A team from Laval University has developed a behavioral intervention that improves the sleep and mental health of people whose work involves night shifts. A demonstration of the effectiveness of this intervention has just been provided by this team, led by Professor Annie Vallières, in a study published by the Journal of Sleep Research.
“About 1 in 4 people have a schedule that involves working shifts outside of the 6 a.m. to 6 p.m. period. It is estimated that 27% of these people suffer from work schedule disorder,” underlines Annie Vallières, professor at the School of Psychology at Laval University and researcher at the CERVO Research Center and at the CHU Research Center of Quebec-Laval University.
“These people experience a desynchronization of their circadian rhythm,” she continues. They are not in sync with their natural sleep rhythm, leading to insomnia and drowsiness. Their mental ruminations about sleep exacerbate their condition. This results in many physiological problems such as gastrointestinal problems and cardiovascular diseases, but also psychological problems such as anxiety, stress and depressive symptoms.
The usual treatments offered to these people use light therapy lamps used to synchronize the circadian rhythm with the work schedule, sleeping pills to counter insomnia or caffeine to remain alert. “These different approaches can help temporarily, but they do not solve the problem in a lasting way,” notes Professor Vallières.
It is for this reason that the researcher has been working for several years to develop a behavioral approach intended for these people. “I take approaches developed to treat nighttime insomnia and adapt them for people who work night shifts and need to sleep during the day. Treatment for work schedule disorder is based on restricting the time spent in bed and gradually increasing it when sleep efficiency improves, adopting fixed periods for daytime sleep, for naps and for night sleep (during days off), and on control of light stimuli in order to create dark conditions aimed at adjusting the circadian rhythm.
To test the effectiveness of this treatment, Professor Vallières and her colleagues recruited 43 people who worked nights and who suffered from work schedule disorder. Almost all of them were nurses or beneficiary attendants. They had been working night shifts for an average of 5 years, and their sleep problems had lasted for 3.5 years.
At the end of the 8-week intervention, the researchers noted a reduction in the daytime insomnia severity index and an increase of 35 to 40 minutes in the duration of daytime sleep. They also noted a reduction in mental ruminations, anxiety and depressive symptoms. “These are substantial improvements,” comments Professor Vallières. Of those who completed treatment, 92% experienced partial or complete remission of work schedule disorder.”
— Annie Vallières
People who work night shifts and who struggle with daytime insomnia problems will have to wait a little before being able to benefit from the benefits of this intervention. “This treatment is not yet offered to the population, but we have undertaken to create an online version,” emphasizes Professor Vallières. Its effectiveness will be evaluated during a pilot project which will take place this fall with the collaboration of the CIUSSS de la Capitale-Nationale and the CIUSSS du Nord-de-l’Île-de-Montréal.”
The signatories of the study published in the Journal of Sleep Research are Annie Vallières, Alric Pappathomas, Séverine de Billy Garnier, Chantal Mérette and Célyne Bastien, from Laval University, Julie Carrier, from the University of Montreal, and Tyna Paquette, from the CIUSSS du Nord-de-l’Île-de -Montreal.
