Long shifts, short rests and vulnerability to shift work

Abstract: At the same time as many urban economies are developing into 24-hour societies it is becoming increasingly popular amongst shift workers to compress their working hours. This is done by working longer shifts (>8h) and/or restricting free time (<16h) in between shifts – the main reasons are to gain longer bouts of free time and extra free weekends. However, there is a limited knowledge of the effects of such arrangements on sleep and wakefulness. Thus, the main purposes of the present thesis were to evaluate the effects of long working hours (in the form of 12h shifts) and short recovery periods. Another aim was to evaluate possible mechanisms that could suggest why some individuals develop problems with shift work while others do not.We used a combination of methods - sleep diaries, wake diaries, blood samples and objective measures of sleep and cognitive performance - across whole or large parts of shift schedules to evaluate acute effects of particularly demanding working periods, as well as the total effects of a shift cycle. Study I evaluated the effect of changing from an 8h- to a 12h-shift system. Study II evaluated the effects of long shifts in a shift schedule with both 8h- and 12h-shifts. Study III evaluated the effects of several consecutive short recovery periods (8-9h of recovery) and whether satisfaction with ones’ work hours was associated to problems with sleep and sleepiness. Study IV evaluated whether endocrinological markers of catabolic (cortisol) and anabolic (testosterone) activity changed across a shift sequence and whether satisfaction were related to them. Study V was a laboratory simulation of the effects of a short recovery period (4h of sleep) and whether a short nap could counteract any detrimental effects.There was no convincing evidence for 12h shifts inducing more problems with sleep and sleepiness than 8h shifts. With regard to recovery time between shifts, the shortest recovery times (only 8h) seriously shortened sleep duration and increased sleepiness, while 12h of recovery (between two consecutive 12h shifts) was judged as having no or limited effects on acute measures. The problems with the shortest recovery periods were worse in a schedule with several consecutive shifts and less pronounced in a schedule with few consecutive shifts. With regard to individual differences, it was found that subjects being dissatisfied with their working hours were vulnerable to short recovery periods, which was evident by less sufficient sleep and an accumulation of sleepiness across work periods with limited recovery time. Interestingly, these problems disappeared when they were allowed to recover after the work period. In addition, dissatisfied male shift workers had lower testosterone levels at the end of work periods, indicating disturbed anabolic activity. The simulated quick return supported that curtailed sleep affected sleepiness and performance and that a short nap could counteract these effects temporarily.It is concluded that long shifts (up to 12h) may be acceptable, whereas short recovery time (8h or less) is not. Most of the problems with short recovery periods were related to short sleep and sleepiness, and there is, clearly, a subgroup of workers that suffer more from this than others. It is argued that insufficient sleep and low testosterone levels (in males) might be key factors for developing shift intolerance, mainly by reducing the capacity to recover from shift work.