Insomnia in shift-workers : a survey for hospital nurses taking account of sleep environment and work stress

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1) Sound environment in the apartment houses of hospital nurses occupied with rotating shift-work was assessed during sleep periods by measuring sound levels. Their sleep environment was often inadequate in terms of sound levels regardless of day or night. It was also suggested that intermittent waking was likely to occur when sound level was high. It should be stressed that shift-workers' sleep environment needs to be kept quiet not only at night but also at daytime. Further research should focus on whether the desirable sound environment at daytime is similar to that at night.2) The work stress in hospital nurses was compared with that in the general white-collar workers. The characteristics of work stress in hospital nurses were high demand and much feeling of reward from work. Their job-control and support from co-workers were at the same levels of the other white-collars'. The nurses were much more depressed and felt much more mental fatigue, compared with the general white-collar … More workers. Their mental health was associated with physical/mental workload and the stress due to interpersonal relationships with co-workers, but not with the work stress which is proper to hospital nurses. This suggests that the main causes of their mental health problems are rather the general working conditions than the nurses' particular situations.3) The prevalence of insomnia in hospital nurses was much higher than that in the general population As for day-to-day variation in self-rated sleep quality, they seemed to experience poor sleep after night shift and also after holidays. The results of multivariate analysis for risk factors of insomnia were as follows. a) Insomnia was frequent among those who recently experienced night shift fewer times, suggesting the adaptation effect to shift-work. b) Insomnia was frequent among those who recently had fewer holidays, suggesting the need of free time for the adjustment of disturbed sleep-wake rhythm. c) Insomnia was also associated with the work stress related to the severity of patients and the less reward from world. d) There was no factors which explains the high prevalence of insomnia in hospital nurses ; it seems to be caused by their shift-work itself. e) There were more users of hypnotic in some hospitals, compared with in the general population. f) There was no evidence that their insomnia is related to the incidence of errors in work. Less