title: Heart rate variability changes in business process outsourcing employees working in shifts.
abstract: OBJECTIVE
  Irregular and poor quality sleep is common in business process outsourcing (BPO) employees due to continuous shift working. The influence of this on the cardiac autonomic activity was investigated by the spectral analysis of heart rate variability (HRV).
  
  
  METHODS
  36 night shift BPO employees (working from 22:00 to 06:00h) and 36 age and sex matched day shift BPO employees (working from 08:00 to 16:00h) were recruited for the study. Five minute electrocardiogram (ECG) was recorded in all the subjects. Heart rate variability was analyzed by fast Fourier transformation using RMS Vagus HRV software. The results were analyzed using Mann Whitney U test, Student t-test, Wilcoxon signed rank test and were expressed as mean ± SD.
  
  
  RESULTS
  Sleepiness was significantly higher among night shift workers as measured by Epworth Sleepiness Scale (p<0.001). Night shift BPO employees were found to have a trend towards lower values of vagal parameters - HF power (ms(2)), and higher values of sympathovagal parameters like LF Power (ms(2)) and the LF/HF power (%) suggesting decreased vagal activity and sympathetic over activity, when compared to day shift employees. However, HRV parameters did not vary significantly between the day shift employees and night shift workers baseline values, and also within the night shift group.
  
  
  CONCLUSIONS
  Night shift working increased the heart rate and shifted the sympathovagal balance towards sympathetic dominance and decreased vagal parameters of HRV. This is an indicator of unfavorable change in the myocardial system, and thus shows increased risk of cardiovascular disease among the night shift employees.
authors.affiliation: Department of Physiology, M S Ramaiah Medical College, Bangalore, India - 560 054.
authors.forename: Kirthana U
authors.initials: KU
authors.lastname: Kunikullaya
authors.forename: Suresh K
authors.initials: SK
authors.lastname: Kirthi
authors.forename: D
authors.initials: D
authors.lastname: Venkatesh
authors.forename: Jaisri
authors.initials: J
authors.lastname: Goturu