ± SD of age = 27.6±4.0 years). The sample was stratified for the rs57875989 polymorphism in PER3, which confers cognitive susceptibility to total sleep deprivation. We observed a deterioration of performance during both repeated partial and acute total sleep deprivation. Furthermore, prior partial sleep deprivation led to poorer cognitive performance in a subsequent total sleep deprivation period, but its effect was modulated by circadian phase such that it was virtually absent in the evening wake maintenance zone, and most prominent during early morning hours. A significant effect of PER3 genotype was observed for Subjective Alertness during partial sleep deprivation and on n-back tasks with a high executive load when assessed in the morning hours during total sleep deprivation after partial sleep loss. Overall, however, Subjective Alertness and Sustained Attention were more affected by both partial and total sleep deprivation than other cognitive domains and tasks including n-back tasks of Working Memory, even when implemented with a high executive load. Conclusions/Significance Sleep loss has a primary effect on Sleepiness and Sustained Attention with much smaller effects on challenging Working Memory tasks. These findings have implications for understanding how sleep debt and circadian rhythmicity interact to determine waking performance across cognitive domains and individuals. PMID:23029352

Sleep and Sickness Absence: A Nationally Representative Register-Based Follow-Up Study

PubMed Central

Lallukka, Tea; Kaikkonen, Risto; Härkänen, Tommi; Kronholm, Erkki; Partonen, Timo; Rahkonen, Ossi; Koskinen, Seppo

2014-01-01

Study Objectives: We aimed to examine various sleep measures as determinants of sickness absence while considering confounders. Design: Nationally representative Health 2000 Survey linked with sickness absence data from the Finnish Social Insurance Institution. Setting: Finland. Participants: Working-aged women (n = 1,875) and men (n = 1,885). Interventions: N/A. Measurements and Results: Insomnia-related symptoms, early morning awakenings, being more tired during daytime than other people of same age, use of sleeping pills, excessive daytime sleepiness, probable sleep apnea (4 items about snoring/apnea), and reporting that sleep duration varies between different seasons were examined as determinants of sickness absence over a 7.2 year follow-up. Poisson and gamma regression models were fitted. After adjusting age, all examined sleep disturbances except excessive daytime sleepiness were associated with sickness absence among men (RRs 1.3-2.5). Among women, after adjusting for age, insomnia-related symptoms, early morning awakenings, being more tired than others, and use of sleeping pills were associated with sickness absence (RRs 1.4-1.8). After further adjustments for education, working conditions, health behaviors, and objectively measured mental and somatic health, the associations somewhat attenuated but mainly remained. The optimal sleep duration with the lowest risk of sickness absence was 7.6 hours for women and 7.8 hours for men. Although persistence of other health problems could affect the estimates, direct costs due to sickness absence could decrease by up to 28% if sleep disturbances could be fully addressed. Conclusions: This study highlights the need for prevention of sleep disturbances and promotion of optimal sleep length to prevent sickness absence. Citation: Lallukka T, Kaikkonen R, Härkänen T, Kronholm E, Partonen T, Rahkonen O, Koskinen S. Sleep and sickness absence: a nationally representative register-based follow-up study. SLEEP 2014;37(9):1413-1425. PMID:25142569

Adenosine and sleep

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yanik, G.M. Jr.

Behavioral and biochemical approaches have been used to determine the relative contribution of endogenous adenosine and adenosine receptors to the sleep-wake cycle in the rat. Adenosine concentrations in specific areas of the rat brain were not affected by 24 hours of total sleep deprivation, or by 24 or 48 hours of REM sleep deprivation. In order to assess the effect of REM sleep deprivation on adenosine A/sub 1/ receptors, /sup 3/H-L-PIA binding was measured. The Bmax values for /sup 3/H-L-PIA binding to membrane preparations of the cortices and corpus striata from 48 hour REM sleep-deprived animals were increased 14.8% andmore » 23%, respectively. These increases were not maintained following the cessation of sleep deprivation and recovered within 2 hours. The results of a 96 hour REM deprivation experiment were similar to those of the 48 hour REM sleep deprivation experiment. However, these increases were not evident in similar structures taken from stress control animals, and conclusively demonstrated that the changes in /sup 3/H-L-PIA binding resulted from REM sleep deprivation and not from stress.« less

Sleep-wake cycle of an unrestrained isolated chimpanzee under entrained and free running conditions.

NASA Technical Reports Server (NTRS)

Mcnew, J. J.; Burson, R. C.; Hoshizaki, T.; Adey, W. R.

1972-01-01

Biorhythmic patterns of EEG activity - the sleep-wake cycle and the sleep cycle - were investigated in an unrestrained chimpanzee subjected to 30 days of isolation in a 4-ft cubical cage placed in a high performance sound isolation chamber. The animal received 10 days of 12 hours of light and 12 hours of dark, then 10 days of continuous light, followed by 10 more days of 12 hours of light and 12 hours of dark. The circadian sleep-wake rhythm and the wake and sleep phases of this rhythm during entrained and free running conditions were analyzed in terms of duration. The awake and nonREM sleep and REM sleep stages were also analyzed. In addition, the mean duration of the sleep cycle of the sleep phase was computed.

[Occupational stress in assembly line workers in electronics manufacturing service and related influencing factors].

PubMed

Ji, Y Q; Li, S; Wang, C; Wang, J; Liu, X M

2016-10-20

Objective: To investigate occupational stress in assembly line workers in electronics manu-facturing service (EMS) and related influencing factors. Methods: From June to October, 2015, a cross-sectional survey was performed for 5 944 assembly line workers in EMS (observation group) and 6 270 workers from other posts (non-assembly line workers and management personnel; control group) using the self-made questionnaire for basic information, job demand-control (JDC) model questionnaire, and effort-reward imbalance (ERI) model questionnaire to collect respondents' basic information and occupational stress. Results: The observation group had significantly lower work autonomy, social support, and work reward scores than the control group (2.72 ± 0.63/3.64 ± 0.68/4.06 ± 0.80 vs 3.00 ± 0.67/3.83 ± 0.68/4.24 ± 0.75, t =23.53, 15.41, and 12.70, all P <0.05) , as well as significantly higher work effort and job involvement scores than the control group (2.34±0.78/2.48±0.78 vs 2.21±0.80/2.33±0.77, t =-9.08 and-10.90, both P <0.05). The observation group had significantly higher proportions of workers with occupational stress determined by JDC and ERI models than the control group (64.5%/12.7% vs 52.6%/9.9%, χ 2 =182.26 and 23.41, both P <0.05). Female sex, migrant workers, working time >60 hours/week, and sleeping time <7 hours/day were major risk factors for occupational stress in JDC model; education background of Bachelor's degree or above, working time >60 hours/week, and sleeping time<7 hours/day were major risk factors for occupational stress in ERI model, while female sex and a high monthly income reduced the risk of occupational stress in ERI model. Conclusion: Assembly line workers in EMS are a relatively vulnerable group and have a high degree of occupational stress. Working time >60 hours/week and sleeping time <7 hours/day are major risk factors for occupational stress.

Association Between Sleep and Productivity Loss Among 598 676 Employees From Multiple Industries.

PubMed

Gingerich, Stefan B; Seaverson, Erin L D; Anderson, David R

2018-05-01

To examine the relationship between sleep habits and employee productivity. Cross-sectional health risk assessment analysis. Employer-sponsored health and well-being programs. A total of 598 676 employed adults from multiple industries. Self-reported average hours of sleep, fatigue, absence days, and presenteeism. Bivariate analyses to assess the relationships between self-reported hours of sleep and self-reported fatigue and mean and median absence and presenteeism. The relationship between sleep hours and both measures of productivity was U-shaped, with the least productivity loss among employees who reported 8 hours of sleep. More daytime fatigue correlated with more absence and presenteeism. Median absence and presenteeism was consistently lower than mean absence and presenteeism, respectively, for the various hours of sleep and levels of fatigue. Organizations looking to expand the value of their investment in employee health and well-being should consider addressing the employee sleep habits that may be negatively impacting productivity.

Alertness, performance and off-duty sleep on 8-hour and 12-hour night shifts in a simulated continuous operations control room setting

DOE Office of Scientific and Technical Information (OSTI.GOV)

Baker, T.L.

A growing number of nuclear power plants in the United States have adopted routine 12-hr shift schedules. Because of the potential impact that extended work shifts could have on safe and efficient power plant operation, the U.S. Nuclear Regulatory Commission funded research on 8-hr and 12-hr shifts at the Human Alertness Research Center (HARC) in Boston, Massachusetts. This report describes the research undertaken: a study of simulated 8-hr and 12-hr work shifts that compares alertness, speed, and accuracy at responding to simulator alarms, and relative cognitive performance, self-rated mood and vigor, and sleep-wake patterns of 8-hr versus 12-hr shift workers.

Effects of 6/6 and 4/8 watch systems on sleepiness among bridge officers.

PubMed

Härmä, Mikko; Partinen, Markku; Repo, Risto; Sorsa, Matti; Siivonen, Pertti

2008-04-01

During the last ten years, severe sleepiness or falling asleep by watch keeping officers has been a direct or a contributing factor in a number of maritime accidents. This study examined the relationship between two watch systems and its impact on fatigue and sleepiness in bridge officers. A questionnaire and a sleep/work diary were sent to a representative sample of the Finnish Maritime Officer Association. In all, 185 bridge officers answered the questionnaire on sleep, work hours, and safety, including the Skogby Excessive Daytime Sleepiness index (SEDS); 42% of the bridge officers worked two 4 h watches (4/8) per day, while 26% worked two 6 h watches per day (6/6). Ninety-five of the participants completed a sleep diary for seven consecutive days while at sea. The timing of the watch duties and sleep was recorded, as was subjective sleepiness every 2 h using the Karolinska Sleepiness Scale (KSS). 17.6% of the participants had fallen asleep at least once while on duty during their career. Compared to the 4/8 watch system, the officers working the 6/6 watch system reported shorter sleep durations, more frequent nodding-off on duty (7.3% vs. 1.5%), and excessive sleepiness (32% vs. 16% with SEDS>14). Based on a logistic regression analysis, high SEDS was significantly related with probable obstructive sleep apnea (OR 5.7), the 6/6 watch system (OR 4.0), and morningness-eveningness while controlling simultaneously several individual and sleep-related factors. Subjective sleepiness (KSS) was highest at 04:00 and 06:00 h. In a multivariate analysis, the KSS was significantly related to time of day, time after awaking, sleep length, and interactions of the watch systems with age, morningness-eveningness, and Epworth sleepiness scale (ESS) score. Severe sleepiness at 04:00-06:00 h was especially problematic in the 6/6 watch system among evening types and among the bridge officers with high ESS. The results suggest the 6/6 watch system is related to a higher risk of severe sleepiness during the early morning hours compared to the 4/8 and the other watch systems assessed.

Blood Pressure, Sleep Quality and Fatigue in Shift Working Police Officers: Effects of a Twelve Hour Roster System on Cardiovascular and Sleep Health.

PubMed

Elliott, Jaymen L; Lal, Sara

2016-01-29

Police officers have been reported to exhibit a high incidence of pathologies, which present prematurely in an otherwise healthy population. Shift work has also been associated with an increased risk of cardiovascular and sleep disorders, attributable to its propensity for circadian rhythm dysfunction. However, contention exists as to whether shift work has a direct effect upon blood pressure (BP) regulation. This cross-sectional study sought to determine changes in BP and associations with the overall sleep quality and fatigue in 206 general duties police officers (n = 140 males) of the New South Wales Police Force in Australia. The subjects' BP was assessed before and after their twelve hour shift, during which time they also completed the Lifestyle Appraisal Questionnaire, Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale and Fatigue Severity Scale (FSS). Poor sleep quality (PSQI) and fatigue severity (FSS) were found to predominate in the sample (69% and 51% respectively). Although there was no change in BP for male participants, female officers' systolic blood pressure (SBP) was found to increase significantly across the shift (p < 0.001), but with no change found in females' diastolic blood pressure (DBP). Finally, higher pre and post-shift SBP (r = -0.26, p = 0.001; r = -0.25, p = 0.001, respectively) and DBP (r = -0.26, p = 0.001; r = -0.26, p = 0.001, respectively) were significantly correlated with lower FSS scores after accounting for age, waist-hip ratio and lifestyle risk factors. Based on these preliminary findings, there was a significant increase in SBP of female police officers after shift work, while BP and fatigue levels in all police officers were strongly related. Moreover, the predominating poor sleep quality and impact of fatigue in this sample remain a concern. Further research is required to ensure the physiological welfare of police officers, while strategies must be implemented to manage the detrimental effects shift work may be having upon their cardiovascular and sleep health.

Sleep duration, snoring habits, and cardiovascular disease risk factors in an ethnically diverse population.

PubMed

Mosca, Matthew; Aggarwal, Brooke

2012-01-01

Lack of sleep has been associated with an increased risk for cardiovascular disease (CVD) and all-cause mortality, but the mechanisms are not fully understood. Prior research has often been conducted in select populations and has not consistently adjusted for confounders, especially psychosocial factors. The aims of this study were to assess the association between sleep habits and established risk factors for CVD and to evaluate potential interactions by race and gender. Participants were part of a CVD screening and educational outreach program in New York City. Free-living men older than 40 years and women older than 50 years (n = 371, mean age = 60 years, 57% women, 60% racial/ethnic minorities) were systematically assessed for CVD risk (including traditional, lifestyle, and psychosocial risk factors) and completed a standardized questionnaire regarding sleep habits (including sleep duration and snoring). Lipids were analyzed by validated finger-stick technology. Stress at work and at home was assessed using a validated screening tool from the INTERHEART study. Associations between participants' sleep habits and CVD risk factors/demographic factors were assessed using multivariable logistic regression. The proportion of participants who reported sleeping less than 6 hours per night on average was 28%, and 52% of participants reported snoring. Sleeping less than 6 hours per night was significantly (P < .05) associated with female gender, being single, increased stress at home, increased financial stress, and low-density lipoprotein cholesterol (LDL-C) level. Gender modified the association between sleep duration and LDL-C level (P = .04): Sleeping less than 6 hours per night was significantly associated with reduced LDL-C level among women and increased LDL-C level among men. Snoring was significantly associated with low high-density lipoprotein cholesterol (HDL-C) level (<40 mg/dL for men/<50 mg/dL for women), being married, increased stress at work and at home, less than 30 minutes of exercise per day, less than 5 servings of fruits and vegetables per day, and being overweight/obese (body mass index ≥25 kg/m). The association between snoring and low HDL-C level remained significant in logistic regression models adjusted for demographic confounders (odds ratio, 1.83; 95% confidence interval, 1.06-3.19) but not after adjustment for body mass index greater than 25 kg/m. Sleeping less than 6 hours per night was associated with several traditional and psychosocial CVD risk factors, and snoring was associated with low HDL-C level, likely mediated through overweight/obesity. These data may have significance for health care providers to identify individuals who may be at increased CVD risk based on sleep habits.

Self-Reported Sleep Duration and Self-Rated Health in Young Adults

PubMed Central

Štefan, Lovro; Juranko, Dora; Prosoli, Rebeka; Barić, Renata; Sporiš, Goran

2017-01-01

Study Objectives: This study aimed to determine the associations between the self-reported sleep duration and self-rated health in young adults. Methods: In this cross-sectional study, participants were 689 young adults (mean age 20 ± 1.35 years, 49.8% female). Sleep duration and self-rated health, as the main outcome of interest, were measured as self-reported. As potential covariates, we included sex, age, smoking status, alcohol consumption, physical activity, sedentary behavior, psychological distress, and body mass index. Results: Approximately 30% of participants slept 7–8 hours, 17.4% were short sleepers (categories < 6 hours and 6–7 hours), and 53.9% were long sleepers (categories 8–10 hours and > 10 hours of sleep). In an unadjusted model, compared with the reference category (7–8 hours of sleep), those who slept < 6 hours (odds ratio 0.20; 95% confidence interval 0.08 to 0.48) and between 6–7 hours (odds ratio 0.43; 95% confidence interval 0.26 to 0.69) were less likely to have good self-rated health. In an adjusted model, short (< 7 hours) and long sleep (> 10 hours) were both associated with poor self-rated health. Conclusions: Our results suggest that both short (< 7 hours) and long (> 10 hours) sleepers have lower odds of having good self-rated health after adjusting for potential covariates. Health professionals should pay more attention to young adults, who have both short and long period of sleep, in order to prevent health problems and potential acute or chronic diseases. Citation: Štefan L, Juranko D, Prosoli R, Barić R, Sporiš G. Self-reported sleep duration and self-rated health in young adults. J Clin Sleep Med. 2017;13(7):899–904. PMID:28502281

Self-Reported Sleep Duration, Napping, and Incident Heart Failure: Prospective Associations in the British Regional Heart Study.

PubMed

Wannamethee, S Goya; Papacosta, Olia; Lennon, Lucy; Whincup, Peter H

2016-09-01

To examine the associations between self-reported nighttime sleep duration and daytime sleep and incident heart failure (HF) in men with and without preexisting cardiovascular disease (CVD). Population-based prospective study. General practices in 24 British towns. Men aged 60-79 without prevalent HF followed for 9 years (N = 3,723). Information on incident HF cases was obtained from primary care records. Assessment of sleep was based on self-reported sleep duration at night and daytime napping. Self-reported short nighttime sleep duration and daytime sleep of longer than 1 hour were associated with preexisting CVD, breathlessness, depression, poor health, physical inactivity, and manual social class. In all men, self-reported daytime sleep of longer than 1 hour duration was associated with significantly greater risk of HF after adjustment for potential confounders (adjusted hazard ratio (aHR) = 1.69, 95% CI = 1.06-2.71) than in those who reported no daytime napping. Self-reported nighttime sleep duration was not associated with HF risk except in men with preexisting CVD (<6 hours: aHR = 2.91, 95% CI = 1.31-6.45; 6 hours: aHR = 1.89, 95% CI = 0.89-4.03; 8 hours: aHR = 1.29, 95% CI = 0.61-2.71; ≥9 hours: aHR = 1.80, 905% CI = 0.71-4.61 vs nighttime sleep of 7 hours). Snoring was not associated with HF risk. Self-reported daytime napping of longer than 1 hour is associated with greater risk of HF in older men. Self-reported short sleep (<6 hours) in men with CVD is associated with particularly high risk of developing HF. © 2016 The Authors. The Journal of the American Geriatrics Society published by Wiley Periodicals, Inc. on behalf of The American Geriatrics Society.

Association of Current Work and Sleep Situations with Excessive Daytime Sleepiness and Medical Incidents among Japanese Physicians

PubMed Central

Kaneita, Yoshitaka; Ohida, Takashi

2011-01-01

Objective: The aim of the present study was to clarify the current work and sleep situations of physicians in Japan and to clarify the association between these situations and excessive daytime sleepiness as well as medical incidents. Methods: A self-administered questionnaire survey was conducted among the members of the Japan Medical Association in 2008. The randomly selected subjects comprised 3,000 male physicians and 1,500 female physicians. Results: Valid responses were obtained from 3,486 physicians (2,298 men and 1,188 women). Mean sleep duration was 6 h 36 min for men and 6 h 8 min for women. The prevalence of lack of rest due to sleep deprivation was 30.4% among men and 36.6% among women; the prevalence of insomnia was 21.0% and 18.1%, respectively; and the prevalence of EDS was 3.5%. The adjusted odds ratio for EDS was high for physicians who reported short sleep duration, lack of rest due to sleep deprivation, and a high frequency of on-call/overnight work. Physicians who had experienced a medical incident within the previous one month accounted for 19.0% of participants. The adjusted odds ratio for medical incidents was high for those subjected to long working hours, high frequency of on-call/overnight works, lack of rest due to sleep deprivation, and insomnia. Conclusion: In order to facilitate optimal health management for physicians as well as securing medical safety, it is important to fully consider the work and sleep situations of physicians. Citation: Kaneita Y; Ohida T. Association of current work and sleep situations with excessive daytime sleepiness and medical incidents among Japanese physicians. J Clin Sleep Med 2011;7(5):512-522. PMID:22003348

Randomized placebo-controlled field study of the effects of bright light and melatonin in adaptation to night work.

PubMed

Bjorvatn, Bjørn; Stangenes, Kristine; Oyane, Nicolas; Forberg, Knut; Lowden, Arne; Holsten, Fred; Akerstedt, Torbjørn

2007-06-01

This study evaluated the effects of bright light and melatonin on adaptation to night work on an oil rig in the North Sea. Seventeen persons working a schedule of 2 weeks on a 12-hour shift, with the first week on night shift and the second week on day shift (ie, the swing shift schedule) participated. In a randomized controlled crossover design, the shift workers received a placebo, melatonin (3 mg, 1 hour before bedtime), or bright light (30-minute exposure, individually scheduled) during the first 4 days on the night shift and during the first 4 days on the day shift. Subjective and objective measures of sleepiness (Karolinska Sleepiness Scale and a simple serial reaction-time test) and sleep (diary and actigraphy) were recorded. Subjective measures indicated that melatonin modestly reduced sleepiness at work during the day shift and increased sleep by 15-20 minutes per day. Bright light gave values in between those of melatonin and the placebo, but with few significant results. According to the objective measures, bright light improved sleep to a minor degree during the night shift. Hardly any side-effects were reported. Melatonin and bright light modestly improved sleep and sleepiness in this field study. In well-controlled simulated nightwork studies, both melatonin and bright light are more effective in alleviating sleepiness and sleep problems. The less effect in this field study may be due to competing or conflicting factors present in real life or to an inoptimal timing and duration of the treatments.

The Association of Sleep Duration and Morbid Obesity in a Working Population: The Baptist Health South Florida Employee Study.

PubMed

Aziz, Muhammad; Osondu, Chukwuemeka U; Younus, Adnan; Malik, Rehan; Rouseff, Maribeth; Das, Sankalp; Guzman, Henry; Maziak, Wasim; Virani, Salim; Feldman, Theodore; Agatston, Arthur S; Veledar, Emir; Aneni, Ehimen C; Nasir, Khurram

2017-03-01

The current study aimed to determine the relationship between self-reported sleep duration and morbid obesity in an employee population. Baptist Health South Florida conducts an annual Health Risk Assessment (HRA) for its employees. Data for this cross-sectional study was collected via this HRA in 2014, and included information on self-reported sleep duration, height and weight for body mass index (BMI), and other biometric measures. Average sleep duration was categorized as short sleep (<6 hr), optimal sleep (6-7.9 hr), and long sleep duration (≥8 hr), while obesity status was categorized as nonobese (BMI <30 kg/m 2 ), obese (30-34.9 kg/m 2 ), and morbid obese (≥35 kg/m 2 ). A total of 9505 participants (mean age 42.8 ± 12.1 years, 75% females, and 55% Hispanic) were included in this study. Prevalence of morbid obesity was about 24% among employees who were sleeping for less than 6 hr compared to 13% and 14% among those sleeping for 6-7.9 hours, and 8 or more hours respectively. In regression analyses, persons who slept less than 6 hr had almost twice the odds of morbid obesity compared to those who slept 6-7.9 hr (odds ratio = 1.8; 1.5-2.2). Our finding that short sleep duration (<6 hr) is significantly associated with a higher risk of morbid obesity should facilitate the development of workplace-based programs that focus on improving sleep among at-risk employees, especially those who work in shift duties to reduce the risk of morbid obesity and other comorbid conditions. Future studies are needed to further explore the relationship of sleep duration and morbid obesity in employee populations.

Can sleep quality and burnout affect the job performance of shift-work nurses? A hospital cross-sectional study.

PubMed

Giorgi, Fabio; Mattei, Antonella; Notarnicola, Ippolito; Petrucci, Cristina; Lancia, Loreto

2018-03-01

The aim of this study was to investigate any possible relationship between sleep disorders, burnout and job performance in a shift-work population of nurses. Sleep disorders and burnout can affect the job performance of nurses in terms of efficiency, productivity, task execution speed and supervision, which can be compromised when work shifts are organized on a 24-hour schedule and when the shift itself is irregular. A cross-sectional observational study was conducted from August 2014 - January 2015 on a sample of 315 shift-work nurses across 39 wards in seven central Italian hospitals. The Pittsburgh Sleep Quality Index was used to detect the presence of sleep disorders, the Copenhagen Burnout Inventory was used to detect the presence of any possible type of burnout and the Job Performance Scale was used to measure job performance. Data analysis was mainly based on a multivariate logistic regression to identify variables significantly associated with investigated outcomes. On shift-work nurses' sleep quality and burnout correlated positively. The female gender and personal burnout were significantly associated with impaired sleep quality, while working in the psychiatric setting, working a long cycle shift pattern and experiencing daytime dysfunction were significantly associated with burnout. A significant negative association between patient-related burnout and job performance was observed. Specific characteristics of shift-work nurses can directly affect sleep quality and burnout and indirectly job performance. This evidence offers healthcare administrators opportunities to intervene with measures to promote nurse's health, well-being and safety. © 2017 John Wiley & Sons Ltd.

EEG Changes Accompanying Successive Cycles of Sleep Restriction With and Without Naps in Adolescents.

PubMed

Ong, Ju Lynn; Lo, June C; Gooley, Joshua J; Chee, Michael W L

2017-04-01

To investigate the temporal evolution of sleep EEG changes in adolescents across two cycles of sleep restriction and recovery simulating an intense school week and to examine the effect of an afternoon nap on nocturnal sleep. A parallel-group design, quasi-laboratory study was conducted in a student hostel. Fifty-seven adolescents (31 males, age = 15-19 years) were randomly assigned to nap or no nap groups. Participants underwent a 15-day protocol comprising two sleep restriction (5-hour time-in-bed [TIB]) and recovery (9-hour TIB) cycles. The nap group was also provided with a 1-hour nap opportunity at 14:00 following each sleep restriction night. Polysomnography recordings were obtained on nine nights and five nap episodes. Naps reduced homeostatic sleep pressure on sleep restriction nights as evidenced by longer N2 latency and reduced total sleep time (TST), sleep efficiency (SE), and slow wave energy. Sleep debt accumulated in both groups, evidenced by increased TST, greater SE, and reduced wake after sleep onset on recovery compared to baseline nights. Changes were greater in the no nap group. Recovery sleep after the first cycle of sleep restriction did not restore sleep architecture to baseline in either group. SE, rapid eye movement (REM), and non-REM sleep increased, and N2 latency was reduced in the second sleep restriction period. Changes in sleep EEG induced by sleep restriction to 5-hour TIB for five nights were not eliminated after two nights of 9-hour recovery sleep. An afternoon nap helped but residual effects on the sleep EEG suggest that there is no substitute for adequate nocturnal sleep. © Sleep Research Society 2017. Published by Oxford University Press [on behalf of the Sleep Research Society].

Sleep and errors in a group of Australian hospital nurses at work and during the commute.

PubMed

Dorrian, Jillian; Tolley, Carolyn; Lamond, Nicole; van den Heuvel, Cameron; Pincombe, Jan; Rogers, Ann E; Drew, Dawson

2008-09-01

There is a paucity of information regarding Australian nurses' sleep and fatigue levels, and whether they result in impairment. Forty-one Australian hospital nurses completed daily logbooks for one month recording work hours, sleep, sleepiness, stress, errors, near errors and observed errors (made by others). Nurses reported exhaustion, stress and struggling to remain (STR) awake at work during one in three shifts. Sleep was significantly reduced on workdays in general, and workdays when an error was reported relative to days off. The primary predictor of error was STR, followed by stress. The primary predictor of extreme drowsiness during the commute was also STR awake, followed by exhaustion, and consecutive shifts. In turn, STR awake was predicted by exhaustion, prior sleep and shift length. Findings highlight the need for further attention to these issues to optimise the safety of nurses and patients in our hospitals, and the community at large on our roads.

Alternative diagnostic criteria for idiopathic hypersomnia: A 32-hour protocol.

PubMed

Evangelista, Elisa; Lopez, Régis; Barateau, Lucie; Chenini, Sofiene; Bosco, Adriana; Jaussent, Isabelle; Dauvilliers, Yves

2018-02-01

To assess the diagnostic value of extended sleep duration on a controlled 32-hour bed rest protocol in idiopathic hypersomnia (IH). One hundred sixteen patients with high suspicion of IH (37 clear-cut IH according to multiple sleep latency test criteria and 79 probable IH), 32 with hypersomnolence associated with a comorbid disorder (non-IH), and 21 controls underwent polysomnography, modified sleep latency tests, and a 32-hour bed rest protocol. Receiver operating characteristic curves were used to find optimal total sleep time (TST) cutoff values on various periods that discriminate patients from controls. TST was longer in patients with clear-cut IH than other groups (probable IH, non-IH, and controls) and in patients with probable IH than non-IH and controls. The TST cutoff best discriminating clear-cut IH and controls was 19 hours for the 32-hour recording (sensitivity = 91.9%, specificity = 85.7%) and 12 hours (100%, 85.7%) for the first 24 hours. The 19-hour cutoff displayed a specificity and sensitivity of 91.9% and 81.2% between IH and non-IH patients. Patients with IH above the 19-hour cutoff were overweight, had more sleep inertia, and had higher TST on all periods compared to patients below 19 hours, whereas no differences were found for the 12-hour cutoff. An inverse correlation was found between the mean sleep latency and TST during 32-hour recording in IH patients. In standardized and controlled stringent conditions, the optimal cutoff best discriminating patients from controls was 19 hours over 32 hours, allowing a clear-cut phenotypical characterization of major interest for research purposes. Sleepier patients on the multiple sleep latency test were also the more severe in terms of extended sleep. Ann Neurol 2018;83:235-247. © 2018 American Neurological Association.

Sleep practices among medical students in Pediatrics Department of University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria.

PubMed

Chinawa, J M; Chukwu, B F; Obu, H A

2014-01-01

Medical students are a population who are at great risk of having bad sleep practice and hygiene due to demanding clinical and academic activities. Poor sleep practices are a disturbing and destabilizing phenomenon. It affects many people and can affect the quality of work, performance and education of medical students. Determining the sleep practices and behaviors could be useful to establish a systematic mental health curriculum in medical schools. The objectives of this study is to describe sleep practices among undergraduate medical students in a Nigerian University. Sleep practices were investigated using a convenience sample of medical students from the University of Nigeria Teaching Hospital Ituku Ozalla, Enugu from October 2012 to February 2013. A total number of participants enrolled were 241 consisting of 150 male and 90 female medical students. However, 222 (response rate: 92.1%) completed and returned the questionnaire. The median number of hours of night sleep on a weekday and weekend were 6 and 7 h respectively. There was a significant correlation between the number of hours of sleep and use of caffeine (Spearman r = -0.148, P < 0.0321). Ninety two (45.3%) had a sleep latency of 10-30 min while 157 (70.7%) woke up 1-2 times/night. Twenty five (11.3%) experience unusual sleep practices such as sleep walking, talking or night terrors. Medical students in our institution have varying degrees of sleeping practice and behavior and this may affect academic performance.

Associations between number of consecutive night shifts and impairment of neurobehavioral performance during a subsequent simulated night shift.

PubMed

Magee, Michelle; Sletten, Tracey L; Ferguson, Sally A; Grunstein, Ronald R; Anderson, Clare; Kennaway, David J; Lockley, Steven W; Rajaratnam, Shantha Mw

2016-05-01

This study aimed to investigate sleep and circadian phase in the relationships between neurobehavioral performance and the number of consecutive shifts worked. Thirty-four shift workers [20 men, mean age 31.8 (SD 10.9) years] worked 2-7 consecutive night shifts immediately prior to a laboratory-based, simulated night shift. For 7 days prior, participants worked their usual shift sequence, and sleep was assessed with logs and actigraphy. Participants completed a 10-minute auditory psychomotor vigilance task (PVT) at the start (~21:00 hours) and end (~07:00 hours) of the simulated night shift. Mean reaction times (RT), number of lapses and RT distribution was compared between those who worked 2-3 consecutive night shifts versus those who worked 4-7 shifts. Following 4-7 shifts, night shift workers had significantly longer mean RT at the start and end of shift, compared to those who worked 2-3 shifts. The slowest and fastest 10% RT were significantly slower at the start, but not end, of shift among participants who worked 4-7 nights. Those working 4-7 nights also demonstrated a broader RT distribution at the start and end of shift and had significantly slower RT based on cumulative distribution analysis (5 (th), 25 (th), 50 (th), 75 (th)percentiles at the start of shift; 75th percentile at the end of shift). No group differences in sleep parameters were found for 7 days and 24 hours prior to the simulated night shift. A greater number of consecutive night shifts has a negative impact on neurobehavioral performance, likely due to cognitive slowing.

Shift work and employee fatigue: implications for occupational health nursing.

PubMed

Yumang-Ross, Doreen J; Burns, Candace

2014-06-01

Long work hours and irregular shifts are part of the nation's 24-hour society and contribute to employee fatigue. Factors affecting employee fatigue are circadian rhythm, sleep quality and quantity, individual health, the environment, and work tasks. Employee fatigue contributes to accidents and injuries, and affects occupational performance, safety, and health. These findings should be used by occupational health nurses to address fatigue management and develop comprehensive fatigue management programs. Copyright 2014, SLACK Incorporated.

Fatigue Risk Management: The Impact of Anesthesiology Residents' Work Schedules on Job Performance and a Review of Potential Countermeasures.

PubMed

Wong, Lily R; Flynn-Evans, Erin; Ruskin, Keith J

2018-04-01

Long duty periods and overnight call shifts impair physicians' performance on measures of vigilance, psychomotor functioning, alertness, and mood. Anesthesiology residents typically work between 64 and 70 hours per week and are often required to work 24 hours or overnight shifts, sometimes taking call every third night. Mitigating the effects of sleep loss, circadian misalignment, and sleep inertia requires an understanding of the relationship among work schedules, fatigue, and job performance. This article reviews the current Accreditation Council for Graduate Medical Education guidelines for resident duty hours, examines how anesthesiologists' work schedules can affect job performance, and discusses the ramifications of overnight and prolonged duty hours on patient safety and resident well-being. We then propose countermeasures that have been implemented to mitigate the effects of fatigue and describe how training programs or practice groups who must work overnight can adapt these strategies for use in a hospital setting. Countermeasures include the use of scheduling interventions, strategic naps, microbreaks, caffeine use during overnight and extended shifts, and the use of bright lights in the clinical setting when possible or personal blue light devices when the room lights must be turned off. Although this review focuses primarily on anesthesiology residents in training, many of the mitigation strategies described here can be used effectively by physicians in practice.

The Effects of Fatigue on Position Determination and Cognitive Workload Using a Visual and 3-Dimensional Auditory Display

DTIC Science & Technology

2004-06-01

in first third of the night. REM sleep is associated with an extremely active brain that is frequently dreaming with bursts of rapid eye movement...these areas. 3. Human Sleep and Fatigue Sleep is nature’s process of resting the body although brain activity continues throughout the rest...midday roughly between 1500 and 1700 (LeClair, 2001). Disruption of one’s circadian rhythm to accommodate adjustments in unconventional working hours

Self-Reported Sleep Duration and Self-Rated Health in Young Adults.

PubMed

Štefan, Lovro; Juranko, Dora; Prosoli, Rebeka; Barić, Renata; Sporiš, Goran

2017-07-15

This study aimed to determine the associations between the self-reported sleep duration and self-rated health in young adults. In this cross-sectional study, participants were 689 young adults (mean age 20 ± 1.35 years, 49.8% female). Sleep duration and self-rated health, as the main outcome of interest, were measured as self-reported. As potential covariates, we included sex, age, smoking status, alcohol consumption, physical activity, sedentary behavior, psychological distress, and body mass index. Approximately 30% of participants slept 7-8 hours, 17.4% were short sleepers (categories < 6 hours and 6-7 hours), and 53.9% were long sleepers (categories 8-10 hours and > 10 hours of sleep). In an unadjusted model, compared with the reference category (7-8 hours of sleep), those who slept < 6 hours (odds ratio 0.20; 95% confidence interval 0.08 to 0.48) and between 6-7 hours (odds ratio 0.43; 95% confidence interval 0.26 to 0.69) were less likely to have good self-rated health. In an adjusted model, short (< 7 hours) and long sleep (> 10 hours) were both associated with poor self-rated health. Our results suggest that both short (< 7 hours) and long (> 10 hours) sleepers have lower odds of having good self-rated health after adjusting for potential covariates. Health professionals should pay more attention to young adults, who have both short and long period of sleep, in order to prevent health problems and potential acute or chronic diseases. © 2017 American Academy of Sleep Medicine

Work-family conflict, cardiometabolic risk, and sleep duration in nursing employees.

PubMed

Berkman, Lisa F; Liu, Sze Yan; Hammer, Leslie; Moen, Phyllis; Klein, Laura Cousino; Kelly, Erin; Fay, Martha; Davis, Kelly; Durham, Mary; Karuntzos, Georgia; Buxton, Orfeu M

2015-10-01

We investigated associations of work-family conflict and work and family conditions with objectively measured cardiometabolic risk and sleep. Multilevel analyses assessed cross-sectional associations between employee and job characteristics and health in analyses of 1,524 employees in 30 extended-care facilities in a single company. We examined work and family conditions in relation to: (a) validated, cardiometabolic risk score based on measured blood pressure, cholesterol, glycosylated hemoglobin, body mass index, and self-reported tobacco consumption and (b) wrist actigraphy-based sleep duration. In fully adjusted multilevel models, work-to-family conflict but not family-to-work conflict was positively associated with cardiometabolic risk. Having a lower level occupation (nursing assistant vs. nurse) was associated with increased cardiometabolic risk, whereas being married and having younger children at home was protective. A significant Age × Work-to-Family Conflict interaction revealed that higher work-to-family conflict was more strongly associated with increased cardiometabolic risk in younger employees. High family-to-work conflict was significantly associated with shorter sleep duration. Working long hours and having children at home were both independently associated with shorter sleep duration. High work-to-family conflict was associated with longer sleep duration. These results indicate that different dimensions of work-family conflict may pose threats to cardiometabolic health and sleep duration for employees. This study contributes to the research on work-family conflict, suggesting that work-to-family and family-to-work conflict are associated with specific health outcomes. Translating theory and findings to preventive interventions entails recognition of the dimensionality of work and family dynamics and the need to target specific work and family conditions. (c) 2015 APA, all rights reserved).

[The relationship between sleep and obesity: current perspective].

PubMed

Piskáčková, Zlata; Forejt, Martin; Martykánová, Lucie

2012-01-01

Disruption of circadian rhythms negatively affects regulation of metabolism and energy homeostasis. Disrupted metabolism in response to disrupted biological rhythms might lead, together with genetic background, to obesity and to other health complications. Results of epidemiologic surveys are consistent with mechanistic theory showing the interconnection between the biological rhythms, sleep and metabolism. Epidemiologic surveys confirm that sleep duration of less than 6 hours increases significantly the risk of obesity. Systematic reviews of epidemiologic surveys examining association of sleep and obesity refer to large heterogeneity in involved subjects, methodological approaches of measuring obesity and sleep, and confounders. Design of study plays also essential role in interpretation and definition of causal relationship. Reduced sleep duration in relation to obesity is in the literature discussed from different points of view: 1. as a possible primary cause of obesity, 2. as a result of comorbidities resulting from obesity and 3. as an accompanied part of the third factor contributing to obesity (e.g. long working hours, chronic emotional stress, overusing of media). Causal relationship between sleep and obesity is not yet fully elucidated, however the association is supposed to be bidirectional. The article gives an overview of current knowledge concerning the influence of sleep on the development of obesity and points to the critical points of current research.

