Heart rate variability during sleep after two, four and seven consecutive night shifts and recovery days: a cross-over intervention study.

Abstract

Recovery after shift work is an important part reducing the health problems related to shift work. Heart rate variability (HRV) is an indicator of the balance between sympathetic and parasympathetic activity in the autonomic nervous system and can be used as a measure of recovery after night shifts. The aim of the study is to investigate autonomic recovery during sleep in response to night work in a crossover intervention study. Seventeen male police officers working in call centres in five different police district participated in the HRV measurements. The participants were exposed to three interventions: 2 + 2: two consecutive night shifts followed by two consecutive day recovery days; 4 + 4: four consecutive night shifts followed by four consecutive recovery days; 7 + 7: seven consecutive night shifts followed by seven consecutive recovery days. On the last day with night shift and the last recovery day in each intervention the participants underwent 24h HRV recordings. We analysed HRV during sleep. The five 5-min intervals with the lowest heart rate during each sleep period were chosen for spectral analysis of the heart interbeat interval time series. The five 5-min intervals could occur at any time during sleep. There were overall differences in HRV during sleep between days with night shifts and recovery days, primarily in parasympathetic activity. There was no difference in the lowest heart rate obtained, but the timing was different for the three interventions. The lowest heart rate after night shifts occurred 112 (SD 79) min, 174 (SD 115) min and 135 (SD 94) min after sleep onset for the 2 + 2 night shift, the 4 + 4 night shift and the 7 + 7 night shift, respectively. Overall sleep-related autonomic recovery had higher parasympathetic modulation of cardiac rhythm on the 2 + 2 shift system compared to the 4 + 4 and 7 + 7 shift system.