Study: Connection Between Shift Work and Sleep Problems

A new study finds individuals working shifts are more prone to experience sleep problems than those who maintain conventional work schedules, and as such may be at greater risk of metabolic disorders.

Using Survey of the Health Wisconsin (SHOW) data from the years 2008 to 2012, a team including researchers from the University of Wisconsin School of Medicine and Public Health sought to analyze the health implications of shift work for sleep, weight, and diabetes risk. The authors evaluated 1,593 participants, who underwent a physical examination, the data of which was used to calculate body mass index (BMI) to establish patients’ status as overweight or obese.
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The researchers assessed data from an additional 1,400 participants with type 2 diabetes. The conditions of these individuals were determined by a self-reported physician diagnosis or by the presence of glycated hemoglobin in the blood at levels of 6.5 percent or higher at physical assessment. Participants’ working patterns were recorded during interviews.

The team found that shift workers, at 47.9 percent, were more likely to be overweight than those working a 9 a.m. to 5 p.m. schedule; 34.7 percent of whom were classified as overweight.

Shift workers were also more likely to deal with sleep problems, with approximately 24 percent experiencing insomnia, compared to 16.3 percent of those working more conventional hours. In addition, 53 percent of shift workers reported insufficient sleep, with 42.9 percent of 9-to-5 workers indicating the same. Nearly 32 percent of shift workers experienced excessive wake-time sleepiness, in comparison to 24.4 percent of workers with more standard schedules.

Primary care providers “should routinely obtain information on patients’ occupations,” says Javier Nieto, MD, MPH, PhD, professor and chair of population health sciences at the University of Wisconsin-Madison’s School of Medicine and Public Health, and co-author of the study.

“If the patient works outside the regular conventional work schedule, particularly if he or she is overweight or have a history or risk of diabetes or related disorders, the provider might want to [delve into] a little bit more detail on this occupational history and related behaviors, e.g., sedentarism, dietary habits,” he continues.

“Importantly, a detailed history and discussion of the patient’s sleep habits or sleep symptoms might be critical on evaluating the patient’s risk as well as on trying to find ways to alleviate the risk associated with shiftwork,” says Nieto, noting that “our results suggest that this risk is more prominent among patients who report insufficient sleep.”

Patients who work shifts may also benefit from physician counseling on healthy eating and active lifestyles, says Marjory Givens, an associate scientist at the University of Wisconsin School of Medicine and Public Health, and lead author of the study.

“Physicians may have an even more influential role in addressing health disparities by stepping outside of the clinic to advocate for workplace wellness initiatives that encourage a healthy lifestyle inclusive of sufficient sleep,” adds Givens.

“For example, many primary care physicians belong to professional organizations such as the American Medical Association and the American Academy of Family Medicine,” she says. “Physicians can take action in these professional groups to improve working conditions for shiftworkers by developing a slate of recommendations appropriate for healthcare practitioners, employers, and even policymakers at the national, state, and local levels.”

—Mark McGraw

Reference

Givens M, Malecki K, et al. Shiftwork, sleep habits, and metabolic disparities: results from the Survey of the Health of Wisconsin. Sleep Health. 2015.