Employees with shift work disorder experience excessive sleepiness also on non-work days: A cross-sectional survey linked to working hours register in finnish hospitals

Abstract

A considerable proportion of shift workers have work schedule-related insomnia and/ or excessive sleepiness, a phenomenon described as shift work disorder (SWD). There is yet a lack of evidence on whether or not employees recover from symptoms of SWD between work shifts. We studied whether SWD and its subtypes are associated with insomnia and excessive sleepiness during weekly non-work days and with 24-h sleep time. Hospital employees answered a survey on SWD, insomnia and excessive sleepiness on weekly non-work days, and 24-h sleep. To identify shift workers with night shifts (n=2,900, 18% with SWD) and SWD, we linked survey responses to employers’ register on working hours. SWD included three subtypes: insomnia only (SWD-I, 4%, n=102), excessive sleepiness only (SWD-Es, 8%, n=244), and both insomnia and excessive sleepiness (SWD-IEs, 6%, n=183). Based on regression analyses, SWD was associated with excessive sleepiness on non-work days (OR: 1.42, 95% CI: 1.07–1.88) and with insomnia on non-work days (0.53, 0.31–0.91). SWD-I was associated with excessive sleepiness on non-work days (2.25, 1.31–3.87) and with shorter sleep (7–7.5 h: 1.96, 1.06–3.63; ≤6.5h: 2.39, 1.24–4.59; reference: ≥8 h). The results sug-gest that especially employees with SWD-I may need longer time to overcome excessive sleepiness than allowed by their roster.