Shift work, sleep disturbances and social jetlag in healthcare workers

Abstract

The aim of this study was to compare chronotype- and age-dependent sleep disturbances and social jetlag between rotating shift workers and non-shift workers, and between different types of shifts. In the Klokwerk+ cohort study, we included 120 rotating shift workers and 74 non-shift workers who were recruited from six Dutch hospitals. Participants wore Actigraph GT3X accelerometers for 24 hr for 7 days. From the Actigraph data, we predicted the sleep duration and social jetlag (measure of circadian misalignment). Mixed models and generalized estimation equations were used to compare the sleep parameters between shift and non-shift workers. Within shift workers, sleep on different shifts was compared with sleep on work-free days. Differences by chronotype and age were investigated using interaction terms. On workdays, shift workers had 3.5 times (95% confidence interval: 2.2-5.4) more often a short (< 7 hr per day) and 4.1 times (95% confidence interval: 2.5-6.8) more often a long (≥ 9 hr per day) sleep duration compared with non-shift workers. This increased odds ratio was present in morning chronotypes, but not in evening chronotypes (interaction p-value < .05). Older shift workers (≥ 50 years) had 7.3 times (95% confidence interval: 2.5-21.8) more often shorter sleep duration between night shifts compared with work-free days, while this was not the case in younger shift workers (< 50 years). Social jetlag due to night shifts increased with increasing age (interaction p-value < .05), but did not differ by chronotype (interaction p-value ≥ .05). In conclusion, shift workers, in particular older workers and morning chronotypes, experienced more sleep disturbances than non-shift workers. Future research should elucidate whether these sleep disturbances contribute to shift work-related health problems.

Keywords: chronobiology; night work; sleep duration; social jetlag.