Effects of Shift Work in a Sample of Italian Nurses: Analysis of Rest-Activity Circadian Rhythm

Letizia Galasso, Antonino Mulè, Lucia Castelli, Emiliano Cè, Vincenzo Condemi, Giuseppe Banfi, Eliana Roveda, Angela Montaruli, Fabio Esposito, Letizia Galasso, Antonino Mulè, Lucia Castelli, Emiliano Cè, Vincenzo Condemi, Giuseppe Banfi, Eliana Roveda, Angela Montaruli, Fabio Esposito

Abstract

Shift work can lead to circadian desynchronization due to temporary misalignment between working hours and physiological and behavioral functioning, resulting in compromised health, insomnia, worsening of sleep quality, reduced ability to work during waking hours, and increased cardiovascular risk. We evaluated the effects of shift work on the rest-activity circadian rhythm (RAR) and health status of Italian orthopaedic nurses. The study population was 59 nurses: 44 worked the night shift and 15 worked the day shift. All carried out continuous 5-day actigraphic monitoring to assess RAR, including both the working and the rest period. The rhythmometric analysis showed that, during the working period, the night shift nurses had a significantly lower amplitude than the day shift nurses (p < 0.001), and the acrophase was significantly different between the two groups (p < 0.01). When we stratified the two groups by median body mass index (<25 kg/m2 normal weight and ≥25 kg/m2 overweight), during the working period, we noted a significantly lower amplitude for both the normal weight and the overweight nurses who worked the night shift (p < 0.01 and p < 0.001, normal weight and overweight respectively). The current findings suggest the need for further study of the relationship between activity levels and shift work.

Trial registration: ClinicalTrials.gov NCT03453398.

Keywords: actigraphic monitoring; activity levels; health care; nurses; occupational health; shift work.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Participant recruitment. Study design, participant adherence, and dropout.
Figure 2
Figure 2
Shift schedule for night shift (NS) and day shift (DS) nurses. The grey indicators denote the duration of actigraphic monitoring. O: night-off; R: rest; D: diurnal shift.
Figure 3
Figure 3
Example of a biological rhythm and its parameters: Acrophase (φ), Amplitude (A) and MESOR (M) [36].
Figure 4
Figure 4
Rest-activity circadian rhythms: data collected by actigraphy in night shift (NS) and day shift nurses (DS) during the working period and the rest period. The dashed black line denotes night shift nurses (NS) for the working and the rest period; the continued grey line denotes day shift nurses (DS) for the working and the rest period.

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