Journal of Korean Biological Nursing Science

Korean society of Biological Nursing Science (한국기초간호학회)
권호 표지
DOI QR코드

DOI QR Code

Comparison of Sleep Duration, Social Jetlag, and Subjective Sleep Disturbance in Rotating Shift Nurses According to the Chronotype

순환교대근무 간호사의 일주기유형에 따른 근무조별 수면시간, 사회적 시차, 주관적 수면장애 비교

  • Choi, Su Jung (Graduate School of Clinical Nursing Science, Sungkyunkwan University) ;
  • Joo, Eun Yeon (Department of Neurology, Neuroscience Center, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kim, Kyeong Sug (Graduate School of Clinical Nursing Science, Sungkyunkwan University)
  • 최수정 (성균관대학교 임상간호대학원) ;
  • 주은연 (성균관대학교 신경과학교실, 삼성서울병원 뇌신경센터) ;
  • 김경숙 (성균관대학교 임상간호대학원)
  • Received : 2021.07.23
  • Accepted : 2021.08.26
  • Published : 2021.08.31
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to investigate the sleep duration, social jetlag (SJL), and subjective sleep disturbance according to the individual chronotype in rotating shift nurses. Methods: A total of 344 rotating 3-shift nurses (mean age 28.67 years) were recruited at one university affiliated hospital. They completed the following questionnaires, which were used to assess their chronotype and sleep: the morningness-eveningness questionnaire (MEQ), self-reported sleep duration of work days (SDWshift) and free days (SDFshift) in each shift (day [D], evening [E], night [N]), and sleep disturbance (Insomnia severity index, ISI). SJLshift was calculated as the difference in midsleep (MS=sleep onset+1/2 sleep duration) between work days (MSW) and free days (MSF). Results: Subjects were divided into 3 chronotype groups according to the MEQ; morning (MG, 4.4%) intermediate (IG, 57.8%), and evening groups (EG, 37.8%). SDWD was shortest (4.68 hr) and SDFE was longest (8.93 hr) in the EG. SJLD was longest in the EG (3.77 hr), and SJLN was longest in the MG (7.37 hr). The prevalence of sleep disturbance was 33.3% (MG), 29.6% (IG), and 40.0% (EG), respectively, without any statistical significance. Conclusion: In order to improve the sleep of shift workers, it is recommended that the evening chronotypes should reduce the day shifts and the morning chronotypes should reduce the night shifts. We also propose a study to determine whether these shift assignments can improve the sleep in shift nurses.

