Individual vulnerability to insomnia, excessive sleepiness and shift work disorder amongst healthcare shift workers. A systematic review.

🥈 Top 2% JournalApr 23, 2018Sleep medicine reviews

Personal risk factors for insomnia, extreme sleepiness, and shift work disorder in healthcare shift workers

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Abstract

About 20-30% of shift workers may experience insomnia symptoms and excessive daytime sleepiness.

Shift work can lead to reduced sleep quality and duration, as well as increased daytime sleepiness.
Older age, morning preference, and having children may increase the risk of sleep-related issues for shift workers.
Higher caffeine intake and neuroticism scores are associated with a greater risk of sleep impairment due to shift work.
Physical activity may help protect against sleep-related problems linked to shift work.
The review found a variety of tools used to measure the impact of shift work on sleep, suggesting a need for standardized methods.

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Shift workers often experience reduced sleep quality, duration and/or excessive sleepiness due to the imposed conflict between work and their circadian system. About 20-30% of shift workers experience prominent insomnia symptoms and excessive daytime sleepiness consistent with the circadian rhythm sleep disorder known as shift work disorder. Individual factors may influence this vulnerability to shift work disorder or sleep-related impairment associated with shift work. This paper was registered with Prospero and was conducted using recommended standards for systematic reviews and meta-analyses. Published literature that measured sleep-related impairment associated with shift work including reduced sleep quality and duration and increased daytime sleepiness amongst healthcare shift workers and explored characteristics associated with individual variability were reviewed. Fifty-eight studies were included. Older age, morning-type, circadian flexibility, being married or having children, increased caffeine intake, higher scores on neuroticism and lower on hardiness were related to a higher risk of sleep-related impairment in response to shift work, whereas physical activity was a protective factor. The review highlights the diverse range of measurement tools used to evaluate the impact of shift work on sleep. Use of standardised and validated tools would enable cross-study comparisons. Longitudinal studies are required to establish causal relationships between individual factors and the development of shift work disorder.

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