Association of changes in work shifts and shift intensity with change in fatigue and disturbed sleep: a within-subject study

Apr 12, 2018Scandinavian journal of work, environment & health

How changes in work shifts and shift length relate to changes in tiredness and poor sleep within the same workers

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Abstract

A change in night shifts is associated with a 45% increase in the odds of longer sleep length.

Changes in night shifts are linked to increased odds of longer sleep length (OR 1.45).
Fatigue during free days may increase with changes in night shifts (OR 1.38).
Short shift intervals are associated with a higher likelihood of fatigue during work (OR 1.42).
Having more than two consecutive night shifts could lead to difficulties falling asleep (OR 1.10).
Stronger associations between night shifts and longer sleep are observed in workers aged 50 years and older (OR 2.24).

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Objectives The aim of this study was to examine whether changes in work shifts and shift intensity are related to changes in difficulties to fall asleep, fatigue, and sleep length. Methods Questionnaire responses of hospital employees (N=7727, 93% women) in 2008, 2012, 2014 and 2015 were linked to daily-based records of working hours during three months preceding each survey. We used conditional logistic regression and longitudinal fixed-effects analyses to investigate odds ratios (OR) and 95% confidence intervals (CI) for each 25% within-individual change in the proportion of working hour characteristics in relation to changes in fatigue, difficulties to fall asleep, and 24-hour sleep length. Results Change in night but not in morning or evening shifts was associated with parallel changes in odds for longer sleep length (OR 1.45, 95% CI 1.28-1.64) and fatigue during free days (OR 1.38, 95% CI 1.16-1.64). Similarly, short shift intervals and having >2 but not >4 consecutive night shifts were associated with increased odds of fatigue during work and difficulties to fall asleep (OR 1.42, 95% CI 1.19-1.72 and OR 1.10, 95% CI 1.05-1.19, respectively). Among workers aged ≥50 years, the associations were the strongest between night shifts and longer sleep (OR 2.24, 95% CI 1.52-3.81) and between higher proportion of short shift intervals and fatigue during free days (OR 1.68, 95% CI 1.10-2.54). Conclusions Among shift workers with fatigue or sleep problems, decreasing the proportion of night shifts and quick returns and giving preference to quickly forward-rotating shift systems may reduce fatigue.

Association of changes in work shifts and shift intensity with change in fatigue and disturbed sleep: a within-subject study

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