Keywords

References

  1. Wickwire EM, Geiger-Brown J, Scharf SM, Drake CL. Shift work and shift work sleep disorder: clinical and organizational perspectives. Chest. 2017;151(5): 1156-1172. https://doi.org/10.1016/j.chest.2016.12.007
  2. Park YW, Shin HK, Lee HS, Young LH, Kim EH, Park JS, et al. A study for developing the effective working pattern for nurses in shift work. Journal of Korean Clinical Nursing Research. 2013;19(3):333-344. https://doi.org/10.22650/JKCNR.2013.19.3.333
  3. Yong LC, Li J, Calvert GM. Sleep-related problems in the US working population: prevalence and association with shiftwork status. Occupational and Environmental Medicine. 2017;74(2):93-104. https://doi.org/10.1136/oemed2016-103638
  4. Niu SF, Chung MH, Chen CH, Hegney D, O'Brien A, Chou KR. The effect of hift rotation on employee cortisol profile, sleep quality, fatigue, and attention level: a systematic review. The Journal of Nursing Research. 2011;19(1):68-81. https://doi.org/10.1097/JNR.0b013e31820c1879
  5. Kecklund G, Axelsson J. Health consequences of shift work and insufficient sleep. British Medical Journal. 2016;355:i5210. https://doi.org/10.1136/bmj.i5210
  6. Haus EL, Smolensky MH. Shift work and cancer risk: potential mechanistic roles of circadian disruption, light at night, and sleep deprivation. Sleep Medicine Reviews. 2013;17(4):273-284. https://doi.org/10.1016/j.smrv.2012.08.003
  7. Yi YH, Choi SJ. Association of sleep characteristics with medication errors for shift work nurses in intensive care units. Journal of Korean Academy of Fundamentals of Nursing. 2014;21(4):403-412. https://doi.org/10.7739/jkafn.2014.21.4.403
  8. Yuan SC, Chou MC, Chen CJ, Lin YJ, Chen MC, Liu HH, et al. Influences of shift work on fatigue among nurses. Journal of Nursing Management. 2011;19 (3):339-345. https://doi.org/10.1111/j.1365-2834.2010.01173.x
  9. Booker LA, Magee M, Rajaratnam SMW, Sletten TL, Howard ME. Individual vulnerability to insomnia, excessive sleepiness and shift work disorder amongst healthcare shift workers. A systematic review. Sleep Medicine Reviews. 2018; 41:220-233. https://doi.org/10.1016/j.smrv.2018.03.005
  10. Juda M, Vetter C, Roenneberg T. The Munich chronotype questionnaire for shift-workers (MCTQShift). Journal of Biological Rhythms. 2013;28(2):130-140. https://doi.org/10.1177/0748730412475041
  11. Juda M, Vetter C, Roenneberg T. Chronotype modulates sleep duration, sleep quality, and social jet lag in shift-workers. Journal of Biological Rhythms. 2013; 28(2):141-151. https://doi.org/10.1177/0748730412475042
  12. Wittmann M, Dinich J, Merrow M, Roenneberg T. Social jetlag: misalignment of biological and social time. Chronobiology International. 2006;23(1-2):497-509. https://doi.org/10.1080/07420520500545979
  13. Roenneberg T, Pilz LK, Zerbini G, Winnebeck EC. Chronotype and social jetlag: a (Self-) critical review. Biology. 2019;8(3):54. https://doi.org/10.3390/biology8030054
  14. Han KS, Park E, Park YH, Lim HS, Lee EM, Kim L, et al. Factors influencing sleep quality in clinical nurses. Journal of Korean Academy of Psychiatric Mental Health Nurses. 2011;20(2):121-131. https://doi.org/10.12934/jkpmhn.2011.20.2.121
  15. Jung YJ, Kang SW. Differences in sleep, fatigue, and neurocognitive function between shift nurses and non-shift nurses. Korean Journal of Adult Nursing. 2017; 29(2):190-199. https://doi.org/10.7475/kjan.2017.29.2.190
  16. Baek JH, Choi-Kwon S. Sleep patterns, alertness and fatigue of shift nurses according to circadian types. Journal of Korean Biological Nursing Science. 2017; 19(3):198-205. https://doi.org/10.7586/jkbns.2017.19.3.198
  17. Choi SJ, Joo EY. Light exposure and sleep-wake pattern in rapidly rotating shift nurses. Journal of Sleep Medicine. 2016;13(1):8-14. https://doi.org/10.13078/jsm.16002
  18. Kim JH, Choi EJ, Kim MS, Yu M, Jun JH, Kim YH. Study on the establishment of fixed night shifts and flexible work arrangements for nurses. Journal of Korean Clinical Nursing Research. 2019;25(2):107-119. https://doi.org/10.22650/JKCNR.2019.25.2.107
