Differences in Daytime Activity Levels and Daytime Sleep Between Night and Day Duty: An Observational Study in Italian Orthopedic Nurses.

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

doi:10.3389/fphys.2021.628231

Eliana Roveda, Antonino Mulè + Show 7 more

Open Access

https://doi.org/10.3389/fphys.2021.628231

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Abstract

Working nonstandard work schedules is often associated with increased sedentary behavior and risk of sleep disorders. Night shift workers are prone to accumulating sleep debt, which they recover by sleeping during the day. The effect on daytime activity levels is unknown. The present study aims to objectively assess whether daytime sleep could affect daytime activity levels of shift worker nurses, resulting in an accumulation of their activity debt differently between working and rest periods. The study population (N = 37; mean age 41.7 ± 9.1 years) was composed of orthopedic nurses working on a rotating schedule, including either a night shift (NS) or only day/afternoon shift (DS). Actigraph monitoring lasted both on the working and the rest period. For the NS nurses, the working period recorded higher daytime activity levels than the rest period, while daytime sleep during the working and rest periods was similar. Conversely, DS nurses showed higher daytime activity levels and shorter daytime sleep during the working period. NS nurses were less active than DS nurses during the working period, probably because NS tended to have a longer daytime sleep. During the rest period, daytime activity levels for both groups were decreased. For NS nurses, sleep recorded the better sleep parameters during the rest period, while sleep parameters did not show significant differences between the working and the rest periods in DS. During the working period, NS nurses slept worse than the DS nurses. Both groups tended to accumulate a debt in daytime activity levels during the rest period. While daytime sleep may be an excellent way to counteract sleep debt and increase sleep duration over 24 h period, on the other hand, it makes nurses less active.

Highlights

In modern society, the transport, industry, commerce, health care, and hospitality sectors require workers all day long, making the work shifts covering a period of 24 h
We evaluated daytime sleep during off-duty and identified the periods spent to compensate for the sleep-debt resulting from the nightshift by matching the actigraphic nap periods with those entered in the daily diary
It remained when the sample was stratified by work shift: over half of the total sample was classified as either overweight (40.5%) or obese (13.5%)

Summary

Introduction

The transport, industry, commerce, health care, and hospitality sectors require workers all day long, making the work shifts covering a period of 24 h. Since hospitals operate around the clock, nursing staff works continuous working schedules (Li et al, 2019). Studies on shift work have largely investigated exposure to health risk factors. Working irregular hours and night shifts increases the risk of hypertension (Rotenberg et al, 2016), cardiovascular events, type 2 diabetes (Kecklund and Axelsson, 2016; Strohmaier et al, 2018), obesity, metabolic syndrome (Wang et al, 2014), melatonin and cortisol imbalance (Bhatti et al, 2014; Niu et al, 2015; Strohmaier et al, 2018), and cancer (Kecklund and Axelsson, 2016; Aneja, 2019). The main mechanism implicated in these disorders is the disruption of circadian rhythm (Roveda et al, 2019; Galasso et al, 2020) because the atypical working times are not aligned with a worker’s endogenous clock (Hittle and Gillespie, 2019)

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