Vangelova K., Cekova I., Dimitrova I.
SLEEP AND FATIGUE IN HOSPITAL PHYSICIANS IN RELATION TO SHIFT WORK
National Center of Public Health and Analyses, Sofia, Bulgaria
Full article (PDF), ENG
Introduction. Sufficient and good quality sleep is crucial for shift workers because of its implications on performance and health. The aim of the study was to follow the effects of night shifts and overtime work on sleep and fatigue of hospital physicians in Bulgaria.
Methods.The study was cross-sectional and comprised 719 physicians, 429 female and 291 male, of average age (44.4 ± 14.2) years from Sofia hospitals. Anonymous questionnaire survey included Karolinska Sleep Diary, demographic information, work place variables, working hours and shift system. The statistical analyses were carried out with SPSS.
Results. 26 % of the physicians worked only in day shifts, 55 % from 1 to 4 night shifts, and 28 % more than 5 night shifts. Great deal of the physicians worked more than 40 hours weekly as follows: 38 % worked 41–50 hours per week, 27 % – 51–60 hours and 14 % > 61 hours. The quality of sleep, estimated by SQI was worse with the increase of the number of night shifts (F = 4.260, p = 0.01) and sleep duration and insufficiency of sleep with increase of the hours worked weekly.
Discussion. Shift working with more night shifts monthly and overtime hours weekly contributed to impaired sleep in the studied group of physicians. The sleep impairment was more evident within the increase in the number of night shifts.
Key words: Night shifts, overtime, sleep quality index
- Hughes R. (2008), Patient safety and quality: An evidence-based handbook for nurses, AHRQ Publication No. 08-0043, Rockville.
- Zhang L., Sun D. M., Li C. B. and Tao M. F. (2016), "Influencing factors for sleep quality among shift-working nurses: across-sectional study in China using 3-factor Pittsburgh sleep quality index", Asian Nursing Research, 10 (4), 277–282, doi: https://doi.org/10.1016/j.anr.2016.09.002
- Wagstaff A. S. and Sigstad Lie J. A. (2011), "Shift and night work and long working hours-a systematic review of safety implications", Scand J Work Environ Health, 37 (3), 173–185. doi:https://doi.org/10.5271/sjweh.3146.
- Frost P., Kolstad H. A. and Bonde J. F. (2009), "Shift work and the risk of ischemic heart disease - a systematic review of the epidemiologic evidence", Scand J Work Environ Health, 35 (3), 163–179. doi:https://doi.org/10.5271/sjweh.1319.
- Puttonen S., Hremd M. and Hublin C. (2010) "Shift work and cardiovascular disease – pathways from circadian stress to morbidity", Scand J Work Environ Health, 36 (2), 96–108. doi:https://doi.org/10.5271/sjweh.2894
- Vyas M. V.,Garg A. X., Iansavichus A. V., Costella J., Donner A. and Laugsand L.E., (2012) " Shift work and vascular events: systematic review and meta-analysis", BMJ, 345, e480. doi:https://doi.org/10.1136/bmj.e4800.
- Knutsson A. and Biggild H. (2010), "Gastrointestinal disorders among shift workers", Scand J Work Environ Health, 36 (2), 85–95. doi:10.5271/sjweh.2897.
- Pan A., Schernhammer E. S., Sun Q., Hu F. B. (2011), "Rotating night shift work and risk of type 2 diabetes: two prospective cohort studies in women", PLoS Med, 8 (12), e1001141. doi:https://doi.org/10.1371/journal.pmed.1001141.
- Puttonen S., Oksanen T., Vahtera J., Pentti J., Virtanen M., Salo and P. (2010), "Is shift work a risk factor for rheumatoid arthritis? The Finnish public sector study", Ann Rheum Dis, 69 (4), 779–80. doi:https://doi.org/10.1136/ard.2008.099184.
- Hedstrom A. K., Akerstedt T., Hillert J., Olsson, T. and Alfredsson L. (2011), "Shift work at young age is associated with increased risk for multiple sclerosis", Annals of neurology, 70 (5), 733–41. doi: https://doi.org/10.1002/ana.22597.
