Abstract
Insomnia and excessive sleepiness are among the most commonly reported sleep problems related to shift work. Sleep-related movement disorders have, however, received far less attention in relation to such work schedules. The objective of this study was to investigate the association between different shift work schedules and the prevalence of Restless legs syndrome/Willis–Ekbom disease (RLS/WED) in a large sample of Norwegian nurses. Our hypothesis was that shift working nurses would report higher prevalence of RLS/WED compared to day workers. A total of 1,788 nurses with different work schedules (day work, two-shift rotation, night work, three shift rotation) participated in a cohort study, started in 2008/2009. Four questions about RLS/WED based on the diagnostic criteria were included in wave 4 (2012). RLS/WED prevalence rates across different shift schedules were explored by the Pearson chi-square test. Logistic regression analysis was used to assess the association between RLS/WED and work schedules and shift work disorder (SWD) with adjustment for sex, age, marital status, smoking, and caffeine use. In total, 90.0% of the nurses were females, mean age 36.5 years (SD = 8.6, range 25–67). The overall prevalence of RLS/WED was 26.8%. We found no significant differences between the prevalence of RLS/WED across the different shift schedules, ranging from 23.3% (day work) to 29.4% (night work). There was a significant difference (p < 0.001) in the prevalence of RLS/WED between nurses having SWD (33.5%) compared to nurses not having SWD (23.8%). SWD remained significantly associated with RLS/WED in the adjusted logistic regression analysis (1.56, CI: 1.24–1.97). This study did not support the hypothesis. RLS/WED was associated with SWD, which might indicate that nurses vulnerable to shift work also are sensitive to other complaints related to a misalignment of the biological clock.
Highlights
Shift work is associated with impaired health, whereof sleep problems are among the most commonly reported complaints (1, 2)
Our main hypothesis was that shift working nurses would report higher prevalence of Restless legs syndrome/ Willis–Ekbom disease (RLS/WED) compared to day workers
This finding did not support our hypothesis that shift working nurses would report higher prevalence of RLS/WED compared to day workers
Summary
Shift work is associated with impaired health, whereof sleep problems are among the most commonly reported complaints (1, 2). Work schedules that involve night work are in particular associated with sleep problems, i.e., sleep onset and maintenance difficulties, reduced sleep duration, and excessive sleepiness during work (3). About 95% of shift workers working nights report sleep problems. RLS/WED Associated with Shift Work compared to 40% of day workers (4). Night workers are on duty during their biological resting phase and try to sleep during their biological active phase which has been proposed as a cause to sleep and health problems (5). Even though insomnia and excessive sleepiness have been widely studied in relation to shift work, other sleep disorders, like for instance sleep-related movement disorders, have received little attention in this type of working population. Studies have shown that RLS/ WED is more prevalent among females and increases with age (9)
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