Finnish Institute of Occupational Health, Helsinki, Finland.
University of Helsinki, Helsinki, Finland.
J Sleep Res. 2019 Jun;28(3):e12658. doi: 10.1111/jsr.12658. Epub 2018 Jan 31.
We examined shift work with or without night work as a risk factor for fatigue and short or long sleep. In a prospective cohort study with 4- and 6-year follow-ups (the Finnish Public Sector study), we linked survey responses of 3,679 full-time hospital employees on sleep duration and fatigue to records on daily working hours in 2008 (baseline), 2012 and 2014. We used logistic regression to estimate risk ratios and their confidence intervals to examine whether continuous exposure to shift work or changes between shift work and day work were associated with short (≤6.5 hr) or long (≥9.0 hr) sleep over 24 hr and fatigue at work and during free days. Compared with continuous day work and adjusting for age, gender, education and fatigue/sleep duration at baseline, continuous shift work with night shifts was associated with increased fatigue during free days (risk ratio = 1.38, 95% confidence interval 1.17-1.63) and long sleep (risk ratio = 8.04, 95% confidence interval 2.88-22.5, without adjustment for education) after 6-year follow-up. Exposure to shift work without night shifts increased only long sleep after 6 years (risk ratio = 5.87, 95% confidence interval 1.94-17.8). A change from day work to shift work with or without night shifts was associated with an increased risk for long sleep, and a change from shift work to day work with a decreased risk for long sleep and fatigue. This study suggests that irregular shift work is a modifiable risk factor for long sleep and increased fatigue, probably reflecting a higher need for recovery.
我们研究了倒班工作(包括轮班工作和夜间工作)和非倒班工作作为疲劳和短或长睡眠的风险因素。在一项具有 4 年和 6 年随访的前瞻性队列研究(芬兰公共部门研究)中,我们将 3679 名全职医院员工的睡眠持续时间和疲劳情况的调查回复与 2008 年(基线)、2012 年和 2014 年的日常工作时间记录相关联。我们使用逻辑回归来估计风险比及其置信区间,以研究连续暴露于轮班工作或轮班工作与日班工作之间的变化是否与 24 小时内的短(≤6.5 小时)或长(≥9.0 小时)睡眠时间以及工作和休息日时的疲劳有关。与连续的日班工作相比,并在调整了年龄、性别、教育程度和基线时的疲劳/睡眠持续时间后,连续的有夜间轮班的轮班工作与休息日时的疲劳增加(风险比=1.38,95%置信区间 1.17-1.63)和长睡眠时间(风险比=8.04,95%置信区间 2.88-22.5,未经教育调整)有关,随访 6 年后。没有夜间轮班的轮班工作仅在 6 年后增加了长睡眠时间(风险比=5.87,95%置信区间 1.94-17.8)。从日班工作转为有或没有夜间轮班的轮班工作与长睡眠时间的风险增加有关,而从轮班工作转为日班工作则与长睡眠时间和疲劳的风险降低有关。本研究表明,不规律的轮班工作是长睡眠时间和疲劳增加的可改变风险因素,这可能反映了更高的恢复需求。