- Ijaz S., Verbeek J., Seidler A., Lindbohm ML., Ojajдrvi A. and Orsini, N. (2013), "Night-shift work and breast cancer – a systematic review and meta-analysis", Scand J Work Environ Health, 39 (5), 431–447. doi:https://doi.org/10.5271/sjweh.3371.
- Еkerstedt T., Knutsson A., Narusyte J., Svedberg P.,Kecklund G. and Alexanderson K. (2015), "Night work and breast cancer in women: a Swedish cohort study", BMJ Open, 5 (4), e008127. doi:https://doi.org/10.1136/bmjopen-2015-008127.
- Åkerstedt T. (2003), "Shift work and disturbed sleep/wakefulness", Occup Med Lond, 53, 89–94. https://doi.org/10.1093/occmed/kqg046
- Hlrid, M. (2006), "Workhours in relation to work stress, recovery and health", Scand J Work Environ Health, 32 (6), 502–514. doi: https://doi.org/10.5271/sjweh.1055.
- Pilcher J. J., Lambert B. J. and Huffcutt A. I. (2000), "Differential effects of permanent and rotating shifts on self-report sleep length: a meta-analytic review", Sleep, 23,155–63. https://doi.org/10.1093/sleep/23.2.1b
- Dembe A. E., Erickson J. B., Delbos R. G. and Banks S. M. (2005), "The impact of overtime and long work hours on occupational injuries and illness: new evidence from the United States", Occupational and Environmental Medicine, 62 (9), 588–597. doi: https://doi.org/10.1136/oem.2004.016667.
- Folkard S. and Tucker P. (2003), "Shift work, safety, and productivity", Occup Med 53, (2), 95–101. doi: https://doi.org/10.1093/occmed/kqg047.
- van der Hulst M. (2003), "Long workhours and health", Scand J Work Environ Health, 29 (3), 171–188. doi: https://doi.org/10.5271/sjweh.720.
- Yang H., Schnall P. L., Jauregui M., Su T. C. and Baker D. (2006), "Work hours and self-reported hypertension among working people in California", Hypertension 48 (4), 744–750. doi:https://doi.org/10.1161/01.HYP.0000238327.41911.52.
- Ferri P., Guadi M., Marcheselli L., Balduzzi S., Magnani D. and Di Lorenzo R. (2016), "The impact of shift work on the psychological and physical health of nurses in a general hospital: a comparison between rotating night shifts and day shifts", Risk Manag Healthc Policy, 9, 203–211. doi : https://doi.org/10.2147/RMHP.S115326.
- Cekova Ir., Stoyanova R., Dimitrova Ir. and Vangelova K. ( 2008), "Sleep and fatigue in hospital physicians in relation to shift work", IEA Congress Proceedings (in print).
- Tucker P., Folkard S., Ansiau D. and Marquiй, J-C. (2011), "The effects of age and shift work on perceived sleep problems: results from the VISAT-combined longitudinal and cross-sectional study", Journal of Occupational and Environmental Medicine, 53 (7), 794– 798.doi:https://doi.org/10.1097/JOM.0b013e318221c64c.
- Sveinsdóttir, H. (2006), "Self-assessed quality of sleep, occupational health, working environment, illness experience and job satisfaction of female nurses working different combination of shifts", Scand J Caring Sci, 20 (2), 229–237. doi:https://doi.org/10.1111/j.1471-6712.2006.00402.x
- Bjorvatn B., Dale S., Hogstad-Erikstein R., Fiske E., Pallesen S. and Waage S. (2012), "Self-reported sleep and health among Norwegian hospital nurses in intensive care units", Nursing in Critical Care, 17 (4), 180–188. doi:https://doi.org/10.1111/j.1478-5153.2012.00504.x.
ORCID ID of co-authors and their contribution in preparation and writing of the paper:
Vangelova K.K. (ORCID ID 0000-0003-4702-3130): defining the purpose and design of the study, analyzing the results received, formulation of the conclusions, design and writing of the article.
Cekova I.V. (ORCID ID 0000-0002-9777-2028): conducting the study, review of literature on the paper subject, statistical processing, analysis of the data received.
Dimitrova I.D. (ORCID ID 0000-0001-5394-4783): conducting the study, review of literature on the paper subject, statistical processing, analysis of the data received.