title: Impact of hypnotics use on daytime function and factors associated with usage by female shift work nurses.
abstract: OBJECTIVE
  We investigated quality of life (QOL) and work performance of hypnotics users, and explored the factors associated with multiple hypnotics usage in shift work nurses.
  
  
  METHODS
  We conducted a questionnaire-based, cross-sectional survey on nurses in university hospitals. We analyzed responses from 1202 nurses; 997 were female shift work nurses (82.9%), including 696 and 281 two- and three-shift workers, respectively.
  
  
  RESULTS
  The rate of hypnotics use was 10% (6.9% were single hypnotic users and 3.1% were multiple hypnotics users). The rate of insomnia did not differ between the single and multiple hypnotics users. However, multiple hypnotics users showed lower QOL, more severe depressive symptoms, and greater frequencies of work-related errors than those using a single hypnotic. A multiple logistic regression analysis revealed that age ≥27 years, presence of depression, eveningness chronotype, and presence of insomnia symptoms were significantly associated with hypnotics use. On the other hand, only the existence of shift work disorder (SWD) was significantly associated with usage of multiple hypnotics.
  
  
  CONCLUSIONS
  The present study suggested that usage of multiple hypnotics is not beneficial for relieving insomnia or for keeping better QOL in shift work nurses. It would be desirable to explore the causal relationship between SWD and multiple hypnotics use in a future longitudinal study.
authors.affiliation: Department of Psychiatry, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Futenma
authors.affiliation: Department of Somnology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan; Sleep Research Institute, Edogawa University, 474 Komagi, Nagareyama, Chiba, 270-0132, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Asaoka
authors.affiliation: Department of Psychiatry, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Takaesu
authors.affiliation: Department of Somnology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan; Japan Somnology Center, Neuropsychiatric Research Institute, 91 Bentencho, Shinjuku-ku, Tokyo, 162-0851, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Komada
authors.affiliation: Department of Psychiatry, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Ishikawa
authors.affiliation: Department of Psychiatry, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Murakoshi
authors.affiliation: Department of Somnology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan; Japan Somnology Center, Neuropsychiatric Research Institute, 91 Bentencho, Shinjuku-ku, Tokyo, 162-0851, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Nishida
authors.affiliation: Department of Psychiatry, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo 160-0023, Japan; Department of Somnology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan; Japan Somnology Center, Neuropsychiatric Research Institute, 91 Bentencho, Shinjuku-ku, Tokyo, 162-0851, Japan. Electronic address: inoue@somnology.com.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Inoue
mesh_terms: D000062:Accidents, Occupational / Q000706:statistics & numerical data; D000203:Activities of Daily Living; D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects* / Q000627:therapeutic use; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data; D009726:Nurses / Q000706:statistics & numerical data*; D015995:Prevalence; D007319:Sleep Initiation and Maintenance Disorders / Q000188:drug therapy; D011795:Surveys and Questionnaires; D014940:Work Schedule Tolerance
chemical_list: D006993:Hypnotics and Sedatives
keywords: Hypnotic medication use; Japan; Nurse; Prevalence; Shift work; Sleep