Sleep duration and sleep-related problems in different occupations in the Hordaland Health Study.

PubMed

Ursin, Reidun; Baste, Valborg; Moen, Bente E

2009-05-01

The aim of this study was to examine the relationship between occupation and sleep duration, sleepiness, insufficient sleep, and insomnia in day and shift workers (including night work and watches). The study was population-based and cross-sectional, and relied on self-administered questionnaires. It was conducted as part of the 1997-1999 Hordaland Health Study in collaboration with the Norwegian National Health Screening Service. Aged 40-45 years, 7782 participants answered a sleep questionnaire, reporting their occupation and whether or not they were employed in shift work. Our study found differences in sleep duration during the working week between occupational groups; in both shift and day workers. Craft workers, plant operators, and drivers slept less than leaders, and non-personal and personal service workers. Within some occupations (leaders, personal service workers, and plant operators), shift workers slept less than day workers. The mean sleep duration of shift workers was 15 minutes shorter than that of day workers. Rise times, but not bedtimes, were earlier in craft-and construction workers, plant operators, and drivers than in leaders and non-personal and personal service workers, particularly day workers. When adjusted for shift work and working hours - compared to leaders - craft workers, plant operators, and drivers had an increased risk of daytime sleepiness (odds ratio 1.5, 1.8, and 1.8 respectively) and of falling asleep at work (odds ratio 1.6, 2.1 and 2.0 respectively). Shift workers had an increased risk of falling asleep at work and insomnia. Occupation has separate effects on sleep duration and sleep-related problems, independent of the effects of shift work.

The Media Response to the ACGME's 2017 Relaxed Resident Duty-Hour Restrictions.

PubMed

Zhang, Zi; Krauthamer, Alan V; Rosenkrantz, Andrew B

2018-03-01

In March 2017, the ACGME relaxed resident duty-hour restrictions to allow first-year residents to work 24-hour shifts, affecting the internship experience of incoming radiology residents. The aim of this study was to assess the media response to this duty-hour change, comparing news articles with favorable and unfavorable views. Google News was used to identify 36 relevant unique news articles published over a 4-week period after the announcement. Articles' stance was categorized as favorable, unfavorable, or neutral. Additional article characteristics were explored. Article sources were 58% national, 22% local, and 20% medical news. Article stance was most commonly unfavorable for national news sources (48%), compared with neutral for local (62%) and medical (72%) news sources. Most common reasons for unfavorable stance were sleep deprivation (n = 11), medical errors (n = 11), residents' health (n = 9), risk for car accidents (n = 9), a patriarchal hazing system (n = 6), and work-life balance (n = 5). Most common reasons for favorable stance were impact on resident education (n = 7) and continuity of care (n = 7). Supporting data were cited by 38% of unfavorable and 100% of favorable articles. Unfavorable articles most commonly quoted physicians affiliated with resident advocacy groups; favorable articles most commonly quoted physicians affiliated with the ACGME. The relaxed duty-hour restrictions received an overall unfavorable media response, particularly in nonmedical news sources, driven by concerns regarding sleep-deprived doctors. Favorable articles ubiquitously cited data supporting the safety of relaxed duty hour restrictions. Further research is warranted to better understand the impact of relaxed resident duty-hour limits on sleep deprivation, residents' health and education, and the quality of patient care. Copyright © 2017 American College of Radiology. Published by Elsevier Inc. All rights reserved.

EEG Changes Accompanying Successive Cycles of Sleep Restriction With and Without Naps in Adolescents

PubMed Central

Ong, Ju Lynn; Lo, June C.; Gooley, Joshua J.

2017-01-01

Abstract Study objectives: To investigate the temporal evolution of sleep EEG changes in adolescents across two cycles of sleep restriction and recovery simulating an intense school week and to examine the effect of an afternoon nap on nocturnal sleep. Methods: A parallel-group design, quasi-laboratory study was conducted in a student hostel. Fifty-seven adolescents (31 males, age = 15–19 years) were randomly assigned to nap or no nap groups. Participants underwent a 15-day protocol comprising two sleep restriction (5-hour time-in-bed [TIB]) and recovery (9-hour TIB) cycles. The nap group was also provided with a 1-hour nap opportunity at 14:00 following each sleep restriction night. Polysomnography recordings were obtained on nine nights and five nap episodes. Results: Naps reduced homeostatic sleep pressure on sleep restriction nights as evidenced by longer N2 latency and reduced total sleep time (TST), sleep efficiency (SE), and slow wave energy. Sleep debt accumulated in both groups, evidenced by increased TST, greater SE, and reduced wake after sleep onset on recovery compared to baseline nights. Changes were greater in the no nap group. Recovery sleep after the first cycle of sleep restriction did not restore sleep architecture to baseline in either group. SE, rapid eye movement (REM), and non-REM sleep increased, and N2 latency was reduced in the second sleep restriction period. Conclusions: Changes in sleep EEG induced by sleep restriction to 5-hour TIB for five nights were not eliminated after two nights of 9-hour recovery sleep. An afternoon nap helped but residual effects on the sleep EEG suggest that there is no substitute for adequate nocturnal sleep. PMID:28329386

Commuting and Sleep: Results From the Hispanic Community Health Study/Study of Latinos Sueño Ancillary Study.

PubMed

Petrov, Megan E; Weng, Jia; Reid, Kathryn J; Wang, Rui; Ramos, Alberto R; Wallace, Douglas M; Alcantara, Carmela; Cai, Jianwen; Perreira, Krista; Espinoza Giacinto, Rebeca A; Zee, Phyllis C; Sotres-Alvarez, Daniela; Patel, Sanjay R

2018-03-01

Commute time is associated with reduced sleep time, but previous studies have relied on self-reported sleep assessment. The present study investigated the relationships between commute time for employment and objective sleep patterns among non-shift working U.S. Hispanic/Latino adults. From 2010 to 2013, Hispanic/Latino employed, non-shift-working adults (n=760, aged 18-64 years) from the Sueño study, ancillary to the Hispanic Community Health Study/Study of Latinos, reported their total daily commute time to and from work, completed questionnaires on sleep and other health behaviors, and wore wrist actigraphs to record sleep duration, continuity, and variability for 1 week. Survey linear regression models of the actigraphic and self-reported sleep measures regressed on categorized commute time (short: 1-44 minutes; moderate: 45-89 minutes; long: ≥90 minutes) were built adjusting for relevant covariates. For associations that suggested a linear relationship, continuous commute time was modeled as the exposure. Moderation effects by age, sex, income, and depressive symptoms also were explored. Commute time was linearly related to sleep duration on work days such that each additional hour of commute time conferred 15 minutes of sleep loss (p=0.01). Compared with short commutes, individuals with moderate commutes had greater sleep duration variability (p=0.04) and lower interdaily stability (p=0.046, a measure of sleep/wake schedule regularity). No significant associations were detected for self-reported sleep measures. Commute time is significantly associated with actigraphy-measured sleep duration and regularity among Hispanic/Latino adults. Interventions to shorten commute times should be evaluated to help improve sleep habits in this minority population. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Sleep and intercontinental flights.

PubMed

Nicholson, Anthony N

2006-12-01

At present there are no 'high-tech' solutions to the problems that may beset intercontinental travellers. Indications for the use of drugs are limited, and their use must accord with Good Clinical Practice. Essentially, travellers must look after their sleep, as far as possible, during and after the flight. The most useful time for sleep during the flight must be anticipated, caution exercised in the use of hypnotics in-flight as reduced mobility is a potential risk factor for venous thrombosis, and a strategy adopted, whether flying east or west, to adapt as quickly as possible to the working hours of the new locality. After an eastward flight a hypnotic may be useful, but this strategy is seldom necessary after a westward flight unless the journey has involved crossing more than 5 or 6 time zones. The claim that melatonin accelerates the shift of the sleep-wakefulness cycle to a new time zone is controversial, and its recommended use may prejudice alertness during working hours. Exposure to artificial light and avoidance of ambient light at certain times of the day could prove to be of help-possibly in conjunction with drugs. However, effective and practical alterations in the light environment must be devised before such strategies can be considered with confidence.

Effects of Acute Sleep Deprivation Resulting from Night Shift Work on Young Doctors.

PubMed

Sanches, Inês; Teixeira, Fátima; dos Santos, José Moutinho; Ferreira, António Jorge

2015-01-01

To evaluate sleep deprivation and its effects on young physicians in relation to concentration capacity and psychomotor performance. Eighteen physicians aged 26 - 33 years were divided into 2 groups: non-sleep deprived group (with no night work) and sleep deprived group (minimum 12 hour of night work/week). We applied Pittsburgh Sleep Quality Index to screen the presence of sleep pathology and Epworth Sleepiness Scale to evaluate subjective daytime sleepiness; we used actigraphy and sleep diary to assess sleep hygiene and standard sleep-wake cycles. To demonstrate the effects of sleep deprivation, we applied Toulouse-Piéron's test (concentration test) and a battery of three reaction time tasks after the night duty. Sleep deprived group had higher daytime sleepiness on Epworth Sleepiness Scale (p < 0.05) and during week sleep deprivation was higher (p < 0.010). The mean duration of sleep during the period of night duty was 184.2 minutes to sleep deprived group and 397.7 minutes to non-sleep deprived group (p < 0.001). In the Toulouse-Piéron's test, the sleep deprived group had more omissions (p < 0.05) with a poorer result in concentration (p < 0.05). Psychomotor tests that evaluated response to simple stimuli revealed longer response latency (p < 0.05) and more errors (p < 0.05) in Sleep deprived group; in reaction to instruction test the sleep deprived group showed worse perfection index (p < 0.05); in the fine movements test there was no statistically significant difference between the groups. Acute sleep deprivation resulting from nocturnal work in medical professions is associated with a reduction in attention and concentration and delayed response to stimuli. This may compromise patient care as well as the physician's health and quality of life. It is essential to study the effects of acute sleep deprivation on the cognitive abilities and performance of health professionals.

Sleep contributes to dendritic spine formation and elimination in the developing mouse somatosensory cortex

PubMed Central

Yang, Guang; Gan, Wen-Biao

2012-01-01

Sleep is maximal during early postnatal life when rapid and extensive synapse remodeling occurs. It remains unknown whether and how sleep affects synapse development and plasticity. Using transcranial two-photon microscopy, we examined the formation and elimination of fluorescently-labeled dendritic spines and filopodia of layer 5 pyramidal neurons in the barrel cortex of 3-week old mice during wakefulness and sleep. We observed high turnover of dendritic protrusions over 2 hours in both wake and sleep states. The formation rate of dendritic spines or filopodia over 2 hours was comparable between the two states. The elimination rate of dendritic spines or filopodia was lower during 2-hour wakefulness than during 2-hour sleep. Similar results were observed on dendritic protrusion dynamics over 12-hour light/dark cycle when mice spent more time asleep or awake. The substantial remodeling of dendritic protrusions during the sleep state supports the notion that sleep plays an important role in the development and plasticity of synaptic connections in the mouse cortex. PMID:22058046

Sleep Duration and Its Association With Ambulatory Blood Pressure in a School-Based, Diverse Sample of Adolescents

PubMed Central

Gallagher, Martina R.; Eissa, Mona A.; Nguyen, Thong Q.; Chan, Wenyaw

2014-01-01

BACKGROUND Evidence is accumulating that sleep duration is related to blood pressure (BP) and hypertensive status, but the strength of the association varies by age, and findings are inconsistent for adolescents. This cross-sectional study tested the hypothesis that sleep duration, both during the night and during naps, would be negatively associated with ambulatory systolic BP (SBP) and diastolic BP (DBP) measured over 24 hours in adolescents. METHODS In this ethnically diverse (37% non-Hispanic black, 31% Hispanic, 29% non-Hispanic white, 3% other), school-based sample of 366 adolescents aged 11–16 years, ambulatory BP was measured every 30 minutes for 24 hours on a school day; actigraphy was used to measure sleep duration. Covariables included demographic factors, anthropometric indices, physical activity, and position and location at the time of each BP measurement. Mixed models were used to test day and night sleep duration as predictors of 24-hour SBP and DBP, controlling for covariables. RESULTS The mean sleep duration was 6.83 (SD = 1.36) hours at night, and 7.23 (SD = 1.67) hours over 24 hours. Controlling for duration of sleep during the day and covariables, each additional hour of nighttime sleep was associated with lower SBP (−0.57; P < 0.0001); controlling for nighttime sleep duration and covariables, each additional hour of daytime sleep was associated with lower SBP (−0.73; P < 0.001) and lower DBP (−0.50; P < 0.001). CONCLUSIONS Longer sleep duration was significantly associated with lower ambulatory SBP and DBP in adolescents. The findings have potential implications for cardiovascular health in this age group. PMID:24487981

Modeling Neurocognitive Decline and Recovery During Repeated Cycles of Extended Sleep and Chronic Sleep Deficiency.

PubMed

St Hilaire, Melissa A; Rüger, Melanie; Fratelli, Federico; Hull, Joseph T; Phillips, Andrew J K; Lockley, Steven W

2017-01-01

Intraindividual night-to-night sleep duration is often insufficient and variable. Here we report the effects of such chronic variable sleep deficiency on neurobehavioral performance and the ability of state-of-the-art models to predict these changes. Eight healthy males (mean age ± SD: 23.9 ± 2.4 years) studied at our inpatient intensive physiologic monitoring unit completed an 11-day protocol with a baseline 10-hour sleep opportunity and three cycles of two 3-hour time-in-bed (TIB) and one 10-hour TIB sleep opportunities. Participants received one of three polychromatic white light interventions (200 lux 4100K, 200 or 400 lux 17000K) for 3.5 hours on the morning following the second 3-hour TIB opportunity each cycle. Neurocognitive performance was assessed using the psychomotor vigilance test (PVT) administered every 1-2 hours. PVT data were compared to predictions of five group-average mathematical models that incorporate chronic sleep loss functions. While PVT performance deteriorated cumulatively following each cycle of two 3-hour sleep opportunities, and improved following each 10-hour sleep opportunity, performance declined cumulatively throughout the protocol at a more accelerated rate than predicted by state-of-the-art group-average mathematical models. Subjective sleepiness did not reflect performance. The light interventions had minimal effect. Despite apparent recovery following each extended sleep opportunity, residual performance impairment remained and deteriorated rapidly when rechallenged with subsequent sleep loss. None of the group-average models were capable of predicting both the build-up in impairment and recovery profile of performance observed at the group or individual level, raising concerns regarding their use in real-world settings to predict performance and improve safety. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Work-family conflict, cardiometabolic risk and sleep duration in nursing employees

PubMed Central

Berkman, Lisa F.; Liu, Sze Yan; Hammer, Leslie; Moen, Phyllis; Klein, Laura Cousino; Kelly, Erin; Fay, Martha; Davis, Kelly; Durham, Mary; Karuntzos, Georgia; Buxton, Orfeu M.

2015-01-01

The study investigates the associations of work-family conflict and other work and family conditions with objectively-measured outcomes cardiometabolic risk and sleep duration in a study of employees in nursing homes. Multilevel analyses are used to assess cross-sectional associations between employee and job characteristics and health in analyses of 1,524 employees in 30 extended care facilities in a single company. We examine work and family conditions in relation to two major study health outcomes: 1) a validated, Framingham cardiometabolic risk score based on measured blood pressure, cholesterol, glycosylated hemoglobin (HbA1c), body mass index (BMI), and self-reported tobacco consumption, and 2) wrist actigraphy-based measures of sleep duration. In fully-adjusted multi-level models, Work-To-Family conflict, but not Family-to-Work conflict was positively associated with cardiometabolic risk. Having a lower-level occupation (nursing assistants vs. nurses) was also associated with increased cardiometabolic risk, while being married and having younger children at home was protective. A significant age by Work-To-Family conflict interaction revealed that higher Work-To-Family conflict was more strongly associated with increased cardiometabolic risk in younger employees. With regard to sleep duration, high Family-To-Work Conflict was significantly associated with shorter sleep duration. In addition, working long hours and having younger children at home were both independently associated with shorter sleep duration. High Work-To-Family Conflict was associated with longer sleep duration. These results indicate that different dimensions of work-family conflict (i.e., Work-To-Family Conflict and Family-To-Work Conflict) may both pose threats to cardiometabolic risk and sleep duration for employees. This study contributes to the research on work- family conflict suggesting that Work-To-Family and Family-To-Work conflict are associated with specific outcomes. Translating theory and our findings to preventive interventions entails recognition of the dimensionality of work and family dynamics and the need to target specific work and family conditions. PMID:25961758

A randomized trial of a three-hour protected nap period in a medicine training program: sleep, alertness, and patient outcomes.

PubMed

Shea, Judy A; Dinges, David F; Small, Dylan S; Basner, Mathias; Zhu, Jingsan; Norton, Laurie; Ecker, Adrian J; Novak, Cristina; Bellini, Lisa M; Dine, C Jessica; Mollicone, Daniel J; Volpp, Kevin G

2014-03-01

Protected sleep periods for internal medicine interns have previously resulted in increased amount slept and improved cognitive alertness but required supplemental personnel. The authors evaluated intern and patient outcomes associated with protected nocturnal nap periods of three hours that are personnel neutral. Randomized trial at Philadelphia Veterans Affairs Medical Center (PVAMC) Medical Service and Hospital of the University of Pennsylvania (HUP) Oncology Unit. During 2010-2011, four-week blocks were randomly assigned to a standard intern schedule (extended duty overnight shifts of up to 30 hours), or sequential protected sleep periods (phone sign-out midnight to 3:00 AM [early shift] intern 1; 3:00 to 6:00 AM [late shift] intern 2). Participants wore wrist Actiwatches, completed sleep diaries, and performed daily assessments of behavioral alertness. Between-group comparisons of means and proportions controlled for within-person correlations. HUP interns had significantly longer sleep durations during both early (2.40 hours) and late (2.44 hours) protected periods compared with controls (1.55 hours, P < .0001). At PVAMC sleep duration was longer only for the late shift group (2.40 versus 1.90 hours, P < .036). Interns assigned to either protected period were significantly less likely to have call nights with no sleep and had fewer attentional lapses on the Psychomotor Vigilance Test. Differences in patient outcomes between standard schedule months versus intervention months were not observed. Protected sleep periods of three hours resulted in more sleep during call and reductions in periods of prolonged wakefulness, providing a plausible alternative to 16-hour shifts.

Flurbiprofen in rapid eye movement sleep deprivation induced hyperalgesia.

PubMed

Gürel, Elif Ezgi; Ural, Keremcan; Öztürk, Gülnur; Öztürk, Levent

2014-04-10

Rapid eye movement (REM) sleep deprivation induces hyperalgesia in healthy rats. Here, we evaluated the effects of flurbiprofen, an anti-inflammatory and neuroprotective agent, on the increased thermal responses observed in REM sleep deprived rats. Forty female rats were divided into four groups following 96-hour REM sleep deprivation: intraperitoneal injections of placebo, and flurbiprofen 5 mg/kg, 15 mg/kg and 40 mg/kg were made in CONT (n=10), FBP5, FBP15 and FBP40 groups respectively. Pain threshold measurements were performed three times at baseline (0.hour), at the end of REM sleep deprivation (96.hour) and at 1 h after injections (97.hour) by hot plate and tail-flick tests. REM sleep deprivation induced a significant decrease in pain thresholds of all rats (hotplate: 0.hour vs 96.hour, 9.75±2.85 vs 5.10±2.02, p<0.001; tail flick: 0.hour vs 96.hour, 11.92±4.62 vs 7.92±5.15, p<0.001). Flurbiprofen in 15 mg/kg and 40 mg/kg doses significantly improved pain tolerance measured by tail flick test (tail flick in FBP15 and FBP40 groups: 96.hour vs 97.hour, 7.01±4.97 vs 8.34±3.61 and 5.06±1.57 vs 7.04±2.49, p<0.05 for both). 96 h of REM sleep deprivation resulted in reduced pain thresholds in both hot plate and tail flick tests. Flurbiprofen was used for the first time in a rat model of REM sleep deprivation, and it provided anti-nociceptive effects in 15 mg/kg and 40 mg/kg doses. Flurbiprofen may have the potential for treatment of painful syndromes accompanying insomnia or sleep loss. Copyright © 2014 Elsevier Inc. All rights reserved.

Making residency work hour rules work.

PubMed

Cohen, I Glenn; Czeisler, Charles A; Landrigan, Christopher P

2013-01-01

In July 2011, the ACGME implemented new rules that limit interns to 16 hours of work in a row, but continue to allow 2nd-year and higher resident physicians to work for up to 28 consecutive hours. Whether the ACGME's 2011 work hour limits went too far or did not go far enough has been hotly debated. In this article, we do not seek to re-open the debate about whether these standards get matters exactly right. Instead, we wish to address the issue of effective enforcement. That is, now that new work hour limits have been established, and given that the ACGME has been unable to enforce work hour limits effectively on its own, what is the best way to make sure the new limits are followed in order to reduce harm to residents, patients, and others due to sleep-deprived residents? We focus on three possible national approaches to the problem, one rooted in funding, one rooted in disclosure, and one rooted in tort law. © 2013 American Society of Law, Medicine & Ethics, Inc.

Keeping the right time in space: importance of circadian clock and sleep for physiology and performance of astronauts.

PubMed

Guo, Jin-Hu; Qu, Wei-Min; Chen, Shan-Guang; Chen, Xiao-Ping; Lv, Ke; Huang, Zhi-Li; Wu, Yi-Lan

2014-01-01

The circadian clock and sleep are essential for human physiology and behavior; deregulation of circadian rhythms impairs health and performance. Circadian clocks and sleep evolved to adapt to Earth's environment, which is characterized by a 24-hour light-dark cycle. Changes in gravity load, lighting and work schedules during spaceflight missions can impact circadian clocks and disrupt sleep, in turn jeopardizing the mood, cognition and performance of orbiting astronauts. In this review, we summarize our understanding of both the influence of the space environment on the circadian timing system and sleep and the impact of these changes on astronaut physiology and performance.

Influence of serial electrical stimulations of perifornical and posterior hypothalamic orexin-containing neurons on regulation of sleep homeostasis and sleep-wakefulness cycle recovery from experimental comatose state and anesthesia-induced deep sleep.

PubMed

Chijavadze, E; Chkhartishvili, E; Babilodze, M; Maglakelidze, N; Nachkebia, N

2013-11-01

The work was aimed for the ascertainment of following question - whether Orexin-containing neurons of dorsal and lateral hypothalamic, and brain Orexinergic system in general, are those cellular targets which can speed up recovery of disturbed sleep homeostasis and accelerate restoration of sleep-wakefulness cycle phases during some pathological conditions - experimental comatose state and/or deep anesthesia-induced sleep. Study was carried out on white rats. Modeling of experimental comatose state was made by midbrain cytotoxic lesions at intra-collicular level.Animals were under artificial respiration and special care. Different doses of Sodium Ethaminal were used for deep anesthesia. 30 min after comatose state and/or deep anesthesia induced sleep serial electrical stimulations of posterior and/or perifornical hypothalamus were started. Stimulation period lasted for 1 hour with the 5 min intervals between subsequent stimulations applied by turn to the left and right side hypothalamic parts.EEG registration of cortical and hippocampal electrical activity was started immediately after experimental comatose state and deep anesthesia induced sleep and continued continuously during 72 hour. According to obtained new evidences, serial electrical stimulations of posterior and perifornical hypothalamic Orexin-containing neurons significantly accelerate recovery of sleep homeostasis, disturbed because of comatose state and/or deep anesthesia induced sleep. Speed up recovery of sleep homeostasis was manifested in acceleration of coming out from comatose state and deep anesthesia induced sleep and significant early restoration of sleep-wakefulness cycle behavioral states.

Bright-light exposure during daytime sleeping affects nocturnal melatonin secretion after simulated night work.

PubMed

Nagashima, Shunsuke; Osawa, Madoka; Matsuyama, Hiroto; Ohoka, Wataru; Ahn, Aemi; Wakamura, Tomoko

2018-02-01

The guidelines for night and shift workers recommend that after night work, they should sleep in a dark environment during the daytime. However, staying in a dark environment during the daytime reduces nocturnal melatonin secretion and delays its onset. Daytime bright-light exposure after night work is important for melatonin synthesis the subsequent night and for maintaining the circadian rhythms. However, it is not clear whether daytime sleeping after night work should be in a dim- or a bright-light environment for maintaining melatonin secretion. The aim of this study, therefore, was to evaluate the effect of bright-light exposure during daytime sleeping on nocturnal melatonin secretion after simulated night work. Twelve healthy male subjects, aged 24.8 ± 4.6 (mean ± SD), participated in 3-day sessions under two experimental conditions, bright light or dim light, in a random order. On the first day, the subjects entered the experimental room at 16:00 and saliva samples were collected every hour between 18:00 and 00:00 under dim-light conditions. Between 00:00 and 08:00, they participated in tasks that simulated night work. At 10:00 the next morning, they slept for 6 hours under either a bright-light condition (>3000 lx) or a dim-light condition (<50 lx). In the evening, saliva samples were collected as on the first day. The saliva samples were analyzed for melatonin concentration. Activity and sleep times were recorded by a wrist device worn throughout the experiment. In the statistical analysis, the time courses of melatonin concentration were compared between the two conditions by three-way repeated measurements ANOVA (light condition, day and time of day). The change in dim light melatonin onset (ΔDLMO) between the first and second days, and daytime and nocturnal sleep parameters after the simulated night work were compared between the light conditions using paired t-tests. The ANOVA results indicated a significant interaction (light condition and3 day) (p = .006). Post hoc tests indicated that in the dim-light condition, the melatonin concentration was significantly lower on the second day than on the first day (p = .046); however, in the bright-light condition, there was no significant difference in the melatonin concentration between the days (p = .560). There was a significant difference in ΔDLMO between the conditions (p = .015): DLMO after sleeping was advanced by 11.1 ± 17.4 min under bright-light conditions but delayed for 7.2 ± 13.6 min after sleeping under dim-light conditions. No significant differences were found in any sleep parameter. Our study demonstrated that daytime sleeping under bright-light conditions after night work could not reduce late evening melatonin secretion until midnight or delay the phase of melatonin secretion without decreasing the quality of the daytime sleeping. Thus, these results suggested that, to enhance melatonin secretion and to maintain their conventional sleep-wake cycle, after night work, shift workers should sleep during the daytime under bright-light conditions rather than dim-light conditions.

Blue-enriched office light competes with natural light as a zeitgeber.

PubMed

Vetter, Céline; Juda, Myriam; Lang, Dieter; Wojtysiak, Andreas; Roenneberg, Till

2011-09-01

Circadian regulation of human physiology and behavior (eg, body temperature or sleep-timing), depends on the "zeitgeber" light that synchronizes them to the 24-hour day. This study investigated the effect of changing light temperature at the workplace from 4000 Kelvin (K) to 8000 K on sleep-wake and activity-rest behavior. An experimental group (N=27) that experienced the light change was compared with a non-intervention group (N=27) that remained in the 4000 K environment throughout the 5-week study period (14 January to 17 February). Sleep logs and actimetry continuously assessed sleep-wake behavior and activity patterns. Over the study period, the timing of sleep and activity on free days steadily advanced parallel to the seasonal progression of sunrise in the non-intervention group. In contrast, the temporal pattern of sleep and activity in the experimental group remained associated with the constant onset of work. The results suggest that artificial blue-enriched light competes with natural light as a zeitgeber. While subjects working under the warmer light (4000 K) appear to entrain (or synchronize) to natural dawn, the subjects who were exposed to blue-enriched (8000 K) light appear to entrain to office hours. The results confirm that light is the dominant zeitgeber for the human clock and that its efficacy depends on spectral composition. The results also indicate that blue-enriched artificial light is a potent zeitgeber that has to be used with diligence.

Self-reported sleep lengths ≥ 9 hours among Swedish patients with stress-related exhaustion: Associations with depression, quality of sleep and levels of fatigue.

PubMed

Grossi, Giorgio; Jeding, Kerstin; Söderström, Marie; Osika, Walter; Levander, Maria; Perski, Aleksander

2015-05-01

Insomnia-type sleep disturbances are frequent among patients suffering from stress-related exhaustion disorder. However, clinical observations indicate that a subgroup suffer from sleep lengths frequently exceeding 9 hours, coupled with great daytime sleepiness. The aim of the present study was to investigate differences in socio-demographic variables, use of medications, sleep parameters, anxiety, depression and fatigue, between individuals with varying sleep lengths, in a sample of 420 Swedish patients (mean age 42 ± 9 years; 77% women) referred to treatment for exhaustion disorder. Patients were allocated to the groups: "never/seldom ≥ 9 hours" (n = 248), "sometimes ≥ 9 hours" (n = 115) and "mostly/always ≥ 9 hours" (n = 57), based on their self-rated frequency of sleep lengths ≥ 9 hours. The design was cross-sectional and data was collected by means of questionnaires at pre-treatment. Univariate analyses showed that patients in the "mostly/always ≥ 9 hours" group were more often on sick leave, and reported more depression and fatigue, better sleep quality and more daytime sleepiness, than patients in the other groups. Multivariate analyses showed that these patients scored higher on measures of fatigue than the rest of the sample independently of gender, use of antidepressants, sick leave, depression and quality of sleep. Patients suffering from exhaustion disorder and reporting excessive sleep seem to have a generally poorer clinical picture but better quality of sleep than their counterparts with shorter sleep lengths. The mechanisms underlying these differences, together with their prognostic value and implications for treatment remain to be elucidated in future studies.

Stress-free automatic sleep deprivation using air puffs

PubMed Central

Gross, Brooks A.; Vanderheyden, William M.; Urpa, Lea M.; Davis, Devon E.; Fitzpatrick, Christopher J.; Prabhu, Kaustubh; Poe, Gina R.

2015-01-01

Background Sleep deprivation via gentle handling is time-consuming and personnel-intensive. New Method We present here an automated sleep deprivation system via air puffs. Implanted EMG and EEG electrodes were used to assess sleep/waking states in six male Sprague-Dawley rats. Blood samples were collected from an implanted intravenous catheter every 4 hours during the 12-hour light cycle on baseline, 8 hours of sleep deprivation via air puffs, and 8 hours of sleep deprivation by gentle handling days. Results The automated system was capable of scoring sleep and waking states as accurately as our offline version (~90% for sleep) and with sufficient speed to trigger a feedback response within an acceptable amount of time (1.76 s). Manual state scoring confirmed normal sleep on the baseline day and sleep deprivation on the two manipulation days (68% decrease in non-REM, 63% decrease in REM, and 74% increase in waking). No significant differences in levels of ACTH and corticosterone (stress hormones indicative of HPA axis activity) were found at any time point between baseline sleep and sleep deprivation via air puffs. Comparison with Existing Method There were no significant differences in ACTH or corticosterone concentrations between sleep deprivation by air puffs and gentle handling over the 8-hour period. Conclusions Our system accurately detects sleep and delivers air puffs to acutely deprive rats of sleep with sufficient temporal resolution during the critical 4-5 h post learning sleep-dependent memory consolidation period. The system is stress-free and a viable alternative to existing sleep deprivation techniques. PMID:26014662

Total Sleep Deprivation and Recovery Sleep Affect the Diurnal Variation of Agility Performance: The Gender Differences.

PubMed

Romdhani, Mohamed; Hammouda, Omar; Smari, Khawla; Chaabouni, Yassine; Mahdouani, Kacem; Driss, Tarak; Souissi, Nizar

2018-05-30

Romdhani, M, Hammouda, O, Smari, K, Chaabouni, Y, Mahdouani, K, Driss, T, and Souissi, N. Total sleep deprivation and recovery sleep affect the diurnal variation of agility performance: The gender differences. J Strength Cond Res XX(X): 000-000, 2018-This study aimed to investigate the effects of time-of-day, 24 and 36 hours of total sleep deprivation (TSD), and recovery sleep (RS) on repeated-agility performances. Twenty-two physical education students (11 male and 11 female students) completed 5 repeated modified agility T-test (RMAT) sessions (i.e., 2 after normal sleep night [NSN] [at 07:00 and 17:00 hours], 2 after TSD [at 07:00 hours, i.e., 24-hour TSD and at 17:00 hours, i.e., 36-hour TSD], and 1 after RS at 17:00 hours). The RMAT index decreased from the morning to the afternoon after NSN (p < 0.05, d = 1.05; p < 0.01, d = 0.73) and after TSD (p < 0.001, d = 0.92; d = 1.08), respectively, for total time (TT) and peak time (PT). This finding indicates a diurnal variation in repeated agility, which persisted after TSD. However, the diurnal increase in PT was less marked in the female group after NSN (2.98 vs. 6.24%). Moreover, TT and PT increased, respectively, after 24-hour TSD (p < 0.001; d = 0.84, d = 0.87) and 36-hour TSD (p < 0.001, d = 1.12; p < 0.01, d = 0.65). Female participants' PT was less affected by 24-hour TSD (1.76 vs. 6.81%) compared with male participants' PT. After 36-hour TSD, the amount of decrease was not different between groups, which increased the diurnal amplitude of PT only for male participants. Total sleep deprivation suppressed the diurnal increase of PT and increased the diurnal amplitude of oral temperature only in women. Nevertheless, RS normalized the sleep-loss-induced performance disruption. Conclusively, sleep loss and RS differently affect repeated-agility performance of men and women during the day. Sleep extension postdeprivation could have potent restorative effect on repeated-agility performances, and female participants could extract greater benefits.

Advancing circadian rhythms before eastward flight: a strategy to prevent or reduce jet lag.

PubMed

Eastman, Charmane I; Gazda, Clifford J; Burgess, Helen J; Crowley, Stephanie J; Fogg, Louis F

2005-01-01

To develop a practical pre-eastward flight treatment to advance circadian rhythms as much as possible but not misalign them with sleep. One group had their sleep schedule advanced by 1 hour per day and another by 2 hours per day. Baseline at home, treatment in lab. Young healthy adults (11 men, 15 women) between the ages of 22 and 36 years. Three days of a gradually advancing sleep schedule (1 or 2 hours per day) plus intermittent morning bright light (one-half hour approximately 5000 lux, one-half hour of <60 lux) for 3.5 hours. The dim light melatonin onset was assessed before and after the 3-day treatment. Subjects completed daily sleep logs and symptom questionnaires and wore wrist activity monitors. The dim light melatonin onset advanced more in the 2-hours-per-day group than in the 1-hour-per-day group (median phase advances of 1.9 and 1.4 hours), but the difference between the means (1.8 and 1.5 hours) was not statistically significant. By the third treatment day, circadian rhythms were misaligned relative to the sleep schedule, and subjects had difficulty falling asleep in the 2-hours-per-day group, but this was not the case in the 1-hour-per-day group. Nevertheless, the 2-hours-per-day group did slightly better on the symptom questionnaires. In general, sleep disturbance and other side effects were small. A gradually advancing sleep schedule with intermittent morning bright light can be used to advance circadian rhythms before eastward flight and, thus, theoretically, prevent or reduce subsequent jet lag. Given the morning light treatment used here, advancing the sleep schedule 2 hours per day is not better than advancing it 1 hour per day because it was too fast for the advance in circadian rhythms. A diagram is provided to help the traveler plan a preflight schedule.

Association Between Short Sleep Duration and Risk Behavior Factors in Middle School Students.

PubMed

Owens, Judith; Wang, Guanghai; Lewin, Daniel; Skora, Elizabeth; Baylor, Allison

2017-01-01

To examine the association between self-reported sleep duration (SD) and peer/individual factors predictive of risky behaviors (risk behavior factors) in a large socioeconomically diverse school-based sample of early adolescents. Survey data collected from 10718 and 11240 eighth-grade students in 2010 and 2012, respectively, were analyzed. N/A. Self-reported school night SD was grouped as ≤4 hours, 5 hours, 6 hours, 7 hours, 8 hours, 9 hours, and ≥10 hours. Scores on 10 peer/individual risk behavior factor scales were dichotomized according to national eigth-grade cut points. The percentage of students reporting an "optimal" SD of 9 hours was 14.8% and 15.6% in 2010 and 2012, respectively; 45.6% and 46.1% reported <7 hours. Adjusted for covariates of gender, race, and SES, multilevel logistic regression results showed that odds ratios (ORs) for 9 of 10 risk factor scales increased with SD <7 hours, with a dose-response effect for each hour less sleep compared to an SD of 9 hours. For example, ORs for students sleeping <7 hours ranged from 1.3 (early initiation of antisocial behavior) to 1.8 (early initiation of drug use). The risk factor scale ORs for <5 hours SD ranged from 3.0 (sensation seeking) to 6.4 (gang involvement). Middle school students are at high risk of insufficient sleep; in particular, an SD <7 hours is associated with increased risk behavior factors. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

The after-hours circadian mutant has reduced phenotypic plasticity in behaviors at multiple timescales and in sleep homeostasis.

PubMed

Maggi, Silvia; Balzani, Edoardo; Lassi, Glenda; Garcia-Garcia, Celina; Plano, Andrea; Espinoza, Stefano; Mus, Liudmila; Tinarelli, Federico; Nolan, Patrick M; Gainetdinov, Raul R; Balci, Fuat; Nieus, Thierry; Tucci, Valter

2017-12-19

Circadian clock is known to adapt to environmental changes and can significantly influence cognitive and physiological functions. In this work, we report specific behavioral, cognitive, and sleep homeostatic defects in the after hours (Afh) circadian mouse mutant, which is characterized by lengthened circadian period. We found that the circadian timing irregularities in Afh mice resulted in higher interval timing uncertainty and suboptimal decisions due to incapability of processing probabilities. Our phenotypic observations further suggested that Afh mutants failed to exhibit the necessary phenotypic plasticity for adapting to temporal changes at multiple time scales (seconds-to-minutes to circadian). These behavioral effects of Afh mutation were complemented by the specific disruption of the Per/Cry circadian regulatory complex in brain regions that govern food anticipatory behaviors, sleep, and timing. We derive statistical predictions, which indicate that circadian clock and sleep are complementary processes in controlling behavioral/cognitive performance during 24 hrs. The results of this study have pivotal implications for understanding how the circadian clock modulates sleep and behavior.

Sleep Duration, Exercise, Shift Work and Polycystic Ovarian Syndrome-Related Outcomes in a Healthy Population: A Cross-Sectional Study.

