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Association between night-shift work, sleep quality and health-related quality of life: a cross-sectional study among manufacturing workers in a middle-income setting.

ABSTRACT: OBJECTIVES:Night-shift work may adversely affect health. This study aimed to determine the impact of night-shift work on health-related quality of life (HRQoL), and to assess whether sleep quality was a mediating factor. DESIGN:A cross-sectional study. SETTING:11 manufacturing factories in Malaysia. PARTICIPANTS:177 night-shift workers aged 40-65 years old were compared with 317 non-night-shift workers. PRIMARY AND SECONDARY OUTCOMES:Participants completed a self-administered questionnaire on socio-demographics and lifestyle factors, 12-item Short Form Health Survey V.2 (SF-12v2) and the Pittsburgh Sleep Quality Index (PSQI). The Baron and Kenny's method, Sobel test and multiple mediation model with bootstrapping were applied to determine whether PSQI score or its components mediated the association between night-shift work and HRQoL. RESULTS:Night-shift work was associated with sleep impairment and HRQoL. Night-shift workers had significantly lower mean scores in all the eight SF-12 domains (p<0.001). Compared with non-night-shift workers, night-shift workers were significantly more likely to report poorer sleep quality, longer sleep latency, shorter sleep duration, sleep disturbances and daytime dysfunction (p<0.001). Mediation analyses showed that PSQI global score mediated the association between night-shift work and HRQoL. 'Subjective sleep quality' (indirect effect=-0.24, SE=0.14 and bias corrected (BC) 95% CI -0.58 to -0.01) and 'sleep disturbances' (indirect effect=-0.79, SE=0.22 and BC 95%?CI -1.30 to -0.42) were mediators for the association between night-shift work and physical well-being, whereas 'sleep latency' (indirect effect=-0.51, SE=0.21 and BC 95%?CI -1.02 to -0.16) and 'daytime dysfunction' (indirect effect=-1.11, SE=0.32 and BC 95%?CI -1.86 to -0.58) were mediators with respect to mental well-being. CONCLUSION:Sleep quality partially explains the association between night-shift work and poorer HRQoL. Organisations should treat the sleep quality of night-shift workers as a top priority area for action to improve their employees' overall wellbeing.

SUBMITTER: Lim YC

PROVIDER: S-EPMC7477971 | biostudies-literature | 2020 Sep

REPOSITORIES: biostudies-literature

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Association between night-shift work, sleep quality and health-related quality of life: a cross-sectional study among manufacturing workers in a middle-income setting.

Lim Yin Cheng YC Hoe Victor C W VCW Darus Azlan A Bhoo-Pathy Nirmala N

BMJ open 20200906 9

<h4>Objectives</h4>Night-shift work may adversely affect health. This study aimed to determine the impact of night-shift work on health-related quality of life (HRQoL), and to assess whether sleep quality was a mediating factor.<h4>Design</h4>A cross-sectional study.<h4>Setting</h4>11 manufacturing factories in Malaysia.<h4>Participants</h4>177 night-shift workers aged 40-65 years old were compared with 317 non-night-shift workers.<h4>Primary and secondary outcomes</h4>Participants completed a s ...[more]

PMID: 32895261

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Project description:BackgroundNight and shift work are suspected to cause various adverse effects on health and sleep. Sleep deprivation through shift work is assumed to be compensated on free days. So far it is not clear how different shift systems and shift lengths affect sleep structure on work and free days. Especially working night shifts disrupts the circadian rhythm but also extended working hours (12h) might affect sleep characteristics. Hitherto, the magnitude of sleep debt, social jetlag, and Locomotor Inactivity During Sleep (LIDS) in different shift systems is unknown.MethodsHere, we investigated the impact of five different shift rosters on sleep in 129 industrial workers from Germany. Permanent night work with multiple shift systems with and without night shifts and with different shift lengths were compared. Wrist-activity was monitored over 28 days revealing sleep on- and offsets as well as LIDS as proxy for sleep quality. Overall, 3,865 sleep bouts comprising 22,310 hours of sleep were examined.ResultsThe mean daily age-adjusted sleep duration (including naps) was 6:43h and did not differ between shift workers of different rosters. However, sleep duration on workdays was particularly low in rotational shift systems with 12h-shifts (5:00h), while overall sleep debt was highest. Shift workers showed a median absolute social jetlag of 3:03h, which differed considerably between shift types and rosters (p<0.0001). Permanent night workers had the highest social jetlag (5:08h) and latest mid-sleeps on workdays and free days. Sleep quality was reduced in permanent night shift workers compared with shift workers in other rosters and differed between daytime and nighttime sleep.ConclusionsShift work leads to partial sleep deprivation, which particularly affects workers in 12h-shifts and permanent night shifts. Working these shifts resulted in higher sleep debts and larger absolute social jetlag whereas sleep quality was especially reduced in permanent night shift workers compared with shift workers of other rosters.

Project description:ObjectiveMost research on night and shift work focuses on employee health in large companies, primarily in the healthcare and transportation sectors. However, many night workers work on their own or in small businesses related to services or food. This survey focuses on sleep habits and disorders concerning night work in pastry production and sales.MethodsAn epidemiological telephone cross-sectional survey of night shift workers and their sleep habits was proposed to all employers and employees in the French pastry industry via their insurance health prevention company. Sleep logs allow us to estimate the total sleep time (TST) on workdays and enquire on napping episodes and length. In order to estimate the ideal TST, we added a question on the ideal amount of sleep the subjects need to be in good shape in the morning. We also define sleep debt as the difference between the ideal TST and TST on workdays, and considered a sleep debt when the difference was above 60?min and severe sleep debt above 90?min. Finally we retained subjects as long sleepers for those with a TSTof more than 7?hours and short sleepers when TST was under 5?hours. Insomnia, sleepiness and sleep apnoea have been defined based on the International Classification of Sleep Disorders-Third Edition and the classification of mental disorders (Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition). Bivariate and multivariate logistic regression models were applied to investigate the association with short TST, long TST, sleep debt and napping.ResultsWe analysed 2622 complete questionnaires from 1313 men and 1309 women aged 22-50 years old. 1397 workers began work before 07:00, whereas 1225 began later. The 24-hour TST was 6.7±1.4?hours, whereas the ideal TST was 7.0±1.2?hours. Severe sleep debt (>90?min) was reported by 6% women versus 5% men, whereas moderate sleep debt (>60?min) was reported by 11.5% women versus 9.3% men. Napping is one way to improve 24-hour TST for 58% of pastry producers (75±13?min) and 23% of shopkeepers (45±8?min). Nevertheless, 26.2% of the respondents complained of chronic insomnia, especially women aged 45-54?years old (31%). Finally, 29.6% had evocative criteria for obstructive sleep apnoea, although only 9.1% had a high score on the Berlin Questionnaire.ConclusionOur study demonstrates that both pastry producers and shopkeepers can have disturbed sleep schedules and a high prevalence of sleep disorders, although many have used napping as a behavioural countermeasure to fight sleep debt. The results of our survey lead us to conclude that, besides the need to take care of night workers in big industries, more information and occupational prevention must be focused on night workers in individual and small businesses.

Dataset Information

Association between night-shift work, sleep quality and health-related quality of life: a cross-sectional study among manufacturing workers in a middle-income setting.

Publications

Association between night-shift work, sleep quality and health-related quality of life: a cross-sectional study among manufacturing workers in a middle-income setting.

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