Introducing a sleep disorder screening and management strategy for workers with future shift work requirements: a feasibility and acceptability study

Abstract

Sleep disorders are common, and largely undiagnosed in early-career workers. The combination of sleep disorders and shift work has implications for mental health, workplace safety, and productivity. Early identification and management of sleep disorders is likely to be beneficial to workers, employers and the community more broadly. We assessed the feasibility and acceptability of a tailored sleep disorder screening and management pathway for individuals with future shift work requirements. Paramedic students were invited to complete an online sleep health survey, which included validated sleep disorder screening questionnaires for insomnia, obstructive sleep apnea and restless legs syndrome. Participants were able to express interest in participating in a sleep monitoring and management study. Participants at risk for a sleep disorder were identified, contacted by the study physician (RJA), notified of their sleep disorder screening results and provided with information regarding management options. Feasibility of the screening and management pathways were determined by completion of the 12 week follow-up, and ability to engage with health services for diagnostic testing or treatment. Acceptability of these pathways was assessed with a semi-structured interview on completion of the study at 12 weeks. Screening was completed in thirty participants (mean age 22.5 ± 6.7, 63% female), 17 of whom were 'at-risk' for a sleep disorder and offered a management pathway. All participants engaged with the study physician (RJA), with 16 completing the study (94% completion rate). Three participants with excessive daytime sleepiness received feedback from the study physician (RJA) and no further care required. Of the remaining 14 participants, 11 (78%) engaged with health services after speaking with the study physician (RJA). Those who engaged with diagnostic and management services reported that a structured pathway with online screening was convenient and easy to follow. Facilitating screening and management of sleep disorders in students with future shift work requirements is both feasible and acceptable. These findings can inform the development of a preventive strategy for sleep disorders and ideally, a health services feasibility trial for future shift workers.

Keywords: Health services; Obstructive; Paramedicine; Shift work schedule; Sleep apnea; Sleep initiation and maintenance disorders.

Figure 1

Overview of the study measurement points in participants identified as at risk of a sleep disorder. ^aObstructive sleep apnea.

Figure 2

Participant progress for OSA and insomnia management during the 12 week follow up period. (A) red colour denotes OSA participant progress at the 12 week follow up, and (B) yellow colour denotes insomnia participant progress at the 12 week follow up. Participant ID is on the y axis. ^aGeneral Practitioner, *Participant 17 withdrew prior to completing the study, black colour denotes progress not possible beyond withdrawal.