Melatonin, Sleep, and Shift Work Adaptation

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Abstract

Background:

Night work is associated with disrupted circadian rhythms, fatigue, accidents, and chronic disease. Melatonin secretion helps regulate sleep and circadian rhythms.

Objective:

Melatonin, sleep disturbances, and symptoms (sleep, fatigue, mental) were compared among workers on permanent day, swing, and night shifts.

Methods:

Urinary 6-hydroxymelatonin sulfate (6-OHMS) was measured in postwork and postsleep samples. Disrupted circadian melatonin production was evaluated using the sleep:work 6-OHMS ratio. Wrist actigraphy characterized light exposures and sleep characteristics.

Results:

Night workers had altered melatonin, disrupted sleep, and elevated symptom prevalence. Subjects grouped by their sleep:work 6-OHMS ratio rather than shift had even greater symptom prevalence. Risks for two or more symptoms were 3.5 to 8 times greater among workers with sleep:work ratios ≤1 compared to those with ratios >1.

Conclusions:

This ratio may help identify workers at increased risk for accidents or injuries.

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