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轮班制夜班医护人员的昼夜类型对睡眠、情绪和心血管昼夜节律的影响。

Effects of chronotype on sleep, mood and cardiovascular circadian rhythms in rotating night shift medical workers.

机构信息

Department of Neurology, Wuhan No.1 Hospital, Wuhan, 430022, People's Republic of China.

The First Clinical Medical Institute, Hubei University of Chinese Medicine, Wuhan, 430065, Hubei, People's Republic of China.

出版信息

Int Arch Occup Environ Health. 2024 May;97(4):461-471. doi: 10.1007/s00420-024-02060-4. Epub 2024 Mar 2.

Abstract

PURPOSE

Whether chronotype affects the health outcomes of night shift work populations is unknown. This study aimed to assess the influence of different chronotypes in the rotating night shift population on sleep status, mood, blood pressure (BP), and heart rate variability (HRV), as well as the circadian rhythm of BP and HRV.

METHODS

A total of 208 rotating night shift workers were included. All participants completed structured questionnaires to assess chronotype, mood and sleep status. During their daily lives outside of the night shift, they underwent 24-hour Holter electrocardiogram monitoring and 24-hour ambulatory blood pressure monitoring. Day-time and night-time BP and BP dipping were obtained. Day-time and night-time HRV values (SDNN, RMSSD, LF, HF, LF nu, SD1, SD2 and SD2/SD1) were calculated and fitted to the cosine period curve. Three circandian parameters (mesor, amplitude and acrophase) were extracted to quantify the circadian rhythm of the HRV indices.

RESULTS

Among all three groups, E-type showed more fatigue and sleepiness. In addition, E-type showed blunted diastolic BP dipping. Notably, E-type showed association with higher RMSSD, LF, HF and SD1 in the night time, and higher mesors of RMSSD and LF and amplitude of SD2/SD1 in circadian analysis.

CONCLUSION

Chronotype is a factor affecting fatigue, sleepiness and cardiovascular circadian rhythms of rotating night shift workers. Chronotype should be taken into consideration for managing night-shift rotation to promote occupational health.

摘要

目的

目前尚不清楚昼夜时型是否会影响倒班人群的健康结果。本研究旨在评估不同昼夜时型对轮班制倒班人群的睡眠状况、情绪、血压(BP)和心率变异性(HRV)、以及 BP 和 HRV 的昼夜节律的影响。

方法

共纳入 208 名轮班制倒班工人。所有参与者均完成了评估昼夜时型、情绪和睡眠状况的结构化问卷。在夜间轮班之外的日常生活中,他们接受了 24 小时动态心电图监测和 24 小时动态血压监测。获得日间和夜间 BP 以及 BP 下降值。计算并拟合了日间和夜间 HRV 值(SDNN、RMSSD、LF、HF、LF nu、SD1、SD2 和 SD2/SD1),以量化 HRV 指数的昼夜节律。提取了三个昼夜节律参数(中值、振幅和高峰相位)来定量 HRV 指数的昼夜节律。

结果

在所有三组中,E 型表现出更多的疲劳和嗜睡。此外,E 型的舒张压下降幅度较小。值得注意的是,E 型在夜间的 RMSSD、LF、HF 和 SD1 较高,昼夜节律分析中的 RMSSD 和 LF 的中值以及 SD2/SD1 的振幅较高。

结论

昼夜时型是影响轮班制倒班工人疲劳、嗜睡和心血管昼夜节律的一个因素。在管理夜间轮班制时,应考虑昼夜时型,以促进职业健康。

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