PubMed

Lim, Audrey J R; Huang, Zhongwei; Chua, Seok Eng; Kramer, Michael S; Yong, Eu-Leong

2016-01-01

Few studies have examined the associations between sleep duration, shiftwork, and exercise to the infrequent menstruation, hyperandrogenism, and ovarian morphological changes observed in women with polycystic ovarian syndrome (PCOS). To examine whether lifestyle factors, including short sleep duration, insufficient exercise, and shiftwork, alone or in combination, are associated with the reproductive and metabolic abnormalities typical of PCOS in a healthy population. Prospective cross-sectional study of 231 women, including healthcare workers recruited for an annual health screen, healthy referral patients from the Women's Clinic and volunteers from the university community at the National University Hospital, Singapore, from 2011 to 2015. The women completed a questionnaire, including their menstrual cycle length, sleep length, frequency of exercise and shift work. Hyperandrogenism (hirsutism score, testosterone, sex hormone binding globulin (SHBG)), ovarian morphology and function (anthral follicle count, ovarian volume, anti-mullerian hormone (AMH)), and metabolic measures (body mass index (BMI), waist hip ratio (WHR), blood pressure, fasting glucose, fasting insulin and fasting lipids) were examined through anthropometric measurements, transvaginal ultrasound scans, and blood tests. No significant associations were observed between shift work, exercise or sleep duration and the androgenic and ovarian measures that define PCOS. However, women reporting fewer than 6 hours of sleep were more likely to report abnormal (short or long) menstrual cycle lengths (OR = 2.1; 95% CI, 1.1 to 4.2). Women who reported fewer than 6 hours of sleep had increased fasting insulin levels (difference in means = 2.13; 95% CI, 0.27 to 3.99 mU/L) and higher odds of insulin resistance (OR = 2.58; CI, 1.16 to 5.76). Lack of regular exercise was associated with higher mean fasting insulin (difference in means = 2.3 mU/L; 95% CI, 0.5 to 4.1) and HOMA-IR (difference in means = 0.49; 95% CI, 0.09 to 0.90) levels. Women with insufficient sleep are at increased risk of menstrual disturbances and insulin resistance, but do not have the hyperandrogenism and polycystic ovarian morphology typical of PCOS. Improved sleep duration may help reduce the risks of diabetes or infertility. Shift work, exercise or sleep duration appear not to impact the androgenic and ovarian measures that define PCOS.

Sleep and sleepiness: impact of entering or leaving shiftwork--a prospective study.

PubMed

Akerstedt, Torbjörn; Nordin, Maria; Alfredsson, Lars; Westerholm, Peter; Kecklund, Göran

2010-07-01

Very little is known about the effects on sleep and sleepiness of entering or exiting shiftwork. The present study used a longitudinal database (n = 3637). Participants completed a questionnaire on work hours, sleep, and work environment at the start and end of a 5-yr period. Changes in shift/day work status were related to change in a number of subjective sleep variables using logistic regression analysis. The analyses were adjusted for age, sex, and differences in socioeconomic status, work demands, work control, physical workload, marriage status, and number of children. In comparison with constant day work, entering shiftwork (with or without night shifts) from day work increased the risk of difficulties in falling asleep, and leaving shiftwork reduced this risk (odds ratio [OR] = 2.8 [confidence interval, CI = 1.8-4.5]). Also falling asleep at work showed a consistent pattern; an increased risk of falling asleep for those with shiftwork on both occasions, and for those with night work on both occasions. Also entering night work was associated with a strongly increased risk of falling asleep at work (OR = 2.9 [CI = 1.3-6.7]). These results suggest that entering and leaving shiftwork has a considerable impact on sleep and alertness. However, there is a need for large and more extended longitudinal studies to support our findings.

Short Sleep Duration Among Middle School and High School Students - United States, 2015.

PubMed

Wheaton, Anne G; Jones, Sherry Everett; Cooper, Adina C; Croft, Janet B

2018-01-26

Insufficient sleep among children and adolescents is associated with increased risk for obesity, diabetes, injuries, poor mental health, attention and behavior problems, and poor academic performance (1-4). The American Academy of Sleep Medicine has recommended that, for optimal health, children aged 6-12 years should regularly sleep 9-12 hours per 24 hours and teens aged 13-18 years should sleep 8-10 hours per 24 hours (1). CDC analyzed data from the 2015 national, state, and large urban school district Youth Risk Behavior Surveys (YRBSs) to determine the prevalence of short sleep duration (<9 hours for children aged 6-12 years and <8 hours for teens aged 13-18 years) on school nights among middle school and high school students in the United States. In nine states that conducted the middle school YRBS and included a question about sleep duration in their questionnaire, the prevalence of short sleep duration among middle school students was 57.8%, with state-level estimates ranging from 50.2% (New Mexico) to 64.7% (Kentucky). The prevalence of short sleep duration among high school students in the national YRBS was 72.7%. State-level estimates of short sleep duration for the 30 states that conducted the high school YRBS and included a question about sleep duration in their questionnaire ranged from 61.8% (South Dakota) to 82.5% (West Virginia). The large percentage of middle school and high school students who do not get enough sleep on school nights suggests a need for promoting sleep health in schools and at home and delaying school start times to permit students adequate time for sleep.

The impact of shift work on nurses' job stress, sleep quality and self-perceived health status.

PubMed

Lin, Shu-Hui; Liao, Wen-Chun; Chen, Mei-Yen; Fan, Jun-Yu

2014-07-01

The aim of this study was to describe the current state of nurses' shift work in Taiwan and how it affects nurses' stress, sleep quality and self-perceived health status. To enable the provision of 24-hour patient care, nurses need to work various shifts. Long-term shift work significantly affects nurses' overall physical and mental health. Nurses from four Chiayi County district hospitals in Taiwan (n = 266) participated in this cross-sectional study from August to September 2010. Demographics, work schedule forms, a stress checklist, a sleep-quality measure and a health-status measure were used to collect data. Independent t-test, one-way anova, Pearson's r, and hierarchical regression were applied for analysis. The results showed that regardless of the amount of shift work they performed, nurses reported moderate job stress, poor sleep quality and moderate self-perceived health. The following significant relationships were observed: job stress was inversely related to sleep quality, which was directly related to self-perceived health status. Hospital managers need to ensure more healthy shift work scheduling in order to improve nurses' clinical performance and personal health status, thereby also improving the quality of patient care. © 2012 John Wiley & Sons Ltd.

A new approach for evaluating flexible working hours.

PubMed

Giebel, Ole; Janssen, Daniela; Schomann, Carsten; Nachreiner, Friedhelm

2004-01-01

Recent studies on flexible working hours show at least some of these working time arrangements seem to be associated with impairing effects of health and well-being. According to available evidence, variability of working hours seems to play an important role. The question, however, is how this variability can be assessed and used to explain or predict impairments. Based on earlier methods used to assess shift-work effects, a time series analysis approach was applied to the matter of flexible working hours. Data on the working hours of 4 week's length of 137 respondents derived from a survey on flexible work hours involving 15 companies of different production and service sectors in Germany were converted to time series and analyzed by spectral analysis. A cluster analysis of the resulting power spectra yielded 5 clusters of flexible work hours. Analyzing these clusters for differences in reported impairments showed that workers who showed suppression of circadian and weekly rhythms experienced severest impairments, especially in circadian controlled functions like sleep and digestion. The results thus indicate that analyzing the periodicity of flexible working hours seems to be a promising approach for predicting impairments which should be investigated further in the future.

Association of current work and sleep situations with excessive daytime sleepiness and medical incidents among Japanese physicians.

PubMed

Kaneita, Yoshitaka; Ohida, Takashi

2011-10-15

The aim of the present study was to clarify the current work and sleep situations of physicians in Japan and to clarify the association between these situations and excessive daytime sleepiness as well as medical incidents. A self-administered questionnaire survey was conducted among the members of the Japan Medical Association in 2008. The randomly selected subjects comprised 3,000 male physicians and 1,500 female physicians. Valid responses were obtained from 3,486 physicians (2,298 men and 1,188 women). Mean sleep duration was 6 h 36 min for men and 6 h 8 min for women. The prevalence of lack of rest due to sleep deprivation was 30.4% among men and 36.6% among women; the prevalence of insomnia was 21.0% and 18.1%, respectively; and the prevalence of EDS was 3.5%. The adjusted odds ratio for EDS was high for physicians who reported short sleep duration, lack of rest due to sleep deprivation, and a high frequency of on-call/overnight work. Physicians who had experienced a medical incident within the previous one month accounted for 19.0% of participants. The adjusted odds ratio for medical incidents was high for those subjected to long working hours, high frequency of on-call/overnight works, lack of rest due to sleep deprivation, and insomnia. In order to facilitate optimal health management for physicians as well as securing medical safety, it is important to fully consider the work and sleep situations of physicians.

Influences of early shift work on the diurnal cortisol rhythm, mood and sleep: within-subject variation in male airline pilots.

PubMed

Bostock, Sophie; Steptoe, Andrew

2013-04-01

We aimed to investigate how early and late work shifts influenced the diurnal cortisol rhythm using a within-subjects study design. Participants were 30 healthy male non-smoking pilots, mean age 39.4, employed by a short-haul airline. The standard rotating shift pattern consisted of 5 early shifts (starting before 0600 h), followed by 3 rest days, 5 late shifts (starting after 1200 h) and 4 rest days. Pilots sampled saliva and completed subjective mood ratings in a logbook 6 times over the day on two consecutive early shift days, two late days and two rest days. Sampling was scheduled at waking, waking+30 m, waking+2.5 h, waking+8 h, waking+12 h and bedtime. Waking time, sleep duration, sleep quality and working hours were also recorded. Cortisol responses were analysed with repeated measures analysis of variance with shift condition (early, late, rest) and sample time (1-6) as within-subject factors. Early shifts were associated with a higher cortisol increase in response to awakening (CAR(i)), a greater total cortisol output over the day (AUC(G)) and a slower rate of decline over the day than late shifts or rest days. Early shifts were also associated with shorter sleep duration but co-varying for sleep duration did not alter the effects of shift on the cortisol rhythm. Both types of work shift were associated with more stress, tiredness and lower happiness than rest days, but statistical adjustment for mood ratings did not alter the findings. Early shift days were associated with significantly higher levels of circulating cortisol during waking hours than late shifts or rest days. Copyright © 2012 Elsevier Ltd. All rights reserved.

Influences of early shift work on the diurnal cortisol rhythm, mood and sleep: Within-subject variation in male airline pilots

PubMed Central

Bostock, Sophie; Steptoe, Andrew

2013-01-01

Summary We aimed to investigate how early and late work shifts influenced the diurnal cortisol rhythm using a within-subjects study design. Participants were 30 healthy male non-smoking pilots, mean age 39.4, employed by a short-haul airline. The standard rotating shift pattern consisted of 5 early shifts (starting before 0600 h), followed by 3 rest days, 5 late shifts (starting after 1200 h) and 4 rest days. Pilots sampled saliva and completed subjective mood ratings in a logbook 6 times over the day on two consecutive early shift days, two late days and two rest days. Sampling was scheduled at waking, waking + 30 m, waking + 2.5 h, waking + 8 h, waking + 12 h and bedtime. Waking time, sleep duration, sleep quality and working hours were also recorded. Cortisol responses were analysed with repeated measures analysis of variance with shift condition (early, late, rest) and sample time (1–6) as within-subject factors. Early shifts were associated with a higher cortisol increase in response to awakening (CARi), a greater total cortisol output over the day (AUCG) and a slower rate of decline over the day than late shifts or rest days. Early shifts were also associated with shorter sleep duration but co-varying for sleep duration did not alter the effects of shift on the cortisol rhythm. Both types of work shift were associated with more stress, tiredness and lower happiness than rest days, but statistical adjustment for mood ratings did not alter the findings. Early shift days were associated with significantly higher levels of circulating cortisol during waking hours than late shifts or rest days. PMID:22877997

Empowering a healthy practice environment.

PubMed

Kushner, Jodi; Ruffin, Tasha

2015-03-01

This article provides frontline nurses a tool kit so they can advocate a healthy practice environment. The healthy nurse, healthy work hours, job satisfaction, adequate sleep, power naps at work, and balancing family/work are discussed. The overweight nurse, nurse fatigue, compassion fatigue, shift work sleep disorder, and role strain are discussed as barriers to a healthy practice environment. Case reports with analysis and recommendations are discussed to overcome these barriers. Resources are presented for frontline nurses to develop a tool kit for transforming their environment to a healthy practice environment and to empower them to become healthy nurses. Copyright © 2015 Elsevier Inc. All rights reserved.

Shift work and the assessment and management of shift work disorder (SWD).

PubMed

Wright, Kenneth P; Bogan, Richard K; Wyatt, James K

2013-02-01

Nearly 20% of the labor force worldwide, work shifts that include work hours outside 07:00 h to 18:00 h. Shift work is common in many occupations that directly affect the health and safety of others (e.g., protective services, transportation, healthcare), whereas quality of life, health, and safety during shift work and the commute home can affect workers in any field. Increasing evidence indicates that shift-work schedules negatively influence worker physiology, health, and safety. Shift work disrupts circadian sleep and alerting cycles, resulting in disturbed daytime sleep and excessive sleepiness during the work shift. Moreover, shift workers are at risk for shift work disorder (SWD). This review focuses on shift work and the assessment and management of sleepiness and sleep disruption associated with shift work schedules and SWD. Management strategies include approaches to promote sleep, wakefulness, and adaptation of the circadian clock to the imposed work schedule. Additional studies are needed to further our understanding of the mechanisms underlying the health risks of shift work, understanding which shift workers are at most risk of SWD, to investigate treatment options that address the health and safety burdens associated with shift work and SWD, and to further develop and assess the comparative effectiveness of countermeasures and treatment options. Copyright © 2012 Elsevier Ltd. All rights reserved.

US public opinion regarding proposed limits on resident physician work hours

PubMed Central

2010-01-01

Background In both Europe and the US, resident physician work hour reduction has been a source of controversy within academic medicine. In 2008, the Institute of Medicine (IOM) recommended a reduction in resident physician work hours. We sought to assess the American public perspective on this issue. Methods We conducted a national survey of 1,200 representative members of the public via random digit telephone dialing in order to describe US public opinion on resident physician work hour regulation, particularly with reference to the IOM recommendations. Results Respondents estimated that resident physicians currently work 12.9-h shifts (95% CI 12.5 to 13.3 h) and 58.3-h work weeks (95% CI 57.3 to 59.3 h). They believed the maximum shift duration should be 10.9 h (95% CI 10.6 to 11.3 h) and the maximum work week should be 50 h (95% CI 49.4 to 50.8 h), with 1% approving of shifts lasting >24 h (95% CI 0.6% to 2%). A total of 81% (95% CI 79% to 84%) believed reducing resident physician work hours would be very or somewhat effective in reducing medical errors, and 68% (95% CI 65% to 71%) favored the IOM proposal that resident physicians not work more than 16 h over an alternative IOM proposal permitting 30-h shifts with ≥5 h protected sleep time. In all, 81% believed patients should be informed if a treating resident physician had been working for >24 h and 80% (95% CI 78% to 83%) would then want a different doctor. Conclusions The American public overwhelmingly favors discontinuation of the 30-h shifts without protected sleep routinely worked by US resident physicians and strongly supports implementation of restrictions on resident physician work hours that are as strict, or stricter, than those proposed by the IOM. Strong support exists to restrict resident physicians' work to 16 or fewer consecutive hours, similar to current limits in New Zealand, the UK and the rest of Europe. PMID:20515479

Work schedule and self-reported hypertension - the potential beneficial role of on-shift naps for night workers.

PubMed

Rotenberg, Lúcia; Silva-Costa, Aline; Vasconcellos-Silva, Paulo Roberto; Griep, Rosane Härter

2016-01-01

Data on the association between shift work and hypertension are controversial. Sleep restriction is hypothesized to be involved in this relationship. Since on-shift nap can partly compensate for sleep deprivation among night workers, this investigation is aimed at (i) comparing the prevalence of hypertension among workers considering both current and former night work, (ii) testing the association between on-shift naps and hypertension among night workers, and (iii) analyzing the influence of sleep complaints in the association between on-shift nap and hypertension. Nap was defined as a sleep episode with duration shorter than the average nighttime sleep. A cross-sectional study was performed at the 18 largest public hospitals in Rio de Janeiro, Brazil, in 2010-2011 (N = 2588 female registered nurses). Nurses were informally allowed to nap for up to three consecutive hours during working nights. Workers completed a multidimensional questionnaire including self-reported information on physician diagnosis of hypertension, napping, and sleep complaints (insomnia, diurnal sleepiness, and non-satisfactory sleep). Epidemiological and statistical treatment of data included binomial logistic regression and interaction tests. Higher chances of hypertension were observed for both current and former night workers compared with workers with no previous experience in night work, i.e. exclusive day workers (OR = 1.68; CI95% 1.22-2.33 and OR = 1.40; CI95% 1.01-1.96, respectively) after adjustment for age, race/ethnicity, physical activity, smoking, alcohol consumption, insomnia, weekly work hours, and BMI. Compared with exclusive day workers, both non-nappers and nappers were at a higher likelihood of reporting hypertension (OR = 1.93 CI95% 1.35-2.79 and OR = 1.41 CI95% 1.08-2.20, respectively). An interaction was observed between napping behavior and insomnia (p = 0.037). In the whole sample of night workers, the lower OR for nappers was confirmed when they were directly compared with non-nappers (OR = 0.76 CI95% 0.59-0.98). Analysis of night workers stratified by insomnia showed a significant reduction in OR for nappers (compared to non-nappers) only among insomniacs (OR = 0.58). Napping during night work may be a protective factor for hypertension, particularly among insomniacs. Factors related to melatonin secretion, blood pressure control, and blood pressure dipping patterns are likely to be involved in the relationship between on-shift napping and blood pressure.

Sleep duration from infancy to adolescence: reference values and generational trends.

PubMed

Iglowstein, Ivo; Jenni, Oskar G; Molinari, Luciano; Largo, Remo H

2003-02-01

The main purpose of the present study was to calculate percentile curves for total sleep duration per 24 hours, for nighttime and for daytime sleep duration from early infancy to late adolescence to illustrate the developmental course and age-specific variability of these variables among subjects. A total of 493 subjects from the Zurich Longitudinal Studies were followed using structured sleep-related questionnaires at 1, 3, 6, 9, 12, 18, and 24 months after birth and then at annual intervals until 16 years of age. Gaussian percentiles for ages 3 months to 16 years were calculated for total sleep duration (time in bed) and nighttime and daytime sleep duration. The mean sleep duration for ages 1 to 16 years was estimated by generalized additive models based on the loess smoother; a cohort effect also had to be included. The standard deviation (SD) was estimated from the loess smoothed absolute residuals from the mean curve. For ages 3, 6, and 9 months, an alternative approach with a simple model linear in age was used. For age 1 month, empirical percentiles were calculated. Total sleep duration decreased from an average of 14.2 hours (SD: 1.9 hours) at 6 months of age to an average of 8.1 hours (SD: 0.8 hours) at 16 years of age. The variance showed the same declining trend: the interquartile range at 6 months after birth was 2.5 hours, whereas at 16 years of age, it was only 1.0 hours. Total sleep duration decreased across the studied cohorts (1974-1993) because of increasingly later bedtime but unchanged wake time across decades. Consolidation of nocturnal sleep occurred during the first 12 months after birth with a decreasing trend of daytime sleep. This resulted in a small increase of nighttime sleep duration by 1 year of age (mean 11.0 +/- 1.1 hours at 1 month to 11.7 +/- 1.0 hours at 1 year of age). The most prominent decline in napping habits occurred between 1.5 years of age (96.4% of all children) and 4 years of age (35.4%). Percentile curves provide valuable information on developmental course and age-specific variability of sleep duration for the health care professional who deals with sleep problems in pediatric practice.

How many hours do people sleep in Bangladesh? A country-representative survey.

PubMed

Yunus, Fakir M; Khan, Safayet; Akter, Tahera; Jhohura, Fatema T; Reja, Saifur; Islam, Akramul; Rahman, Mahfuzar

2016-06-01

This study investigated total sleep time in the Bangladeshi population and identified the proportion of the population at greater risk of developing chronic diseases due to inadequate sleep. Using a cross-sectional survey, total sleep time was captured and analysed in 3968 respondents aged between 6 and 106 years in 24 (of 64) districts in Bangladesh. Total sleep time was defined as the hours of total sleep in the previous 24 h. We used National Sleep Foundation (2015) guidelines to determine the recommended sleep hours in different age categories. Less or more than the recommended total sleep time (in hours) was considered 'shorter' and 'longer' sleep time, respectively. Linear and multinomial logistic regression models were used to determine the relationship between demographic variables and estimated risk of shorter and longer total sleep time. The mean (±standard deviation) total sleep time of children (6-13 years), teenagers (14-17 years), young adults and adults (18-64 years) and older adults (≥65 years) were 8.6 (±1.1), 8.1 (±1.0), 7.7 (±0.9) and 7.8 (±1.4) h, respectively, which were significantly different (P < 0.01). More than half of school-age children (55%) slept less than, and 28.2% of older adults slept longer than, recommended. Residents in all divisions (except Chittagong) in Bangladesh were less likely to sleep longer than in the Dhaka division. Rural populations had a 3.96× greater chance of sleeping for a shorter time than urban residents. The Bangladeshi population tends to sleep for longer and/or shorter times than their respective recommended sleep hours, which is detrimental to health. © 2016 European Sleep Research Society.

The multiple time scales of sleep dynamics as a challenge for modelling the sleeping brain.

PubMed

Olbrich, Eckehard; Claussen, Jens Christian; Achermann, Peter

2011-10-13

A particular property of the sleeping brain is that it exhibits dynamics on very different time scales ranging from the typical sleep oscillations such as sleep spindles and slow waves that can be observed in electroencephalogram (EEG) segments of several seconds duration over the transitions between the different sleep stages on a time scale of minutes to the dynamical processes involved in sleep regulation with typical time constants in the range of hours. There is an increasing body of work on mathematical and computational models addressing these different dynamics, however, usually considering only processes on a single time scale. In this paper, we review and present a new analysis of the dynamics of human sleep EEG at the different time scales and relate the findings to recent modelling efforts pointing out both the achievements and remaining challenges.

Physical Activity, Mind Wandering, Affect, and Sleep: An Ecological Momentary Assessment.

PubMed

Fanning, Jason; Mackenzie, Michael; Roberts, Sarah; Crato, Ines; Ehlers, Diane; McAuley, Edward

2016-08-31

A considerable portion of daily thought is spent in mind wandering. This behavior has been related to positive (eg, future planning, problem solving) and negative (eg, unhappiness, impaired cognitive performance) outcomes. Based on previous research suggesting future-oriented (ie, prospective) mind wandering may support autobiographical planning and self-regulation, this study examined associations between hourly mind wandering and moderate-to-vigorous physical activity (MVPA), and the impact of affect and daily sleep on these relations. College-aged adults (N=33) participated in a mobile phone-delivered ecological momentary assessment study for 1 week. Sixteen hourly prompts assessing mind wandering and affect were delivered daily via participants' mobile phones. Perceived sleep quality and duration was assessed during the first prompt each day, and participants wore an ActiGraph accelerometer during waking hours throughout the study week. Study findings suggest present-moment mind wandering was positively associated with future MVPA (P=.03), and this relationship was moderated by affective state (P=.04). Moreover, excessive sleep the previous evening was related to less MVPA across the following day (P=.007). Further, mind wandering was positively related to activity only among those who did not oversleep (P=.007). Together, these results have implications for multiple health behavior interventions targeting physical activity, affect, and sleep. Researchers may also build on this work by studying these relationships in the context of other important behaviors and psychosocial factors (eg, tobacco use, depression, loneliness).

Sleep Duration and Patterns in Chinese Older Adults: a Comprehensive Meta-analysis.

PubMed

Lu, Li; Wang, Shi-Bin; Rao, Wen-Wang; Ungvari, Gabor S; Ng, Chee H; Chiu, Helen F K; Zhang, Juan; Kou, Changgui; Jia, Fu-Jun; Xiang, Yu-Tao

2017-01-01

This meta-analysis examined the mean sleep duration and patterns in Chinese older adult population. A literature search was systematically conducted covering major English (PubMed, Embase and PsycINFO) and Chinese (Chinese National Knowledge Infrastructure (CNKI), WanFang and SinoMed) databases. Data in studies with the mean and standard deviation of sleep duration and/or the proportion of short and long sleep durations in Chinese older adults were extracted and pooled using random-effects models. Subgroup analyses were conducted according to gender, region, area, survey time and sample size. A total of 36 studies with 150,616 subjects were included for analyses. The pooled mean sleep duration of 21 studies with available data was 6.82 hours/day (95% CI: 6.59-7.05 hours/day). The estimated proportions of sleep duration <5 hours/day, <6 hours/day, <7 hours/day were 18.8% (95% CI: 1.7%-35.9%), 26.7% (95% CI: 19.7%-33.7%) and 42.3% (95% CI: 34.8%-49.8%), respectively. The pooled proportions for long sleepers were 22.6% (95% CI: 13.9%-31.4%) (>8 hours/day) and 17.6% (95% CI: 12.4%-22.9%) (>9 hours/day). Given the adverse effects of unhealthy sleep patterns, health professionals should pay more attention to sleep patterns in this population in China.

[Associations among physical condition, life hour, and dietary intake male Japanese shift workers: physical condition and lifestyle survey of male Japanese shift workers].

PubMed

Fukumura, Tomoe; Yoshita, Katsushi; Tabata, Masaji

2015-01-01

The purpose of this study was to understand the actual state of life hours (working time, sleep time, and time of meal intake) and dietary habits of male shift work employees, and to elucidate the impact of working arrangements and dietary habits on their physical condition and health problems. The subjects were 187 male employees (aged 18-64 years) working for an industrial company in Toyama prefecture. We used a self-administered questionnaire to assess dietary habit, lifestyle habits, and life hours at the time of a periodic health examination in April 2013. The subjects were grouped based on their working condition (i.e., day shift, late shift, and late-night shift) into two groups of day shift (n = 107) and shiftwork (n = 80). The proportion of time spent sleeping and feeding was determined in half hour increments, and the incidences of skipping meals (breakfast, lunch and dinner) and midnight snack intake were calculated for each working condition. We also examined the association between the frequency of eating and physical condition for each working condition. The state of life hours of the shiftwork group during the day was similar to that of the day shift group. However, the workers' state of life hours, incidences of skipping meals, and midnight snack intake varied considerably when working at the other shift times. In the shiftwork group, regardless of the working patterns, the BMI and % body fat of the group that ate more than three times a day were significantly lower than those of the group that ate less than twice a day. The results of the present study suggest that it is difficult to ensure the time and opportunity for meals for shift workers. We consider that it is necessary to prevent them skipping of meals, and to support a proper dietary intake during the night.

Workplace bullying and sleep disturbances: findings from a large scale cross-sectional survey in the French working population.

PubMed

Niedhammer, Isabelle; David, Simone; Degioanni, Stephanie; Drummond, Anne; Philip, Pierre; Acquarone, D; Aicardi, F; André-Mazeaud, P; Arsento, M; Astier, R; Baille, H; Bajon-Thery, F; Barre, E; Basire, C; Battu, J L; Baudry, S; Beatini, C; Beaud'huin, N; Becker, C; Bellezza, D; Beque, C; Bernstein, O; Beyssier, C; Blanc-Cascio, F; Blanchet, N; Blondel, C; Boisselot, R; Bordes-Dupuy, G; Borrelly, N; Bouhnik, D; Boulanger, M F; Boulard, J; Borreau, P; Bourret, D; Boustière, A M; Breton, C; Bugeon, G; Buono-Michel, M; Canonne, J F; Capella, D; Cavin-Rey, M; Cervoni, C; Charreton, D; Charrier, D; Chauvin, M A; Chazal, B; Cougnot, C; Cuvelier, G; Dalivoust, G; Daumas, R; Debaille, A; De Bretteville, L; Delaforge, G; Delchambre, A; Domeny, L; Donati, Y; Ducord-Chapelet, J; Duran, C; Durand-Bruguerolle, D; Fabre, D; Faivre, A; Falleri, R; Ferrando, G; Ferrari-Galano, J; Flutet, M; Fouché, J P; Fournier, F; Freyder, E; Galy, M; Garcia, A; Gazazian, G; Gérard, C; Girard, F; Giuge, M; Goyer, C; Gravier, C; Guyomard, A; Hacquin, M C; Halimi, E; Ibagnes, T; Icart, P; Jacquin, M C; Jaubert, B; Joret, J P; Julien, J P; Kacel, M; Kesmedjian, E; Lacroix, P; Lafon-Borelli, M; Lallai, S; Laudicina, J; Leclercq, X; Ledieu, S; Leroy, J; Leroyer, L; Loesche, F; Londi, D; Longueville, J M; Lotte, M C; Louvain, S; Lozé, M; Maculet-Simon, M; Magallon, G; Marcelot, V; Mareel, M C; Martin, P; Masse, A M; Méric, M; Milliet, C; Mokhtari, R; Monville, A M; Muller, B; Obadia, G; Pelser, M; Peres, L; Perez, E; Peyron, M; Peyronnin, F; Postel, S; Presseq, P; Pyronnet, E; Quinsat, C; Raulot-Lapointe, H; Rigaud, P; Robert, F; Robert, O; Roger, K; Roussel, A; Roux, J P; Rubini-Remigy, D; Sabate, N; Saccomano-Pertus, C; Salengro, B; Salengro-Trouillez, P; Samson, E; Sendra-Gille, L; Seyrig, C; Stoll, G; Tarpinian, N; Tavernier, M; Tempesta, S; Terracol, H; Torresani, F; Triglia, M F; Vandomme, V; Vieillard, F; Vilmot, K; Vital, N

2009-09-01

The purpose of this study was to explore the associations between workplace bullying, the characteristics of workplace bullying, and sleep disturbances in a large sample of employees of the French working population. Workplace bullying, evaluated using the validated instrument developed by Leymann, and sleep disturbances, as well as covariates, were measured using a self-administered questionnaire. Covariates included age, marital status, presence of children, education, occupation, working hours, night work, physical and chemical exposures at work, self-reported health, and depressive symptoms. Statistical analysis was performed using logistic regression analysis and was carried out separately for men and women. General working population. The study population consisted of a random sample of 3132 men and 4562 women of the working population in the southeast of France. Workplace bullying was strongly associated with sleep disturbances. Past exposure to bullying also increased the risk for this outcome. The more frequent the exposure to bullying, the higher the risk of experiencing sleep disturbances. Observing someone else being bullied in the workplace was also associated with the outcome. Adjustment for covariates did not modify the results. Additional adjustment for self-reported health and depressive symptoms diminished the magnitude of the associations that remained significant. The prevalence of workplace bullying (around 10%) was found to be high in this study as well was the impact of this major job-related stressor on sleep disturbances. Although no conclusion about causality could be drawn from this cross-sectional study, the findings suggest that the contribution of workplace bullying to the burden of sleep disturbances may be substantial.

29 CFR 785.22 - Duty of 24 hours or more.

Code of Federal Regulations, 2011 CFR

2011-07-01

... can usually enjoy an uninterrupted night's sleep. If sleeping period is of more than 8 hours, only 8.... Pa. 1947).) (b) Interruptions of sleep. If the sleeping period is interrupted by a call to duty, the... cannot get a reasonable night's sleep, the entire period must be counted. For enforcement purposes, the...

29 CFR 785.22 - Duty of 24 hours or more.

Code of Federal Regulations, 2012 CFR

2012-07-01

... can usually enjoy an uninterrupted night's sleep. If sleeping period is of more than 8 hours, only 8.... Pa. 1947).) (b) Interruptions of sleep. If the sleeping period is interrupted by a call to duty, the... cannot get a reasonable night's sleep, the entire period must be counted. For enforcement purposes, the...

29 CFR 785.22 - Duty of 24 hours or more.

Code of Federal Regulations, 2014 CFR

2014-07-01

... can usually enjoy an uninterrupted night's sleep. If sleeping period is of more than 8 hours, only 8.... Pa. 1947).) (b) Interruptions of sleep. If the sleeping period is interrupted by a call to duty, the... cannot get a reasonable night's sleep, the entire period must be counted. For enforcement purposes, the...

29 CFR 785.22 - Duty of 24 hours or more.

Code of Federal Regulations, 2013 CFR

2013-07-01

... can usually enjoy an uninterrupted night's sleep. If sleeping period is of more than 8 hours, only 8.... Pa. 1947).) (b) Interruptions of sleep. If the sleeping period is interrupted by a call to duty, the... cannot get a reasonable night's sleep, the entire period must be counted. For enforcement purposes, the...

Long working hours and cognitive function: the Whitehall II Study.

PubMed

Virtanen, Marianna; Singh-Manoux, Archana; Ferrie, Jane E; Gimeno, David; Marmot, Michael G; Elovainio, Marko; Jokela, Markus; Vahtera, Jussi; Kivimäki, Mika

2009-03-01

This study examined the association between long working hours and cognitive function in middle age. Data were collected in 1997-1999 (baseline) and 2002-2004 (follow-up) from a prospective study of 2,214 British civil servants who were in full-time employment at baseline and had data on cognitive tests and covariates. A battery of cognitive tests (short-term memory, Alice Heim 4-I, Mill Hill vocabulary, phonemic fluency, and semantic fluency) were measured at baseline and at follow-up. Compared with working 40 hours per week at most, working more than 55 hours per week was associated with lower scores in the vocabulary test at both baseline and follow-up. Long working hours also predicted decline in performance on the reasoning test (Alice Heim 4-I). Similar results were obtained by using working hours as a continuous variable; the associations between working hours and cognitive function were robust to adjustments for several potential confounding factors including age, sex, marital status, education, occupation, income, physical diseases, psychosocial factors, sleep disturbances, and health risk behaviors. This study shows that long working hours may have a negative effect on cognitive performance in middle age.

Long Working Hours and Cognitive Function

PubMed Central

Singh-Manoux, Archana; Ferrie, Jane E.; Gimeno, David; Marmot, Michael G.; Elovainio, Marko; Jokela, Markus; Vahtera, Jussi; Kivimäki, Mika

2009-01-01

This study examined the association between long working hours and cognitive function in middle age. Data were collected in 1997–1999 (baseline) and 2002–2004 (follow-up) from a prospective study of 2,214 British civil servants who were in full-time employment at baseline and had data on cognitive tests and covariates. A battery of cognitive tests (short-term memory, Alice Heim 4-I, Mill Hill vocabulary, phonemic fluency, and semantic fluency) were measured at baseline and at follow-up. Compared with working 40 hours per week at most, working more than 55 hours per week was associated with lower scores in the vocabulary test at both baseline and follow-up. Long working hours also predicted decline in performance on the reasoning test (Alice Heim 4-I). Similar results were obtained by using working hours as a continuous variable; the associations between working hours and cognitive function were robust to adjustments for several potential confounding factors including age, sex, marital status, education, occupation, income, physical diseases, psychosocial factors, sleep disturbances, and health risk behaviors. This study shows that long working hours may have a negative effect on cognitive performance in middle age. PMID:19126590

Habitual sleep variability, not sleep duration, is associated with caloric intake in adolescents

PubMed Central

Fan, HE; BIXLER, Edward O.; BERG, Arthur; KAWASAWA, Yuka IMAMURA; VGONTZAS, Alexandros N.; FERNANDEZ-MENDOZA, Julio; YANOSKY, Jeff; LIAO, Duanping

2015-01-01

Objective To investigate the associations between objectively-measured habitual sleep duration (HSD), habitual sleep variability (HSV) and energy and snack intake in adolescents. Methods We used data from 324 adolescents participated in the Penn State Child Cohort follow-up examination. Actigraphy was used over 7 consecutive nights to estimate nightly sleep duration. The 7-night mean and standard deviation of sleep duration were used to represent HSD and HSV, respectively. Youth/Adolescent Food Frequency Questionnaire was used to obtain daily average total energy, protein, fat, carbohydrates intakes, and number of snacks consumed. Linear regression models were used to investigate the associations between habitual sleep patterns and caloric, protein, fat, and carbohydrates intakes. Proportional odds models were used to associate habitual sleep patterns and snack consumption. Results After adjusting for age, sex, race, BMI percentile, and smoking status, increased HSV was associated with higher energy intake, particularly from fat and carbohydrate. For example, with 1-hour increase in HSV, there was 170 (66) kcal increase in daily total energy intake. Increased HSV also related to increased snack consumption, especially snacks consumed after dinner. For instance, 1 hour increase in HSV was associated with 65% and 94% higher odds of consuming more snacks after dinner during school/work days and weekends/vacation days, respectively. Neither energy intake nor snack consumption was significantly related to HSD. Conclusion High variability in habitual sleep duration, not habitual sleep duration, is related to increased energy and food consumptions in adolescents. Maintaining a regular sleep pattern may decrease the risk of obesity in adolescents. PMID:26002758

Effects of Sleep Deprivation on the Cognitive Performance of Nurses Working in Shift.

PubMed

Kaliyaperumal, Deepalakshmi; Elango, Yaal; Alagesan, Murali; Santhanakrishanan, Iswarya

2017-08-01

Sleep deprivation and altered circadian rhythm affects the cognitive performance of an individual. Quality of sleep is compromised in those who are frequently involved in extended working hours and shift work which is found to be more common among nurses. Cognitive impairment leads to fatigability, decline in attention and efficiency in their workplace which puts their health and patients' health at risk. To find out the prevalence of sleep deprivation and its impact on cognition among shift working nurses. Sleep deprivation among 97 female and three male healthy nurses of age 20-50 years was assessed by Epworth sleepiness scale (ESS). Cognition was assessed by Montreal Cognitive Assessment (MoCA) questionnaire. Mobile applications were used to test their vigilance, reaction time, photographic memory and numerical cognition. The above said parameters were assessed during end of day shift and 3-4 days after start of night shift. Poor sleep quality was observed among 69% of shift working nurses according to ESS scores. The cognitive performance was analysed using Wilcoxon signed rank test. The MoCA score was found to be lesser among 66% of nurses during night (25.72) than day (26.81). During the night, 32% made more mathematical errors. It was also found that, 71%, 83% and 68% of the nurses scored lesser during night in the Stroop's colour test, vigilance test and memory tests respectively. Thus, impairment in cognitive performance was statistically significant (p<0.001) among shift working nurses. Cognitive performance was found to be impaired among shift working nurses, due to poor sleep quality and decreased alertness during wake state. Thus, shift work poses significant cognitive risks in work performance of nurses.

LIGHT EXPOSURE AMONG ADOLESCENTS WITH DELAYED SLEEP PHASE DISORDER: A PROSPECTIVE COHORT STUDY

PubMed Central

Auger, R. Robert; Burgess, Helen J.; Dierkhising, Ross A.; Sharma, Ruchi G.; Slocumb, Nancy L.

