Separated insomnia severity index (ISI) distinguishes two phenotypes of shift work disorder

Details

• Personal Author:
  Bazan L ; Belcher R ; Drake CL ; Gumenyuk V ; Mengel HJ ; Roth T
• Description:
  Introduction: Most patients meeting diagnostic criteria tor SWD report insomnia. At the same time, 20-25% of the general population has insomnia. We hypothesize that a subgroup of SWD patients experience sleep difficulties primarily related to circadian misalignment, while another subgroup has an insomnia disorder per se precipitated by shift work. Methods: 35 night workers participated in an overnight phase and MSLT assessment. Subjects with a history of insomnia or other sleep disorders prior to shift work were excluded. At 17:00, each subject completed an Epworth Sleepiness Scale (ESS) and two ISI scales: one specific to nighttime/off-shift sleep (ISI-N) and the other specific to day time/on-shift sleep (ISI-D). Questions were identical to the standardized ISI, but instructions referred specifically to either daytime or nighttime sleep. 12 subjects with normal scores on all scales were classified as controls. 12 subjects with ESS < 10 and ISI-D >/= 10 were classified "alert insomniacs" (AI). 11 subjects with ISI-D >/= 10 and ESS >/= 10 were classified "sleepy insomniacs" (SI). Results: AI showed elevated ISI scores with no significant difference between ISI-D (14.67 +/- 3.17) and ISI-N (11.42 +/- 6.93, p > .10), indicating sleep disturbances even during nighttime sleep. In contrast, SI had significantly lower ISI-N scores (9.18 +/- 6.73) than ISI-D scores (14.27 +/- 4.8 1, p < .001), indicating they sleep better at night. Nocturnal five-nap MSLT scores (22:30-06:30) were not significantly different between AI (7.8 +/- 5.1) and controls (8.1 +/- 3.4), but scores among the SI group were significantly lower (3.1 +/- 3.0, p < .01). Conclusion: Use of a separated day/night ISI distinguishes between two insomnia phenotypes of SWD and may assist in the clinical management of the disorder. The insomnia/excessive sleepiness phenotype is associated with normal sleep during the night and pathological sleepiness, while the insomnia-only phenotype shows no difference in sleep disturbances between nocturnal and diurnal sleep. Patients with elevated scores on both scales may benefit from insomnia treatment in addition to phase alignment. [Description provided by NIOSH]
• Subjects:
  Circadian Rhythm Fatigue Occupational Health Safety Shift Work Schedule Sleep Sleep Initiation And Maintenance Disorders Surveys And Questionnaires
• Keywords:
  Analytical-instruments Analytical-models Circadian-rhythms Health-surveys Humans Physiological-fatigue Physiological-response Physiology Physiopathology Questionnaires Shift-work Shift-workers Sleep-deprivation Sleep-disorders Work-intervals

  More +
• ISSN:
  0161-8105
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Abstract or Summary
• Place as Subject:
  Michigan ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  37
• NIOSHTIC Number:
  nn:20045388
• Citation:
  Sleep 2014 Mar; 37(Abstract Suppl):A204
• Contact Point Address:
  R. Belcher, Sleep Disorders and Research Center, Henry Ford Hospital, Detroit, MI, USA
• Federal Fiscal Year:
  2014
• Performing Organization:
  Henry Ford Health System, Detroit, Michigan
• Peer Reviewed:
  False
• Start Date:
  20110901
• Source Full Name:
  Sleep
• Supplement:
  Abstract Supplement
• End Date:
  20140831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:34ba46124747cc4fc91b08575e5953cf313784988f35bc08f37cae6fc5d0f38fba72dfaa8953098f3b70b4008cfa278f193f248d5ab05a39172249f1b24cdefb
• Download URL:
  https://stacks.cdc.gov/view/cdc/200828/cdc_200828_DS1.pdf
• File Type:
  [PDF - 1.15 MB ]