Moderating effect of shift work on sleep and depression in individuals at high risk of bipolar disorder

May 22, 2024Journal of affective disorders

How shift work affects sleep and depression in people at high risk for bipolar disorder

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Abstract

A total of 3379 participants (50.7%) scored high on the Mood Disorder Questionnaire.

Disruptions in social rhythms, such as those caused by shift work, may increase the risk of bipolar disorder.
Significant interactive effects were found between high Mood Disorder Questionnaire scores and shift work on sleep quality and depressive symptoms.
Daytime workers reported fewer sleep disturbances and depressive symptoms than those in other types of shift work.
The study highlights the potential benefits of maintaining a consistent daytime work schedule for those at high risk of bipolar disorder.

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BACKGROUND: Social Zeitgeber Theory posits that disruptions in social rhythms can increase susceptibility to bipolar disorder (BD). Shift work (SW) is one of the external factors that cause instability in social rhythms and the sleep-wake cycle. This study evaluated the moderating influences of SW on the risks of BD and sleep-related parameters and depressive symptoms. Furthermore, we evaluated the specific work schedules including daytime, nighttime, and regular and irregular rotating SW.

METHODS: An online survey was administered to 6665 participants, with 3379 (50.7 %) classified as individuals with high scores of Mood Disorder Questionnaire (MDQ). The survey included the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Scale (ISI), Epworth Sleepiness Scale (ESS), and Center for Epidemiologic Studies Depression Scale (CES-D).

RESULTS: A multivariate regression model revealed significant interactive effects of MDQ positivity and SW on PSQI, ISI, and CES-D scores, but not ESS scores. In a secondary analysis of the high MDQ screen group, daytime workers had lower scores in sleep disturbances and depressive symptoms compared to those engaged in other forms of SW.

LIMITATIONS: Online surveys were accessible voluntarily, leading to potential selection bias. Cross-sectional data identified associations, not causal relationships. Only a self-reported questionnaire was used.

CONCLUSIONS: Our findings emphasize the advantages of a daytime work schedule for individuals at high risk of BD. In accordance with the principles of social rhythm interpersonal therapy, sleep interventions for individuals at high risk of BD should include the maintenance of a consistent daytime schedule.

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Moderating effect of shift work on sleep and depression in individuals at high risk of bipolar disorder

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