Department of Epidemiology, Center for Public Health, Medical University of Vienna, Vienna, Austria.
Department of Virology, Medical University of Vienna, Vienna, Austria.
Chronobiol Int. 2021 Jun;38(6):893-906. doi: 10.1080/07420528.2021.1895200. Epub 2021 Mar 23.
Sleep impairment is highly prevalent in night shift workers, but evidence on the association of former night shift work (NSW) and its metrics (duration and frequency) in relation to sleep complaints is lacking. We evaluated the association of former and current NSW with chronic insomnia or circadian rhythm sleep disorder in a sample of the general worker (GW) population and in hospital workers (HW) in Austria. Information on sleep, NSW history, sociodemographic, and lifestyle factors was collected through an online cross-sectional survey in a representative sample of GW (= 1,004) and a sample of HW (= 799) between 2017 and 2019. Multi-variable adjusted logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for various measures of sleep (including chronic insomnia, daytime sleepiness, sleep duration, napping habits) and doctor-diagnosed chronic insomnia across NSW exposure (never night shift work; ever; ever/former; ever/current) and related metrics (cumulative duration, average frequency), compared to never NSW. Effect modification by chronotype and daytime napping was investigated. Former NSW was associated with higher odds of chronic insomnia in both samples (GW: OR = 2.28, 95% CI = 1.07-4.83; HW: OR = 1.17, 95% CI = 0.60-2.27). Chronic insomnia odds tended to increase among current night shift workers (HW: OR = 1.50, 95% CI = 0.79-2.83), compared to day workers. Higher NSW frequency (shifts/month) was associated with higher chronic insomnia odds in former night shift workers in both samples (GW: OR = 1.06, 95% CI = 1.00-1.12; HW: OR = 1.12, 95% CI = 1.00-1.25). Former NSW was also associated with increased daytime sleepiness among GW (OR = 2.26, 95% CI 1.28-3.99). Associations were more pronounced among early chronotypes and participants who reported no daytime naps. Our results suggest that NSW is associated with chronic insomnia even in the years after cessation of involvement in working it.
睡眠障碍在夜班工人中非常普遍,但目前缺乏关于既往夜班工作(NSW)及其指标(持续时间和频率)与睡眠问题之间关联的证据。我们评估了既往和当前 NSW 与奥地利普通工人(GW)人群和医院工人(HW)慢性失眠或昼夜节律睡眠障碍的关联。2017 年至 2019 年期间,通过 GW(= 1004 人)和 HW(= 799 人)的代表性样本在线横断面调查收集了睡眠、NSW 史、社会人口统计学和生活方式因素信息。多变量调整后的逻辑回归用于估计各种睡眠措施(包括慢性失眠、白天嗜睡、睡眠时间、小睡习惯)和医生诊断的慢性失眠的比值比(ORs)和 95%置信区间(CIs),以比较 NSW 暴露(从不夜班工作;曾有;曾有/既往;曾有/当前)和相关指标(累积时间、平均频率)。调查了睡眠时型和白天小睡的修饰作用。既往 NSW 与两个样本中的慢性失眠几率增加相关(GW:OR = 2.28,95% CI = 1.07-4.83;HW:OR = 1.17,95% CI = 0.60-2.27)。与白天工人相比,当前夜班工人的慢性失眠几率趋于增加(HW:OR = 1.50,95% CI = 0.79-2.83)。在两个样本中,既往夜班工人的 NSW 频率(轮班/月)较高与慢性失眠几率增加相关(GW:OR = 1.06,95% CI = 1.00-1.12;HW:OR = 1.12,95% CI = 1.00-1.25)。既往 NSW 也与 GW 中的白天嗜睡增加相关(OR = 2.26,95% CI 1.28-3.99)。在早时型和报告无白天小睡的参与者中,关联更为明显。我们的结果表明,即使在停止参与夜班工作多年后,NSW 仍与慢性失眠有关。