title: Short rest periods between work shifts predict sleep and health problems in nurses at 1-year follow-up.
abstract: OBJECTIVE
  We investigated whether the number of work shifts separated by less than 11 hours (quick returns) at baseline (T1) could predict health problems in nurses at 1-year follow-up (T2).
  
  
  METHODS
  1224 nurses responded to a questionnaire-based survey in 2009 (T1) and 2010 (T2). Crude and adjusted logistic regression analyses were completed to assess the association between annual number of quick returns at T1 and the following outcome variables at T2: shift work disorder (SWD), excessive sleepiness (Epworth Sleepiness Scale), pathological fatigue (Chalder Fatigue Scale) and anxiety and depression (Hospital Anxiety and Depression Scale), while controlling for age, gender, the corresponding outcome variable at T1, number of night shifts at T1, change in number of quick returns and number of night shifts from T1 to T2.
  
  
  RESULTS
  The adjusted analyses showed that the annual number of quick returns at T1 predicted the occurrence of SWD (OR=1.01, 95% CI 1.00 to 1.01) and pathological fatigue (OR=1.01, 95% CI 1.00 to 1.01) at T2. A decreased number of quick returns from T1 to T2 entailed a reduced risk of pathological fatigue (OR=0.67, 95% CI 0.45 to 0.99) at T2. There was no association between quick returns at T1 and excessive sleepiness, anxiety or depression at T2 in the adjusted analyses.
  
  
  CONCLUSIONS
  This is the first longitudinal study investigating the associations between quick returns and future health problems. Quick returns increased the risk of SWD and pathological fatigue at 1-year follow-up. Reducing the number of quick returns from 1 year to the next was related to reduced risk of developing pathological fatigue.
authors.affiliation: Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Flo
authors.affiliation: Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway Department of Psychosocial Science, University of Bergen, Bergen, Norway.
authors.forename: Ståle
authors.initials: S
authors.lastname: Pallesen
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Centre for International Health, University of Bergen, Bergen, Norway.
authors.forename: Bente Elisabeth
authors.initials: BE
authors.lastname: Moen
authors.affiliation: Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
authors.forename: Siri
authors.initials: S
authors.lastname: Waage
authors.affiliation: Norwegian Competence Center for Sleep Disorders, Haukeland University Hospital, Bergen, Norway Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
authors.forename: Bjørn
authors.initials: B
authors.lastname: Bjorvatn
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology; D003625:Data Collection; D003863:Depression / Q000209:etiology; D020920:Dyssomnias / Q000209:etiology*; D005221:Fatigue / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009726:Nurses; D016273:Occupational Exposure / Q000009:adverse effects; D012146:Rest; D012890:Sleep; D011795:Surveys and Questionnaires; D014940:Work Schedule Tolerance; D016526:Workload