2012-01-01

Our study objective was to compare light exposure and sleep parameters between adolescents with delayed sleep phase disorder (n=16, 15.3 ± 1.8 years) and unaffected controls (n=22, 13.7 ± 2.4 years) using a prospective cohort design. Participants wore wrist actigraphs with photosensors for 14 days. Mean hourly lux levels from 20:00-05:00 h and 05:00-14:00 h were examined, in addition to the 9-hour intervals prior to sleep onset and after sleep offset. Sleep parameters were compared separately, and were also included as covariates within models that analyzed associations with specified light intervals. Additional covariates included group and school night status. Adolescent subjects with delayed sleep phase disorder received more evening (p<0.02, 22:00-02:00 h) and less morning light (p<0.05, 08:00-09:00 h and 10:00-12:00 h) than controls, but had less pre-sleep exposure with adjustments for the time of sleep onset (p<0.03, fifth-seventh hours prior to onset hour). No differences were identified with respect to the sleep offset interval. Increased total sleep time and later sleep offset times were associated with decreased evening (p<0.001 and p=0.02, respectively) and morning (p=0.01 and p<0.001, respectively) exposure, and later sleep onset times were associated with increased evening exposure (p<0.001). Increased total sleep time also correlated with increased exposure during the 9 hours before sleep-onset (p=0.01), and a later sleep onset time corresponded with decreased exposure during the same interval (p<0.001). Outcomes persisted regardless of school night status. In conclusion, light exposure interpretation requires adjustments for sleep timing among adolescents with delayed sleep phase disorder. Pre- and post-sleep exposure do not appear to contribute directly to phase delays. Sensitivity to morning light may be reduced among adolescents with delayed sleep phase disorder. PMID:22080736

Effects of Acute Sleep Deprivation on Motor and Reversal Learning in Mice

PubMed Central

Varga, Andrew W.; Kang, Mihwa; Ramesh, Priyanka V.; Klann, Eric

2014-01-01

Sleep supports the formation of a variety of declarative and non-declarative memories, and sleep deprivation often impairs these types of memories. In human subjects, natural sleep either during a nap or overnight leads to long-lasting improvements in visuomotor and fine motor tasks, but rodent models recapitulating these findings have been scarce. Here we present evidence that 5 hours of acute sleep deprivation impairs mouse skilled reach learning compared to a matched period of ad libitum sleep. In sleeping mice, the duration of total sleep time during the 5 hours of sleep opportunity or during the first bout of sleep did not correlate with ultimate gain in motor performance. In addition, we observed that reversal learning during the skilled reaching task was also affected by sleep deprivation. Consistent with this observation, 5 hours of sleep deprivation also impaired reversal learning in the water-based Y-maze. In conclusion, acute sleep deprivation negatively impacts subsequent motor and reversal learning and memory. PMID:25046627

Sleep patterns in Amazon rubber tappers with and without electric light at home.

PubMed

Moreno, C R C; Vasconcelos, S; Marqueze, E C; Lowden, A; Middleton, B; Fischer, F M; Louzada, F M; Skene, D J

2015-09-11

Today's modern society is exposed to artificial electric lighting in addition to the natural light-dark cycle. Studies assessing the impact of electric light exposure on sleep and its relation to work hours are rare due to the ubiquitous presence of electricity. Here we report a unique study conducted in two phases in a homogenous group of rubber tappers living and working in a remote area of the Amazon forest, comparing those living without electric light (n = 243 in first phase; n = 25 in second phase) to those with electric light at home (n = 97 in first phase; n = 17 in second phase). Questionnaire data (Phase 1) revealed that rubber tappers with availability of electric light had significantly shorter sleep on work days (30 min/day less) than those without electric light. Analysis of the data from the Phase 2 sample showed a significant delay in the timing of melatonin onset in workers with electric light compared to those without electric light (p < 0.01). Electric lighting delayed sleep onset and reduced sleep duration during the work week and appears to interfere with alignment of the circadian timing system to the natural light/dark cycle.

Fluctuations in heart rate variability of health care workers during four consecutive extended work shifts and recovery during rest and sleep.

PubMed

Goffeng, Elisabeth M; Nordby, Karl-Christian; Tarvainen, Mika P; Järvelin-Pasanen, Susanna; Wagstaff, Anthony; Goffeng, Lars Ole; Bugge, Merete; Skare, Øivind; Sigstad Lie, Jenny-Anne

2018-04-07

The aim of this study was to investigate fluctuations in heart rate variability (HRV), which reflect autonomic nervous system (ANS) function and potential psychological and physical strain, among 24 health care workers during work and sleep during four consecutive extended work shifts. Data included 24/36/12 h of HRV measurements, two logbooks, and a questionnaire. A cross-shift/cross-week design was applied. HRV was measured during work, leisure time, and sleep. The HRV data included time-domain [mean RR, SD of normal to normal R-R intervals (SDNN), and root mean square of the successive differences (RMSSD)] and frequency-domain [low frequency (LF)/high frequency (HF) ratio] parameters. HRV parameters revealed significant differences among work, leisure time, and sleep. Mean RR, RMSSD, and SDNN values were lower and the LF/HF ratio was higher on the first versus last day of the work period; however, the differences were most prominent in the morning hours. The results indicate higher levels of cardiovascular stress on the first versus fourth day of the working period, and measurements at night indicate a satisfactory recovery from the extended shifts.

The impact of sleep deprivation on surgeons' performance during night shifts.

PubMed

Amirian, Ilda

2014-09-01

The median incidence of adverse events that may result in patient injury is a total of 9% of all in-hospital admissions. In order to reduce this high incidence initiatives are continuously worked on that can reduce the risk of patient harm during admission by strengthening hospital systems. However, the influence of physicians' shift work on the risk on adverse events in patients remains controversial. In the studies included in this PhD thesis we wished to examine the impact of sleep deprivation and circadian rhythm disturbances on surgeons' during night shifts. Further we wished to examine the impact sleep deprivation had on surgeons' performance as a measure of how patient safety would be affected. We found that sleep deprivation subjectively had an impact on the surgeons and that they were aware of the effect fatigue had on their work performance. As a result they applied different mechanisms to cope with fatigue. Attending surgeons felt that they had a better overview now, due to more experience and better skills, than when they were residents, despite the fatigue on night shifts. We monitored surgeons' performance during night shifts by laparoscopic simulation and cognitive tests in order to assess their performance; no deterioration was found when pre call values were compared to on call values. The surgeons were monitored prospectively for 4 days across a night shift in order to assess the circadian rhythm and sleep. We found that surgeons' circadian rhythm was affected by working night shifts and their sleep pattern altered, resembling that of shift workers on the post call day. We assessed the quality of admission in medical records as a measure of surgeons' performance, during day, evening and night hours and found no deterioration in the quality of night time medical records. However, consistent high errors were found in several categories. These findings should be followed up in the future with respect of clarifying mechanism and consequences for patient safety. In conclusion the assessment of the impact of sleep deprivation on surgeons' performance during night shift is complex and multi-faceted. Surgeons do feel an impact of sleep deprivation during night shifts, and their circadian rhythm is affected. Despite this, it appears that the surgeons are able to compensate for the effects of sleep loss. We did not find any results to support that sleep loss results in psychomotor or cognitive deterioration during a 17-hour night shift or that sleep deprivation during a night shift results in reduced patient safety.

Smoking, Screen-Based Sedentary Behavior, and Diet Associated with Habitual Sleep Duration and Chronotype: Data from the UK Biobank.

PubMed

Patterson, Freda; Malone, Susan Kohl; Lozano, Alicia; Grandner, Michael A; Hanlon, Alexandra L

2016-10-01

Sleep duration has been implicated in the etiology of obesity but less is known about the association between sleep and other behavioral risk factors for cardiovascular disease. The aim of this study was to examine the associations among sleep duration, chronotype, and physical activity, screen-based sedentary behavior, tobacco use, and dietary intake. Regression models were used to examine sleep duration and chronotype as the predictors and cardiovascular risk factors as outcomes of interest in a cross-sectional sample of 439,933 adults enrolled in the UK Biobank project. Short sleepers were 45 % more likely to smoke tobacco than adequate sleepers (9.8 vs. 6.9 %, respectively). Late chronotypes were more than twice as likely to smoke tobacco than intermediate types (14.9 vs. 7.4 %, respectively). Long sleepers reported 0.61 more hours of television per day than adequate sleepers. Early chronotypes reported 0.20 fewer daily hours of computer use per day than intermediate chronotypes. Early chronotypes had 0.25 more servings of fruit and 0.13 more servings of vegetables per day than late chronotypes. Short and long sleep duration and late chronotype are associated with greater likelihood of cardiovascular risk behaviors. Further work is needed to determine whether these findings are maintained in the context of objective sleep and circadian estimates, and in more diverse samples. The extent to which promoting adequate sleep duration and earlier sleep timing improves heart health should also be examined prospectively.

Dark goggles and bright light improve circadian rhythm adaptation to night-shift work.

PubMed

Eastman, C I; Stewart, K T; Mahoney, M P; Liu, L; Fogg, L F

1994-09-01

We compared the contributions of bright light during the night shift and dark goggles during daylight for phase shifting the circadian rhythm of temperature to realign with a 12-hour shift of sleep. After 10 baseline days there were 8 night-work/day-sleep days. Temperature was continuously recorded from 50 subjects. There were four groups in a 2 x 2 design: light (bright, dim), goggles (yes, no). Subjects were exposed to bright light (about 5,000 lux) for 6 hours on the first 2 night shifts. Dim light was < 500 lux. Both bright light and goggles were significant factors for producing circadian rhythm phase shifts. The combination of bright light plus goggles was the most effective, whereas the combination of dim light and no goggles was the least effective. The temperature rhythm either phase advanced or phase delayed when it aligned with daytime sleep. However, when subjects did not have goggles only phase advances occurred. Goggles were necessary for producing phase delays. The most likely explanation is that daylight during the travel-home window after a night shift inhibits phase-delay shifts, and goggles can prevent this inhibition. Larger temperature-rhythm phase shifts were associated with better subjective daytime sleep, less subjective fatigue and better mood.

Differences in short and long sleep durations between blacks and whites attributed to emotional distress: analysis of the National Health Interview Survey in the United States.

PubMed

Seixas, Azizi A; Auguste, Emmanuella; Butler, Mark; James, Caryl; Newsome, Valerie; Auguste, Evan; da Silva Fonseca, Vilma Aparecida; Schneeberger, Andres; Zizi, Ferdinand; Jean-Louis, Girardin

2017-02-01

The current study examined the role of emotional distress in explaining racial/ethnic differences in unhealthy sleep duration. Data from the 2004-2013 National Health Interview Survey were analyzed using SPSS 20. Data were collected through personal household interviews in the United States. Of the total 261,686 participants (age≥18 years), 17.0% were black, 83.0% were white, and the mean age was 48 years (SE=0.04). To ascertain total sleep duration, participants were asked, "How many hours of sleep do you get on average in a 24-hour period?" Sleep duration was coded as short sleep (<7hours), average sleep (7-8hours), or long sleep (>8hours). Emotional distress-feeling sad, nervous, restless, hopeless, worthless, and burdened over a 30-day period-was measured using Kessler-6, a 6-item screening scale. Of the participants reporting significant emotional distress (4.0% black, 3.5% white), χ 2 analyses revealed that a higher percentage of blacks, compared with whites, reported unhealthy sleep durations. Relative to Whites, Blacks had increased prevalence of short sleep (prevalence ratio=1.32, P<.001) or long sleep (odds ratio =1.189, P<.001). The interaction between race/ethnicity and emotional distress was significantly associated with short (prevalence ratio=0.99, P<.001) and long sleep (odds ratio=0.98, P<.001) durations. Individuals of the black race/ethnicity or those reporting greater levels of emotional distress are more likely to report short or long sleep duration. Emotional distress might partially explain racial/ethnic differences in unhealthy sleep duration between blacks and whites. Copyright © 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Feeding methods, sleep arrangement, and infant sleep patterns: a Chinese population-based study.

PubMed

Huang, Xiao-Na; Wang, Hui-Shan; Chang, Jen-Jen; Wang, Lin-Hong; Liu, Xi-Cheng; Jiang, Jing-Xiong; An, Lin

2016-02-01

Findings from prior research into the effect of feeding methods on infant sleep are inconsistent. The objectives of this study were to examine infants' sleep patterns by feeding methods and sleep arrangement from birth to eight months old. This longitudinal cohort study enrolled 524 pregnant women at 34-41 weeks of gestation and their infants after delivery in 2006 and followed up until eight months postpartum. The study subjects were recruited from nine women and children hospitals in nine cities in China (Beijing, Chongqing, Wuhan, Changsha, Nanning, Xiamen, Xi'an, Jinan, and Hailin). Participating infants were followed up weekly during the first month and monthly from the second to the eighth month after birth. Twenty-four hour sleep diaries recording infants' sleeping and feeding methods were administered based on caregiver's self-report. Multivariable mixed growth curve models were fitted to estimate the effects of feeding methods and sleep arrangement on infants' sleep patterns over time, controlling for maternal and paternal age, maternal and paternal education level, household income, supplementation of complementary food, and infant birth weight and length. Exclusively formula fed infants had the greatest sleep percentage/24 h, followed by exclusively breast milk fed infants and partially breast milk fed infants (P<0.01). Night waking followed a similar pattern. However, the differences in sleep percentage and night waking frequency between exclusively formula and exclusively breast milk fed infants weakened over time as infants developed. In addition, compared to infants with bed-sharing sleep arrangement, those with room sharing sleep arrangement had greater daytime and 24-hour infant sleep percentage, whereas those with sleeping alone sleep arrangement had greater nighttime sleep percentage. Our data based on caregiver's self-report suggested that partial breastfeeding and bed-sharing may be associated with less sleep in infants. Health care professionals need to work with parents of newborns to develop coping strategies that will help prevent early weaning of breastfeeding.

Sweet/Dessert Foods Are More Appealing to Adolescents after Sleep Restriction

PubMed Central

Simon, Stacey L.; Field, Julie; Miller, Lauren E.; DiFrancesco, Mark; Beebe, Dean W.

2015-01-01

Study Objective Examine the effect of experimental sleep restriction (SR) on adolescents’ subjective hunger and perceived appeal of sweet/dessert foods versus other foods. A secondary goal was to replicate previous findings on the effects of SR on dietary intake. Design Randomized cross-over sleep restriction-extension paradigm. Setting Sleep was obtained and monitored at home. Outcome measures were gathered during office visits. Participants 31 typically-developing adolescents aged 14–17 years. Interventions The three-week protocol consisted of a baseline week, followed randomly by five consecutive nights of SR (6.5 hours in bed) versus healthy sleep duration (HS; 10 hours in bed), a 2-night wash-out period, and a 5-night cross-over. Measurements Sleep was monitored via actigraphy. The morning after each experimental condition, teens rated their hunger, underwent a 24-hour diet recall interview, and rated the appeal of a series of pictures of sweet/dessert foods (e.g., ice cream, candy) and non-sweets (meat, eggs, fruits, vegetables). Results Teens rated pictures of sweet/dessert foods to be more appealing after SR than after HS (Cohen’s d = .41, t = 2.07, p = .045). The sleep manipulation did not affect self-reported hunger or the appeal of non-sweet foods (p >.10). Consistent with our prior work, intake of overall calories was 11% higher and consumption of sweet/dessert servings was 52% greater during SR than HS. Conclusions Adolescent SR appears to increase the subjective appeal of sweet/dessert foods, indicating a potential mechanism by which SR might contribute to weight gain and the risk for obesity and chronic illness. PMID:25706861

Implementing the 2009 Institute of Medicine recommendations on resident physician work hours, supervision, and safety.

PubMed

Blum, Alexander B; Shea, Sandra; Czeisler, Charles A; Landrigan, Christopher P; Leape, Lucian

2011-01-01

Long working hours and sleep deprivation have been a facet of physician training in the US since the advent of the modern residency system. However, the scientific evidence linking fatigue with deficits in human performance, accidents and errors in industries from aeronautics to medicine, nuclear power, and transportation has mounted over the last 40 years. This evidence has also spawned regulations to help ensure public safety across safety-sensitive industries, with the notable exception of medicine. In late 2007, at the behest of the US Congress, the Institute of Medicine embarked on a year-long examination of the scientific evidence linking resident physician sleep deprivation with clinical performance deficits and medical errors. The Institute of Medicine's report, entitled "Resident duty hours: Enhancing sleep, supervision and safety", published in January 2009, recommended new limits on resident physician work hours and workload, increased supervision, a heightened focus on resident physician safety, training in structured handovers and quality improvement, more rigorous external oversight of work hours and other aspects of residency training, and the identification of expanded funding sources necessary to implement the recommended reforms successfully and protect the public and resident physicians themselves from preventable harm. Given that resident physicians comprise almost a quarter of all physicians who work in hospitals, and that taxpayers, through Medicare and Medicaid, fund graduate medical education, the public has a deep investment in physician training. Patients expect to receive safe, high-quality care in the nation's teaching hospitals. Because it is their safety that is at issue, their voices should be central in policy decisions affecting patient safety. It is likewise important to integrate the perspectives of resident physicians, policy makers, and other constituencies in designing new policies. However, since its release, discussion of the Institute of Medicine report has been largely confined to the medical education community, led by the Accreditation Council for Graduate Medical Education (ACGME). To begin gathering these perspectives and developing a plan to implement safer work hours for resident physicians, a conference entitled "Enhancing sleep, supervision and safety: What will it take to implement the Institute of Medicine recommendations?" was held at Harvard Medical School on June 17-18, 2010. This White Paper is a product of a diverse group of 26 representative stakeholders bringing relevant new information and innovative practices to bear on a critical patient safety problem. Given that our conference included experts from across disciplines with diverse perspectives and interests, not every recommendation was endorsed by each invited conference participant. However, every recommendation made here was endorsed by the majority of the group, and many were endorsed unanimously. Conference members participated in the process, reviewed the final product, and provided input before publication. Participants provided their individual perspectives, which do not necessarily represent the formal views of any organization. In September 2010 the ACGME issued new rules to go into effect on July 1, 2011. Unfortunately, they stop considerably short of the Institute of Medicine's recommendations and those endorsed by this conference. In particular, the ACGME only applied the limitation of 16 hours to first-year resident physicans. Thus, it is clear that policymakers, hospital administrators, and residency program directors who wish to implement safer health care systems must go far beyond what the ACGME will require. We hope this White Paper will serve as a guide and provide encouragement for that effort. RESIDENT PHYSICIAN WORKLOAD AND SUPERVISION: By the end of training, a resident physician should be able to practice independently. Yet much of resident physicians' time is dominated by tasks with little educational value. The caseload can be so great that inadequate reflective time is left for learning based on clinical experiences. In addition, supervision is often vaguely defined and discontinuous. Medical malpractice data indicate that resident physicians are frequently named in lawsuits, most often for lack of supervision. The recommendations are: The ACGME should adjust resident physicians workload requirements to optimize educational value. Resident physicians as well as faculty should be involved in work redesign that eliminates nonessential and noneducational activity from resident physician dutiesMechanisms should be developed for identifying in real time when a resident physician's workload is excessive, and processes developed to activate additional providersTeamwork should be actively encouraged in delivery of patient care. Historically, much of medical training has focused on individual knowledge, skills, and responsibility. As health care delivery has become more complex, it will be essential to train resident and attending physicians in effective teamwork that emphasizes collective responsibility for patient care and recognizes the signs, both individual and systemic, of a schedule and working conditions that are too demanding to be safeHospitals should embrace the opportunities that resident physician training redesign offers. Hospitals should recognize and act on the potential benefits of work redesign, eg, increased efficiency, reduced costs, improved quality of care, and resident physician and attending job satisfactionAttending physicians should supervise all hospital admissions. Resident physicians should directly discuss all admissions with attending physicians. Attending physicians should be both cognizant of and have input into the care patients are to receive upon admission to the hospitalInhouse supervision should be required for all critical care services, including emergency rooms, intensive care units, and trauma services. Resident physicians should not be left unsupervised to care for critically ill patients. In settings in which the acuity is high, physicians who have completed residency should provide direct supervision for resident physicians. Supervising physicians should always be physically in the hospital for supervision of resident physicians who care for critically ill patientsThe ACGME should explicitly define "good" supervision by specialty and by year of training. Explicit requirements for intensity and level of training for supervision of specific clinical scenarios should be providedCenters for Medicare and Medicaid Services (CMS) should use graduate medical education funding to provide incentives to programs with proven, effective levels of supervision. Although this action would require federal legislation, reimbursement rules would help to ensure that hospitals pay attention to the importance of good supervision and require it from their training programs. RESIDENT PHYSICIAN WORK HOURS: Although the IOM "Sleep, supervision and safety" report provides a comprehensive review and discussion of all aspects of graduate medical education training, the report's focal point is its recommendations regarding the hours that resident physicians are currently required to work. A considerable body of scientific evidence, much of it cited by the Institute of Medicine report, describes deteriorating performance in fatigued humans, as well as specific studies on resident physician fatigue and preventable medical errors. The question before this conference was what work redesign and cultural changes are needed to reform work hours as recommended by the Institute of Medicine's evidence-based report? Extensive scientific data demonstrate that shifts exceeding 12-16 hours without sleep are unsafe. Several principles should be followed in efforts to reduce consecutive hours below this level and achieve safer work schedules. The recommendations are: Limit resident physician work hours to 12-16 hour maximum shiftsA minimum of 10 hours off duty should be scheduled between shiftsResident physician input into work redesign should be actively solicitedSchedules should be designed that adhere to principles of sleep and circadian science; this includes careful consideration of the effects of multiple consecutive night shifts, and provision of adequate time off after night work, as specified in the IOM reportResident physicians should not be scheduled up to the maximum permissible limits; emergencies frequently occur that require resident physicians to stay longer than their scheduled shifts, and this should be anticipated in scheduling resident physicians' work shiftsHospitals should anticipate the need for iterative improvement as new schedules are initiated; be prepared to learn from the initial phase-in, and change the plan as neededAs resident physician work hours are redesigned, attending physicians should also be considered; a potential consequence of resident physician work hour reduction and increased supervisory requirements may be an increase in work for attending physicians; this should be carefully monitored, and adjustments to attending physician work schedules made as needed to prevent unsafe work hours or working conditions for this group"Home call" should be brought under the overall limits of working hours; work load and hours should be monitored in each residency program to ensure that resident physicians and fellows on home call are getting sufficient sleepMedicare funding for graduate medical education in each hospital should be linked with adherence to the Institute of Medicine limits on resident physician work hours. MOONLIGHTING BY RESIDENT PHYSICIANS: The Institute of Medicine report recommended including external as well as internal moonlighting in working hour limits. The recommendation is: All moonlighting work hours should be included in the ACGME working hour limits and actively monitored. (ABSTRACT TRUNCATED)

Long-term memory, sleep, and the spacing effect.

PubMed

Bell, Matthew C; Kawadri, Nader; Simone, Patricia M; Wiseheart, Melody

2014-01-01

Many studies have shown that memory is enhanced when study sessions are spaced apart rather than massed. This spacing effect has been shown to have a lasting benefit to long-term memory when the study phase session follows the encoding session by 24 hours. Using a spacing paradigm we examined the impact of sleep and spacing gaps on long-term declarative memory for Swahili-English word pairs by including four spacing delay gaps (massed, 12 hours same-day, 12 hours overnight, and 24 hours). Results showed that a 12-hour spacing gap that includes sleep promotes long-term memory retention similar to the 24-hour gap. The findings support the importance of sleep to the long-term benefit of the spacing effect.

Sleep Loss, Circadian Mismatch, and Abnormalities in Reorienting of Attention in Night Workers with Shift Work Disorder

PubMed Central

Gumenyuk, Valentina; Howard, Ryan; Roth, Thomas; Korzyukov, Oleg; Drake, Christopher L.

2014-01-01

Study Objectives: Permanent night-shift workers may develop shift-work disorder (SWD). In the current study, we evaluated neurophysiological and behavioral indices of distractibility across times prior to the night shift (T1), during night hours (T2), and after acute sleep deprivation (T3) in permanent hospital night workers with and without SWD. Methods: Ten asymptomatic night workers (NW) and 18 NW with SWD participated in a 25-h sleep deprivation study. Circadian phase was evaluated by dim-light salivary melatonin onset (DLMO). Objective sleepiness was evaluated using the Multiple Sleep Latency Test (MSLT). Electrophysiological distractibility was evaluated by brain event-related potentials (ERP), whereas behavioral distractibility was evaluated by performance on a visual task in an auditory-visual distraction paradigm. Statistical analyses: Comparisons of ERP results were performed by repeated-measures analysis of variance, and t-tests were used where appropriate. A Mann-Whitney U test was used for comparison of variables (MLST, Stanford Sleepiness Scale, and DLMO) that deviated from normal. Results: First, in the SWD group, the reorienting negativity ERP amplitude was significantly attenuated compared to that in the NW group. Second, the SWD group had shorter MSLT during night shift hours (4.8 ± 4.9 min) compared to that in NW (7.8 ± 3.7 min; U = 47; z = -2.1; P < 0.03). Third, NW with SWD had a DLMO at 20:27 ± 5.0 h, whereas healthy NW had a DLMO at 05:00 ± 3.4 h (U = 43.5; z = -2.22, P < 0.03). Finally, acute sleep deprivation impaired behavioral performance and the P3a ERP in both groups. Conclusions: Our results demonstrate specific deficits in neurophysiological activity in the attentional domain among the shift-work disorder group relative to night workers. Citation: Gumenyuk V; Howard R; Roth T; Korzyukov O; Drake CL. Sleep loss, circadian mismatch, and abnormalities in reorienting of attention in night workers with shift work disorder. SLEEP 2014;37(3):545-556. PMID:24587577

Cross-sectional associations between daily rest periods during weekdays and psychological distress, non-restorative sleep, fatigue, and work performance among information technology workers.

PubMed

Tsuchiya, Masao; Takahashi, Masaya; Miki, Keiichi; Kubo, Tomohide; Izawa, Shuhei

2017-04-07

A daily rest period (DRP; rest taken from daily work during a 24 h period), is essential to work recovery. This study examined DRPs' distribution and association with health outcomes among information technology workers recruited from an internet panel (N=1,811). Participants completed a web questionnaire examining psychological distress as a primary outcome, along with non-restorative sleep, fatigue (stress reaction), and work performance. Logistic regression analysis showed elevated psychological distress when DRP was <12 h (OR: 2.54; 95% CI: 1.47-4.42) and <11 h (OR: 2.48, 95% CI: 1.17-5.26), although the 95% CI included 1 after adjusting for age, sex, and working and commuting hours. After the above adjustment, similar associations were found with non-restorative sleep and fatigue, but not work performance, when DRP was <12 h. These findings constitute the first analysis of a dose-response relationship between DRP and subjective health outcomes among white-collar workers.

Sleepless in Fairfax: the difference one more hour of sleep can make for teen hopelessness, suicidal ideation, and substance use.

PubMed

Winsler, Adam; Deutsch, Aaron; Vorona, Robert Daniel; Payne, Phyllis Abramczyk; Szklo-Coxe, Mariana

2015-02-01

Insufficient sleep is a risk factor for depression, suicidality, and substance use, yet little is known about gender, ethnic, and community-level differences in sleep and its associated outcomes, especially during adolescence. Further, much of the prior work has compared groups of teens getting plenty as opposed to insufficient amounts of sleep rather than examine sleep hours continuously. The present study examined adolescent weekday self-reported sleep duration and its links with hopelessness, suicidality, and substance use in a suburban community with very early high school start times. We utilized a large (N = 27,939, 51.2% female) and ethnically diverse sample of adolescents from the 2009 Fairfax County (Virginia) Youth Survey, an anonymous, self-report, population-level survey administered to all 8th, 10th and 12th grade students in public schools in the county. High-school students reported an average 6.5 h of sleep per school night, with 20% obtaining ≤5 h, and only 3% reporting the recommended 9 h/night. Females and minority youth obtained even less sleep on average, and the reduction in sleep in the transition from middle school to high school was more pronounced for females and for Asian students. Hierarchical, multivariate, logistic regression analyses, controlling for background variables, indicated that just 1 h less of weekday sleep was associated with significantly greater odds of feeling hopeless, seriously considering suicide, suicide attempts, and substance use. Relationships between sleep duration and suicidality were stronger for male teens, and sleep duration was more associated with hopelessness for white students compared to most ethnic minority groups. Implications for intervention at multiple levels are discussed.

Human prolactin - 24-hour pattern with increased release during sleep.

NASA Technical Reports Server (NTRS)

Sassin, J. F.; Weitzman, E. D.; Kapen, S.; Frantz, A. G.

1972-01-01

Human prolactin was measured in plasma by radioimmunoassay at 20-minute intervals for a 24-hour period in each of six normal adults, whose sleep-wake cycles were monitored polygraphically. A marked diurnal variation in plasma concentrations was demonstrated, with highest values during sleep. Periods of episodic release occurred throughout the 24 hours.

Prior sleep with zolpidem enhances the effect of caffeine or modafinil during 18 hours continuous work.

PubMed

Batéjat, Denise; Coste, Olivier; Van Beers, Pascal; Lagarde, Didier; Piérard, Christophe; Beaumont, Maurice

2006-05-01

Continuous military operations may disrupt sleep-wakefulness cycles, resulting in impaired performance and fatigue. We assessed the treatment efficacy of a hypnotic-psychostimulant combination to maintain sleep quality, performance, and alertness during a 42-h simulated military operation. A 6-h prophylactic sleep period with zolpidem (ZOL) followed by a 18-h continuous work period with administration at midway of 300 mg of slow release caffeine (CAF) or 200 mg of modafinil (MOD) was performed by eight healthy male subjects. Performance level was assessed with a reaction time test, a memory search test, a dual task, an attention test, and a computerized Stroop test. Cortical activation level was evaluated by the Critical Flicker Frequency test. Subjective sleepiness was evaluated using a visual analog scale and questionnaires. Effects of drugs on prophylactic and recovery sleep were also quantified from EEG recordings. CAF and MOD maintained performance and alertness throughout the 18-h work period. As shown by EEG recordings, ZOL improved prophylactic sleep without any deleterious effect on performance immediately after waking. As a result of its positive effects on prophylactic sleep, a lower pressure for slow wave sleep during recovery sleep was observed; nevertheless, zolpidem did not enhance the effects of either psychostimulant on performance. MOD and CAF may be of value in promoting performance and wakefulness during shiftwork or military operations while zolpidem improves prophylactic sleep quality without any deleterious effect after waking. We concluded that a zolpidem/ caffeine or modafinil combination could be useful in a context of environmental conditions not conducive to sleep.

The impact of junior doctors' worktime arrangements on their fatigue and well-being.

PubMed

Tucker, Philip; Brown, Menna; Dahlgren, Anna; Davies, Gwyneth; Ebden, Philip; Folkard, Simon; Hutchings, Hayley; Akerstedt, Torbjörn

2010-11-01

Many doctors report working excessively demanding schedules that comply with the European Working Time Directive (EWTD). We compared groups of junior doctors working on different schedules in order to identify which features of schedule design most negatively affected their fatigue and well-being in recent weeks. Completed by 336 doctors, the questionnaires focused on the respondents' personal circumstances, work situation, work schedules, sleep, and perceptions of fatigue, work-life balance and psychological strain. Working 7 consecutive nights was associated with greater accumulated fatigue and greater work-life interference, compared with working just 3 or 4 nights. Having only 1 rest day after working nights was associated with increased fatigue. Working a weekend on-call between 2 consecutive working weeks was associated with increased work-life interference. Working frequent on-calls (either on weekends or during the week) was associated with increased work-life interference and psychological strain. Inter-shift intervals of <10 hours were associated with shorter periods of sleep and increased fatigue. The number of hours worked per week was positively associated with work-life interference and fatigue on night shifts. The current findings identify parameters, in addition to those specified in the EWTD, for designing schedules that limit their impact on doctors' fatigue and well-being.

Habitual Sleep Duration, Unmet Sleep Need, and Excessive Daytime Sleepiness in Korean Adults.

PubMed

Hwangbo, Young; Kim, Won Joo; Chu, Min Kyung; Yun, Chang Ho; Yang, Kwang Ik

2016-04-01

Sleep need differs between individuals, and so the same duration of sleep will lead to sleep insufficiency in some individuals but not others. The aim of this study was to determine the separate and combined associations of both sleep duration and unmet sleep need with excessive daytime sleepiness (EDS) in Korean adults. The participants comprised 2,769 Korean adults aged 19 years or older. They completed questionnaires about their sleep habits over the previous month. The question regarding sleep need was "How much sleep do you need to be at your best during the day?" Unmet sleep need was calculated as sleep need minus habitual sleep duration. Participants with a score of >10 on the Epworth Sleepiness Scale were considered to have EDS. The overall prevalence of EDS was 11.9%. Approximately one-third of the participants (31.9%) reported not getting at least 7 hours of sleep. An unmet sleep need of >0 hours was present in 30.2% of the participants. An adjusted multivariate logistic regression analysis revealed a significant excess risk of EDS in the groups with unmet sleep needs of ≥2 hours [odds ratio (OR), 1.80; 95% confidence interval (CI), 1.27-2.54] and 0.01-2 hours (OR, 1.42; 95% CI, 1.02-1.98). However, habitual sleep duration was not significantly related to EDS. EDS was found to be associated with unmet sleep need but not with habitual sleep duration when both factors were examined together. We suggest that individual unmet sleep need is more important than habitual sleep duration in terms of the relation to EDS.

Association of TV watching with sleep problems in a church-going population.

PubMed

Serrano, Salim; Lee, Jerry W; Dehom, Salem; Tonstad, Serena

2014-01-01

Sensory stimuli/inactivity may affect sleep. Sleep problems are associated with multiple health problems. We assessed TV habits in the Adventist Health Study-2 at baseline and sleep problems in the Biopsychosocial Religion and Health Study 1 to 4 years later. After exclusions, 3914 subjects split equally into TV watchers less than 2 hours per day or 2 or more hours per day. Watching TV 2 or more hours per day predicted problems falling asleep, middle of the night awakening, and waking early with inability to sleep again in multiple logistic regression. Excess TV watching disturbed sleep induction and quality, though the relationship may be bidirectional. TV habits should be considered in individuals with sleep problems.

Work health determinants in employees without sickness absence.

PubMed

Schell, E; Theorell, T; Nilsson, B; Saraste, H

2013-01-01

Working ability is known to be related to good physical condition, clear work tasks, positive feedback and other occupational, organizational and psychosocial factors. In Sweden, high levels of sickness absence are due to stress-related disorders and musculoskeletal pain. To identify work health characteristics in a working population with a large variety of professional skills and occupational tasks. Employers' data on occupation, sickness absence, age and gender in a working population of 11 occupational groups and questionnaire responses regarding work-organization, environment, work stress, pain, health, and socio-demographic factors were collected. Employees with no history of sick-leave were compared with those with a history of sick-leave (1-182 days, mean 25 days). Of 2641 employees, 1961 participated. Those with no history of sick-leave reported less work-related pain, work-related stress, sleep disturbances, worry about their health, 'sick-presenteeism', monotonous work, bent and twisted working positions and exposure to disturbing noise than those with a history of sick-leave (P < 0.001). They also reported better health, support from superiors, having influence on their working hours and evening and week-end working, longer working hours per week (P < 0.001) and more regular physical training (P < 0.01). Socio-demographic factors were less important than gender, and differences in responses between occupational groups were also found. Workers without a history of sick-leave experienced less stress, sleep disturbances, worry about their own health and less neck, shoulder and back pain and more support from their superiors and influence on their working hours.

When policy meets physiology: the challenge of reducing resident work hours.

PubMed

Lockley, Steven W; Landrigan, Christopher P; Barger, Laura K; Czeisler, Charles A

2006-08-01

Considerable controversy exists regarding optimal work hours for physicians and surgeons in training. In a series of studies, we assessed the effect of extended work hours on resident sleep and health as well as patient safety. In a validated nationwide survey, we found that residents who had worked 24 hours or longer were 2.3 times more likely to have a motor vehicle crash following that shift than when they worked < 24 hours, and that the monthly risk of a crash increased by 16.2% after each extended duration shift. We also found in a randomized trial that interns working a traditional on-call schedule slept 5.8 hours less per week, had twice as many attentional failures on duty overnight, and made 36% more serious medical errors and nearly six times more serious diagnostic errors than when working on a schedule that limited continuous duty to 16 hours. While numerous opinions have been published opposing reductions in extended work hours due to concerns regarding continuity of patient care, reduced educational opportunities, and traditionally-defined professionalism, there are remarkably few objective data in support of continuing to schedule medical trainees to work shifts > 24 hours. An evidence-based approach is needed to minimize the well-documented risk that current work hour practices confer on resident health and patient safety while optimizing education and continuity of care.

Occupational and public health considerations for work-hour limitations policy regarding public health workers during response to natural and human-caused disasters.

PubMed

Berkowitz, Murray R

2012-01-01

This article examines the occupational health considerations that might impact the health and wellbeing of public health workers during responses to natural (eg, floods and hurricanes) and human-caused (eg, terrorism, war, and shootings) disasters. There are a number of articles in the medical literature that argue the impact of how working long hours by house staff physicians, nurses, and first-responders may pose health and safety concerns regarding the patients being treated. The question examined here is how working long hours may pose health and/or safety concerns for the public health workers themselves, as well as to those in the communities they serve. The health problems related to sleep deprivation are reviewed. Current policies and legislations regarding work-hour limitations are examined. Policy implications are discussed.

The effects of a 12-hour shift in the wake-sleep cycle on physiological and biochemical responses and on multiple task performance.

DOT National Transportation Integrated Search

1975-01-01

Fifteen male paid volunteers (ages 20 to 28) were studied in three groups of five each. The first 4 days of the experiment they slept nights (2230 to 0600( and worked days. On the fifth night, they slept only 3 hours (2100 to 2400) before starting a ...

Microsurgical Performance After Sleep Interruption: A NeuroTouch Simulator Study.

PubMed

Micko, Alexander; Knopp, Karoline; Knosp, Engelbert; Wolfsberger, Stefan

2017-10-01

In times of the ubiquitous debate about doctors' working hour restrictions, it is still questionable if the physician's performance is impaired by high work load and long shifts. In this study, we evaluated the impact of sleep interruption on neurosurgical performance. Ten medical students and 10 neurosurgical residents were tested on the virtual-reality simulator NeuroTouch by performing an identical microsurgical task, well rested (baseline test), and after sleep interruption at night (stress test). Deviation of total score, timing, and excessive force on tissue were evaluated. In addition, vital parameters and self-assessment were analyzed. After sleep interruption, total performance score increased significantly (45.1 vs. 48.7, baseline vs. stress test, P = 0.048) while timing remained stable (10.1 vs. 10.4 minutes for baseline vs. stress test, P > 0.05) for both students and residents. Excessive force decreased in both groups during the stress test for the nondominant hand (P = 0.05). For the dominant hand, an increase of excessive force was encountered in the group of residents (P = 0.05). In contrast to their results, participants of both groups assessed their performance worse during the stress test. In our study, we found an increase of neurosurgical simulator performance in neurosurgical residents and medical students under simulated night shift conditions. Further, microsurgical dexterity remained unchanged. Based on our results and the data in the available literature, we cannot confirm that working hour restrictions will have a positive effect on neurosurgical performance. Copyright © 2017 Elsevier Inc. All rights reserved.

Hours of sleep in adolescents and its association with anxiety, emotional concerns, and suicidal ideation.