  19. Choi SJ, Suh S, Joo EY. Assessing sleep-wake pattern and chronotype with the Korean Munich chronotype for shift-workers in shift working nurses. Journal of Sleep Medicine. 2017;14(1):23-35. https://doi.org/10.13078/jsm.17004
  20. Horne JA, Ostberg O. A self-assessment questionnaire to determine morningness-eveningness in human circadian rhythms. International Journal of Chronobiology. 1976;4(2):97-110.
  21. Park YM, Seo YJ, Songmoto K. The morningness-eveningness questionnaire in Korean version and its relations with sleep-wake habits. Journal of Ergonomics Society of Korea. 1996;15(2):37-49.
  22. Bastien CH, Vallieres A, Morin CM. Validation of the insomnia severity index as an outcome measure for insomnia research. Sleep Medicine. 2001;2(4):297-307. https://doi.org/10.1016/S1389-9457(00)00065-4
  23. Cho YW, Song ML, Morin CM. Validation of a Korean version of the insomnia severity index. Journal of Clinical Neurology. 2014;10(3):210-215. https://doi.org/10.3988/jcn.2014.10.3.210
  24. Kervezee L, Gonzales-Aste F, Boudreau P, Boivin DB. The relationship between chronotype and sleep behavior during rotating shift work: a field study. Sleep. 2021;44(4):zsaa225. https://doi.org/10.1093/sleep/zsaa225.
  25. Korsiak J, Tranmer J, Day A, Aronson KJ. Sleep duration as a mediator between an alternating day and night shift work schedule and metabolic syndrome among female hospital employees. Occupational and Environmental Medicine. 2018;75(2):132-138. https://doi.org/10.1136/oemed-2017-104371
  26. Roenneberg T, Allebrandt KV, Merrow M, Vetter C. Social jetlag and obesity. Current Biology. 2012;22(10):939-943. https://doi.org/10.1016/j.cub.2012.03.038
  27. van de Ven HA, van der Klink JJ, Vetter C, Roenneberg T, Gordijn M, Koolhaas W, et al. Sleep and need for recovery in shift workers: do chronotype and age matter? Ergonomics. 2016;59(2):310-324. https://doi.org/10.1080/00140139.2015.1058426
  28. Vetter C, Fischer D, Matera JL, Roenneberg T. Aligning work and circadian time in shift workers improves sleep and reduces circadian disruption. Current Biology. 2015;25(7):907-911. https://doi.org/10.1016/j.cub.2015.01.064
  29. Hulsegge G, Loef B, van Kerkhof LW, Roenneberg T, van der Beek AJ, Proper KI. Shift work, sleep disturbances and social jetlag in healthcare workers. Journal of Sleep Research. 2019;28(4):e12802. https://doi.org/10.1111/jsr.12802
  30. Choi SJ, Park HR, Joo EY. Effects of light on daytime sleep in 12 hours night shift workers: a field study. Journal of Sleep Medicine. 2019;16(1):26-35. https://doi.org/10.13078/jsm.19026
  31. Dutheil F, Bessonnat B, Pereira B, Baker JS, Moustafa F, Fantini ML, et al. Napping and cognitive performance during night shifts: a systematic review and meta-analysis. Sleep. 2020;43(12):zsaa109. https://doi.org/10.1093/sleep/zsaa109
  32. Cho SJ, Oh DH, Park YC, Nam JH, Kim SH. The clinical association between the prevalence of insomnia and physical and psychiatric disorders in two areas of Gyeonggi province of South Korea. Journal of Korean Neuropsychiatric Association. 2016;55(1):41-50. https://doi.org/10.4306/jknpa.2016.55.1.41
  33. Eastman C. How to reduce circadian misalignment in rotating shift workers. ChronoPhysiology and Therapy. 2016;6:41-46. https://doi.org/10.2147/CPT.S111424
  34. Olson JA, Artenie DZ, Cyr M, Raz A, Lee V. Developing a light-based intervention to reduce fatigue and improve sleep in rapidly rotating shift workers. Chronobiology International. 2020;37(4):573-591. https://doi.org/10.1080/07420528.2019.1698591
  35. Daley M, Morin CM, LeBlanc M, Gregoire JP, Savard J, Baillargeon L. Insomnia and its relationship to health-care utilization, work absenteeism, productivity and accidents. Sleep Medicine. 2009;10(4):427-438. https://doi.org/10.1016/j.sleep.2008.04.005
  36. Chan ZC, Tam WS, Lung MK, Wong WY, Chau CW. A systematic literature review of nurse shortage and the intention to leave. Journal of Nursing Management. 2013;21(4):605-613. https://doi.org/10.1111/j.1365-2834.2012.01437.x