Impact of sleep timing on attention, sleepiness, and sleep quality among real-life night shift workers with shift work disorder: a cross-over clinical trial

Abstract

Abstract Study Objectives To examine the effect of sleep timing intervention on sleep quality, attention, and sleepiness at work among night shift workers with shift work disorder. Methods We recruited 60 real-life night shift workers through advertisements to participate this cross-over clinical trial. Shift work disorder was confirmed with interview and sleep log. Participants were designated to follow evening sleep (15:00–23:00) and morning sleep (09:00–17:00) schedules in a randomized order. Chronotype was confirmed by the Munich Chronotype Questionnaire. Sleep behaviors and light exposure were recorded using actigraphy. Outcome measures were sleepiness evaluated by the Karolinska Sleepiness Scale, sleep quality evaluated by the Pittsburgh Sleep Quality Index, and attention performance assessed with psychomotor vigilance test. Differences in outcome between the morning and evening sleep schedules were compared using repeated measures ANOVA. Results The participants slept for longer durations during evening sleep schedules compared with morning sleep schedules. Lower sleepiness scores, higher sleep quality, and shorter reaction times and less lapse numbers in the psychomotor vigilance test were observed for participants during evening sleep schedules than morning sleep schedules after adjustment for light exposure and sleep duration. Significant interaction effects were observed for reaction time and lapse number between chronotype and sleep schedule, where the differences between sleep schedules were most prominent among those with late chronotypes. Conclusions It is recommended that night shift workers with shift work disorder arrange to sleep in the evening instead of the morning for better sleep and attention performance, especially those with late chronotypes. Trial registration Sleep Schedule Intervention Study Among Night Shift Workers, https://clinicaltrials.gov/ct2/show/NCT04160572, ClinicalTrials.gov Identifier: NTC04160572.