High sleep responsiveness can negatively impact the relationship between night work and symptoms of insomnia

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1. Sleep responsiveness to stress was a moderator in the association between the number of night shifts and symptoms of insomnia in participants from safety-sensitive occupations (such as physicians).

2. With low to moderate sleep responsiveness to stress scores, there was a positive relationship between the number of night shifts worked per month and symptoms of insomnia.

Level of Evidence Assessment: 2 (Good)

Sleep responsiveness to stress is a concept describing the impact of poor coping skills on sleep. Studies have suggested that doctors with higher sleep responsiveness to stress are at increased risk for burnout. The objective of this study was to observe whether sleep reactivity to stress can act as a moderator in the association between the number of night shifts over a period of one month and insomnia.

In this study, an online survey was widely distributed and targeted to participants from safety-sensitive professions (such as doctors). Participants first answered questions related to socio-demographic data, caffeine consumption, work experience and smoking. Subsequently, participants completed two standardized scales: sleep responsiveness to stress was assessed by the Ford Insomnia Response to Stress Test (FIRST) (high FIRST scores indicating high sleep responsiveness to stress); Symptoms of insomnia and the extent to which it affected daily function were assessed with the Insomnia Severity Index (ISI).

The results showed that sleep responsiveness to stress was a significant moderator of the association between the number of night shifts worked per month and symptoms of insomnia. Specifically, high sleep responsiveness to stress (high FIRST scores) was correlated with poor sleep, despite a low number of night shifts per month. In addition, at low and moderate sleep responsiveness to stress, there was a significant positive relationship between the number of night shifts worked and symptoms of insomnia. Participants’ demographics such as age, caffeine consumption, cigarette consumption, and work experience did not have a significant impact on insomnia symptoms. This study was limited by the fact that the survey was internet-based, the participants were self-selected and more women than men participated. Therefore, the results cannot be extrapolated to the general population. Nonetheless, this study demonstrated a relationship between insomnia, sleep responsiveness and the number of night shifts worked, which should be addressed in the most vulnerable people working in shift work systems.

Click to read the study in Journal of Sleep Research

Image: PD

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