Sleep disturbances and depressive symptoms of shift workers: Effects of shift schedules

Abstract

This study explored sleep disturbances and depression among various types of shift workers (SWs) and non-SWs, focusing on work schedule diversity. We enrolled 6,654 adults (4,561 SWs, 2,093 non-SWs). Based on self-report questionnaires on work schedules, the participants were classified according to shift work type: non-shift work; and fixed evening, fixed night, regularly rotating, irregularly rotating, casual, and flexible shift work. All completed the Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), and short-term Center for Epidemiologic Studies-Depression scale (CES-D). SWs reported higher PSQI, ESS, ISI, and CES-D than non-SWs. Fixed SWs (fixed evenings and fixed nights) and true SWs (regularly and irregularly rotating SWs) scored higher on the PSQI, ISI, and CES-D than non-SWs. True SWs scored higher on the ESS than fixed SWs and non-SWs. Among fixed SWs, fixed night SWs scored higher on the PSQI and ISI than fixed evening SWs. Among true SWs, irregular SWs (irregularly rotating and casual SWs) scored higher on the PSQI, ISI, and CES-D compared to regularly rotating SWs. The PSQI, ESS, and ISI independently were associated with the CES-D of all SWs. We found an interaction between the ESS and the work schedule on the one hand, and the CES-D on the other, which was stronger in SWs than non-SWs. Fixed night and irregular shifts were linked with sleep disturbances. The depressive symptoms of SWs are associated with sleep problems. The effects of sleepiness on depression were more prominent in SWs than non-SWs.

Keywords: Depression; Shift work; Sleep.