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Digital circadian and sleep health in individual hospital shift workers : a cross sectional telemonitoring study
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Zhang, Yiyuan, Cordina-Duverger, Emilie, Komarzynski, Sandra, Attari, Amal M., Huang, Qi, Aristizabal, Guillen, Faraut, Brice, Léger, Damien, Adam, René, Guénel, Pascal, Brettschneider, Julia, Finkenstädt, Bärbel and Lévi, Francis (2022) Digital circadian and sleep health in individual hospital shift workers : a cross sectional telemonitoring study. eBioMedicine, 81 . 104121. doi:10.1016/j.ebiom.2022.104121 ISSN 2352-3964.
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Official URL: https://doi.org/10.1016/j.ebiom.2022.104121
Abstract
Background
Telemonitoring of circadian and sleep cycles could identify shift workers at increased risk of poor health, including cancer and cardiovascular diseases, thus supporting personalized prevention.
Methods
The Circadiem cross-sectional study aimed at determining early warning signals of risk of health alteration in hospital nightshifters (NS) versus dayshifters (DS, alternating morning and afternoon shifts). Circadian rhythmicity in activity, sleep, and temperature was telemonitored on work and free days for one week. Participants wore a bluetooth low energy thoracic accelerometry and temperature sensor that was wirelessly connected to a GPRS gateway and a health data hub server. Hidden Markov modelling of activity quantified Rhythm Index, rest quality (probability, p1-1, of remaining at rest), and rest duration. Spectral analyses determined periods in body surface temperature and accelerometry. Parameters were compared and predictors of circadian and sleep disruption were identified by multivariate analyses using information criteria-based model selection. Clusters of individual shift work response profiles were recognized.
Findings
Of 140 per-protocol participants (133 females), there were 63 NS and 77 DS. Both groups had similar median rest amount, yet NS had significantly worse median rest-activity Rhythm Index (0·38 [IQR, 0·29-0·47] vs. 0·69 [0·60-0·77], p<0·0001) and rest quality p1-1 (0·94 [0·94-0·95] vs 0·96 [0·94-0·97], p<0·0001) over the whole study week. Only 48% of the NS displayed a circadian period in temperature, as compared to 70% of the DS (p=0·026). Poor p1-1 was associated with nightshift work on both work (p<0·0001) and free days (p=0·0098). The number of years of past night work exposure predicted poor rest-activity Rhythm Index jointly with shift type, age and chronotype on workdays (p= 0·0074), and singly on free days (p=0·0005).
Interpretation
A dedicated analysis toolbox of streamed data from a wearable device identified circadian and sleep rhythm markers, that constitute surrogate candidate endpoints of poor health risk in shift-workers.
Item Type: | Journal Article | ||||||||||||
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Subjects: | Q Science > QP Physiology R Medicine > RA Public aspects of medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Science > Statistics Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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SWORD Depositor: | Library Publications Router | ||||||||||||
Library of Congress Subject Headings (LCSH): | Hospitals -- Employees -- Health and hygiene, Circadian rhythms -- Health aspects, Sleep -- Health aspects, Night work -- Health aspects | ||||||||||||
Journal or Publication Title: | eBioMedicine | ||||||||||||
Publisher: | Elsevier | ||||||||||||
ISSN: | 2352-3964 | ||||||||||||
Official Date: | July 2022 | ||||||||||||
Dates: |
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Volume: | 81 | ||||||||||||
Article Number: | 104121 | ||||||||||||
DOI: | 10.1016/j.ebiom.2022.104121 | ||||||||||||
Status: | Peer Reviewed | ||||||||||||
Publication Status: | Published | ||||||||||||
Reuse Statement (publisher, data, author rights): | ** Article version: VoR ** From Elsevier via Jisc Publications Router ** History: accepted 07-06-2022; epub 27-06-2022; issued 31-07-2022. ** Licence for VoR version of this article starting on 09-06-2022: http://creativecommons.org/licenses/by/4.0/ | ||||||||||||
Access rights to Published version: | Open Access (Creative Commons) | ||||||||||||
Date of first compliant deposit: | 13 July 2022 | ||||||||||||
Date of first compliant Open Access: | 13 July 2022 | ||||||||||||
RIOXX Funder/Project Grant: |
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