PubMed

Sarchiapone, Marco; Mandelli, Laura; Carli, Vladimir; Iosue, Miriam; Wasserman, Camilla; Hadlaczky, Gergö; Hoven, Christina W; Apter, Alan; Balazs, Judit; Bobes, Julio; Brunner, Romuald; Corcoran, Paul; Cosman, Doina; Haring, Christian; Kaess, Michael; Keeley, Helen; Keresztény, Agnes; Kahn, Jean-Pierre; Postuvan, Vita; Mars, Urša; Saiz, Pilar A; Varnik, Peter; Sisask, Merike; Wasserman, Danuta

2014-02-01

Anxiety and concerns in daily life may result in sleep problems and consistent evidence suggests that inadequate sleep has several negative consequences on cognitive performance, physical activity, and health. The aim of our study was to evaluate the association between mean hours of sleep per night, psychologic distress, and behavioral concerns. A cross-sectional analysis of the correlation between the number of hours of sleep per night and the Zung Self-rating Anxiety Scale (Z-SAS), the Paykel Suicidal Scale (PSS), and the Strengths and Difficulties Questionnaire (SDQ), was performed on 11,788 pupils (mean age±standard deviation [SD], 14.9±0.9; 55.8% girls) from 11 different European countries enrolled in the SEYLE (Saving and Empowering Young Lives in Europe) project. The mean number of reported hours of sleep per night during school days was 7.7 (SD, ±1.3), with moderate differences across countries (r=0.06; P<.001). A reduced number of sleeping hours (less than the average) was more common in girls (β=0.10 controlling for age) and older pupils (β=0.10 controlling for sex). Reduced sleep was found to be associated with increased scores on SDQ subscales of emotional (β=-0.13) and peer-related problems (β=-0.06), conduct (β=-0.07), total SDQ score (β=-0.07), anxiety (Z-SAS scores, β=-10), and suicidal ideation (PSS, β=-0.16). In a multivariate model including all significant variables, older age, emotional and peer-related problems, and suicidal ideation were the variables most strongly associated with reduced sleep hours, though female gender, conduct problems measured by the SDQ, and anxiety only showed modest effects (β=0.03-0.04). Our study supports evidence that reduced hours of sleep are associated with potentially severe mental health problems in adolescents. Because sleep problems are common among adolescents partly due to maturational processes and changes in sleep patterns, parents, other adults, and adolescents should pay more attention to their sleep patterns and implement interventions, if needed. Copyright © 2013 Elsevier B.V. All rights reserved.

Sleep Duration versus Sleep Insufficiency as Predictors of Cardiometabolic Health Outcomes

PubMed Central

Altman, Nicole G.; Schopfer, Elizabeth; Jackson, Nicholas; Izci-Balserak, Bilgay; Rattanaumpawan, Pinyo; Gehrman, Philip R.; Patel, Nirav P.; Grandner, Michael A.

2012-01-01

Objective The objective of the present study was to investigate the relationship between sleep insufficiency and sleep duration, particularly regarding negative cardiometabolic health outcomes already considered to be affected by reduced sleep time. Methods A total of N=30,934 participants from the 2009 Behavioral Risk Factor Surveillance System (BRFSS) answered questions about their sleep duration as well as subjective feelings of sleep insufficiency. Outcomes included body mass index (BMI), obesity (BMI≥30), and history of hypertension, diabetes, hypercholesterolemia, heart attack, and stroke. Linear and logistic regression models examined whether cardiometabolic outcomes were associated with (1) sleep duration alone, (2) sleep insufficiency alone, and (3) the combined effect of sleep duration and sleep insufficiency. Results Results indicated that, when examined alone, sleep duration <5 hours (vs 7 hours) was related to BMI (B=2.716, p<0.01), obesity (B=2.080, p<0.000001), diabetes (B=3.162, p<0.000001), hypertension (B=2.703, p<0.000001), hypercholesterolemia (B=1.922, p<0.00001), heart attack (B=4.704, p<0.000001), and stroke (B=4.558, p<0.000001), and sleep insufficiency (days per week, continuous) was related to BMI (B=0.181, p<.01), obesity (B=1.061, p<0.000001), and hypercholesterolemia (B=1.025, p<.01). All of these relationships remained significant after adjustment for covariates, except for diabetes and sleep duration. Also, after adjustment, a significant relationship between insufficient sleep and hypertension emerged (B=1.039, p<.001). When evaluated together, after adjustment for covariates, significant relationships remained between sleep duration <5 hours (vs 7 hours) and BMI (B=1.266, p<0.05), obesity (B=1.389, p<.05), hypertension (B=1.555, p<0.01), heart attack (B=2.513, p<0.01)and stroke (B=1.807, p<0.05). It should be noted that relationships between sleep duration >9 hours (vs 7 hours) were seen for heart attack (B=1.863, p<0.001) and stroke (B=1.816, p<0.01). In these models, sleep insufficiency was associated with hypercholesterolemia (B=1.031, p<0.01)and hypertension (B=1.027, p<0.05). Conclusions These analyses show that both sleep duration and insufficiency are related to cardiometabolic health outcomes, and that when evaluated together, both variables demonstrate unique effects. PMID:23141932

Split-shift work in relation to stress, health and psychosocial work factors among bus drivers.

PubMed

Ihlström, Jonas; Kecklund, Göran; Anund, Anna

2017-01-01

Shift work has been associated with poor health, sleep and fatigue problems and low satisfaction with working hours. However, one type of shift working, namely split shifts, have received little attention. This study examined stress, health and psychosocial aspects of split-shift schedules among bus drivers in urban transport. A questionnaire was distributed to drivers working more than 70% of full time which 235 drivers in total answered. In general, drivers working split-shift schedules (n = 146) did not differ from drivers not working such shifts (n = 83) as regards any of the outcome variables that were studied. However, when individual perceptions towards split-shift schedules were taken into account, a different picture appeared. Bus drivers who reported problems working split shifts (36%) reported poorer health, higher perceived stress, working hours interfering with social life, lower sleep quality, more persistent fatigue and lower general work satisfaction than those who did not view split shifts as a problem. Moreover, drivers who reported problems with split shifts also perceived lower possibilities to influence working hours, indicating lower work time control. This study indicates that split shifts were not associated with increased stress, poorer health and adverse psychosocial work factors for the entire study sample. However, the results showed that individual differences were important and approximately one third of the drivers reported problems with split shifts, which in turn was associated with stress, poor health and negative psychosocial work conditions. More research is needed to understand the individual and organizational determinants of tolerance to split shifts.

Sleep Loss Effects on Continuous Sustained Performance.

DTIC Science & Technology

1982-11-30

Sleep loss, continuous performance, sustained performance, sleep deprivation, sleepiness, fatigue, circadian rhythm, hallucination . 20, ABSTRACT...complete the 42 hours and 9 experienced "psychological events such as hallucinations , visual illusions, and disorientation. Of the 20 subjects who... hallucinations , derealizations, and distortions (Mullaney, Kripke, and Fleck, 1981). All 20 subjects who were given either one 6-hour or six 1-hour

Adolescents' technology and face-to-face time use predict objective sleep outcomes.

PubMed

Tavernier, Royette; Heissel, Jennifer A; Sladek, Michael R; Grant, Kathryn E; Adam, Emma K

2017-08-01

The present study examined both within- and between-person associations between adolescents' time use (technology-based activities and face-to-face interactions with friends and family) and sleep behaviors. We also assessed whether age moderated associations between adolescents' time use with friends and family and sleep. Adolescents wore an actigraph monitor and completed brief evening surveys daily for 3 consecutive days. Adolescents (N=71; mean age=14.50 years old, SD=1.84; 43.7% female) were recruited from 3 public high schools in the Midwest. We assessed 8 technology-based activities (eg, texting, working on a computer), as well as time spent engaged in face-to-face interactions with friends and family, via questions on adolescents' evening surveys. Actigraph monitors assessed 3 sleep behaviors: sleep latency, sleep hours, and sleep efficiency. Hierarchical linear models indicated that texting and working on the computer were associated with shorter sleep, whereas time spent talking on the phone predicted longer sleep. Time spent with friends predicted shorter sleep latencies, while family time predicted longer sleep latencies. Age moderated the association between time spent with friends and sleep efficiency, as well as between family time and sleep efficiency. Specifically, longer time spent interacting with friends was associated with higher sleep efficiency but only among younger adolescents. Furthermore, longer family time was associated with higher sleep efficiency but only for older adolescents. Findings are discussed in terms of the importance of regulating adolescents' technology use and improving opportunities for face-to-face interactions with friends, particularly for younger adolescents. Copyright © 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

A Simulation Analysis of Work Based Navy Manpower Requirements

DTIC Science & Technology

2012-09-01

Workweek is also the subject of greater discussion in the 2002 CNA study. At the time, the Navy Standard Workweek was 67 hours of...policies, states that the Navy Standard Workweek includes 8 hours of sleep a day (Navy, 2007). To properly model this while also treating...system during these non-scheduled hours . Figure 4 shows an example of a sailor’s schedule as built into Arena. The graph’s x-axis represents the

Sleep Loss and Fatigue in Shift Work and Shift Work Disorder

PubMed Central

Åkerstedt, Torbjörn; Wright, Kenneth P.

2010-01-01

Shift work is highly prevalent in industrialized societies (>20%) but, when it includes night work, it has pronounced negative effects on sleep, subjective and physiological sleepiness, performance, accident risk, as well as on health outcomes such as cardiovascular disease and certain forms of cancer. The reason is the conflict between the day oriented circadian physiology and the requirement for work and sleep at the “wrong” biological time of day. Other factors that negatively impact work shift sleepiness and accident risk include long duration shifts greater than 12 hours and individual vulnerability for phase intolerance that may lead to a diagnosis of shift work disorder; i.e., those shift workers with the greatest sleepiness and performance impairment during the biological night and insomnia during the biological day. Whereas some countermeasures may be used to ameliorate the negative impact of shift work on nighttime sleepiness and daytime insomnia (combined countermeasures may be the best available), there seems at present to be no way to eliminate most of the negative effects of shift work on human physiology and cognition. PMID:20640236

A 6-hour working day--effects on health and well-being.

PubMed

Akerstedt, T; Olsson, B; Ingre, M; Holmgren, M; Kecklund, G

2001-12-01

The effect of the total amount of work hours and the benefits of a shortening is frequently debated, but very little data is available. The present study compared a group (N = 41) that obtained a 9 h reduction of the working week (to a 6 h day) with a comparison group (N = 22) that retained normal work hours. Both groups were constituted of mainly female health care and day care nursery personnel. The experimental group retained full pay and extra personnel were employed to compensate for loss of hours. Questionnaire data were obtained before and 1 year after the change. The data were analyzed using a two-factor ANOVA with the interaction term year*group as the main focus. The results showed a significant interaction of year*group for social factors, sleep quality, mental fatigue, and heart/respiratory complaints, and attitude to work hours. In all cases the experimental group improved whereas the control group did not change. It was concluded that shortened work hours have clear social effects and moderate effects on well-being.

Diagnostic and Treatment Challenges of Sighted Non-24-Hour Sleep-Wake Disorder.

PubMed

Malkani, Roneil G; Abbott, Sabra M; Reid, Kathryn J; Zee, Phyllis C

2018-04-15

To report the diagnostic and treatment challenges of sighted non-24-hour sleep-wake disorder (N24SWD). We report a series of seven sighted patients with N24SWD clinically evaluated by history and sleep diaries, and when available wrist actigraphy and salivary melatonin levels, and treated with timed melatonin and bright light therapy. Most patients had a history of a delayed sleep-wake pattern prior to developing N24SWD. The typical sleep-wake pattern of N24SWD was seen in the sleep diaries (and in actigraphy when available) in all patients with a daily delay in midpoint of sleep ranging 0.8 to 1.8 hours. Salivary dim light melatonin onset (DLMO) was evaluated in four patients but was missed in one. The estimated phase angle from DLMO to sleep onset ranged from 5.25 to 9 hours. All six patients who attempted timed melatonin and bright light therapy were able to entrain their sleep-wake schedules. Entrainment occurred at a late circadian phase, possibly related to the late timing of melatonin administration, though the patients often preferred late sleep times. Most did not continue treatment and continued to have a non-24-hour sleep-wake pattern. N24SWD is a chronic debilitating disorder that is often overlooked in sighted people and can be challenging to diagnose and treat. Tools to assess circadian pattern and timing can be effectively applied to aid the diagnosis. The progressive delay of the circadian rhythm poses a challenge for determining the most effective timing for melatonin and bright light therapies. Furthermore, once the circadian sleep-wake rhythm is entrained, long-term effectiveness is limited because of the behavioral and environmental structure that is required to maintain stable entrainment. © 2018 American Academy of Sleep Medicine.

Interaction of Sleep Duration and Sleep Quality on Hypertension Prevalence in Adult Chinese Males.

PubMed

Lu, Kai; Chen, Jia; Wu, Shouling; Chen, Ji; Hu, Dayi

2015-01-01

Previous studies demonstrated conflicting results about the association of sleep duration and hypertension. Given the potential relationship between sleep quality and hypertension, this study aimed to investigate the interaction of self-reported sleep duration and sleep quality on hypertension prevalence in adult Chinese males. We undertook a cross-sectional analysis of 4144 male subjects. Sleep duration were measured by self-reported average sleep time during the past month. Sleep quality was evaluated using the standard Pittsburgh Sleep Quality Index. Hypertension was defined as blood pressure level ≥140/90 mm Hg or current antihypertensive treatment. The association between hypertension prevalence, sleep duration, and sleep quality was analyzed using logistic regression after adjusting for basic cardiovascular characteristics. Sleep duration shorter than 8 hours was found to be associated with increased hypertension, with odds ratios and 95% confidence intervals (CIs) of 1.25 (95% CI, 1.03-1.52) for 7 hours, 1.41 (95% CI, 1.14-1.73) for 6 hours, and 2.38 (95% CI, 1.81-3.11) for <6 hours. Using very good sleep quality as the reference, good, poor, and very poor sleep quality were associated with hypertension, with odds ratios of 1.20 (95% CI, 1.01-1.42), 1.67 (95% CI, 1.32-2.11), and 2.32 (95% CI, 1.67-3.21), respectively. More importantly, further investigation of the association of different combinations of sleep duration and quality in relation to hypertension indicated an additive interaction. There is an additive interaction of poor sleep quality and short sleep duration on hypertension prevalence. More comprehensive measurement of sleep should be performed in future studies.

Physical Activity, Mind Wandering, Affect, and Sleep: An Ecological Momentary Assessment

PubMed Central

Mackenzie, Michael; Roberts, Sarah; Crato, Ines; Ehlers, Diane; McAuley, Edward

2016-01-01

Background A considerable portion of daily thought is spent in mind wandering. This behavior has been related to positive (eg, future planning, problem solving) and negative (eg, unhappiness, impaired cognitive performance) outcomes. Objective Based on previous research suggesting future-oriented (ie, prospective) mind wandering may support autobiographical planning and self-regulation, this study examined associations between hourly mind wandering and moderate-to-vigorous physical activity (MVPA), and the impact of affect and daily sleep on these relations. Methods College-aged adults (N=33) participated in a mobile phone-delivered ecological momentary assessment study for 1 week. Sixteen hourly prompts assessing mind wandering and affect were delivered daily via participants’ mobile phones. Perceived sleep quality and duration was assessed during the first prompt each day, and participants wore an ActiGraph accelerometer during waking hours throughout the study week. Results Study findings suggest present-moment mind wandering was positively associated with future MVPA (P=.03), and this relationship was moderated by affective state (P=.04). Moreover, excessive sleep the previous evening was related to less MVPA across the following day (P=.007). Further, mind wandering was positively related to activity only among those who did not oversleep (P=.007). Conclusions Together, these results have implications for multiple health behavior interventions targeting physical activity, affect, and sleep. Researchers may also build on this work by studying these relationships in the context of other important behaviors and psychosocial factors (eg, tobacco use, depression, loneliness). PMID:27580673

Prevalence of insufficient, borderline, and optimal hours of sleep among high school students - United States, 2007.

PubMed

Eaton, Danice K; McKnight-Eily, Lela R; Lowry, Richard; Perry, Geraldine S; Presley-Cantrell, Letitia; Croft, Janet B

2010-04-01

We describe the prevalence of insufficient, borderline, and optimal sleep hours among U.S. high school students on an average school night. Most students (68.9%) reported insufficient sleep, whereas few (7.6%) reported optimal sleep. The prevalence of insufficient sleep was highest among female and black students, and students in grades 11 and 12. Published by Elsevier Inc.

Task errors by emergency physicians are associated with interruptions, multitasking, fatigue and working memory capacity: a prospective, direct observation study.

PubMed

Westbrook, Johanna I; Raban, Magdalena Z; Walter, Scott R; Douglas, Heather

2018-01-09

Interruptions and multitasking have been demonstrated in experimental studies to reduce individuals' task performance. These behaviours are frequently used by clinicians in high-workload, dynamic clinical environments, yet their effects have rarely been studied. To assess the relative contributions of interruptions and multitasking by emergency physicians to prescribing errors. 36 emergency physicians were shadowed over 120 hours. All tasks, interruptions and instances of multitasking were recorded. Physicians' working memory capacity (WMC) and preference for multitasking were assessed using the Operation Span Task (OSPAN) and Inventory of Polychronic Values. Following observation, physicians were asked about their sleep in the previous 24 hours. Prescribing errors were used as a measure of task performance. We performed multivariate analysis of prescribing error rates to determine associations with interruptions and multitasking, also considering physician seniority, age, psychometric measures, workload and sleep. Physicians experienced 7.9 interruptions/hour. 28 clinicians were observed prescribing 239 medication orders which contained 208 prescribing errors. While prescribing, clinicians were interrupted 9.4 times/hour. Error rates increased significantly if physicians were interrupted (rate ratio (RR) 2.82; 95% CI 1.23 to 6.49) or multitasked (RR 1.86; 95% CI 1.35 to 2.56) while prescribing. Having below-average sleep showed a >15-fold increase in clinical error rate (RR 16.44; 95% CI 4.84 to 55.81). WMC was protective against errors; for every 10-point increase on the 75-point OSPAN, a 19% decrease in prescribing errors was observed. There was no effect of polychronicity, workload, physician gender or above-average sleep on error rates. Interruptions, multitasking and poor sleep were associated with significantly increased rates of prescribing errors among emergency physicians. WMC mitigated the negative influence of these factors to an extent. These results confirm experimental findings in other fields and raise questions about the acceptability of the high rates of multitasking and interruption in clinical environments. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Medical Decisions of Pediatric Residents Turn Riskier after a 24-Hour Call with No Sleep.

PubMed

Aran, Adi; Wasserteil, Netanel; Gross, Itai; Mendlovic, Joseph; Pollak, Yehuda

2017-01-01

Despite a gradual reduction in the workload during residency, 24-hour calls are still an integral part of most training programs. While sleep deprivation increases the risk propensity, the impact on medical risk taking has not been studied. This study aimed to assess the clinical decision making and psychomotor performance of pediatric residents following a limited nap time during a 24-hour call. A neurocognitive battery (IntegNeuro) and a medical decision questionnaire were completed by 44 pediatric residents at 2 time points: after a 24-hour call and following 3 nights with no calls (sleep ≥5 hours). To monitor sleep, residents wore actigraphs and completed sleep logs. Nap time during the shift was <1 hour in 14 cases (32%), 1 to 2 hours in 16 cases (35%), and 2 to 3 hours in 14 cases (32%). Residents who napped less than 1 hour chose the riskier medical option in 50% of cases compared with 36% when answering the same questionnaire after 3 nights with no calls (P = 0.002). This effect was not found in residents who napped 1 to 2 hours (no change in risk taking) or 2 to 3 hours (4% decreased risk taking) (difference between groups, P = 0.001). Risk-taking tendency inversely correlated with sustained attention scores (Pearson = -0.433, P = 0.003). Sustained attention was the neurocognitive domain most affected by sleep deprivation (effect size = 0.29, P = 0.025). This study suggests that residents napping less than an hour during a night shift are prone to riskier clinical decisions. Hence, enabling residents to nap at least 1 hour during shifts is recommended. © The Author(s) 2016.

The dim light melatonin onset following fixed and free sleep schedules.

PubMed

Burgess, Helen J; Eastman, Charmane I

2005-09-01

The time at which the dim light melatonin onset (DLMO) occurs can be used to ensure the correct timing of light and/or melatonin administration in order to produce desired circadian phase shifts. Sometimes however, measuring the DLMO is not feasible. Here we determined if the DLMO was best estimated from fixed sleep times (based on habitual sleep times) or free (ad libitum) sleep times. Young healthy sleepers on fixed (n=60) or free (n=60) sleep schedules slept at home for 6 days. Sleep times were recorded with sleep logs verified with wrist actigraphy. Half-hourly saliva samples were then collected during a dim light phase assessment and were later assayed to determine the DLMO. We found that the DLMO was more highly correlated with sleep times in the free sleepers than in the fixed sleepers (DLMO versus wake time, r=0.70 and r=0.44, both P<0.05). The regression equation between wake time and the DLMO in the free sleepers predicted the DLMO in an independent sample of free sleepers (n=23) to within 1.5 h of the actual DLMO in 96% of cases. These results indicate that the DLMO can be readily estimated in people whose sleep times are minimally affected by work, class and family commitments. Further work is necessary to determine if the DLMO can be accurately estimated in people with greater work and family responsibilities that affect their sleep times, perhaps by using weekend wake times, and if this method will apply to the elderly and patients with circadian rhythm disorders.

The dim light melatonin onset following fixed and free sleep schedules

PubMed Central

Burgess, Helen J.; Eastman, Charmane I.

2013-01-01

Summary The time at which the dim light melatonin onset (DLMO) occurs can be used to ensure the correct timing of light and/or melatonin administration in order to produce desired circadian phase shifts. Sometimes however, measuring the DLMO is not feasible. Here we determined if the DLMO was best estimated from fixed sleep times (based on habitual sleep times) or free (ad libitum) sleep times. Young healthy sleepers on fixed (n = 60) or free (n = 60) sleep schedules slept at home for 6 days. Sleep times were recorded with sleep logs verified with wrist actigraphy. Half-hourly saliva samples were then collected during a dim light phase assessment and were later assayed to determine the DLMO. We found that the DLMO was more highly correlated with sleep times in the free sleepers than in the fixed sleepers (DLMO versus wake time, r = 0.70 and r = 0.44, both P < 0.05). The regression equation between wake time and the DLMO in the free sleepers predicted the DLMO in an independent sample of free sleepers (n = 23) to within 1.5 h of the actual DLMO in 96% of cases. These results indicate that the DLMO can be readily estimated in people whose sleep times are minimally affected by work, class and family commitments. Further work is necessary to determine if the DLMO can be accurately estimated in people with greater work and family responsibilities that affect their sleep times, perhaps by using weekend wake times, and if this method will apply to the elderly and patients with circadian rhythm disorders. PMID:16120097

[Relationships between walking hours, sleeping hours, meaningfulness of life (ikigai) and mortality in the elderly: prospective cohort study].

PubMed

Seki, N

2001-07-01

The purpose of this study was to determine lifestyle factors in the elderly that affected longevity, using a population-based prospective study. The participants were 440 men and 625 women aged 60 to 74 living in a rural Japanese community. The baseline data such as age, sex, present illness, walking hours per day, sleeping hours per day, alcohol consumption, a history of smoking, and "ikigai" (meaningfulness of life) were collected in July 1990. During 90 months of follow-up from July 1990 to December 31 1997, there were 123 deaths. By Cox's multivariate hazard model adjusted age, sex, and medical histories, walking > or = 1 hour/day (HR = 0.63, 95% CI 0.44-0.91) and an "ikigai" (HR = 0.66, 95% CI 0.44-0.99) lowered the risk for all-cause mortality independently. In regard to hours of sleep, the cumulative survival curve showed that 7 hours/day was the border and sleeping > or = 7 hours/day lowered the risk (HR = 0.49 95% CI 0.33-0.74). Based on the findings in this study, walking > or = 1 hour/day, sleeping > or = 7 hours/day, and "ikigai" are important factors for longevity in the elderly.

Mobile usage and sleep patterns among medical students.

PubMed

Yogesh, Saxena; Abha, Shrivastava; Priyanka, Singh

2014-01-01

Exposure of humans to radio frequency electromagnetic field (EMF) both during receiving and transmitting the signals has amplified public and scientific debate about possible adverse effects on human health. The study was designed with the objective of assessing the extent of mobile phone use amongst medical students and finding correlation if any between the hours of usage of mobile to sleep pattern and quality. hundred medical students grouped as cases (n = 57) (> 2 hours/day of mobile usage) and control (n = 43) (≤ 2 hours/day of mobile usage) were examined for their sleep quality & pattern by Pittsburg sleep Quality Index (PSQI). Differences between groups were examined with the Mann Whitney "U" test for proportions (Quantitative values) and with Student't' test for continuous variables. The association of variables was analyzed by Spearman Rank's correlation. Probability was set at < 0.05 as significant. Sleep disturbance, latency and day dysfunction was more in cases especially females. A significant association of hours of usage and sleep indices were observed in both genders (males r = 0.25; p = 0.04, females r = 0.31; p = 0.009). Evening usage of mobile phone in cases showed a statistically significant negative association (-0.606; p = 0.042) with Sleep quality (higher PSQI means sleep deprivation). Students using mobile for > 2 hours/day may cause sleep deprivation and day sleepiness affecting cognitive and learning abilities of medical students.

Reduction of Sleep Deprivation and Fatigue in Mass Transit Rail Operators.

PubMed

Haynes, Ajeenah L

2017-08-01

Sleep and work schedules differ considerably between rail workers and the broader U.S. workforce. Due to extended work hours and night shift schedules, train and engine service workers who operate passenger trains or move freight are most vulnerable to fatigue. This article addresses the need for comprehensive fatigue risk management systems (FRMS) for rail operators. Using a transactional ergonomic perspective, FRMS are discussed with a focus on fatigue education and administrative controls to reduce feelings of tiredness, low motivation, poor concentration, and low physical activity among mass transit rail operators. Recommendations for intervention implementation and evaluation are provided.

Sleep education in pediatric residency programs: a cross-cultural look.

PubMed

Mindell, Jodi A; Bartle, Alex; Ahn, Youngmin; Ramamurthy, Mahesh Babu; Huong, Huynh Thi Duy; Kohyama, Jun; Li, Albert M; Ruangdaraganon, Nichara; Sekartini, Rini; Teng, Arthur; Goh, Daniel Y T

2013-04-03

The objective of this study was to assess the prevalence of education about sleep and sleep disorders in pediatric residency programs and to identify barriers to providing such education. Surveys were completed by directors of 152 pediatric residency programs across 10 countries (Hong Kong, India, Indonesia, Japan, Singapore, South Korea, Thailand, United States-Canada, and Vietnam). Overall, the average amount of time spent on sleep education is 4.4 hours (median = 2.0 hours), with 23% responding that their pediatric residency program provides no sleep education. Almost all programs (94.8%) offer less than 10 hours of instruction. The predominant topics covered include sleep-related development, as well as normal sleep, sleep-related breathing disorders, parasomnias, and behavioral insomnia of childhood. These results indicate that there is still a need for more efforts to include sleep-related education in all pediatric residency programs, as well as coverage of the breadth of sleep-related topics. Such education would be consistent with the increased recognition of the importance of sleep and under-diagnosis of sleep disorders in children and adolescents.

Sleep education in pediatric residency programs: a cross-cultural look

PubMed Central

2013-01-01

Background The objective of this study was to assess the prevalence of education about sleep and sleep disorders in pediatric residency programs and to identify barriers to providing such education. Methods Surveys were completed by directors of 152 pediatric residency programs across 10 countries (Hong Kong, India, Indonesia, Japan, Singapore, South Korea, Thailand, United States-Canada, and Vietnam). Results Overall, the average amount of time spent on sleep education is 4.4 hours (median = 2.0 hours), with 23% responding that their pediatric residency program provides no sleep education. Almost all programs (94.8%) offer less than 10 hours of instruction. The predominant topics covered include sleep-related development, as well as normal sleep, sleep-related breathing disorders, parasomnias, and behavioral insomnia of childhood. Conclusions These results indicate that there is still a need for more efforts to include sleep-related education in all pediatric residency programs, as well as coverage of the breadth of sleep-related topics. Such education would be consistent with the increased recognition of the importance of sleep and under-diagnosis of sleep disorders in children and adolescents. PMID:23552445

Physical Activity of Nurse Clinical Practitioners and Managers.

PubMed

Jirathananuwat, Areeya; Pongpirul, Krit

2017-11-01

This study was aimed (1) to compare the level of physical activity (PA) between working and nonworking hours and (2) to compare the level of PA during working hours of nurse clinical practitioners (NCPs) with that of nurse managers (NMs). This cross-sectional survey was conducted at a Thai university hospital from October 2015 to March 2016. All randomly selected participants wore an activity tracker on their hip for 5 days, except during bathing and sleeping periods, to record step counts and time points. Of 884 nurses, 289 (142 NCPs and 147 NMs) were randomly selected. The average age was 35.87 years. They spent 9.76 and 6.01 hours on work and nonwork activities, respectively. Daily steps per hour were significantly lower during work than nonwork periods (P < .001). An NCP had significantly higher overall hourly PA (P = .002). The number of steps per hour during work period of NCP was significantly higher than that of NM even after adjusting for age, work experience, and body mass index (P = .034). NCP had higher overall PA than NM, which was partly contributed by work-related PA. Level of PA for a professional with variation of actual work hours should be measured on hourly basis.

Smoking, Screen-Based Sedentary Behavior, and Diet Associated with Habitual Sleep Duration and Chronotype: Data from the UK Biobank

PubMed Central

Patterson, Freda; Malone, Susan Kohl; Lozano, Alicia; Grandner, Michael A.; Hanlon, Alexandra L.

2016-01-01

Background Sleep duration has been implicated in the etiology of obesity but less is known about the association between sleep and other behavioral risk factors for cardiovascular disease. Purpose The aim of this study was to examine the associations among sleep duration, chronotype, and physical activity, screen-based sedentary behavior, tobacco use, and dietary intake. Methods Regression models were used to examine sleep duration and chronotype as the predictors and cardiovascular risk factors as outcomes of interest in a cross-sectional sample of 439,933 adults enrolled in the UK Biobank project. Results Short sleepers were 45 % more likely to smoke tobacco than adequate sleepers (9.8 vs. 6.9 %, respectively). Late chronotypes were more than twice as likely to smoke tobacco than intermediate types (14.9 vs. 7.4 %, respectively). Long sleepers reported 0.61 more hours of television per day than adequate sleepers. Early chronotypes reported 0.20 fewer daily hours of computer use per day than intermediate chronotypes. Early chronotypes had 0.25 more servings of fruit and 0.13 more servings of vegetables per day than late chronotypes. Conclusions Short and long sleep duration and late chronotype are associated with greater likelihood of cardiovascular risk behaviors. Further work is needed to determine whether these findings are maintained in the context of objective sleep and circadian estimates, and in more diverse samples. The extent to which promoting adequate sleep duration and earlier sleep timing improves heart health should also be examined prospectively. PMID:27056396

Socioeconomic status, occupational characteristics, and sleep duration in African/Caribbean immigrants and US White health care workers.

PubMed

Ertel, Karen A; Berkman, Lisa F; Buxton, Orfeu M

2011-04-01

o advance our understanding of the interplay of socioeconomic factors, occupational exposures, and race/ethnicity as they relate to sleep duration. We hypothesize that non Hispanic African/Caribbean immigrant employees in long term health care have shorter sleep duration than non Hispanic white employees, and that low education, low income, and occupational exposures including night work and job strain account for some of the African/Caribbean immigrant-white difference in sleep duration. Cross sectional Four extended care facilities in Massachusetts, United States 340 employees in extended care facilities Sleep duration was assessed with wrist actigraphy for a mean of 6.3 days. In multivariable regression modeling controlling for gender and age, African/Caribbean immigrants slept 64.4 fewer minutes (95% CI: -81.0, -47.9) per night than white participants; additional control for education and income reduced the racial gap to 50.9 minutes (-69.2, -32.5); additional control for the occupational factors of hours worked per week and working the night shift reduced the racial gap to 37.7 minutes (-57.8, -17.6). his study provides support for the hypothesis that socioeconomic and occupational characteristics explain some of the African/ Caribbean immigrant-white difference in sleep duration in the United States, especially among health care workers.

Sleep-dependent Memory Consolidation in the Epilepsy Monitoring Unit: a Pilot Study

PubMed Central

Sarkis, Rani A.; Alam, Javad; Pavlova, Milena K.; Dworetzky, Barbara A.; Pennell, Page B.; Stickgold, Robert; Bubrick, Ellen J.

2018-01-01

Objective We sought to examine whether patients with focal epilepsy exhibit sleep dependent memory consolidation, whether memory retention rates correlated with particular aspects of sleep physiology, and how the process was affected by seizures. Methods We prospectively recruited patients with focal epilepsy and assessed declarative memory using a task consisting of 15 pairs of colored pictures on a 5 × 6 grid. Patients were tested 12 hours after training, once after 12 hours of wakefulness and once after 12 hours that included sleep. EMG chin electrodes were placed to enable sleep scoring. The number and density of sleep spindles were assessed using a wavelet-based algorithm. Results Eleven patients were analyzed age 21–56 years. The percentage memory retention over 12 hours of wakefulness was 62.7% % and over 12 hours which included sleep 83.6 % (p = 0.04). Performance on overnight testing correlated with the duration of slow wave sleep (SWS) (r=+0.63, p <0.05). Three patients had seizures during the day, and another 3 had nocturnal seizures. Day-time seizures did not affect retention rates, while those patients who had night time seizures had a drop in retention from an average of 92% to 60.5%. Conclusions There is evidence of sleep dependent memory consolidation in patients with epilepsy which mostly correlates with the amount of SWS. Our preliminary findings suggest that nocturnal seizures likely disrupt sleep dependent memory consolidation. Significance Findings highlight the importance of SWS in sleep dependent memory consolidation and the adverse impact of nocturnal seizures on this process. PMID:27417054

[Sleep habits, sleep quality and sleep medicine use of the Swiss population result].

PubMed

Tinguely, Gilberte; Landolt, Hans-Peter; Cajochen, Christian

2014-11-01

A survey in a representative sample of the Swiss population revealed an average sleep duration of 7.5 hours on workdays and of 8.5 hours on free days, which reflected a more than half an hour (38 min) shorter sleep duration than 28 years ago. The mean time in bed was between 22:41 and 06:37 on workdays and between 23:29 and 08:27 on free days. On workdays as well as on free days the bedtime was delayed by 47 minutes in comparison to a similar survey 28 years ago. By contrast, the mean rise times on workdays and free days did not change. The sleep duration required to feel refreshed was indicated with 7 hours, which was 41 minutes less than 28 years ago. Roughly 90 % of the interviewees answered that they felt healthy, and 75 % described their sleep as good or very good compared to 79 % 28 years ago. The most frequent reasons stated for bad sleep were personal problems and strain at the workplace. The effect of bad quality sleep on every day functioning was considered as essential by 65 % of the respondents compared to 69 % 28 years ago. The use of medication to improve sleep was declared by 2.8 % (2.7 % 28 years ago), most often benzodiazepines, but also Valerian products and so-called z-drugs. In comparison with similar surveys in other countries (France, Great Britain and USA), Swiss residents slept roughly half an hour longer, but these other countries alike showed a sizable shortening of their habitual sleep duration over the last decades.

Hours of television viewing and sleep duration in children: a multicenter birth cohort study.

PubMed

Marinelli, Marcella; Sunyer, Jordi; Alvarez-Pedrerol, Mar; Iñiguez, Carmen; Torrent, Maties; Vioque, Jesús; Turner, Michelle C; Julvez, Jordi

2014-05-01

This study used longitudinal data to examine potential associations between hours of television viewing and sleep duration in children. To examine the association between hours of television viewing and sleep duration in preschool and school-aged children. Longitudinal, multicenter study among birth cohorts in Menorca, Sabadell, and Valencia from the Spanish Infancia y Medio Ambiente (environment and childhood) project. The study sample included 1713 children (468 from Menorca, 560 from Sabadell, and 685 from Valencia). Parent-reported child television viewing duration measured in hours per day at 2 and 4 years of age in Sabadell and Valencia and at 6 and 9 years of age in Menorca. Parent-reported child sleep duration measured in hours per day at 2 and 4 years of age in Sabadell and Valencia and at 6 and 9 years of age in Menorca. In cross-sectional analysis, children with longer periods of television viewing reported at baseline (≥ 1.5 hours per day) had shorter sleep duration. Longitudinally, children with reported increases in television viewing duration over time (from <1.5 to ≥ 1.5 hours per day) had a reduction in sleep duration at follow-up visits. Results were similar when examining television viewing duration as a continuous variable, with each 1 hour per day of increased viewing decreasing sleep duration at follow-up visits (β = -0.11; 95% CI, -0.18 to -0.05). Associations were similar when television viewing duration was assessed during weekends and after adjusting for potential intermediate factors (child executive function and attention-deficit/hyperactivity disorder symptoms) and confounders (child physical activity level, parental mental health status, maternal IQ, and maternal marital status). Children spending longer periods watching television had shorter sleep duration. Changes in television viewing duration were inversely associated with changes in sleep duration in longitudinal analysis. Parents should consider avoiding long periods of daily television exposure among preschool and school-aged children.

16 CFR 305.17 - Television labeling.

Code of Federal Regulations, 2013 CFR

2013-01-01

... this part and based on a usage rate of 5 hours in on mode and 19 hours in standby (sleep) mode per day... rate of 5 hours in on mode and 19 hours in sleep (standby) mode per day. (8) No marks or information...

16 CFR 305.17 - Television labeling.

Code of Federal Regulations, 2012 CFR

2012-01-01

... this part and based on a usage rate of 5 hours in on mode and 19 hours in standby (sleep) mode per day... rate of 5 hours in on mode and 19 hours in sleep (standby) mode per day. (8) No marks or information...

Sleep Duration, Mortality, and Heredity-A Prospective Twin Study.

PubMed

Åkerstedt, Torbjörn; Narusyte, Jurgita; Alexanderson, Kristina; Svedberg, Pia

2017-10-01

A number of studies have shown a U-shaped association between sleep duration and mortality. Since sleep duration is partly genetically determined, it seems likely that its association with mortality is also genetically influenced. The purpose of the present study was to investigate the influence on heredity on the association between sleep duration and mortality. We used a cohort of 14267 twins from the Swedish Twin Registry. A Cox proportional hazards regression analysis, adjusted for a number of covariates, confirmed a clear U shape with a hazard ratio (HR) = 1.34 and 95% confidence interval (CI) = 1.15-1.57 for a sleep duration of ≤6.5 hours and HR = 1.18 (CI = 1.07-1.30) for sleep of ≥9.5 hours. Reference value was 7.0 hours. A co-twin analysis of 1942 twins discordant on mortality showed a HR = 2.66 (CI = 1.17-6.04) for long (≥9.5 hours) sleep in monzygotic twins and an HR = 0.66 (CI = 0.20-2.14) for short (<6.5 hours) sleep. In dizygotic twins, no association was significant. The heritability for mortality was 28% for the whole group, while it was 86% for short sleepers and 42% for long sleepers. Thus, the link with mortality for long sleep appears to be more due to environmental factors than to heredity, while heritability dominates among short sleepers. We found that both long and short sleep were associated with higher total mortality, that the difference in mortality within twin pairs is associated with long sleep, and that short sleep has a higher heritability for mortality, while long sleep is associated with more environmental influences on mortality. © Sleep Research Society 2017. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

Sleep patterns and insomnia among portuguese adolescents: a cross-sectional study.

