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DISENTANGLING THE EFFECTS OF INSOMNIA AND NIGHT WORK ON CARDIOVASCULAR DISEASES: A STUDY IN NURSING PROFESSIONALS
Affilliation
Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.
Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Laboratório de Educação em Ambiente e Saúde. Rio de Janeiro, RJ, Brasil.
Abstract
Cardiovascular diseases (CVDs) are known to be associated with poor sleep quality in general populations, but they have not
been consistently associated with specific work schedules. Studies of CVD generally do not simultaneously consider sleep and
work schedules, but that approach could help to disentangle their effects. We investigated the association between insomnia
and a self-reported physician diagnosis of CVD in day and night workers, considering all sleep episodes during nocturnal and
diurnal sleep. A cross-sectional study was conducted in 1307 female nursing professionals from 3 public hospitals, using
baseline data from the ‘‘Health and Work in Nursing - a Cohort Study.’’ Participants were divided into two groups: i) day workers
with no previous experience in night shifts (n=281) and whose data on insomnia were related to nocturnal sleep and ii) those
who worked exclusively at night (n=340) and had data on both nocturnal and diurnal sleep episodes, as they often sleep at
daytime. Multiple logistic regression analysis was performed. Among day workers, insomnia complaints increased the odds of
CVD 2.79-fold (95% CI=1.01-6.71) compared with workers who had no complaints. Among night workers, reports of insomnia
during both nocturnal and diurnal sleep increased the odds of reported CVD 3.07-fold (95% CI=1.30-7.24). Workers with
insomnia had similar probabilities of reporting CVD regardless of their work schedule, suggesting a relationship to insomnia
and not to night work per se. The results also highlighted the importance of including evaluation of all sleep episodes (diurnal
plus nocturnal sleep) for night workers.
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