Cognitive factors increase the risk of shift work disorder through insomnia symptoms

IF 3.4 2区医学 Q1 CLINICAL NEUROLOGY

Sleep medicine Pub Date : 2025-09-10 DOI:10.1016/j.sleep.2025.106806

Rachael Harris, Sean P.A. Drummond, Tracey L. Sletten, Alexander P. Wolkow

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引用次数: 0

Abstract

Objectives

The primary aims of the current study were to 1) investigate whether cognitive factors are associated with an increased risk of shift work disorder (SWD), and 2) whether symptoms of insomnia and/or excessive sleepiness mediate this association. Additionally, a third exploratory aim of the study was to examine whether these mediators of insomnia and excessive sleepiness vary in the relationship between cognitive factors and two phenotypes of SWD (i.e., SWD with high insomnia and low excessive sleepiness (SWD-I), and SWD with high excessive sleepiness with or without high insomnia (SWD-E)).

Methods

Shift workers (n = 126), predominantly working a schedule involving night shifts, completed a survey comprising measures of SWD risk, insomnia, excessive sleepiness, and cognitive factors, including pre-sleep cognitive and somatic arousal, dysfunctional beliefs about sleep, and sleep reactivity.

Results

Logistic regressions found cognitive factors were not associated with SWD risk. Mediation analysis showed insomnia symptoms mediated the impact of pre-sleep somatic arousal, dysfunctional beliefs about sleep, and sleep reactivity on high SWD risk. Of those at high risk of SWD (37 %), 43 % and 34 % had the SWD-I and SWD-E phenotype, respectively. Insomnia symptoms mediated the relationship between all cognitive factors and SWD-I, but not SWD-E.

Conclusions

Although cognitive factors were not directly associated with SWD risk, insomnia severity, but not excessive sleepiness, was a significant cross-sectional mediator in the relationship between cognitive factors and risk of SWD. When exploring SWD phenotypes, cognitive factors were associated with a risk of having SWD when participants did not have excessive sleepiness (i.e., SWD-I). To expand on our findings, future research should investigate insomnia's role as a mediator in individuals diagnosed with SWD and to investigate the SWD phenotypes with larger samples.

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认知因素通过失眠症状增加轮班工作障碍的风险。

目的：本研究的主要目的是：1)调查认知因素是否与轮班工作障碍（SWD）风险增加相关；2)失眠和/或过度嗜睡的症状是否介导了这种关联。此外，本研究的第三个探索性目的是研究这些失眠和过度嗜睡的介质在认知因素与两种SWD表型（即重度失眠伴低过度嗜睡（SWD- i）和重度过度嗜睡伴或不伴重度失眠（SWD- e））之间的关系中是否存在差异。方法：轮班工人（n = 126），主要工作时间涉及夜班，完成了一项调查，包括测量SWD风险、失眠、过度嗜睡和认知因素，包括睡眠前认知和躯体唤醒、睡眠功能失调信念和睡眠反应。结果：Logistic回归发现认知因素与SWD风险无关。中介分析显示，失眠症状介导了睡眠前躯体唤醒、睡眠功能失调信念和睡眠反应对高SWD风险的影响。在SWD高危人群中（37%），分别有43%和34%的人患有SWD- i和SWD- e表型。失眠症状介导了所有认知因素与SWD-I之间的关系，但不介导SWD-E之间的关系。结论：虽然认知因素与SWD风险无直接关系，但失眠严重程度是认知因素与SWD风险关系的重要横截面中介，而非过度嗜睡。在探索SWD表型时，当参与者没有过度嗜睡（即SWD- i）时，认知因素与患SWD的风险相关。为了扩大我们的研究结果，未来的研究应该调查失眠在被诊断为SWD的个体中的中介作用，并在更大的样本中调查SWD表型。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Sleep medicine 医学-临床神经学

CiteScore

8.40

自引率

6.20%

发文量

1060

审稿时长

49 days

期刊介绍： Sleep Medicine aims to be a journal no one involved in clinical sleep medicine can do without. A journal primarily focussing on the human aspects of sleep, integrating the various disciplines that are involved in sleep medicine: neurology, clinical neurophysiology, internal medicine (particularly pulmonology and cardiology), psychology, psychiatry, sleep technology, pediatrics, neurosurgery, otorhinolaryngology, and dentistry. The journal publishes the following types of articles: Reviews (also intended as a way to bridge the gap between basic sleep research and clinical relevance); Original Research Articles; Full-length articles; Brief communications; Controversies; Case reports; Letters to the Editor; Journal search and commentaries; Book reviews; Meeting announcements; Listing of relevant organisations plus web sites.