PubMed

Amaral, Odete; Garrido, António; Pereira, Carlos; Veiga, Nélio; Serpa, Carla; Sakellarides, Constantino

2014-11-01

Inadequate sleep patterns and insomnia are frequently linked and represent common sleep disorders among adolescents. The present study provides data on sleep patterns and insomnia among Portuguese adolescents. In a cross-sectional study we evaluated 6,919 students from the 7th to the 12th grade from twenty-six secondary schools. Data was collected using a self-administered questionnaire. Insomnia was defined based on the Diagnostic and Statistical Manual of Mental Disorders IV criteria and daytime sleepiness was assessed with the Epworth Sleepiness Scale. Sleep patterns evaluated both sleep duration ("insufficient" sleep was defined as < 8 hours per night) and bedtime schedules and regularity. The prevalence of insomnia was 8.3%, insomnia symptoms 21.4% and insufficient sleep 29.3%. All prevalence were higher among girls (P<.001). Average sleep time, on weeknights, was 8:04±1:13 hours. On average adolescents went to bed at 22:18±1:47 hours, took 21 minutes to fall asleep and woke up at 7:15±0:35 hours. Only 6.4% of adolescents stated having a regular bedtime. The majority of adolescents (90.6%) reported having difficulty waking up, 64.7% experienced daytime sleepiness and 53.3% experienced sleep during classes. There are high prevalence of inadequate sleep patterns, insufficient sleep and insomnia among Portuguese adolescents. Insufficient sleep is associated with sleep patterns and social and behavioural factors. These results add to our knowledge of adolescent sleep worldwide. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Do sleep disturbances mediate the association between work-family conflict and depressive symptoms among nurses? A cross-sectional study.

PubMed

Zhang, Y; Duffy, J F; De Castillero, E Ronan

2017-10-01

Nurses are at a high risk for work-family conflict due to long and irregular work hours and multiple physical and psychosocial stressors in their work environment. Nurses report higher rates of depressive symptoms than the general public, leading to a high rate of burnout, absenteeism, and turnover. Work-family conflict is associated with negative consequences in nurses including physical illnesses and mental disorders. Past research on this topic has not examined the mechanisms for the effect of work family conflict on depression. Studies rarely examine the influence of health behaviors such as sleep in explaining this association. Our study identified significant association of sleep disturbances with both work-family conflict and depressive symptoms in nurses. Our main contribution is reporting the important role of sleep disturbances in translating the effect of work-family conflict on depressive symptoms among nurses. Nurses need to receive training in best practices for maintaining their own sleep and mental health. Organizations should include sleep health education and training in workplace health programs. Evidence-based interventions to promote healthy sleep practices such as cognitive behavioral therapy and complementary and integrative approaches should be evaluated for their effectiveness in addressing the impact of work-family conflict on the mental health of nurses. Healthcare organizations should incorporate mental health services as part of their Employee Assistance Program for nurses and include psychological and sleep disorders screening, counseling, and follow-up. Introduction Depression has been identified as the leading cause of disability worldwide. Nurses report higher rates of depression than the general public. Work-family conflict is challenging for nurses and may lead to depression and poor health. However, the mechanisms for the effect of work-family conflict on depression have not been well understood. Aim The objective is to use a cross-sectional design to examine the role of sleep disturbances in the association between work-family conflict and depressive symptoms in nurses. Methods Questionnaires, measuring working conditions, work-family conflict, sleep disturbances and depressive symptoms were collected from 397 nurses at a not-for-profit community hospital in the north-eastern United States. Results We observed a significant association between work-family conflict and depressive symptoms (β = 2.22, p < .001) among nurses. Sleep disturbances partially mediated this association by 40.54%. Discussion Sleep disturbances play an important role in translating work-family conflict into depressive symptoms. Implications Evidence-based interventions to promote healthy sleep practices should be evaluated for their effectiveness in addressing the impact of work-family conflict on mental health. Organizations should include sleep education and training as a component of workplace health promotion and employee assistance programmes to mitigate the effect of work-family conflict and promote overall health in nurses. © 2017 John Wiley & Sons Ltd.

Actigraphy Measured Sleep Indices and Adiposity: The Multi-Ethnic Study of Atherosclerosis (MESA).

PubMed

Ogilvie, Rachel P; Redline, Susan; Bertoni, Alain G; Chen, Xiaoli; Ouyang, Pamela; Szklo, Moyses; Lutsey, Pamela L

2016-09-01

To investigate the cross-sectional relationship between objectively measured sleep characteristics and multiple indices of adiposity in racially/ethnically diverse older adults within the MESA Sleep study (n = 2,146). 7-day actigraphy was used to assess sleep duration, sleep efficiency, and night-to-night variability. Body mass index (BMI), waist circumference, and total body fat were modeled continuously and according to obesity cut-points. Models were adjusted for demographic, socioeconomic, and behavioral variables. Participants who slept less than 6 hours a night had significantly higher BMI, waist circumference, and body fat relative to those who slept 7-8 hours. Those who slept less than 5 hours had a 16% higher prevalence of general obesity (BMI ≥ 30 vs. < 25 kg/m(2)) (95% [CI]: 0.08-0.24) and a 9% higher prevalence of abdominal obesity (waist circumference: women ≥ 88 centimeters, men ≥ 102 centimeters; 95% CI: 0.03-0.16) compared to those who slept 7-8 hours. Results were similar for sleep efficiency and night-to-night sleep variability. Among an older multi-ethnic cohort, we found robust associations across multiple indices of sleep and adiposity. Targeting sleep characteristics may be of benefit in obesity interventions, but more research is needed to rule out reverse causality. © 2016 Associated Professional Sleep Societies, LLC.

Sleep Duration and School Readiness of Chinese Preschool Children.

PubMed

Tso, Winnie; Rao, Nirmala; Jiang, Fan; Li, Albert Martin; Lee, So-Lun; Ho, Frederick Ka-Wing; Li, Sophia Ling; Ip, Patrick

2016-02-01

To examine the average sleep duration in Chinese preschoolers and to investigate the association between sleep duration and school readiness. This is a cross-sectional study that included 553 Chinese children (mean age = 5.46 years) from 20 preschools in 2 districts of Hong Kong. Average daily sleep duration in the last week was reported by parents and school readiness as measured by the teacher-rated Chinese Early Development Instrument (CEDI). Most Chinese preschoolers had 9-10 hours of sleep per day. Only 11% of preschoolers had the recommended 11-12 hours of sleep per day. This group was associated with more "very ready" CEDI domains. Sleep deprivation (≤7 hours per day) was associated with a lower CEDI total score, lower scores in the emotional maturity and language/cognitive domain, and prosocial behaviors subdomain but a greater score in the hyperactivity/inattention subdomain. Children with a lower family socioeconomic index, lower maternal education level, infrequent parent-child interactions, and who used electronic devices for more than 3 hours per day had shortened sleep durations. Optimal sleep duration was associated with better school readiness in preschool children, whereas sleep deprivation was associated with lower school readiness, more hyperactivity and inattention, and less prosocial behavior. Copyright © 2016 Elsevier Inc. All rights reserved.

Anandamide enhances extracellular levels of adenosine and induces sleep: an in vivo microdialysis study.

PubMed

Murillo-Rodriguez, Eric; Blanco-Centurion, Carlos; Sanchez, Cristina; Piomelli, Daniele; Shiromani, Priyattam J

2003-12-15

The principal component of marijuana, delta-9-tetrahydrocannabinol increases sleep in humans. Endogenous cannabinoids, such as N-arachidonoylethanolamine (anandamide), also increase sleep. However, the mechanism by which these molecules promote sleep is not known but might involve a sleep-inducing molecule such as adenosine. Microdialysis samples were collected from the basal forebrain in order to detect levels of adenosine before and after injection of anandamide. Rats were implanted for sleep studies, and a cannula was placed in the basal forebrain to collect microdialysis samples. Samples were analyzed using high-performance liquid chromatography. Basic neuroscience research laboratory. Three-month-old male F344 rats. At the start of the lights-on period, animals received systemic injections of dimethyl sulfoxide (vehicle), anandamide, SR141716A (cannabinoid receptor 1 [CB1] antagonist), or SR141716A and anandamide. One hour after injections, microdialysis samples were collected (5 microL) from the basal forebrain every hour over a 20-minute period for 5 hours. The samples were immediately analyzed via high-performance liquid chromatography for adenosine levels. Sleep was also recorded continuously over the same period. Anandamide increased adenosine levels compared to vehicle controls with the peak levels being reached during the third hour after drug injection. There was a significant increase in slow-wave sleep during the third hour. The induction in sleep and the rise in adenosine were blocked by the CB1-receptor antagonist, SR141716A. Anandamide increased adenosine levels in the basal forebrain and also increased sleep. The soporific effects of anandamide were mediated by the CB1 receptor, since the effects were blocked by the CB1-receptor antagonist. These findings identify a potential therapeutic use of endocannabinoids to induce sleep in conditions where sleep may be severely attenuated.

Dose-response relationship between sleep duration and human psychomotor vigilance and subjective alertness

NASA Technical Reports Server (NTRS)

Jewett, M. E.; Dijk, D. J.; Kronauer, R. E.; Dinges, D. F.

1999-01-01

Although it has been well documented that sleep is required for human performance and alertness to recover from low levels after prolonged periods of wakefulness, it remains unclear whether they increase in a linear or asymptotic manner during sleep. It has been postulated that there is a relation between the rate of improvement in neurobehavioral functioning and rate of decline of slow-wave sleep and/or slow-wave activity (SWS/SWA) during sleep, but this has not been verified. Thus, a cross-study comparison was conducted in which dose-response curves (DRCs) were constructed for Stanford Sleepiness Scale (SSS) and Psychomotor Vigilance Task (PVT) tests taken at 1000 hours by subjects who had been allowed to sleep 0 hours, 2 hours, 5 hours or 8 hours the previous night. We found that the DRCs to each PVT metric improved in a saturating exponential manner, with recovery rates that were similar [time constant (T) approximately 2.14 hours] for all the metrics. This recovery rate was slightly faster than, though not statistically significantly different from, the reported rate of SWS/SWA decline (T approximately 2.7 hours). The DRC to the SSS improved much more slowly than psychomotor vigilance, so that it could be fit equally well by a linear function (slope = -0.26) or a saturating exponential function (T = 9.09 hours). We conclude that although SWS/SWA, subjective alertness, and a wide variety of psychomotor vigilance metrics may all change asymptotically during sleep, it remains to be determined whether the underlying physiologic processes governing their expression are different.

The impact of multiple care giving roles on fatigue, stress, and work performance among hospital staff nurses.

PubMed

Scott, Linda D; Hwang, Wei-Ting; Rogers, Ann E

2006-02-01

This study describes fatigue and stress among a random sample of full-time hospital staff nurses (n=393) who provide care for aging family members, compares the results to nurses with and without children younger than 18 years living at home, examines differences in sleep duration, and explores the effects on work performance by care giving status during a 4-week period. Little attention has been given to the effects of care giver well-being when individuals assume dual roles as family and professional care givers. Hospital staff nurses recorded daily information concerning their work hours, errors, sleep/wake patterns, perceptions of fatigue, alertness, and stress and periods of drowsiness and sleep episodes while on duty for 28 days. Fatigue and stress levels were significantly higher among nurses caring for both children and elders. However, nurses providing elder care at home were more fatigued, sleep-deprived, and likely to make errors at work. These findings underscore the importance of restorative sleep interventions and fatigue countermeasures for hospital staff nurses involved in dual care giving roles. Limiting overtime and applying circadian principles to hospital scheduling processes would ensure a more alert workforce, minimize health risks for nurses, and maximize the safety of those in their care.

Effects of direction of rotation in continuous and discontinuous 8 hour shift systems

PubMed Central

Tucker, P.; Smith, L.; Macdonald, I.; Folkard, S.

2000-01-01

OBJECTIVES—Previous research has produced conflicting evidence on the relative merits of advancing and delaying shift systems. The current study assessed the effects of the direction of shift rotation within 8 hour systems, upon a range of measures including sleep, on shift alertness, physical health, and psychological wellbeing.
METHODS—An abridged version of the standard shiftwork index which included retrospective alertness ratings was completed by four groups of industrial shiftworkers on relatively rapidly rotating 8 hour systems (n=611). Two groups worked continuous systems that were either advancing or delaying; the other two groups worked discontinuous systems that were either advancing or delaying.
RESULTS—Few effects were found of direction of rotation on chronic measures of health and wellbeing, even when the systems incorporated "quick returns" (a break of only 8 hours when changing from one shift to another). This was despite the use of measures previously shown to be sensitive to the effects of a broad range of features of shift systems. However, advancing continuous systems seemed to be associated with marginally steeper declines in alertness across the shift (F (3,1080)=2.87, p<0.05). They were also associated with shorter sleeps between morning shifts (F (1,404)=4.01, p<0.05), but longer sleeps between afternoons (F (1,424)=4.16, p<0.05).
CONCLUSIONS—The absence of negative effects of advancing shifts upon the chronic outcome measures accorded with previous evidence that advancing shifts may not be as harmful as early research indicated. However, this interpretation is tempered by the possibility that difficult shift systems self select those workers most able to cope with their deleterious effects. The presence of quick returns in advancing continuous systems seemed to impact upon some of the acute measures such as duration of sleep, although the associated effects on alertness seemed to be marginal.


Keywords: shift rotation; health; alertness PMID:10984340

Adaptation rate of 6-sulfatoxymelatonin and cognitive performance in offshore fleet shift workers: a field study.

PubMed

Hansen, Jakob H; Geving, Ingunn H; Reinertsen, Randi E

2010-08-01

To determine the total phase delay and adaptation rate of 6-sulfatoxymelatonin (aMT6s) on subjective and objective sleep quality and cognitive performance after 7 days of working night shifts (1800-0600 hours). The subjects studied were offshore fleet workers (N = 7). Seven days of urine samples were collected to determine the total phase delay and adaptation rate of aMT6s. Subjective and objective sleep quality was registered with sleep diaries and actigraphy on a daily basis. Cognitive performance, as measured by vigilance and reaction time, was measured with the Vienna test system on days 1 and 7. Light exposure was measured in the vessel compartments daily. The rhythm of aMT6s shifted significantly from 4.78 +/- 0.94 h on day 1 to 8.84 +/- 1.76 h on day 7. Rate of adaptation was 0.84 h per day. Subjective sleep quality showed significant time effects on four variables, but objective sleep quality did not show any significant time effects. Vigilance and reaction time improved significantly from days 1 to 7. Light exposure intensities varied between 3 and 243 lux. This field study showed that offshore fleet workers are able to adapt to the imposed regimen of 12-h night shifts. The adaptation is slower compared to other branches of the offshore industry, which most likely is due to lower light exposure. Subjective sleep quality improved to some extent, but the results were not conclusive. No significant effects were observed in the objective measures. Cognitive performance improved significantly, which was likely to be caused by the extended working hours on day 1 and an entrainment of the suprachiasmatic nuclei (SCN).

Effect of cessation of late-night landing noise on sleep electrophysiology in the home

NASA Technical Reports Server (NTRS)

Pearsons, K. S.; Fidell, S.; Bennett, R. L.; Friedman, J.; Globus, G.

1974-01-01

Simultaneous measurements of noise exposure and sleep electrophysiology were made in homes before and after cessation of nighttime aircraft landing noise. Six people were tested, all of whom had been exposed to intense aircraft noise for at least two years. Noise measurements indicated a large reduction in the hourly noise level during nighttime hours, but no charge during the daytime hours. Sleep measures indicated no dramatic changes in sleep patterns either immediately after a marked change in nocturnal noise exposure or approximately a month thereafter. No strong relationship was observed between noise level and sleep disturbances over the range from 60 to 90 db(A).

Effects of recovery sleep after one work week of mild sleep restriction on interleukin-6 and cortisol secretion and daytime sleepiness and performance.

PubMed

Pejovic, Slobodanka; Basta, Maria; Vgontzas, Alexandros N; Kritikou, Ilia; Shaffer, Michele L; Tsaoussoglou, Marina; Stiffler, David; Stefanakis, Zacharias; Bixler, Edward O; Chrousos, George P

2013-10-01

One workweek of mild sleep restriction adversely impacts sleepiness, performance, and proinflammatory cytokines. Many individuals try to overcome these adverse effects by extending their sleep on weekends. To assess whether extended recovery sleep reverses the effects of mild sleep restriction on sleepiness/alertness, inflammation, and stress hormones, 30 healthy young men and women (mean age ± SD, 24.7 ± 3.5 yr; mean body mass index ± SD, 23.6 ± 2.4 kg/m(2)) participated in a sleep laboratory experiment of 13 nights [4 baseline nights (8 h/night), followed by 6 sleep restriction nights (6 h/night) and 3 recovery nights (10 h/night)]. Twenty-four-hour profiles of circulating IL-6 and cortisol, objective and subjective daytime sleepiness (Multiple Sleep Latency Test and Stanford Sleepiness Scale), and performance (Psychomotor Vigilance Task) were assessed on days 4 (baseline), 10 (after 1 wk of sleep restriction), and 13 (after 2 nights of recovery sleep). Serial 24-h IL-6 plasma levels increased significantly during sleep restriction and returned to baseline after recovery sleep. Serial 24-h cortisol levels during restriction did not change compared with baseline, but after recovery they were significantly lower. Subjective and objective sleepiness increased significantly after restriction and returned to baseline after recovery. In contrast, performance deteriorated significantly after restriction and did not improve after recovery. Extended recovery sleep over the weekend reverses the impact of one work week of mild sleep restriction on daytime sleepiness, fatigue, and IL-6 levels, reduces cortisol levels, but does not correct performance deficits. The long-term effects of a repeated sleep restriction/sleep recovery weekly cycle in humans remain unknown.

Effects of recovery sleep after one work week of mild sleep restriction on interleukin-6 and cortisol secretion and daytime sleepiness and performance

PubMed Central

Pejovic, Slobodanka; Basta, Maria; Kritikou, Ilia; Shaffer, Michele L.; Tsaoussoglou, Marina; Stiffler, David; Stefanakis, Zacharias; Bixler, Edward O.; Chrousos, George P.

2013-01-01

One workweek of mild sleep restriction adversely impacts sleepiness, performance, and proinflammatory cytokines. Many individuals try to overcome these adverse effects by extending their sleep on weekends. To assess whether extended recovery sleep reverses the effects of mild sleep restriction on sleepiness/alertness, inflammation, and stress hormones, 30 healthy young men and women (mean age ± SD, 24.7 ± 3.5 yr; mean body mass index ± SD, 23.6 ± 2.4 kg/m2) participated in a sleep laboratory experiment of 13 nights [4 baseline nights (8 h/night), followed by 6 sleep restriction nights (6 h/night) and 3 recovery nights (10 h/night)]. Twenty-four-hour profiles of circulating IL-6 and cortisol, objective and subjective daytime sleepiness (Multiple Sleep Latency Test and Stanford Sleepiness Scale), and performance (Psychomotor Vigilance Task) were assessed on days 4 (baseline), 10 (after 1 wk of sleep restriction), and 13 (after 2 nights of recovery sleep). Serial 24-h IL-6 plasma levels increased significantly during sleep restriction and returned to baseline after recovery sleep. Serial 24-h cortisol levels during restriction did not change compared with baseline, but after recovery they were significantly lower. Subjective and objective sleepiness increased significantly after restriction and returned to baseline after recovery. In contrast, performance deteriorated significantly after restriction and did not improve after recovery. Extended recovery sleep over the weekend reverses the impact of one work week of mild sleep restriction on daytime sleepiness, fatigue, and IL-6 levels, reduces cortisol levels, but does not correct performance deficits. The long-term effects of a repeated sleep restriction/sleep recovery weekly cycle in humans remain unknown. PMID:23941878

The efficacy of a restart break for recycling with optimal performance depends critically on circadian timing.

PubMed

Van Dongen, Hans P A; Belenky, Gregory; Vila, Bryan J

2011-07-01

Under simulated shift-work conditions, we investigated the efficacy of a restart break for maintaining neurobehavioral functioning across consecutive duty cycles, as a function of the circadian timing of the duty periods. As part of a 14-day experiment, subjects underwent two cycles of five simulated daytime or nighttime duty days, separated by a 34-hour restart break. Cognitive functioning and high-fidelity driving simulator performance were tested 4 times per day during the two duty cycles. Lapses on a psychomotor vigilance test (PVT) served as the primary outcome variable. Selected sleep periods were recorded polysomnographically. The experiment was conducted under standardized, controlled laboratory conditions with continuous monitoring. Twenty-seven healthy adults (13 men, 14 women; aged 22-39 years) participated in the study. Subjects were randomly assigned to a nighttime duty (experimental) condition or a daytime duty (control) condition. The efficacy of the 34-hour restart break for maintaining neurobehavioral functioning from the pre-restart duty cycle to the post-restart duty cycle was compared between these two conditions. Relative to the daytime duty condition, the nighttime duty condition was associated with reduced amounts of sleep, whereas sleep latencies were shortened and slow-wave sleep appeared to be conserved. Neurobehavioral performance measures ranging from lapses of attention on the PVT to calculated fuel consumption on the driving simulators remained optimal across time of day in the daytime duty schedule, but degraded across time of night in the nighttime duty schedule. The 34-hour restart break was efficacious for maintaining PVT performance and other objective neurobehavioral functioning profiles from one duty cycle to the next in the daytime duty condition, but not in the nighttime duty condition. Subjective sleepiness did not reliably track objective neurobehavioral deficits. The 34-hour restart break was adequate for maintaining performance in the case of optimal circadian placement of sleep and duty periods (control condition) but was inadequate (and perhaps even detrimental) for maintaining performance in a simulated nighttime duty schedule (experimental condition). Current US transportation hours-of-service regulations mandate time off duty but do not consider the circadian aspects of shift scheduling. Reinforcing a recent trend of applying sleep science to inform policymaking for duty and rest times, our findings indicate that restart provisions in hours-of-service regulations could be improved by taking the circadian timing of the duty schedules into account.

Motorcoach Driver Fatigue Study, 2011

DOT National Transportation Integrated Search

2012-12-01

Eighty-four commercial motorcoach drivers participated in a month-long study of duty start time, total duty time, total sleep time per 24 hours, with sleepiness, fatigue, and performance measured as they were going on and off duty. Drivers worked the...

Professional burnout syndrome in doctors of surgical specialties in Ukraine: causes, consequences, labor optimization ways.

PubMed

Skurupii, Dmytro A; Kholod, Dmytro A; Sonnik, Evgen G

The professional burnout syndrome (PBS) affects quality of medical care provision for people, which is acquires the special actuality in terms of reforming the health care system. To study ways to improve the efficiency of doctors of surgical specialties based on analyzes of PBS and its consequences. A survey of psychological tests and 62 surgical doctors was carried out. It was found out that the PBS reaches a peak after 11 to 15 years of working experience. Anesthesiologists have high levels of PBS, emotional exhaustion, cynicism, low desire for career growth, frequent misunderstanding with the administration, they prefer 8-hour working day, and relieve stress by sleeping and consuming alcohol. Obstetrician-gynecologists show moderate level of PBS and emotional exhaustion, high degree of cynicism, strong desire for career growth, frequent misunderstandings with patients and their relatives, prefer 8-hour working day, relieve stress by smoking and socializing with family and friends. Traumatic surgeons have moderate level of PBS, emotional exhaustion, high degree of cynicism, strong desire for career growth, frequent misunderstandings with their colleagues of related specialties, prefer the 24-hour working day, and reli eve their stress with alcohol and sports. Surgeons have moderate level of PBS, emotional exhaustion, low degree of cynicism, moderate desire for career growth, frequent misunderstandings with their colleagues of related specialties, prefer the 8-hour working day, and relieve stress by smoking and sleeping. PBS is most expressed in doctors having working experience of 11 to 15 years and in anesthesiologists. They get professional deformations. These features should be considered in course of organization of working process of medical teams.

Work hours reform: perceptions and desires of contemporary surgical residents.

PubMed

Whang, Edward E; Perez, Alexander; Ito, Hiromichi; Mello, Michelle M; Ashley, Stanley W; Zinner, Michael J

2003-10-01

New Accreditation Council for Graduate Medical Education (ACGME) requirements on resident duty hours are scheduled to undergo nationwide implementation in July 2003. General surgery residents, because of their long duty hours, are likely to be among those most affected by changes imposed to comply with the ACGME requirements. There are few contemporary data on their attitudes toward work hours reform. The study entailed a region-wide survey of residents enrolled in general surgery residencies in New England to characterize the perceptions and desires of surgical residents on the issue of work hours reform. Respondents reported working a mean of 105 +/- 0.7 hours per week, considerably more than the 80-hour limit stipulated by the ACGME. Of the respondents, 81% reported that sleep deprivation had negatively affected their work. A strong majority of respondents believe that work hours reform would improve their quality of life but less than one half expect it to have a positive impact on patient care. A greater percentage of senior residents than junior residents (p < 0.05) have negative perceptions of work hour limitations, particularly with respect to consequences for patient care. Other findings suggest that residents who have actually experienced work hour restrictions are less positive about such restrictions than these residents who had not yet experienced them. Changes imposed by residency programs to comply with work hour requirements might have detrimental effects on senior residents and patient care. The impact of such changes should be carefully monitored as the ACGME requirements are implemented.

[Relationship between employees' management factor of visual display terminal (VDT) work time and 28-item General Health Questionnaire (GHQ-28) at one Japanese IT company's computer worksite].

PubMed

Sugimura, Hisamichi; Horiguchi, Itsuko; Shimizu, Takashi; Marui, Eiji

2007-09-01

We studied 1365 male workers at a Japanese computer worksite in 2004 to determine the relationship between employees' time management factor of visual display terminal (VDT) work and General Health Questionnaire (GHQ) score. We developed questionnaires concerning age, management factor of VDT work time (total daily VDT work time, duration of continuous work), other work-related conditions (commuting time, job rank, type of job, hours of monthly overtime), lifestyle (smoking, alcohol consumption, exercise, having breakfast, sleeping hours), and the Japanese version of 28-item General Health Questionnaire (GHQ). Multivariate logistic regression analyses were performed to estimate the odds ratios (ORs) of the high-GHQ groups (>6.0) associated with age and the time management factor of VDT work. Multivariate logistic regression analyses indicated lower ORs for certain groups: workers older than 50 years old had significantly a lower OR than those younger than 30 years old; workers sleeping less than 6 h showed a lower OR than those sleeping more than 6 h. In contrast, significantly higher ORs were shown for workers with continuous work durations of more than 3 h compared with those with less than 1 h, those with more than 25 h/mo overtime compared with those with less, those doing VDT work of more than 7.5 h/day compared with those doing less than 4.5 h/day, and those with more than 25 h/mo of overtime compared with those with less. Male Japanese computer workers' GHQ scores are significantly associated with time management factors of VDT work.

An hour of bright white light in the early morning improves performance and advances sleep and circadian phase during the Antarctic winter.

PubMed

Corbett, R W; Middleton, B; Arendt, J

2012-09-13

Previous work has demonstrated that exposure to an hour of bright light in the morning and the evening during the Polar winter has beneficial effects on circadian phase. This study investigated the effect of a single hour of bright white morning light on circadian phase, sleep, alertness and cognitive performance. Nine individuals (eight male, one female, median age 30 years), wintering at Halley Research Station (75°S), Antarctica from 7th May until 6th August 2007, were exposed to bright white light for a fortnight from 08:30 to 09:30 h, with two fortnight control periods on either side. This sequence was performed twice, before and following Midwinter. Light exposure, sleep and alertness were assessed daily by actigraphy, sleep diaries and subjective visual analogue scales. Circadian phase (assessed by urinary 6-sulphatoxymelatonin rhythm) and cognitive performance were evaluated at the end of each fortnight. During light exposure circadian phase was advanced from 4.97 ± 0.96 decimal hours (dh) (mean ± SD) to 4.08 ± 0.68 dh (p = 0.003). Wake-up time was shifted by a similar margin from 8.45 ± 1.83 dh to 7.59 ± 0.78 dh (p < 0.001). Sleep start time was also advanced (p = 0.047) but by a lesser amount, consequently, actual sleep time was slightly reduced. There was no change in objective or subjective measures of sleep quality or subjective measures of alertness. An improvement in cognitive performance was found with both the Single Letter Cancellation Test (p < 0.001) and the Digit Symbol Substitution Test (p = 0.026) with preserved circadian variation. These beneficial effects of a single short duration light treatment may have implications not only for the Antarctic but other remote environments where access to natural light and delayed circadian phase, is problematic. These results require validation in larger studies at varying locations. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Characterization of sleep patterns and problems in healthcare workers in a tertiary care hospital.

PubMed

Buscemi, Dolores; Anvari, Rezza; Raj, Rishi; Nugent, Kenneth

2014-01-01

Restrictions in sleep can have important adverse effects on health and job performance. We collected information about sleep from US healthcare workers to determine whether they had sleep difficulties. We used an Internet-based survey to collect information on sleep patterns and sleep quality in healthcare workers at a tertiary care hospital. We classified these workers into short sleepers (<7 hours), normal sleepers (7-8 hours), and long sleepers (≥9 hours). We compared these three groups using simple descriptive statistics. We used logistic regression to identify factors associated with short sleep times. Of 3012 questionnaires distributed, 376 healthcare workers (12.5%) replied to this survey. The median age was 38 years, the median body mass index was 28 kg/m, and 76% were women. The median sleep duration on weekdays was 7 hours. Sixty-nine respondents (18.4%) were short sleepers, 269 of the respondents (71.5%) were normal sleepers, and 38 respondents (10.1%) were long sleepers. A total of 113 (30.1%) had sleep difficulties more than 50% of the time and 140 respondents (37.3%) were bothered by lack of energy from poor sleep. Short sleepers were less likely than other types of sleepers to have normal bedtimes and regular mealtimes. Eighty-four respondents (22.3%) went to bed between 2 AM and 2 PM. These workers were younger; slept less on the weekdays and weekends; and reported more difficulty with sleeping, feeling depressed, overconsumption of alcoholic beverages, and personal stressors. Most healthcare workers have healthy sleep patterns; however, many workers have poor sleep quality. Workers with "odd" bedtimes have abnormal sleep patterns and abnormal sleep quality; these workers need additional evaluation to understand the causes and consequences of their sleep patterns.

[Relationships between prevalence of youth risk behaviors and sleep duration among Japanese high school students].

PubMed

Kataoka, Chie; Nozu, Yuji; Kudo, Masako; Sato, Yuki; Kubo, Motoyoshi; Nakayama, Naoko; Iwata, Hideki; Watanabe, Motoi

2014-01-01

This study aimed to clarify relationships between prevalence of risk behaviors and sleep duration among Japanese high school students. Data from a national survey, the Japan Youth Risk Behavior Survey 2011 (the subjects were 9,778 students: 5,027 males, 4,751 females, in the first grade to the third grade of 102 schools randomly selected among high schools throughout Japan) was used for this analysis. We focused on nine items of risk behavior in JYRBS: "lack of vigorous physical activity," "skipping breakfast," "current cigarette use," "current alcohol use," "lifetime thinner use," "ever had sexual intercourse," "rarely or never wore seatbelts," "in a physical fight," and "seriously considered attempting suicide." Students with less than six hours of sleep duration accounted for approximately 40% of males and females. The odds ratios of prevalence of each of the nine risk behaviors were calculated on the basis of the group "six hours or more and less than eight hours" of sleep, whose prevalence of risk behaviors was the lowest. In the group with "four hours or more and less than six hours," the odds ratios of "lack of vigorous physical activity" and "skipping breakfast" for both males and females were significantly high. Furthermore, in the group with shorter sleep duration of "less than four hours," the odds ratios of all nine risk behaviors for males (odds ratios: 1.47-3.28) and eight risk behaviors (except for "rarely or never wore seatbelts") for females (1.54-4.68) were significantly high. On the other hand, in the group with long sleep duration of "10 hours or more," the odds ratios of "current cigarette use" and "lifetime thinner use" for both males and females were significantly high. It was shown that short sleep duration of less than six hours and long sleep duration of 10 hours or more related to the prevalence of youth risk behaviors among Japanese high school students. It was suggested that sleep duration should be considered as an important category of youth risk behaviors.

Slaves of the state - medical internship and community service in South Africa.

PubMed

Erasmus, Nicolette

2012-06-05

Owing to a chronic shortage of medical staff in South Africa, sleep-deprived medical interns and community service doctors work up to 200 hours of overtime per month under the state's commuted overtime policy. Nurses moonlight in circumvention of the Basic Conditions of Employment Act. For trainee doctors, overtime over 80 hours is unpaid, and rendered involuntarily under threat of not qualifying to practise medicine in South Africa. As forced labour, and sleep deprivation amounting to cruel and degrading treatment, it is outlawed in international law. No other professional group in the country is subjected to such levels of exploitation and discrimination by the state. These abuses should be challenged under the Constitution. Solutions include the installation of electronic time-recording in state hospitals, cessation of unpaid overtime, limits on medical intern shifts to a maximum of 16 hours, and an investigation by the Human Rights Commission of South Africa.

American time use survey: sleep time and its relationship to waking activities.

PubMed

Basner, Mathias; Fomberstein, Kenneth M; Razavi, Farid M; Banks, Siobhan; William, Jeffrey H; Rosa, Roger R; Dinges, David F

2007-09-01

To gain some insight into how various behavioral (lifestyle) factors influence sleep duration, by investigation of the relationship of sleep time to waking activities using the American Time Use Survey (ATUS). Cross-sectional data from ATUS, an annual telephone survey of a population sample of US citizens who are interviewed regarding how they spent their time during a 24-hour period between 04:00 on the previous day and 04:00 on the interview day. Data were pooled from the 2003, 2004, and 2005 ATUS databases involving N=47,731 respondents older than 14 years of age. N/A. Adjusted multiple linear regression models showed that the largest reciprocal relationship to sleep was found for work time, followed by travel time, which included commute time. Only shorter than average sleepers (<7.5 h) spent more time socializing, relaxing, and engaging in leisure activities, while both short (<5.5 h) and long sleepers (> or =8.5 h) watched more TV than the average sleeper. The extent to which sleep time was exchanged for waking activities was also shown to depend on age and gender. Sleep time was minimal while work time was maximal in the age group 45-54 yr, and sleep time increased both with lower and higher age. Work time, travel time, and time for socializing, relaxing, and leisure are the primary activities reciprocally related to sleep time among Americans. These activities may be confounding the frequently observed association between short and long sleep on one hand and morbidity and mortality on the other hand and should be controlled for in future studies.

Associations Between Sedentary Behaviors, Sleep Patterns, and BMI in Young Dancers Attending a Summer Intensive Dance Training Program.

PubMed

Stracciolini, Andrea; Stein, Cynthia J; Kinney, Susan; McCrystal, Tara; Pepin, Michael J; Meehan Iii, William P

2017-09-15

The purpose of this study was to investigate associations between sedentary behaviors, sleep hours, and body mass index (BMI) in 12- to 17-year-old dancers. This was a cross sectional survey in which bivariate correlation and simple linear regression were used to determine associations between self-reported components. One hundred fifteen dancers were queried, 91.3% of whom were female. The mean BMI was 19.6 ± 2.3 kg/m2. Two-thirds of dancers fell below the 50th percentile for age-adjusted BMI, and 30.4% fell below the 25th percentile. Better than 12% of dancers reported a history of anxiety, and 2.6% reported depression. Mean hours of sleep per night was 7.8 ± 0.9, with 58% of the dancers getting less than 8 hours of sleep per night. The mean total screen time for dancers was 3.4 ± 2.1 hours/day, which consisted of tablet and computer usage: 1.6 ± 1.1 hours/day; texting: 0.5 ± 1.1 hours/day; watching television: 1.2 ± 1.1 hours/day; and playing video games 1.2 ± 1.1 hours/ day. Total screen time was independently associated positively with BMI, explaining nearly 10% of the variability in BMI. Age, hours dancing per day, and hours of sleep per night were not independently associated with BMI. To summarize: screen time was associated with increased BMI in this young dancer cohort; the majority of dancers slept less than 8 hours per night; anticipatory guidance addressing media use and sleep hygiene in the adolescent dancer population is needed.

A follow-up study on the association of working conditions and lifestyles with the development of (perceived) mental symptoms in workers of a telecommunication enterprise.

PubMed

Suwazono, Y; Okubo, Y; Kobayashi, E; Kido, T; Nogawa, K

2003-10-01

This study investigated the association of working conditions and lifestyle with mental health in Japanese workers. A follow-up study was carried out in the Kanto district of Japan of workers in a telecommunications enterprise who received their first annual health check-up between 1992 and 1996 and were between 20 and 54 years old. Workers who reported mental symptoms, had a past history of disease, or current illness at their first check-up were excluded from the analysis. In total, the study included 23 837 workers. The association between working conditions and lifestyle and the development of mental symptoms was investigated by pooled logistic regression analyses. Working long hours and part-time work, as opposed to normal daytime hours of work, were factors associated with the development of mental symptoms in males, as were smoking, short sleeping hours, little physical exercise, rarely taking three meals a day, frequently eating within 1 h before sleep, much preference for salty meals and little preference for vegetables. Consumption of alcohol was negatively associated with the development of mental symptoms in males. Overall, the results suggested that the lower the Healthy Work and Lifestyle Score, the higher the risk of developing mental symptoms. Working conditions and lifestyle, especially food preferences, have an apparent influence on the mental health of Japanese workers. Moreover, the Healthy Work and Lifestyle Score indicates that working conditions and lifestyle appear to have a cumulative influence upon the mental health of Japanese workers.

The Association Between Trait Gratitude and Self-Reported Sleep Quality Is Mediated by Depressive Mood State.

PubMed

Alkozei, Anna; Smith, Ryan; Kotzin, Megan D; Waugaman, Debby L; Killgore, William D S

2017-01-27

It has been shown that higher levels of trait gratitude are associated with better self-reported sleep quality, possibly due to differences in presleep cognitions. However previous studies have not taken into account the role of depressive symptoms in this relationship. In this study, 88 nonclinical 18-29-year-olds completed the Gratitude Resentment and Appreciation Test (GRAT) as a measure of trait gratitude. The Glasgow Content of Thought Inventory (GCTI) was used to measure the intrusiveness of cognitions prior to sleep onset, the Motivation and Energy Inventory (MEI) assessed daytime fatigue, and the Pittsburgh Sleep Quality Index (PSQI) was used to assess self-reported sleep quality. The BDI-II assessed self-reported depressive symptoms. Consistent with previous work, GRAT scores were positively associated with higher daytime energy and greater number of hours of sleep per night. Importantly, however, we further observed that depressive symptoms mediated the relationships between gratitude scores and sleep metrics. Depressive mood state appears to mediate the association between gratitude and self-reported sleep quality metrics. We suggest, as one plausible model of these phenomena, that highly grateful individuals have lower symptoms of depression, which in turn leads to fewer presleep worries, resulting in better perceived sleep quality. Future work should aim to disentangle the causal nature of these relationships in order to better understand how these important variables interact.

Putting a price on worker fatigue

DOE Office of Scientific and Technical Information (OSTI.GOV)

Carter, R.A.

