Night and shift work and incidence of physician-diagnosed sleep disorders in nursing staff: A prospective cohort study
Abstract
BACKGROUND
Epidemiological studies provide evidence for an association between shift work and sleep problems but often lack precise exposure and outcome data.
OBJECTIVE
To investigate the risk of first-time physician-diagnosed sleep disorder in nursing staff using register-based data of shift work and health outcomes.
DESIGN
A prospective cohort study with a 4.5-year follow-up.
PARTICIPANTS
25,639 healthcare employees (nurses including midwives, nursing assistants, and related care professions) employed for at least six months between 2012 and 2016 by Region Stockholm were included.
METHODS
Information on hour-by-hour and day-by-day working hours was obtained from a computerised employee register. Physician-diagnosed sleep disorders (N = 326) were obtained from an outpatient register from January 2013 to June 2017. Discrete time proportional hazards models were used to estimate hazard ratios (HR) adjusting for age, sex, country of birth and profession.
RESULTS
An increased risk of physician-diagnosed sleep disorder was seen among those who, during the preceding six months, only or frequently (>66 times) worked night shifts compared to those who did not work nights (HR 1.70, 95 % CI 1.17-2.43 and HR 1.77, 95 % CI 1.21-2.50 respectively). The associations were supported by a dose-response pattern (p = 0.0006). Among those who work night shifts, the risk associated with 9-12 times of three or more consecutive nights was of borderline statistical significance (HR 1.66, 95 % CI…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 326 participants or records.
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