Associations between night work and anxiety, depression, insomnia, sleepiness and fatigue in a sample of Norwegian nurses

Nicolas M F Øyane, Ståle Pallesen, Bente Elisabeth Moen, Torbjörn Akerstedt, Bjørn Bjorvatn, Nicolas M F Øyane, Ståle Pallesen, Bente Elisabeth Moen, Torbjörn Akerstedt, Bjørn Bjorvatn

Abstract

Background: Night work has been reported to be associated with various mental disorders and complaints. We investigated relationships between night work and anxiety, depression, insomnia, sleepiness and fatigue among Norwegian nurses.

Methods: The study design was cross-sectional, based on validated self-assessment questionnaires. A total of 5400 nurses were invited to participate in a health survey through the Norwegian Nurses' Organization, whereof 2059 agreed to participate (response rate 38.1%). Nurses completed a questionnaire containing items on demographic variables (gender, age, years of experience as a nurse, marital status and children living at home), work schedule, anxiety/depression (Hospital Anxiety and Depression Scale), insomnia (Bergen Insomnia Scale), sleepiness (Epworth Sleepiness Scale) and fatigue (Fatigue Questionnaire). They were also asked to report number of night shifts in the last 12 months (NNL). First, the parameters were compared between nurses i) never working nights, ii) currently working nights, and iii) previously working nights, using binary logistic regression analyses. Subsequently, a cumulative approach was used investigating associations between NNL with the continuous scores on the same dependent variables in hierarchical multiple regression analyses.

Results: Nurses with current night work were more often categorized with insomnia (OR = 1.48, 95% CI = 1.10-1.99) and chronic fatigue (OR = 1.78, 95% CI = 1.02-3.11) than nurses with no night work experience. Previous night work experience was also associated with insomnia (OR = 1.45, 95% CI = 1.04-2.02). NNL was not associated with any parameters in the regression analyses.

Conclusion: Nurses with current or previous night work reported more insomnia than nurses without any night work experience, and current night work was also associated with chronic fatigue. Anxiety, depression and sleepiness were not associated with night work, and no cumulative effect of night shifts during the last 12 months was found on any parameters.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

References

    1. Costa G (2003) Shift work and occupational medicine: an overview. Occup Med (Lond) 53: 83–88.
    1. Bara AC, Arber S (2009) Working shifts and mental health–findings from the British Household Panel Survey (1995-2005). Scand J Work Environ Health 35: 361–367.
    1. Shen J, Botly LC, Chung SA, Gibbs AL, Sabanadzovic S, et al. (2006) Fatigue and shift work. J Sleep Res 15: 1–5.
    1. Pallesen S, Bjorvatn B, Mageroy N, Saksvik IB, Waage S, et al. (2010) Measures to counteract the negative effects of night work. Scand J Work Environ Health 36: 109–120.
    1. Scott AJ, Monk TH, Brink LL (1997) Shiftwork as a Risk Factor for Depression: A Pilot Study. Int J Occup Environ Health 3: S2–S9.
    1. Bildt C, Michelsen H (2002) Gender differences in the effects from working conditions on mental health: a 4-year follow-up. Int Arch Occup Environ Health 75: 252–258.
    1. Muecke S (2005) Effects of rotating night shifts: literature review. J Adv Nurs 50: 433–439.
    1. Harma M, Kecklund G (2010) Shift work and health – how to proceed? Scand J Work Environ Health 36: 81–84.
    1. Bohle P, Tilley AJ (1989) The impact of night work on psychological well-being. Ergonomics 32: 1089–1099.
    1. Skipper JK Jr, Jung FD, Coffey LC (1990) Nurses and shiftwork: effects on physical health and mental depression. J Adv Nurs 15: 835–842.
    1. Parkes KR (1999) Shiftwork, job type, and the work environment as joint predictors of health-related outcomes. J Occup Health Psychol 4: 256–268.
    1. Mitler MM, Miller JC, Lipsitz JJ, Walsh JK, Wylie CD (1997) The sleep of long-haul truck drivers. N Engl J Med 337: 755–761.
    1. Pilcher JJ, Lambert BJ, Huffcutt AI (2000) Differential effects of permanent and rotating shifts on self-report sleep length: a meta-analytic review. Sleep 23: 155–163.
    1. Akerstedt T (1988) Sleepiness as a consequence of shift work. Sleep 11: 17–34.
    1. Dumont M, Montplaisir J, Infante-Rivard C (1997) Sleep Quality of Former Night-shift Workers. Int J Occup Environ Health 3: S10–S14.
    1. Ingre M, Akerstedt T (2004) Effect of accumulated night work during the working lifetime, on subjective health and sleep in monozygotic twins. J Sleep Res 13: 45–48.
    1. Tepas DI, Barnes-Farrell JL, Bobko N, Fischer FM, Iskra-Golec I, et al. (2004) The impact of night work on subjective reports of well-being: an exploratory study of health care workers from five nations. Rev Saude Publica 38 Suppl: 26–31
    1. Natvik S, Bjorvatn B, Moen BE, Mageroy N, Sivertsen B, et al. (2011) Personality factors related to shift work tolerance in two- and three-shift workers. Appl Ergon 42: 719–724.
    1. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67: 361–370.
    1. Bjelland I, Dahl AA, Haug TT, Neckelmann D (2002) The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 52: 69–77.
    1. Pallesen S, Bjorvatn B, Nordhus IH, Sivertsen B, Hjornevik M, et al. (2008) A new scale for measuring insomnia: the Bergen Insomnia Scale. Percept Mot Skills 107: 691–706.
    1. American_Psychiatric_Association (2000) Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC.
    1. Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14: 540–545.
    1. Chalder T, Berelowitz G, Pawlikowska T, Watts L, Wessely S, et al. (1993) Development of a fatigue scale. J Psychosom Res 37: 147–153.
    1. Greenland S (1994) Hierarchical regression for epidemiologic analyses of multiple exposures. Environ Health Perspect 102 Suppl 833–39.
    1. Hansen V, Jacobsen BK, Arnesen E (2001) Prevalence of serious psychiatric morbidity in attenders and nonattenders to a health survey of a general population : the Tromso Health Study. Am J Epidemiol 154: 891–894.
    1. Knutsson A (2004) Methodological aspects of shift-work research. Chronobiol Int 21: 1037–1047.
    1. Flo E, Pallesen S, Mageroy N, Moen BE, Gronli J, et al. (2012) Shift work disorder in nurses–assessment, prevalence and related health problems. PLoS One 7: e33981.
    1. Davidson JR (2008) Insomnia : therapeutic options for women. Sleep Med Clinic 3: 109–119.
    1. Bonnet MH, Arand DL (2010) Hyperarousal and insomnia: state of the science. Sleep Med Rev 14: 9–15.
    1. Parkes JD, Chen SY, Clift SJ, Dahlitz MJ, Dunn G (1998) The clinical diagnosis of the narcoleptic syndrome. J Sleep Res 7: 41–52.
    1. Johns M, Hocking B (1997) Daytime sleepiness and sleep habits of Australian workers. Sleep 20: 844–849.
    1. Pallesen S, Nordhus IH, Omvik S, Sivertsen B, Tell GS, et al. (2007) Prevalence and risk factors of subjective sleepiness in the general adult population. Sleep 30: 619–624.

Source: PubMed

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