Abstract
Background: Women appear more vulnerable to shift work than men, but field studies are lacking. We assessed the impact of sex and hormonal contraceptives [HC] use on the homeostatic and diurnal variation of sleep, sleepiness, alertness, and psychomotor performance in police officers working shifts. Methods: A total of 56 males and 20 females (11 using HC, 6 not using HC, and 3 with unknown use of HC) aged 32·0 ± 5·3 years, participated in an observational study throughout a month-long work cycle, including morning, evening, night shifts, and rest days. Participants wore an actigraph, filled out a sleep and work log, answered questionnaires (Samn-Perelli, KSS, Visual Analogue Scales, ~5/day), and completed 5-min Psychomotor Vigilance Tasks (PVT, ~2/day). Linear mixed-effects models were used to analyze the effects of group, time awake and time-of-day on fatigue, sleepiness, alertness, mood and PVT measures. Findings: All parameters significantly varied with time awake and time-of-day. Female police officers were more fatigued and sleepier than males, both with time awake and across the 24-h day. These variations were similar between non-HC females and the other groups, whereas, compared to males, HC females were more fatigued and less alert, both with time awake and across the 24-h day, and sleepier with time awake. Interpretation: Sex differences on sleep and wakefulness parameters were mainly explained by hormonal contraceptives use. Sex and hormonal parameters are critical factors that must be considered in occupational medicine as well as in future laboratory and field studies on shift workers and circadian rhythms. Funding: Institut de recherche Robert-Sauve en sante et en securite du travail (operating grant 2013-0046). Fonds de Recherche du Quebec–Sante. Conflict of Interest: DBB provides conferences and legal expert advices on various shift work-related cases. Ethical Approval: The protocol was approved by the Douglas Mental Health University Institute Research Ethics Board and was within the ethical standards of the Declaration of Helsinki.
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