Anxiety and depression associated with sleep disturbances in shift workers

Introduction There is increasing evidence that shift work has negative consequences for cardiovascular and metabolic level, and is associated with an increased risk of accident. These consequences would be mediated primarily by chronic sleep deprivation and circadian misalignment suffered by these workers. However, there is less evidence on the impact on the mental health of shift workers. Objective: Studying the effects of rotating night shift work on levels of anxiety and depression in health care workers. Materials and methods As a part of an occupational health program, we conducted a cross-sectional study among workers at a public hospital in Santiago, Chile. According to their work schedule they were classified in daytime work (DW) or shift work (SW). The whole group underwent a medical evaluation that included measurement of weight and height, and they were given a battery of questionnaires: Berlin Questionnaire (BQ), Hospital Anxiety and Depression Scale (ADS) and Pittsburgh's Sleep Quality Index (PSQI). The BQ classifies subjects into Low Risk (LR) or High Risk (HR) of suffering from obstructive sleep apnea syndrome (OSAS). According to their work schedule and outcome of BQ, they were classified into 4 groups: DW/LR (Group 1, n =40), DW/HR (Group 2, n =33), SW/LR (Group 3, n =28) and SW/HR (Group 4, n =34). ANOVA test was applied. Results The study group consisted of 136 workers, of whom 110 (80.9%) were women and 26 (19.1%) were men. Of the total, 74 (54.4%) were working in daytime, and 62 (45.6%) at night in a rotating shift system (37 in 4th Shift and 25 in 3rd Shift). The results according to age were: Group 1=39.41( ± 13.27), Group 2=44.34( ± 10.43), Group 3=42.34( ± 14.25), and Group 4=49.25( ± 12.51) ( p =0.011). For BMI, the results were: Group 1=24.63( ± 6.65), Group 2=31.19( ± 4.65), Group 3=28.87( ± 4.99), and Group 4=33.49( ± 8.56) ( p 0.001). The anxiety score was: Group 1=6.73( ± 3.90), Group 2=10.39( ± 5.25), Group 3=7.39( ± 3.55), and Group 4=10.94( ± 5.09) ( p 0.001). The depression score was: Group 1=4.08( ± 3.49), Group2=6.79( ± 4.00), Group 3=4.14( ± 3.11), and Group 4=8.06 ( ± 4.82) ( p 0.001). The average hours of sleep reported were: Group 1=5.96( ± 1.21), Group 2=5.92( ± 1.13), Group 3=5.87( ± 1.77), and Group 4=5.85( ± 1.66) ( p =0.988). The PSQI score was: Group 1=7.95( ± 3.29), Group 2=9.15( ± 4.85), Group 3=9.50( ± 4.99), and Group 4=11.29( ± 4.93); ( p =0.019). Conclusion In the group studied one can see a level of anxiety and depression significantly higher in subjects with HR of OSAS, which is even greater when this condition is associated with SW. In addition, there was a reduced time spent sleeping in the entire studied group. Sleep, in general, is poor and worsens when subjects with HR of OSAS work in SW. These results suggest that the SW is associated with increased anxiety and depression, and exacerbates the negative consequences of OSAS on mental health. Acknowledgement Workers at the Felix Bulnes Hospital