In a round-the-clock industry such as mining, extended work hours may be necessary for production but damaging to the bottom line. A recent report commissioned by the Minerals Council of Australia (MCA) attempts to document the relationship between sleep, working arrangements and fatigue. The study, titled Work Design, Fatigue and Sleep by Dr. Angela Baker and Dr. Sally Ferguson of the Australian Center for Sleep Research at the University of South Australia contains information useful for managing fatigue in the workplace. The publication is available free online at http://www.minerals.org.au. The study offers guidelines for planing work schedules or for chaningmore » shifts. William G. Sirosis, senior vice president and COO of Circadian Technologies Inc., also addressed this topic in a presentation at the recent MineWest 2006 conference. He pointed out that the exact dollar costs of operating with a fatigued workforce was difficult to pinpoint but the cumulative effect can be damaging to a company's production and profitability. He suggested steps to a successful management programme.« less

Human daily rhythms measured for one year.

PubMed

Binkley, S; Tome, M B; Crawford, D; Mosher, K

1990-08-01

Four human subjects recorded their wake-up and to-sleep times for one year each. The data were plotted to display individual circadian rhythms and the data were analyzed statistically. First, individuals had characteristic patterns in which visible changes in the patterns were observed mainly when time zones were changed because of travel. Second, the months with the latest wake-up and latest to-sleep times concentrated around the winter solstice; the months with the earliest wake-up and earliest to-sleep times concentrated around the fall equinox. Third, new moon versus full moon days were not different. Fourth, one-hour changes between standard and daylight savings time in the USA were reflected by near one-hour changes in two subjects, but not in a third. Fifth, weekend delays in wake-up time (0.8-1.6 hours), weekend delays in to-sleep time (0.1-0.5 hours), and shorter weekend awake time (0.8-1.3 hours) were observed. Sixth, throughout the year, wake-up times were close to the time of sunrise, but to-sleep times were several hours past sunset.

Short sleep duration is independently associated with overweight and obesity in Quebec children.

PubMed

Chaput, Jean-Philippe; Lambert, Marie; Gray-Donald, Katherine; McGrath, Jennifer J; Tremblay, Mark S; O'Loughlin, Jennifer; Tremblay, Angelo

2011-01-01

To investigate the association of sleep duration with adiposity and to determine if caloric intake and physical activity mediate this relationship. The Quebec Adiposity and Lifestyle Investigation in Youth (QUALITY) study is an ongoing longitudinal investigation of Caucasian children with at least one obese biological parent. Children (n = 550) with an average age of 9.6 years (SD = 0.9) who provided complete data at baseline were included in the cross-sectional analyses. Objective measures of adiposity (BMI Z-score, waist circumference, percent body fat measured by dual-energy X-ray absorptiometry), sleep duration and physical activity (accelerometer over 7 days), and diet (24-hour food recalls) were collected. Children were categorized into 4 groups according to sleep duration: < 10 hours, 10-10.9 hours, 11-11.9 hours, and > or = 12 hours of sleep per night. We observed a U-shaped relationship between sleep duration and all adiposity indices. None of energy intake, snacking, screen time or physical activity intensity differed significantly between sleep categories. After adjusting for age, sex, Tanner stage, highest educational level of the parents, total annual family income, and parental BMI, only short-duration sleepers (< 10 hours) had an increased odds of overweight/obesity (OR 2.08, 95% CI 1.16-3.67). Addition of total energy intake and physical activity to the model did not change the association substantially (OR 2.05, 95% CI 1.15-3.63). The present study provides evidence that short sleep duration is a risk factor for overweight and obesity in children, independent of potential covariates. These results further emphasize the need to add sleep duration to the determinants of obesity.

Hypnotic efficacy of zaleplon for daytime sleep in rested individuals.

PubMed

Whitmore, Jeffrey N; Fischer, Joseph R; Storm, William F

2004-08-01

The primary objective of this study was to determine whether zaleplon (10 mg) effectively promoted sleep during the daytime in well-rested individuals when compared to placebo. A secondary objective was to see if, while not expected, the use of zaleplon impacted the performance of well-rested individuals upon awakening. Repeated measures with 2 within-subject factors: drug (placebo/zaleplon) and trial (hourly testing during waking hours). Polysomnographic variables were recorded during a 3.5-hour nap following drug administration. Performance measures and subjective reports were collected during every waking trial of each session. The study was conducted at the Chronobiology and Sleep Laboratory located at Brooks Air Force Base. Twelve participants, 6 men and 6 women. 10-mg zaleplon or placebo capsules, single afternoon dose. Drug administration was counterbalanced and double-blinded. Zaleplon allowed participants to obtain significantly more slow-wave sleep than under placebo. There was also a trend for participants under zaleplon to accomplish a greater amount of sleep than under placebo. Performance was not adversely impacted following a 3.5-hour daytime sleep under zaleplon, nor were any undesirable symptoms induced. Zaleplon improves sleep quality when used by rested individuals to accomplish daytime sleep.

Sleep Duration and Quality as Related to Left Ventricular Structure and Function.

PubMed

Lee, Jae-Hon; Park, Sung Keun; Ryoo, Jae-Hong; Oh, Chang-Mo; Kang, Jeong Gyu; Mansur, Rodrigo B; Alfonsi, Jeffrey E; Lee, Yena; Shin, Sun-Han; McIntyre, Roger S; Jung, Ju Young

2018-01-01

Inadequate sleep is associated with increased risk of cardiovascular events; however, the associations between sleep duration or quality and cardiac function or structure are not well understood. This cross-sectional study was conducted to investigate to what extent sleep duration and quality are associated with left ventricular (LV) diastolic dysfunction or structural deterioration. A total of 31,598 healthy Korean adults who received echocardiography and completed the Pittsburg Sleep Quality Index were enrolled in this study. Participants were stratified into three groups by self-reported sleep duration (i.e., <7, 7-9, >9 hours) and into two groups by subjective sleep quality. Sleep duration was also assessed as a continuous variable. The odds ratios for impaired LV diastolic function, increased relative wall thickness, and LV hypertrophy (LVH) were compared between groups using multivariable logistic regression analyses. After adjustment for confounding variables (e.g., age, smoking, body mass index), there was a statistically significant association between short sleep duration (<7 hours) and greater LVH (fully adjusted odds ratio = 1.32 [95% confidence interval {CI} = 1.02-1.73]). Short sleep duration was also significantly associated with greater LVH (0.87 per hour [95% CI = 0.78-0.98]) and increased relative wall thickness (0.92 [95% CI = 0.86-0.99]), but there was no significant association between sleep and LV diastolic function. Among individuals with normal sleep duration, poor quality of sleep was not associated with adverse cardiac measures. These results indicate that short sleep duration (<7 hours) is associated with unfavorable LV structural characteristics. The association of insufficient sleep with adverse cardiovascular health outcomes may be mediated in part by adverse changes in cardiac structure and function.

Changes in sleep duration in Spanish children aged 2-14 years from 1987 to 2011.

PubMed

de Ruiter, Ingrid; Olmedo-Requena, Rocío; Sánchez-Cruz, José-Juan; Jiménez-Moleón, José-Juan

2016-05-01

Historical decreases in sleep duration in children have been documented worldwide; however, there is sparse information on sleep duration in differing cultural regions. We assess sleep duration and its trends for children in Spain from 1987 to 2011 and associated sociodemographic characteristics. Data from eight Spanish National Health Surveys, from 1987 to 2011, were collected on parent-reported sleep duration and associated socio-demographic characteristics including age, sex, parental level of education, child body mass index (BMI), and physical activity. A total of 24,867 children aged 2-14 years were included in the final sample. Overall, short sleep duration increased to 44.7% from 29.8% in 1987. Decreasing sleep duration trends were found in all demographic groups, decreasing by around 20 minutes in 24 hours from 1987 to 2011; decreasing to 10 hours 16 minutes in 2- to 5-year olds, 9 hours 31 minutes in 6- to 9-year-olds, and 8 hours 52 minutes in 10- to 14-year-olds. No difference in sleep duration was found between girls and boys. Sleep duration was associated with year of survey, age, level of parental education, obesity, and exercise. Almost 45% of children in Spain are not sleeping the recommended amount. Regional differences in sleep attitudes and duration alongside a lack of consistency in cut-offs for age-appropriate ideal sleep in literature is a barrier for international comparison and highlights the need for research in physiological sleep requirements. With the association of short sleep duration with many different health outcomes, sleep should be considered as a modifiable lifestyle factor and a public health issue. Copyright © 2016 Elsevier B.V. All rights reserved.

Effects of napping on sleepiness and sleep-related performance deficits in night-shift workers: a systematic review.

PubMed

Ruggiero, Jeanne S; Redeker, Nancy S

2014-04-01

Night-shift workers are prone to sleep deprivation, misalignment of circadian rhythms, and subsequent sleepiness and sleep-related performance deficits. The purpose of this narrative systematic review is to critically review and synthesize the scientific literature regarding improvements in sleepiness and sleep-related performance deficits following planned naps taken during work-shift hours by night workers and to recommend directions for future research and practice. We conducted a literature search using the Medline, PsychInfo, CINAHL, Cochrane Library, and Health and Safety Science Abstracts databases and included English-language quasi-experimental and experimental studies that evaluated the effects of a nighttime nap taken during a simulated or actual night-work shift. We identified 13 relevant studies, which consisted primarily of small samples and mixed designs. Most investigators found that, despite short periods of sleep inertia immediately following naps, night-shift napping led to decreased sleepiness and improved sleep-related performance. None of the studies examined the effects of naps on safety outcomes in the workplace. Larger-scale randomized clinical trials of night-shift napping and direct safety outcomes are needed prior to wider implementation.

Sleep stages, memory and learning.

PubMed Central

Dotto, L

1996-01-01

Learning and memory can be impaired by sleep loss during specific vulnerable "windows" for several days after new tasks have been learned. Different types of tasks are differentially vulnerable to the loss of different stages of sleep. Memory required to perform cognitive procedural tasks is affected by the loss of rapid-eye-movement (REM) sleep on the first night after learning occurs and again on the third night after learning. REM-sleep deprivation on the second night after learning does not produce memory deficits. Declarative memory, which is used for the recall of specific facts, is not similarly affected by REM-sleep loss. The learning of procedural motor tasks, including those required in many sports, is impaired by the loss of stage 2 sleep, which occurs primarily in the early hours of the morning. These findings have implications for the academic and athletic performance of students and for anyone whose work involves ongoing learning and demands high standards of performance. Images p1194-a PMID:8612256

Short Sleep Duration, Obstructive Sleep Apnea, Shiftwork, and the Risk of Adverse Cardiovascular Events in Patients After an Acute Coronary Syndrome.

PubMed

Barger, Laura K; Rajaratnam, Shantha M W; Cannon, Christopher P; Lukas, Mary Ann; Im, KyungAh; Goodrich, Erica L; Czeisler, Charles A; O'Donoghue, Michelle L

2017-10-10

It is unknown whether short sleep duration, obstructive sleep apnea, and overnight shift work are associated with the risk of recurrent cardiovascular events in patients after an acute coronary syndrome. SOLID-TIMI 52 (The Stabilization of PLaques UsIng Darapladib-Thrombolysis in Myocardial Infarction 52 Trial) was a multinational, double-blind, placebo-controlled trial that enrolled 13 026 patients ≤30 days of acute coronary syndrome. At baseline, all patients were to complete the Berlin questionnaire to assess risk of obstructive sleep apnea and a sleep and shift work survey. Median follow-up was 2.5 years. The primary outcome was major coronary events (MCE; coronary heart disease death, myocardial infarction, or urgent revascularization). Cox models were adjusted for clinical predictors. Patients who reported <6 hours sleep per night had a 29% higher risk of MCE (adjusted hazard ratio, 1.29; 95% confidence interval, 1.12-1.49; P <0.001) compared with those with longer sleep. Patients who screened positive for obstructive sleep apnea had a 12% higher risk of MCE (1.12; 1.00-1.24; P =0.04) than those who did not screen positive. Overnight shift work (≥3 night shifts/week for ≥1 year) was associated with a 15% higher risk of MCE (1.15; 1.03-1.29; P =0.01). A step-wise increase in cardiovascular risk was observed for individuals with more than 1 sleep-related risk factor. Individuals with all 3 sleep-related risk factors had a 2-fold higher risk of MCE (2.01; 1.49-2.71; P <0.0001). Short sleep duration, obstructive sleep apnea, and overnight shift work are under-recognized as predictors of adverse outcomes after acute coronary syndrome. Increased efforts should be made to identify, treat, and educate patients about the importance of sleep for the potential prevention of cardiovascular events. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01000727. © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Sleep in the pediatric ICU: an empirical investigation.

PubMed

Cureton-Lane, R A; Fontaine, D K

1997-01-01

Although sleep is important for physical and psychological health, no research has assessed the sleep of children in a pediatric ICU and the factors that affect sleep. To observe the sleep of children in a pediatric ICU and to determine the relationship of noise, light, contact with caregivers, parental presence, and severity of illness to the sleep obtained by children in a pediatric ICU during a 10-hour night. At 5-minute intervals from 8 PM until 6 AM, a convenience sample of nine patients was observed. Sleep state, noise and light levels, contact with caregivers, and parental presence were recorded. Severity of illness was measured on admission and within 26 hours of data collection. Subjects slept for a mean total of 4.7 hours (SD = 0.49) during the 10-hour night, interrupted by a mean of 9.8 awakenings (SD = 2.48). The mean length of a sleep episode was only 27.6 minutes (SD = 25.85). Mean noise level was 55.1 dB(A) (SD = 6.82), with sudden, sharp elevations of up to 90 dB(A). Probit analysis indicated that noise, light, and contact with caregivers were significant predictors of sleep. Parental presence and severity of illness were not. Patients in the pediatric ICU sleep significantly less than is normal for children of the same ages, and their patterns of sleep are seriously disturbed. Because noise, light, and contact with caregivers are significant predictors of sleep state, health professionals can use these findings to structure the environment and the care they give to promote the sleep of critically ill children.

[Sleep duration and functional limitations in older adult].

PubMed

Eumann Mesas, Arthur; López-García, Esther; Rodríguez-Artalejo, Fernando

2011-04-30

To examine the association between sleep duration and functional limitation in older adults from Spain. Cross-sectional study with 3,708 individuals representative of the non-institutionalized population aged ≥ 60 years in Spain. Sleep duration was self-reported, and the functional limitations in the instrumental activities of daily living (IADL) were assessed. Functional limitations in IADL were identified in 1,424 (38.4%) participants. In analyses adjusted for sociodemographic and lifestyle variables, the percentage of participants with limitation in IADL was higher in those who slept ≤ 5 hours (odds ratio [OR]=1.56; 95% confidence interval [CI]=1.18-2.06) or ≥ 10 hours (OR=2.08; 95%CI=1.67-2.60; p for trend<0.001) than in those who slept 8 hours. The association between long sleep (≥ 10 hours) and functional limitations held even after adjustment for comorbidity and sleep quality (OR=1.77; 95%CI=1.38-2.28) while the association between short sleep (≤ 5 hours) and functional limitation no longer held after this adjustment (OR=1.10; 95%CI=0.80-1.50). In older adults, long sleep duration is a marker of functional limitations independent of comorbidity. Copyright © 2010 Elsevier España, S.L. All rights reserved.

Sleeping under the Ocean: Despite Total Isolation, Nuclear Submariners Maintain Their Sleep and Wake Patterns throughout Their Under Sea Mission

PubMed Central

Trousselard, Marion; Leger, Damien; van Beers, Pascal; Coste, Olivier; Vicard, Arnaud; Pontis, Julien; Crosnier, Sylvain-Nicolas; Chennaoui, Mounir

2015-01-01

Background To assess the effects of isolation, inadequate exposure to light and specific shift work on the subjective and objective measurements of sleep and alertness of submariners. Purpose A strictly controlled randomized crossover study with the polysomnography recorded twice during the mission. Methods Setting: Shift and night work with prolonged (70 days) social isolation from the real world (with no phone or Internet contact with families or friends during a routine mission aboard the “Téméraire” French Strategic Submarine with Ballistic Nuclear missiles (SSBN). Participants: 19 submariners working on a 24-hour shift for three days in a row schedule. Interventions: The participants attended two polysomnographic (PSG) recordings of night sleep on Day 21 (D21) and Day 51 (D51) of the 70-day patrol; urine cortisol levels were also taken after sleep, and subjective assessments of sleep, sleepiness, mood and anxiety on D21 and D51. The light and temperature on board were also recorded. Results PSG analyses showed that sleep did not significantly vary in length (total sleep time) or in quality between D21 and D51. The mariners reported the same subjective sleep, sleepiness, anxiety or mood (except for a slightly worse score for confusion on D51). Blood cortisol levels did not vary significantly. Conclusions These results show that humans living in an isolated environment for more than two months with this specific shift schedule do not suffer from any significant effects on sleep, sleepiness and confusion between D21 and D51, when they follow an organized regular shift pattern with controlled light and temperature. PMID:26016656

The impact of sleep duration on adolescent development: a genetically informed analysis of identical twin pairs.

PubMed

Barnes, J C; Meldrum, Ryan C

2015-02-01

Recent work provides evidence that reduced sleep duration has detrimental effects on a range of developmentally related outcomes during adolescence. Yet, the potential confounding influence of genetic and shared environmental effects has not been sufficiently addressed. This study addresses this issue by analyzing cross-sectional data from the twin sub-sample of the first wave of the National Longitudinal Study of Adolescent Health [N ≈ 287 MZ (monozygotic) twin pairs; 50% male; 22% Black; mean age = 15.75]. Associations between sleep duration (measured through two different strategies, one tapping number of hours slept at night and the other measuring weeknight bedtimes) and seven outcomes (self-control, depressive symptoms, suicidal ideation, body mass index, violent delinquency, non-violent delinquency, and drug use) were estimated. Consistent with prior research, associations between sleep duration and several outcomes were statistically significant when using standard social science analytic methods. Yet, when employing a methodology that accounts for genetic and shared environmental influences, some of these associations were reduced to non-significance. Still, two consistent associations remained in that participants who reported sleeping fewer hours at night (or who reported later bedtimes) exhibited lower levels of self-control and more depressive symptoms. Implications of the findings and directions for future research are discussed.

Prevalence of bruxism in children with episodic migraine--a case-control study with polysomnography.

PubMed

Masuko, Alice Hatsue; Villa, Thais Rodrigues; Pradella-Hallinan, Marcia; Moszczynski, Alexander Joseph; Carvalho, Deusvenir de Souza; Tufik, Sergio; do Prado, Gilmar Fernandes; Coelho, Fernando Morgadinho Santos

2014-05-14

Parents of children with migraine have described a higher prevalence of sleep bruxism and other sleep disturbances in their children. The objective of this study was to use polysomnography to investigate the prevalence of bruxism during sleep in children with episodic migraine relative to controls. Controls and patients were matched by sex, age, years of formal education, presence of snoring, arousals per hour, and respiratory events per hour.A total of 20 controls, between 6 and 12 years old, with no history of headache, recruited from public schools in Sao Paulo between 2009 and 2012, and 20 patients with episodic migraine recruited from the Headache Clinic at the Federal University of Sao Paulo between 2009 and 2012 underwent polysomnography.No intervention was performed before sleep studies.Among migraine patients, 27.5% experienced aura prior to migraine onset. The sleep efficiency, sleep latency, REM sleep latency, arousals per hour, percentage of sleep stages, and breathing events per hour were similar between groups. Five children (25%) with episodic migraine exhibited bruxism during the sleep study while this finding was not observed in any control (p = 0.045). Our data demonstrate that bruxism during sleep is more prevalent in children with episodic migraine. Further prospective studies will help elucidate the underlying shared pathogenesis between bruxism and episodic migraine in children.

Prevalence of bruxism in children with episodic migraine - a case–control study with polysomnography

PubMed Central

2014-01-01

Background Parents of children with migraine have described a higher prevalence of sleep bruxism and other sleep disturbances in their children. The objective of this study was to use polysomnography to investigate the prevalence of bruxism during sleep in children with episodic migraine relative to controls. Findings Controls and patients were matched by sex, age, years of formal education, presence of snoring, arousals per hour, and respiratory events per hour. A total of 20 controls, between 6 and 12 years old, with no history of headache, recruited from public schools in Sao Paulo between 2009 and 2012, and 20 patients with episodic migraine recruited from the Headache Clinic at the Federal University of Sao Paulo between 2009 and 2012 underwent polysomnography. No intervention was performed before sleep studies. Among migraine patients, 27.5% experienced aura prior to migraine onset. The sleep efficiency, sleep latency, REM sleep latency, arousals per hour, percentage of sleep stages, and breathing events per hour were similar between groups. Five children (25%) with episodic migraine exhibited bruxism during the sleep study while this finding was not observed in any control (p = 0.045). Conclusions Our data demonstrate that bruxism during sleep is more prevalent in children with episodic migraine. Further prospective studies will help elucidate the underlying shared pathogenesis between bruxism and episodic migraine in children. PMID:24886343

Prevalence of sleep duration among Saudi adults

PubMed Central

Ahmed, Anwar E.; Al-Jahdali, Fares; AlALwan, Abdulaziz; Abuabat, Faisal; Salih, Salih Bin; Al-Harbi, Abdullah; Baharoon, Salim; Khan, Mohammad; Ali, Yosra Z.; Al-Jahdali, Hamdan

2017-01-01

Objectives: To examine the associations between sleep duration and a variety of demographic and clinical variables in a sample of Saudi adults. Methods: A cross-sectional study among 2,095 participants was conducted at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia, between May and October 2014. A questionnaire was administered to collect data related to clinical health outcomes and demographic characteristics. Participants were asked to report their average sleep duration per night in hours. Results: One-third (33.8%) reported short sleep duration of less than 7 hours/night. Short sleep duration was more prevalent in females (37.3% versus 31.4%, p=0.004). The most common medical problems reported were obesity with body mass index of >30 Kg/m2 (39.1%), hypertension (33.9%), diabetes mellitus (20.8%), depression (4.3%), asthma (17.3%), COPD (6.6%), and hyperlipidemia (2.7%). Diabetes mellitus was associated with long sleep of more than 9 hours/night (25.4%, p=0.011) and hypertension (54.2%, p=0.001). The linear regression model tend to reduce their sleep duration by roughly 22 minutes in female gender, 66 minutes in participants with hyperlipidemia, and 70 minutes in participants with poor sleep quality. Conclusions: Short sleep duration per night was prevalent, it affects one in every 3 Saudi adults. Long sleep duration of more than 9 hours was associated with increased comorbid conditions. PMID:28251223

Association Between Daily Sleep Duration and Risk of Dementia and Mortality in a Japanese Community.

PubMed

Ohara, Tomoyuki; Honda, Takanori; Hata, Jun; Yoshida, Daigo; Mukai, Naoko; Hirakawa, Yoichiro; Shibata, Mao; Kishimoto, Hiro; Kitazono, Takanari; Kanba, Shigenobu; Ninomiya, Toshiharu

2018-06-06

To investigate the association between daily sleep duration and risk of dementia and death in a Japanese elderly population. Prospective cohort study. The Hisayama Study, Japan. Community-dwelling Japanese individuals aged 60 and older without dementia. Self-reported daily sleep duration was grouped into 5 categories (<5.0, 5.0-6.9, 7.0-7.9, 8.0-9.9, ≥10.0 hours). The association between daily sleep duration and risk of dementia and death was determined using a Cox proportional hazards models. During follow-up, 294 participants developed dementia, and 282 died. Age- and sex-adjusted incidence rates of dementia and all-cause mortality were significantly greater in subjects with daily sleep duration of less than 5.0 hours and 10.0 hours and more than in those with daily sleep duration of 5.0 to 6.9 hours. These associations remained unchanged after adjustment for potential confounding factors (<5.0 hours: hazard ratio (HR)=2.64, 95% confidence interval (CI)=1.38-5.05 for dementia; HR=2.29, 95% CI=1.15-4.56 for death; ≥10.0 hours: HR=2.23, 95% CI=1.42-3.49 for dementia; HR=1.67, 95% CI=1.07-2.60 for death). Similar U-shaped associations were observed for Alzheimer's disease and vascular dementia. With regard to the influence of hypnotic use on risk of dementia and death, subjects who used hypnotics and had any sleep duration had a risk of dementia that was 1.66 times as great and a risk of death that was 1.83 times as great as those who did not use hypnotics and had a daily sleep duration of 5.0 to 6.9 hours. Short and long daily sleep duration and hypnotic use are risk factors for dementia and death in Japanese elderly adults. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

Shift Work Disorder Among Oil Rig Workers in the North Sea

PubMed Central

Waage, Siri; Moen, Bente Elisabeth; Pallesen, Ståle; Eriksen, Hege R.; Ursin, Holger; Åkerstedt, Torbj⊘rn; Bjorvatn, Bj⊘rn

2009-01-01

Study Objectives: Shift work disorder (SWD) is a circadian rhythm sleep disorder caused by work hours during the usual sleep period. The main symptoms are excessive sleepiness and insomnia temporally associated with the working schedule. The aim of the present study was to examine SWD among shift workers in the North Sea. Design and Participants: A total of 103 shift workers (2 weeks on 7 nights/ 7days, 12-h shifts, 4 weeks off), mean age 39.8 years, working at an oil rig in the North Sea responded to a questionnaire about SWD. They also completed the Pittsburgh Sleep Quality Index, Bergen Insomnia Scale, Epworth Sleepiness Scale, Composite Morningness Questionnaire, Subjective Health Complaint Inventory, Demand/Control, and Instrumental Mastery Oriented Coping (based on the Utrecht Coping list). Most of these instruments were administered during the first day of the 2-week working period, thus reflecting symptoms and complaints during the 4-week non-work period. The shift workers were also compared to day workers at the oil rig. Results: Twenty-four individuals were classified as suffering from SWD, yielding a prevalence for SWD of 23.3%. During the 4-week non-work period, individuals with SWD reported significantly poorer sleep quality, as measured by the Pittsburgh Sleep Quality Index, and more subjective health complaints than individuals not having SWD. There were no differences between the 2 groups in sleepiness, insomnia, circadian preference, psychological demands, or control. Individuals with SWD reported significantly lower scores on coping. The reports of shift workers without SWD were similar to those of day workers regarding sleep, sleepiness, subjective health complaints, and coping. Conclusions: The prevalence of SWD was relatively high among these shift workers. Individuals with SWD reported poorer sleep quality and more subjective health complaints in the non-work period than shift workers not having SWD. Citation: Waage S; Moen BE; Pallesen S; Eriksen HR; Ursin H; Åkerstedt T; BjorvatnB. Shift work disorder among oil rig workers in the North Sea. SLEEP 2009;32(4):558-565. PMID:19413151

Army Families and Soldier Readiness.

DTIC Science & Technology

1992-01-01

ments, for example, lead to long working hours (an average of 57.5 hours per week as reported by these respondents). Our analyses confirm that such...distress (i.e., symptoms of anxiety and depression) and emo- tional well-being (i.e., level of positive affect). The related indicator of depression1 ... sleep disturbance, psychomotor agitation or retardation, loss of interest or pleasure in usual activi- ties, loss of energy, feelings of

Associations of Short Sleep and Shift Work Status with Hypertension among Black and White Americans

PubMed Central

Ceïde, Mirnova E.; Pandey, Abhishek; Ravenell, Joe; Donat, Margaret; Ogedegbe, Gbenga; Jean-Louis, Girardin

2015-01-01

Objective. The purpose of this study was to investigate whether short sleepers (<6 hrs) who worked the non-day-shift were at greater likelihood of reporting hypertension and if these associations varied by individuals' ethnicity. Methods. Analysis was based on the 2010 National Health Interview Survey (NHIS). A total of 59,199 American adults provided valid data for the present analyses (mean age = 46.2 ± 17.7 years; 51.5% were female). Respondents provided work schedule and estimated habitual sleep durations as well as self-report of chronic conditions. Results. Of the sample, 30.8% reported a diagnosis of hypertension, 79.1% reported daytime shift work, 11.0% reported rotating shift work, and 4.0% reported night shift work. Logistic regression analysis showed that shift work was significantly associated with hypertension among Blacks [OR = 1.35, CI: 1.06–1.72. P < 0.05], but not among Whites [OR = 1.01, CI: 0.85–1.20, NS]. Black shift workers sleeping less than 6 hours had significantly increased odds of reporting hypertension [OR = 1.81, CI: 1.29–2.54, P < 0.01], while their White counterparts did not [OR = 1.17, CI: 0.90–1.52, NS]. Conclusions. Findings suggest that Black Americans working the non-day-shift especially with short sleep duration have increased odds of reporting hypertension. PMID:26495140

Sleep Deprivation Disrupts Recall of Conditioned Fear Extinction.

PubMed

Straus, Laura D; Acheson, Dean T; Risbrough, Victoria B; Drummond, Sean P A

2017-03-01

Learned fear is crucial in the development and maintenance of posttraumatic stress disorder (PTSD) and other anxiety disorders, and extinction of learned fear is necessary for response to exposure-based treatments. In humans, research suggests disrupted sleep impairs consolidation of extinction, though no studies have examined this experimentally using total sleep deprivation. Seventy-one healthy controls underwent a paradigm to acquire conditioned fear to a visual cue. Twenty-four hours after fear conditioning, participants underwent extinction learning. Twenty-four hours after extinction learning, participants underwent extinction recall. Participants were randomized to three groups: 1) well-rested throughout testing ("normal sleep"; n = 21); 2) 36 hours total sleep deprivation before extinction learning ("pre-extinction deprivation"; n = 25); or 3) 36 hours total sleep deprivation after extinction learning and before extinction recall ("post-extinction deprivation"; n = 25). The groups were compared on blink EMG reactivity to the condition stimulus during extinction learning and recall. There were no differences among the three groups during extinction learning. During extinction recall, the pre-extinction deprivation group demonstrated significantly less extinction recall than the normal sleep group. There was no significant difference between the normal sleep and post-extinction deprivation group during extinction recall. Results indicated sleep deprivation prior to extinction training significantly disrupts extinction recall. These findings suggest that (1) sleep deprivation in the immediate aftermath of trauma could be a potential contributor to PTSD development and maintenance via interference with natural extinction processes and (2) management of sleep symptoms should be considered during extinction-based therapy.

Sleep can reduce proactive interference.

PubMed

Abel, Magdalena; Bäuml, Karl-Heinz T

2014-01-01

Sleep has repeatedly been connected to processes of memory consolidation. While extensive research indeed documents beneficial effects of sleep on memory, little is yet known about the role of sleep for interference effects in episodic memory. Although two prior studies reported sleep to reduce retroactive interference, no sleep effect has previously been found for proactive interference. Here we applied a study format differing from that employed by the prior studies to induce a high degree of proactive interference, and asked participants to encode a single list or two interfering lists of paired associates via pure study cycles. Testing occurred after 12 hours of diurnal wakefulness or nocturnal sleep. Consistent with the prior work, we found sleep in comparison to wake did not affect memory for the single list, but reduced retroactive interference. In addition we found sleep reduced proactive interference, and reduced retroactive and proactive interference to the same extent. The finding is consistent with the view that arising benefits of sleep are caused by the reactivation of memory contents during sleep, which has been suggested to strengthen and stabilise memories. Such stabilisation may make memories less susceptible to competition from interfering memories at test and thus reduce interference effects.

Flight Attendant Work/Rest Patterns, Alertness, and Performance Assessment: Field Validation of Biomathematical Fatigue Modeling

DTIC Science & Technology

2012-09-01

of ma- rine pilots working extended hours. Chronobiology International, 25(2), 399-411. Goel, N., & Dinges, D.F. (2011). Behavioral and genetic...Differences in sleep, light, and circadian phase in offshore 18:00-06:00 h and 19:00-07:00 h shift workers. Chronobiology International, 25(2&3

Working hours, work-life conflict and health in precarious and "permanent" employment.

PubMed

Bohle, Philip; Quinlan, Michael; Kennedy, David; Williamson, Ann

2004-12-01

The expansion of precarious employment in OECD countries has been widely associated with negative health and safety effects. Although many shiftworkers are precariously employed, shiftwork research has concentrated on full-time workers in continuing employment. This paper examines the impact of precarious employment on working hours, work-life conflict and health by comparing casual employees to full-time, "permanent" employees working in the same occupations and workplaces. Thirty-nine convergent interviews were conducted in two five-star hotels. The participants included 26 full-time and 13 casual (temporary) employees. They ranged in age from 19 to 61 years and included 17 females and 22 males. Working hours ranged from zero to 73 hours per week. Marked differences emerged between the reports of casual and full-time employees about working hours, work-life conflict and health. Casuals were more likely to work highly irregular hours over which they had little control. Their daily and weekly working hours ranged from very long to very short according to organisational requirements. Long working hours, combined with low predictability and control, produced greater disruption to family and social lives and poorer work-life balance for casuals. Uncoordinated hours across multiple jobs exacerbated these problems in some cases. Health-related issues reported to arise from work-life conflict included sleep disturbance, fatigue and disrupted exercise and dietary regimes. This study identified significant disadvantages of casual employment. In the same hotels, and doing largely the same jobs, casual employees had less desirable and predictable work schedules, greater work-life conflict and more associated health complaints than "permanent" workers.

Working hours of surgical residence: perspective of a group of surgeons in a regional hospital in Hong Kong.

PubMed

Lo, Siu-Fai; Spurgeon, Peter

2007-01-01

The Accreditation Council for Graduate Medical Education and European working time directive have restricted residents' workweek to 80 and 48 hours, respectively. Impacts on resident's training and health services are under evaluation in western countries. However, relevant studies are deficient in Hong Kong. Surgeons in a regional hospital of Hong Kong were recruited. Opinions were collected by semi-structured questionnaire. Response rate was 82%. Most respondents agreed that residents' work hours should be limited. Seventy-two percent thought that the addition of physician assistants, nurse practitioners and ancillary staff could help decrease the workload of residents. More than 60% thought that residents should have post-call afternoon off. Seventy-two percent worried that the number of operations residents performed would decrease. Only half agreed that long work hours was part of resident training and 56.3% agreed that the training period should be lengthened because of limiting work hours. Ninety-four percent agreed that sleep-deprived residents would create more medical errors; 72% thought that long work hours would impair quality of care. Surprisingly, only 28% thought that limiting work hours would compromise continued patient care. Most respondents opine that resident work hours should be regulated and welcome minor rescheduling of residents' workflow. The impacts on residents' training and patient care require further evaluation.

Miscarriage among flight attendants.

PubMed

Grajewski, Barbara; Whelan, Elizabeth A; Lawson, Christina C; Hein, Misty J; Waters, Martha A; Anderson, Jeri L; MacDonald, Leslie A; Mertens, Christopher J; Tseng, Chih-Yu; Cassinelli, Rick T; Luo, Lian

2015-03-01

Cosmic radiation and circadian disruption are potential reproductive hazards for flight attendants. Flight attendants from 3 US airlines in 3 cities were interviewed for pregnancy histories and lifestyle, medical, and occupational covariates. We assessed cosmic radiation and circadian disruption from company records of 2 million individual flights. Using Cox regression models, we compared respondents (1) by levels of flight exposures and (2) to teachers from the same cities, to evaluate whether these exposures were associated with miscarriage. Of 2654 women interviewed (2273 flight attendants and 381 teachers), 958 pregnancies among 764 women met study criteria. A hypothetical pregnant flight attendant with median first-trimester exposures flew 130 hours in 53 flight segments, crossed 34 time zones, and flew 15 hours during her home-base sleep hours (10 pm-8 am), incurring 0.13 mGy absorbed dose (0.36 mSv effective dose) of cosmic radiation. About 2% of flight attendant pregnancies were likely exposed to a solar particle event, but doses varied widely. Analyses suggested that cosmic radiation exposure of 0.1 mGy or more may be associated with increased risk of miscarriage in weeks 9-13 (odds ratio = 1.7 [95% confidence interval = 0.95-3.2]). Risk of a first-trimester miscarriage with 15 hours or more of flying during home-base sleep hours was increased (1.5 [1.1-2.2]), as was risk with high physical job demands (2.5 [1.5-4.2]). Miscarriage risk was not increased among flight attendants compared with teachers. Miscarriage was associated with flight attendant work during sleep hours and high physical job demands and may be associated with cosmic radiation exposure.

Workaholism and negative work-related incidents among nurses.

PubMed

Andreassen, Cecilie Schou; Pallesen, Ståle; Moen, Bente E; Bjorvatn, Bjørn; Waage, Siri; Schaufeli, Wilmar B

2018-05-15

The present study comprised 1,781 nurses who participated in an investigation about working conditions, sleep, and health. They answered a questionnaire about age, sex, marital status, children living at home, work hours per week, number of night shifts last year, and total sleep duration and that also included a validated instrument assessing workaholism. In addition, they were asked to report on eight items concerning negative work-related incidents (dozed off at work, dozed while driving, harmed or nearly harmed self, harmed or nearly harmed patients/others, and harmed or nearly harmed equipment). Logistic regression analyses identified several predictors of these specific incidents: Low age (dozed at work, harmed and nearly harmed self, harmed and nearly harmed equipment), male sex (harmed and nearly harmed self, nearly harmed equipment), not living with children (harmed patients/others), low percentage of full-time equivalent (nearly harmed self and harmed patients/others), number of night shifts last year (dozed off at work and while driving, nearly harmed patients/others) and sleep duration (inversely related to dozed off at work and while driving, nearly harmed self). However, the most consistent predictor of negative work-related incidents was workaholism which was positively and significantly associated with all the eight incidents.

Behavioral and Physiological Consequences of Sleep Restriction

PubMed Central

Banks, Siobhan; Dinges, David F.

2007-01-01

Adequate sleep is essential for general healthy functioning. This paper reviews recent research on the effects of chronic sleep restriction on neurobehavioral and physiological functioning and discusses implications for health and lifestyle. Restricting sleep below an individual's optimal time in bed (TIB) can cause a range of neurobehavioral deficits, including lapses of attention, slowed working memory, reduced cognitive throughput, depressed mood, and perseveration of thought. Neurobehavioral deficits accumulate across days of partial sleep loss to levels equivalent to those found after 1 to 3 nights of total sleep loss. Recent experiments reveal that following days of chronic restriction of sleep duration below 7 hours per night, significant daytime cognitive dysfunction accumulates to levels comparable to that found after severe acute total sleep deprivation. Additionally, individual variability in neurobehavioral responses to sleep restriction appears to be stable, suggesting a traitlike (possibly genetic) differential vulnerability or compensatory changes in the neurobiological systems involved in cognition. A causal role for reduced sleep duration in adverse health outcomes remains unclear, but laboratory studies of healthy adults subjected to sleep restriction have found adverse effects on endocrine functions, metabolic and inflammatory responses, suggesting that sleep restriction produces physiological consequences that may be unhealthy. Citation: Banks S; Dinges DF. Behavioral and physiological consequences of sleep restriction. J Clin Sleep Med 2007;3(5):519-528. PMID:17803017

Long work hours and obesity in Korean adult workers.

