The presence and the nature of dysfunctional cognitions and the focus of attention during pre-sleep period in shift workers

Abstract

Introduction While research concentrates on biological aspects of shift work sleep disorder (SWSD), few studies addressed psychosocial variables. To date, no studies have investigated cognition in SWSD. However, cognitive variables could play a role in the development and maintenance of this disorder. The present study examines the presence and the nature of dysfunctional cognitions and the focus of attention during pre-sleep period in shift worker with and without SWSD. Materials and methods The sample included 47 shift worker participants (mean age: 35.0%; 87.2% women), 25 with SWSD and 22 good sleepers. A semi-structured interview for sleep difficulties was administered to make the diagnosis. Participants wore an actigraph and completed sleep diaries during 2 weeks. Self-report questionnaires measuring pre-sleep content of thought were completed: Epworth sleepiness scale, Chronotype questionnaire, Thought control questionnaire-insomnia revised (TCQ-IR), Pre-sleep activation scale (PSAS), Glasgow Content of Thoughts Inventory (GCTI) et le Dysfunctional Beliefs and Attitudes about Sleep (DBAS). Harvey semi-structured interview designed to assess pre-sleep cognition was administered by a qualified graduate student in psychology after the 2-week period. Results Shift workers with SWSD scored significantly higher on GCTI (t = −2.05, p .05) and on cognitive activation subscale of PSAS (t = −2.75, p .01) compared to shift workers who were good sleepers. Harvey interview showed that SWSD group were significantly more likely than good sleepers to focus their attention on worries and preoccupations than good sleepers (F(1,45) = 6.07, p = .02). SWSD were significantly more likely to listen to noises than good sleepers (F(1,45) = 5.24, p = 0.3). SWSD group reported spending more time thinking or worrying about these topics compared with good sleepers (F(1,45) = 17.7, p = .00). Conclusion This study is a first step in identifying cognitive variables involved in SWSD. These results suggest that pre-sleep activation and focus of attention are different depending of the presence or the absence of the disorder. It seems that cognitive variables could be a promising research avenue in a more multidimensional conceptualization of this sleep disorder. The development of the cognitive activation in shift workers with SWSD could be studied.