PubMed

Jang, Tae-Won; Kim, Hyoung-Ryoul; Lee, Hye-Eun; Myong, Jun-Pyo; Koo, Jung-Wan

2014-01-01

The present study was designed to identify the association between work hours and obesity in Korean adult manual and nonmanual workers, and to determine whether there is a gender difference in this association. The study was conducted using Korean National Health and Nutrition Examination Survey data collected between 2007 and 2010. Individuals aged below 25 or over 64 years, pregnant women, part-time workers, soldiers, housewives and students were excluded. The total number of individuals included in the analysis was 8,889 (5,241 male and 3,648 female subjects). The outcome variable was obesity, defined as body mass index ≥25 kg/m(2). Variables considered in the model were age, education, income, marital status, alcohol drinking, smoking, daily energy intake, physical activity, sleep hours per day, the type of job, work hours, and work schedule. Work hours were categorized as <40, 40-48 (reference), 49-60, and >60 hours per week. In the multiple SURVEYLOGISTIC regression analyses, the adjusted odds ratio of obesity for long work hours (>60 hours per week) in male manual workers was 1.647 (95% confidence interval 1.262-2.151). Long work hours did not significantly increase the odds ratio for obesity in male nonmanual workers and female manual and nonmanual workers. More than 60 work hours per week increased the risk of obesity in Korean male manual workers. This result might be helpful in preventing obesity in Korean adult workers, especially male manual workers.

The effects of acute sleep deprivation during residency training.

PubMed

Bartle, E J; Sun, J H; Thompson, L; Light, A I; McCool, C; Heaton, S

1988-08-01

Verbal and symbol concentration, learning, problem solving, clear thinking, manual skills, and memory were tested in 42 surgical residents to assess the effects of acute sleep deprivation on specific neuropsychological parameters. A series of eight neuropsychological tests--digit symbols, digit vigilance, story memory, trail making, PASAT, Raven matrices, delayed story, and pegboard--and a questionnaire on mood states were completed by the residents both when fatigued (less than 4 hours of sleep: mean, 2.0 +/- 1.5 hours) and when rested (more than 4 hours of sleep: mean, 6.5 +/- 1.0 hours), with at least 7 days between tests. In order to eliminate the effects of learning from the first test series, randomization of residents was performed so that one half were first evaluated when rested and one half when fatigued. ANOVA, multiple regression analysis, and the Student t test were used to assess differences. In the acute sleep-deprived state, residents were less vigorous and more fatigued, depressed, tense, confused, and angry (p less than 0.05) than they were in rested state. Despite these changes in mood, however, the responses on all of the functional tests were no different statistically in those who were rested and those who were fatigued (even in those with less than 2 hours' sleep). We conclude that acute sleep deprivation of less than 4 hours alters mood state but does not change performance in test situations in which concentration, clear thinking, and problem solving are important.

Impact of sleep duration on seizure frequency in adults with epilepsy: a sleep diary study.

PubMed

Cobabe, Maurine M; Sessler, Daniel I; Nowacki, Amy S; O'Rourke, Colin; Andrews, Noah; Foldvary-Schaefer, Nancy

2015-02-01

Prolonged sleep deprivation activates epileptiform EEG abnormalities and seizures in people with epilepsy. Few studies have addressed the effect of chronic partial sleep deprivation on seizure occurrence in populations with epilepsy. We tested the primary hypothesis that partial sleep deprivation over 24- and 72-hour periods increases seizure occurrence in adults with epilepsy. Forty-four subjects completed a series of self-reported instruments, as well as 1-month sleep and seizure diaries, to characterize their sleep and quality of life. Diaries were used to determine the relationship between seizure occurrence and total sleep time 24 and 72h before seizure occurrence using random effects models and a logistic regression model fit by generalized estimating equations. A total of 237 seizures were recorded during 1295 diary days, representing 5.5±7.0 (mean±SD) seizures per month. Random effects models for 24- and 72-hour total sleep times showed no clinically or statistically significant differences in the total sleep time between preseizure periods and seizure-free periods. The average 24-hour total sleep time during preseizure 24-hour periods was 8min shorter than that during seizure-free periods (p=0.51). The average 72-hour total sleep time during preseizure periods was 20min longer than that during seizure-free periods (p=0.86). The presence of triggers was a significant predictor of seizure occurrence, with stress/anxiety noted most often as a trigger. Mean total sleep time was 9h, and subjects took an average of 12±10 naps per month, having a mean duration of 1.9±1.2h. Daytime sleepiness, fatigue, and insomnia symptoms were commonly reported. Small degrees of sleep loss were not associated with seizure occurrence in our sample of adults with epilepsy. Our results also include valuable observations of the altered sleep times and frequent napping habits of adults with refractory epilepsy and the potential contribution of these habits to quality of life and seizure control. Copyright © 2014 Elsevier Inc. All rights reserved.

Flavanol-rich chocolate acutely improves arterial function and working memory performance counteracting the effects of sleep deprivation in healthy individuals.

PubMed

Grassi, Davide; Socci, Valentina; Tempesta, Daniela; Ferri, Claudio; De Gennaro, Luigi; Desideri, Giovambattista; Ferrara, Michele

2016-07-01

Sleep deprivation is a risk factor for cardiovascular disease. Cocoa flavonoids exert cardiovascular benefits and neuroprotection. Whether chocolate consumption may mitigate detrimental effects of sleep loss on cognitive performance and cardiovascular parameters has never been studied. We investigated the effects of flavanol-rich chocolate consumption on cognitive skills and cardiovascular parameters after sleep deprivation. Thirty-two healthy participants underwent two baseline sessions after one night of undisturbed sleep and two experimental sessions after one night of total sleep deprivation. Two hours before each testing session, participants were randomly assigned to consume high or poor flavanol chocolate bars. During the tests were evaluated, the Psychomotor Vigilance Task and a working memory task, office SBP and DBP, flow-mediated dilation and pulse-wave velocity. Sleep deprivation increased SBP/DBP. SBP/DBP and pulse pressure were lower after flavanol-rich treatment respect to flavanol-poor treatment (SBP: 116.9 ± 1.6 vs. 120.8 ± 1.9 mmHg, respectively, P = 0.00005; DBP: 70.5 ± 1.2 vs. 72.3 ± 1.2 mmHg, respectively, P = 0.01; pulse pressure: 46.4 ± 1.3 vs. 48.4 ± 1.5 mmHg, P = 0.004). Sleep deprivation impaired flow-mediated dilation (5.5 ± 0.5 vs. 6.5 ± 0.6%, P = 0.02), flavanol-rich, but not flavanol-poor chocolate counteracted this alteration (flavanol-rich/flavanol-poor chocolate: 7.0 ± 0.6 vs. 5.0 ± 0.4%, P = 0.000001). Flavanol-rich chocolate mitigated the pulse-wave velocity increase (P = 0.001). Flavanol-rich chocolate preserved working memory accuracy in women after sleep deprivation. Flow-mediated dilation correlated with working memory performance accuracy in the sleep condition (P = 0.04). Flavanol-rich chocolate counteracted vascular impairment after sleep deprivation and restored working memory performance. Improvement in cognitive performance could be because of the effects of cocoa flavonoids on blood pressure and peripheral and central blood flow.

An interventional approach for patient and nurse safety: a fatigue countermeasures feasibility study.

PubMed

Scott, Linda D; Hofmeister, Nancee; Rogness, Neal; Rogers, Ann E

2010-01-01

Studies indicate that extended shifts worked by hospital staff nurses are associated with higher risk of errors. Long work hours coupled with insufficient sleep and fatigue are even riskier. Although other industries have developed programs to reduce fatigue-related errors and injury, fatigue countermeasures program for nurses (FCMPN) are lacking. The objective of this study was to evaluate the feasibility of an FCMPN for improving sleep duration and quality while reducing daytime sleepiness and patient care errors. Selected sleep variables, errors and drowsy driving, were evaluated among hospital staff nurses (n = 47) before and after FCMPN implementation. A one-group pretest-posttest repeated-measures approach was used. Participants provided data 2 weeks before the FCMPN, 4 weeks after receiving the intervention, and again at 3 months after intervention. Most of the nurses experienced poor sleep quality, severe daytime sleepiness, and decreased alertness at work and while operating a motor vehicle. After the FCMPN, significant improvements were noted in sleep duration, sleep quality, alertness, and error prevention. Although significant improvements were not found in daytime sleepiness scores, severity of daytime sleepiness appeared to decrease. Despite improvements in fatigue management, nurses reported feelings of guilt when engaging in FCMPN activities, especially strategic naps and relieved breaks. Initial findings support the feasibility of using an FCMPN for mitigating fatigue, improving sleep, and reducing errors among hospital staff nurses. In future investigations, the acceptability, efficacy, and effectiveness of FCMPNs can be examined.

Comparison of Self-Reported Sleep Duration With Actigraphy: Results From the Hispanic Community Health Study/Study of Latinos Sueño Ancillary Study

PubMed Central

Cespedes, Elizabeth M.; Hu, Frank B.; Redline, Susan; Rosner, Bernard; Alcantara, Carmela; Cai, Jianwen; Hall, Martica H.; Loredo, Jose S.; Mossavar-Rahmani, Yasmin; Ramos, Alberto R.; Reid, Kathryn J.; Shah, Neomi A.; Sotres-Alvarez, Daniela; Zee, Phyllis C.; Wang, Rui; Patel, Sanjay R.

2016-01-01

Most studies of sleep and health outcomes rely on self-reported sleep duration, although correlation with objective measures is poor. In this study, we defined sociodemographic and sleep characteristics associated with misreporting and assessed whether accounting for these factors better explains variation in objective sleep duration among 2,086 participants in the Hispanic Community Health Study/Study of Latinos who completed more than 5 nights of wrist actigraphy and reported habitual bed/wake times from 2010 to 2013. Using linear regression, we examined self-report as a predictor of actigraphy-assessed sleep duration. Mean amount of time spent asleep was 7.85 (standard deviation, 1.12) hours by self-report and 6.74 (standard deviation, 1.02) hours by actigraphy; correlation between them was 0.43. For each additional hour of self-reported sleep, actigraphy time spent asleep increased by 20 minutes (95% confidence interval: 19, 22). Correlations between self-reported and actigraphy-assessed time spent asleep were lower with male sex, younger age, sleep efficiency <85%, and night-to-night variability in sleep duration ≥1.5 hours. Adding sociodemographic and sleep factors to self-reports increased the proportion of variance explained in actigraphy-assessed sleep slightly (18%–32%). In this large validation study including Hispanics/Latinos, we demonstrated a moderate correlation between self-reported and actigraphy-assessed time spent asleep. The performance of self-reports varied by demographic and sleep measures but not by Hispanic subgroup. PMID:26940117

The biologic effects of grounding the human body during sleep as measured by cortisol levels and subjective reporting of sleep, pain, and stress.

PubMed

Ghaly, Maurice; Teplitz, Dale

2004-10-01

Diurnal cortisol secretion levels were measured and circadian cortisol profiles were evaluated in a pilot study conducted to test the hypothesis that grounding the human body to earth during sleep will result in quantifiable changes in cortisol. It was also hypothesized that grounding the human body would result in changes in sleep, pain, and stress (anxiety, depression, irritability), as measured by subjective reporting. Twelve (12) subjects with complaints of sleep dysfunction, pain, and stress were grounded to earth during sleep for 8 weeks in their own beds using a conductive mattress pad. Saliva tests were administered to establish pregrounding baseline cortisol levels. Levels were obtained at 4-hour intervals for a 24-hour period to determine the circadian cortisol profile. Cortisol testing was repeated at week 6. Subjective symptoms of sleep dysfunction, pain, and stress were reported daily throughout the 8-week test period. Measurable improvements in diurnal cortisol profiles were observed, with cortisol levels significantly reduced during night-time sleep. Subjects' 24-hour circadian cortisol profiles showed a trend toward normalization. Subjectively reported symptoms, including sleep dysfunction, pain, and stress, were reduced or eliminated in nearly all subjects. Results indicate that grounding the human body to earth ("earthing") during sleep reduces night-time levels of cortisol and resynchronizes cortisol hormone secretion more in alignment with the natural 24-hour circadian rhythm profile. Changes were most apparent in females. Furthermore, subjective reporting indicates that grounding the human body to earth during sleep improves sleep and reduces pain and stress.

"Is there an Association Between Self-Reported Sleep Duration, Body Mass Index and Waist-Hip Ratio in Young Adults? A Cross-Sectional Pilot Study".

PubMed

Kamath, M Ganesh; Prakash, Jay; Dash, Sambit; Chowdhury, Sudipta; Ahmed, Zuhilmi Bin; Yusof, Muhammad Zaim Zharif Bin Mohd

2014-09-01

Sleep is vital for mental and physical health of an individual. Duration of sleep influences the metabolism and regulates body weight. To assess the cross-sectional association of sleep duration with body mass index (BMI) and waist-hip ratio in Malaysian students. Eighty-nine Malaysian students of both genders, and with a mean (standard deviation) age of 21.2 (0.9) years were included. Institutional Ethics Committee clearance was obtained prior to the start of study. The subjects were interviewed regarding the average hours of sleep/day, their self-reported sleep duration was categorized as < 6hour/day (short sleep duration), 6-7hour/day and > 7hour/day. Their height (in meters), weight (in kilograms), waist and hip circumference (in centimetre) were measured. BMI and waist-hip ratio were calculated using appropriate formulas and expressed as mean (standard deviation). The duration of sleep was compared with BMI and waist-hip ratio using one way ANOVA. No statistical significance was observed when sleep duration was associated with BMI (p=0.65) and waist-hip ratio (p=0.95). Duration of sleep did not affect BMI and waist hip ratio in the Malaysian students in our study. The age and healthy lifestyle of the subjects in this study may have been a reason for no significant influence of short sleep duration on the BMI and waist-hip ratio. No association was found between sleep duration with BMI and waist hip ratio in the Malaysian students.

Two hours of evening reading on a self-luminous tablet vs. reading a physical book does not alter sleep after daytime bright light exposure.

PubMed

Rångtell, Frida H; Ekstrand, Emelie; Rapp, Linnea; Lagermalm, Anna; Liethof, Lisanne; Búcaro, Marcela Olaya; Lingfors, David; Broman, Jan-Erik; Schiöth, Helgi B; Benedict, Christian

2016-07-01

The use of electronic devices emitting blue light during evening hours has been associated with sleep disturbances in humans, possibly due to the blue light-mediated suppression of the sleep-promoting hormone melatonin. However, experimental results have been mixed. The present study therefore sought to investigate if reading on a self-luminous tablet during evening hours would alter sleepiness, melatonin secretion, nocturnal sleep, as well as electroencephalographic power spectral density during early slow-wave sleep. Following a constant bright light exposure over 6.5 hours (~569 lux), 14 participants (six females) read a novel either on a tablet or as physical book for two hours (21:00-23:00). Evening concentrations of saliva melatonin were repeatedly measured. Sleep (23:15-07:15) was recorded by polysomnography. Sleepiness was assessed before and after nocturnal sleep. About one week later, experiments were repeated; participants who had read the novel on a tablet in the first experimental session continued reading the same novel in the physical book, and vice versa. There were no differences in sleep parameters and pre-sleep saliva melatonin levels between the tablet reading and physical book reading conditions. Bright light exposure during daytime has previously been shown to abolish the inhibitory effects of evening light stimulus on melatonin secretion. Our results could therefore suggest that exposure to bright light during the day - as in the present study - may help combat sleep disturbances associated with the evening use of electronic devices emitting blue light. However, this needs to be validated by future studies with larger sample populations. Copyright © 2016 The Author(s). Published by Elsevier B.V. All rights reserved.

Sleep Architecture in Night Shift Workers Police Officers with Obstructive Sleep Apnea-hypopnea Syndrome.

PubMed

Verde-Tinoco, Selene; Santana-Miranda, Rafael; Gutiérrez-Escobar, Romel; Haro, Reyes; Miranda-Ortiz, Joana; Berruga-Fernandez, Talia; Jimenez-Correa, Ulises; Poblano, Adrián

2017-01-01

Reduced sleep to increase work hours is common among police officers, when this situation is combined with Obstructive sleep apnea/hypopnea syndrome (OSAHS), health consequences are greater, therefore we believe there is a need of research for these alterations. The aim of this study was to measure the changes in sleep architecture (SA) in police officers who currently have Night shift work (NSW) and OSAHS. We compared SA in 107 subjects divided in three groups: the first group included police officers with NSW and severe OSAHS (n = 48); the second group were non-police officers with diurnal work time and severe OSAHS (n = 48) and the third group was formed by healthy controls (n = 11). Polysomnography (PSG) variables and Epworth sleepiness scale (ESS) scores were compared. SA was more disrupted in the group of police officers with NSW and OSAHS than in patients with OSAHS only and in the control group. Police officers with NSW and OSAHS presented an increased number of electroencephalographic activations, apnea/hypopnea index, and sleep latency, and showed lower scores of oxygen saturation, and in the ESS. Multivariate analysis revealed significant influence of age and Body mass index (BMI). Data suggested with caution an additive detrimental effect of NSW and OSAHS in SA and ESS of police officers. However age and BMI must be also taken into account in future studies.

Sleep deficiency and motor vehicle crash risk in the general population: a prospective cohort study.

PubMed

Gottlieb, Daniel J; Ellenbogen, Jeffrey M; Bianchi, Matt T; Czeisler, Charles A

2018-03-20

Insufficient sleep duration and obstructive sleep apnea, two common causes of sleep deficiency in adults, can result in excessive sleepiness, a well-recognized cause of motor vehicle crashes, although their contribution to crash risk in the general population remains uncertain. The objective of this study was to evaluate the relation of sleep apnea, sleep duration, and excessive sleepiness to crash risk in a community-dwelling population. This was a prospective observational cohort study nested within the Sleep Heart Health Study, a community-based study of the health consequences of sleep apnea. The participants were 1745 men and 1456 women aged 40-89 years. Sleep apnea was measured by home polysomnography and questionnaires were used to assess usual sleep duration and daytime sleepiness. A follow-up questionnaire 2 years after baseline ascertained driving habits and motor vehicle crash history. Logistic regression analysis was used to examine the relation of sleep apnea and sleep duration at baseline to the occurrence of motor vehicle crashes during the year preceding the follow-up visit, adjusting for relevant covariates. The population-attributable fraction of motor vehicle crashes was estimated from the sample proportion of motor vehicle crashes and the adjusted odds ratios for motor vehicle crash within each exposure category. Among 3201 evaluable participants, 222 (6.9%) reported at least one motor vehicle crash during the prior year. A higher apnea-hypopnea index (p < 0.01), fewer hours of sleep (p = 0.04), and self-reported excessive sleepiness (p < 0.01) were each significantly associated with crash risk. Severe sleep apnea was associated with a 123% increased crash risk, compared to no sleep apnea. Sleeping 6 hours per night was associated with a 33% increased crash risk, compared to sleeping 7 or 8 hours per night. These associations were present even in those who did not report excessive sleepiness. The population-attributable fraction of motor vehicle crashes was 10% due to sleep apnea and 9% due to sleep duration less than 7 hours. Sleep deficiency due to either sleep apnea or insufficient sleep duration is strongly associated with motor vehicle crashes in the general population, independent of self-reported excessive sleepiness.

A One-Hour Sleep Restriction Impacts Brain Processing in Young Children Across Tasks: Evidence From Event-related Potentials

PubMed Central

Molfese, Dennis L.; Ivanenko, Anna; Key, Alexandra Fonaryova; Roman, Adrienne; Molfese, Victoria J.; O'Brien, Louise M.; Gozal, David; Kota, Srinivas; Hudac, Caitlin M.

2014-01-01

The effect of mild sleep restriction on cognitive functioning in young children is unclear, yet sleep loss may impact children's abilities to attend to tasks with high processing demands. In a preliminary investigation, six children (6.6 - 8.3 years of age) with normal sleep patterns performed three tasks: attention (“Oddball”), speech perception (conconant-vowel syllables) and executive function (Directional Stroop). Event-related potentials (ERP) responses were recorded before (Control) and following one-week of 1-hour per day of sleep restriction. Brain activity across all tasks following Sleep Restriction differed from activity during Control Sleep, indicating that minor sleep restriction impacts children's neurocognitive functioning. PMID:23862635

Socioeconomic Status, Occupational Characteristics, and Sleep Duration in African/Caribbean Immigrants and US White Health Care Workers

PubMed Central

Ertel, Karen A.; Berkman, Lisa F.; Buxton, Orfeu M.

2011-01-01

Study Objectives: o advance our understanding of the interplay of socioeconomic factors, occupational exposures, and race/ethnicity as they relate to sleep duration. We hypothesize that non Hispanic African/Caribbean immigrant employees in long term health care have shorter sleep duration than non Hispanic white employees, and that low education, low income, and occupational exposures including night work and job strain account for some of the African/Caribbean immigrant–white difference in sleep duration. Design: Cross sectional Setting: Four extended care facilities in Massachusetts, United States Participants: 340 employees in extended care facilities Measurements and Results: Sleep duration was assessed with wrist actigraphy for a mean of 6.3 days. In multivariable regression modeling controlling for gender and age, African/Caribbean immigrants slept 64.4 fewer minutes (95% CI: −81.0, −47.9) per night than white participants; additional control for education and income reduced the racial gap to 50.9 minutes (−69.2, −32.5); additional control for the occupational factors of hours worked per week and working the night shift reduced the racial gap to 37.7 minutes (−57.8, −17.6). Conclusions: his study provides support for the hypothesis that socioeconomic and occupational characteristics explain some of the African/ Caribbean immigrant–white difference in sleep duration in the United States, especially among health care workers. Citation: Ertel KA; Berkman LF; Buxton OM. Socioeconomic status, occupational characteristics, and sleep duration in African/Caribbean immi grants and US white health care workers. SLEEP 2011; 34(4):509-518. PMID:21461330

Body mass index: accounting for full time sedentary occupation and 24-hr self-reported time use.

PubMed

Tudor-Locke, Catrine; Schuna, John M; Katzmarzyk, Peter T; Liu, Wei; Hamrick, Karen S; Johnson, William D

2014-01-01

We used linked existing data from the 2006-2008 American Time Use Survey (ATUS), the Current Population Survey (CPS, a federal survey that provides on-going U.S. vital statistics, including employment rates) and self-reported body mass index (BMI) to answer: How does BMI vary across full time occupations dichotomized as sedentary/non-sedentary, accounting for time spent in sleep, other sedentary behaviors, and light, moderate, and vigorous intensity activities? We classified time spent engaged at a primary job (sedentary or non-sedentary), sleep, and other non-work, non-sleep intensity-defined behaviors, specifically, sedentary behavior, light, moderate, and vigorous intensity activities. Age groups were defined by 20-29, 30-39, 40-49, and 50-64 years. BMI groups were defined by 18.5-24.9, 25.0-27.4, 27.5-29.9, 30.0-34.9, and ≥35.0 kg/m2. Logistic and linear regression were used to examine the association between BMI and employment in a sedentary occupation, considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age race/ethnicity, and household income. The analysis data set comprised 4,092 non-pregnant, non-underweight individuals 20-64 years of age who also reported working more than 7 hours at their primary jobs on their designated time use reporting day. Logistic and linear regression analyses failed to reveal any associations between BMI and the sedentary/non-sedentary occupation dichotomy considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age, race/ethnicity, and household income. We found no evidence of a relationship between self-reported full time sedentary occupation classification and BMI after accounting for sex, age, race/ethnicity, and household income and 24-hours of time use including non-work related physical activity and sedentary behaviors. The various sources of error associated with self-report methods and assignment of generalized activity and occupational intensity categories could compound to obscure any real relationships.

Body Mass Index: Accounting for Full Time Sedentary Occupation and 24-Hr Self-Reported Time Use

PubMed Central

Tudor-Locke, Catrine; Schuna, John M.; Katzmarzyk, Peter T.; Liu, Wei; Hamrick, Karen S.; Johnson, William D.

2014-01-01

Objectives We used linked existing data from the 2006–2008 American Time Use Survey (ATUS), the Current Population Survey (CPS, a federal survey that provides on-going U.S. vital statistics, including employment rates) and self-reported body mass index (BMI) to answer: How does BMI vary across full time occupations dichotomized as sedentary/non-sedentary, accounting for time spent in sleep, other sedentary behaviors, and light, moderate, and vigorous intensity activities? Methods We classified time spent engaged at a primary job (sedentary or non-sedentary), sleep, and other non-work, non-sleep intensity-defined behaviors, specifically, sedentary behavior, light, moderate, and vigorous intensity activities. Age groups were defined by 20–29, 30–39, 40–49, and 50–64 years. BMI groups were defined by 18.5–24.9, 25.0–27.4, 27.5–29.9, 30.0–34.9, and ≥35.0 kg/m2. Logistic and linear regression were used to examine the association between BMI and employment in a sedentary occupation, considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age race/ethnicity, and household income. Results The analysis data set comprised 4,092 non-pregnant, non-underweight individuals 20–64 years of age who also reported working more than 7 hours at their primary jobs on their designated time use reporting day. Logistic and linear regression analyses failed to reveal any associations between BMI and the sedentary/non-sedentary occupation dichotomy considering time spent in sleep, other non-work time spent in sedentary behaviors, and light, moderate, and vigorous intensity activities, sex, age, race/ethnicity, and household income. Conclusions We found no evidence of a relationship between self-reported full time sedentary occupation classification and BMI after accounting for sex, age, race/ethnicity, and household income and 24-hours of time use including non-work related physical activity and sedentary behaviors. The various sources of error associated with self-report methods and assignment of generalized activity and occupational intensity categories could compound to obscure any real relationships. PMID:25295601

Sleep disturbance and neurocognitive function during the recovery from a sport-related concussion in adolescents.

PubMed

Kostyun, Regina O; Milewski, Matthew D; Hafeez, Imran

2015-03-01

Sleep disturbances are a hallmark sign after a sport-related concussion (SRC). Poor sleep has been shown to adversely affect baseline neurocognitive test scores, but it is not comprehensively understood how neurocognitive function is affected by disrupted sleep during recovery from a concussion. To identify the correlation between adolescent athletes' neurocognitive function and their self-reported sleep quantity and sleep disturbance symptoms during recovery from SRC. Cross-sectional study; Level of evidence, 3. Immediate Post-Concussion Assessment and Cognition Testing (ImPACT) data were retrospectively collected for 545 adolescent athletes treated for SRC at a sports medicine concussion clinic. Patients were stratified into groups based on 2 criteria: self-reported sleep duration and self-reported sleep disturbance symptoms during postinjury ImPACT testing. Sleep duration was classified as short (<7 hours), intermediate (7-9 hours), and long (>9 hours). Sleep disturbance symptoms were self-reported as part of the Post-Concussion Symptom Scale (PCSS) as either sleeping less than normal, sleeping more than normal, or having trouble falling asleep. One-way analyses of variance were conducted to examine the effects that sleep duration as well as self-reported sleep disturbance symptoms had on composite scores. A total of 1067 ImPACT tests were analyzed: test 1, 545; test 2, 380; and test 3, 142. Sleeping fewer than 7 hours the night before testing correlated with higher PCSS scores (P < .001), whereas sleeping longer than 9 hours correlated with worse visual memory (P = .01), visual motor speed (P <.001), and reaction time (P = .04) composite scores. With regard to self-reported sleep disturbance symptoms, patients demonstrated worse composite scores during ImPACT testing when they self-reported sleeping more than normal (ImPACT test 1: verbal memory, P < .001; visual motor speed, P = .05; reaction time, P = .01; ImPACT test 2: verbal memory, P < .001; visual memory, P < .001; visual motor speed, P < .001; reaction time, P = .01). Adolescent patients recovering from SRC demonstrated higher (worse) PCSS scores (P < .001) when they sensed that their sleep had been disrupted. Adolescent patients who perceive that their sleep is somehow disrupted after SRC may report a greater number of concussion symptoms during their recovery. In addition, the study results suggest that sleeping more than normal may identify an individual who continues to be actively recovering from concussion, given the correlation between lower neurocognitive function and this self-reported symptom. © 2014 The Author(s).

Sleep duration and patterns in adolescents: correlates and the role of daily stressors.

PubMed

Bauducco, S V; Flink, I K; Jansson-Fröjmark, M; Linton, S J

2016-09-01

The first aim of this study was to assess the prevalence of sleep deficit in a large sample of adolescents. Second, the study aimed to assess whether short sleep duration in the sample was associated with emotional and behavioral problems. Lastly, the study aimed to investigate the association between daily stressors--bedtime activities and sleep duration. Cross-sectional survey. The questionnaires were completed during school hours in 17 municipal junior high schools in Sweden. A total of 2767 adolescents aged 12 to 16 years, 48% girls. Sleep measures included total sleep time (TST) for schooldays and weekends, obtained as combined measures of self-reported bed-time, wake-time, and sleep onset latency. We used the new National Sleep Foundation's guidelines to operationalize sleep duration. Overall 12% of younger adolescents (age 12-13 years) and 18% of older adolescents (14-16 years) slept less than recommended (TST < 7 hours). Adolescents reporting nonrecommended TST also reported more behavioral (ie, norm-breaking behaviors) and emotional problems (ie, depression, anxiety, and anger), with effects in the small-medium range. Finally, adolescents reporting bedtime arousal and use of information and communication technology in bed were more likely to report TST < 7 hours. Stress at home (for younger adolescents) and stress of school performance (for older adolescents) were also associated with TST less than 7 hours. The new National Sleep Foundation's recommendations were informative in this context. Future sleep interventions need to target barriers to good sleep practices, such as use of information and communication technology, stress, and worry that may contribute to arousal at bedtime. Copyright © 2016 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.

Excessive sleep duration and quality of life.

PubMed

Ohayon, Maurice M; Reynolds, Charles F; Dauvilliers, Yves

2013-06-01

Using population-based data, we document the comorbidities (medical, neurologic, and psychiatric) and consequences for daily functioning of excessive quantity of sleep (EQS), defined as a main sleep period or 24-hour sleep duration ≥ 9 hours accompanied by complaints of impaired functioning or distress due to excessive sleep, and its links to excessive sleepiness. A cross-sectional telephone study using a representative sample of 19,136 noninstitutionalized individuals living in the United States, aged ≥ 18 years (participation rate = 83.2%). The Sleep-EVAL expert system administered questions on life and sleeping habits; health; and sleep, mental, and organic disorders (Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision; International Classification of Sleep Disorders: Diagnostic and Coding Manual II, International Classification of Diseases and Related Health Problems, 10th edition). Sleeping at least 9 hours per 24-hour period was reported by 8.4% (95% confidence interval = 8.0-8.8%) of participants; EQS (prolonged sleep episode with distress/impairment) was observed in 1.6% (1.4-1.8%) of the sample. The likelihood of EQS was 3 to 12× higher among individuals with a mood disorder. EQS individuals were 2 to 4× more likely to report poor quality of life than non-EQS individuals as well as interference with socioprofessional activities and relationships. Although between 33 and 66% of individuals with prolonged sleep perceived it as a major problem, only 6.3 to 27.5% of them reported having sought medical attention. EQS is widespread in the general population, co-occurring with a broad spectrum of sleep, medical, neurologic, and psychiatric disorders. Therefore, physicians must recognize EQS as a mixed clinical entity indicating careful assessment and specific treatment planning. © 2013 American Neurological Association.

The Link Between Excessive Quantity of Sleep and Deteriorated Quality of Wakefulness – Implications for the DSM-5

PubMed Central

Ohayon, Maurice M.; Reynolds, Charles F.; Dauvilliers, Yves

2013-01-01

Objectives Using population-based data, we document the comorbidities (medical, neurologic and psychiatric) and consequences for daily functioning of excessive quantity of sleep (EQS), defined as a main sleep period or 24-hour sleep duration ≥9 hours accompanied by complaints of impaired functioning or distress due to excessive sleep, and its links to excessive sleepiness. Methods A cross-sectional telephone study using a representative sample of 19,136 non-institutionalized individuals living in the United States, aged ≥18 (participation rate: 83.2%). The Sleep-EVAL expert system administered questions on life and sleeping habits; health; and sleep, mental and organic disorders (DSM-IV-TR, ICSD-II, ICD-10). Results Sleeping at least 9 hours per 24-hour period was reported by 8.4% (95% confidence intervals: 8.0%-8.8%) of participants; EQS (prolonged sleep episode with distress/impairment) was observed in 1.6% (1.4% to 1.8%) of the sample. The likelihood of EQS was 3-12 times higher among individuals with a mood disorder. EQS individuals were 2-4 times more likely to report poor quality of life than non-EQS individuals as well as interference with socio-professional activities and relationships. Although between 33% and 66% of individuals with prolonged sleep perceived it as a major problem, only 6.3% to 27.5% of them reported having sought medical attention. Interpretation Excessive Quantity of Sleep is widespread in the general population, co-occurring with a broad spectrum of sleep, medical, neurologic and psychiatric disorders. Therefore, physicians must recognize EQS as a mixed clinical entity indicating careful assessment and specific treatment planning. PMID:23846792

Work stress, poor recovery and burnout in teachers.

PubMed

Gluschkoff, K; Elovainio, M; Kinnunen, U; Mullola, S; Hintsanen, M; Keltikangas-Järvinen, L; Hintsa, T

2016-10-01

Both work stress and poor recovery have been shown to contribute to the development of burnout. However, the role of recovery as a mediating mechanism that links work stress to burnout has not been sufficiently addressed in research. To examine recovery as a mediator in the relationship between work stress and burnout among teachers. A cross-sectional study of Finnish primary school teachers, in whom burnout was measured with the Maslach Burnout Inventory-General Survey and work stress was conceptualized using the effort-reward imbalance (ERI) model. Recovery was measured with the Recovery Experience Questionnaire and the Jenkins Sleep Problems Scale. Multiple linear regression analyses and bootstrap mediation analyses adjusted for age, gender and total working hours were performed. Among the 76 study subjects, high ERI was associated with burnout and its dimensions of exhaustion, cynicism and reduced professional efficacy. Poor recovery experiences, in terms of low relaxation during leisure time, partially mediated the relationship between ERI and reduced professional efficacy. Sleep problems, in the form of non-restorative sleep, partially mediated the relationship between ERI and both burnout and exhaustion. Supporting a balance between effort and reward at work may enhance leisure time recovery and improve sleep quality, as well as help to reduce burnout rates. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

French consensus. Idiopathic hypersomnia: Investigations and follow-up.

PubMed

Leu-Semenescu, S; Quera-Salva, M-A; Dauvilliers, Y

Idiopathic hypersomnia is a rare, central hypersomnia, recently identified and to date of unknown physiopathology. It is characterised by a more or less permanent, excessive daytime sleepiness, associated with long and unrefreshing naps. Night-time sleep is of good quality, excessive in quantity, associated with sleep inertia in the subtype previously described as "with long sleep time". Diagnosis of idiopathic hypersomnia is complex due to the absence of a quantifiable biomarker, the heterogeneous symptoms, which overlap with the clinical picture of type 2 narcolepsy, and its variable evolution over time. Detailed evaluation enables other frequent causes of somnolence, such as depression or sleep deprivation, to be eliminated. Polysomnography and multiple sleep latency tests (MSLT) are essential to rule out other sleep pathologies and to objectify excessive daytime sleepiness. Sometimes the MSLT do not show excessive sleepiness, hence a continued sleep recording of at least 24hours is necessary to show prolonged sleep (>11h/24h). In this article, we propose recommendations for the work-up to be carried out during diagnosis and follow-up for patients suffering from idiopathic hypersomnia. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Variations of cortisol, fatigue and sleep disturbances in sound engineers: effect of job task and fast backward-rotating shifts.

PubMed

Vangelova, Katia K

2008-01-01

The aim was to study the effect of job task and fast backward-rotating shifts on the time-of-day variations of cortisol, fatigue, and sleep disturbances in broadcasting sound engineers. The concentration of saliva cortisol and ratings of stress, sleepiness, and fatigue were followed at 3-hour intervals during the fast backward-rotating shifts in 26 sound engineers: 14 subjects from control rooms, aged 45.1 +/- 7.3 years, and 12 subjects working in direct transmissions, aged 51.7 +/- 6.0 years. Saliva cortisol was assessed using an radioimmunology kit. The participants reported for stress symptoms after the shifts and filled a sleep diary. The effects of job task, shift, and time-of-day were analyzed by tests of between-subjects effects (SPSS). Cortisol retained the typical diurnal pattern with a highly significant effect of the shift. The job task and the shift interacted significantly. Higher cortisol values during the morning and night shifts in engineers working in direct transmissions were found. Their stress ratings were also higher, as well as the ratings of sleepiness and fatigue. The quality of sleep was worse in engineers working in direct transmissions. In conclusion, our data indicate that stress and fast backward-rotating shifts in sound engineers working in direct transmissions affect physiological stress markers such as cortisol and increase sleepiness, fatigue, and sleep problems.

Effect of brief sleep hygiene education for workers of an information technology company.

PubMed

Kakinuma, Mitsuru; Takahashi, Masaya; Kato, Noritada; Aratake, Yutaka; Watanabe, Mayumi; Ishikawa, Yumi; Kojima, Reiko; Shibaoka, Michi; Tanaka, Katsutoshi

2010-01-01

To investigate the effects of sleep hygiene education for workers of an information technology (IT) company, we conducted a controlled clinical trial providing 581 workers one-hour sleep hygiene education. The contents of the sleep hygiene education program were a review of sleep habits, provide sleep hygiene education, and the establishment of sleep habit goals. A self-report questionnaire was used to measure outcomes including the Pittsburgh Sleep Quality Index (PSQI), Karolinska Sleepiness Scale (KSS), Checklist Individual Strength (CIS), Center for Epidemiologic Studies for Depression (CES-D), and mean sleep duration on weekdays before and 4 wk after the intervention. A total of 391 participants were included in the analysis, with 214 participants in the sleep hygiene education group and 177 in the waiting list group. KSS score at 2 P.M. decreased by 0.42 points in the sleep hygiene education group, but increased by 0.08 points in the waiting list group, showing a significant effect size of 0.50 (95%CI, -0.97 to -0.04, p<0.05). PSQI score also improved, but the inter-group difference was not statically significant. The present study provides preliminary evidence that brief sleep hygiene education may improve afternoon sleepiness at work, but not sleep at night for IT workers.

Short nights reduce light-induced circadian phase delays in humans.

PubMed

Burgess, Helen J; Eastman, Charmane I

2006-01-01

Short sleep episodes are common in modern society. We recently demonstrated that short nights reduce phase advances to light. Here we show that short nights also reduce phase delays to light. Two weeks of 6-hour sleep episodes in the dark (short nights) and 2 weeks of long 9-hour sleep episodes (long nights) in counterbalanced order, separated by 7 days. Following each series of nights, there was a dim-light phase assessment to assess baseline phase. Three days later, subjects were exposed to a phase-delaying light stimulus for 2 days, followed by a final phase assessment. Subjects slept at home in dark bedrooms but came to the laboratory for the phase assessments and light stimulus. Seven young healthy subjects. The 3.5-hour light stimulus was four 30-minute pulses of bright light (-5000 lux) separated by 30-minute intervals of room light. The stimulus began 2.5 hours after each subject's dim-light melatonin onset, followed by a 6- or 9-hour sleep episode. On the second night, the bright light and sleep episode began 1 hour later. The dim-light melatonin onset and dimlight melatonin offset phase delayed 1.4 and 0.7 hours less in the short nights, respectively (both p < or = .015). These results indicate for the first time that short nights can reduce circadian phase delays, that long nights can increase phase delays to light, or both. People who curtail their sleep may inadvertently reduce their circadian responsiveness to evening light.