OBJECTIVE: Shift work and Shift Work Sleep Disorder (SWSD) are known to affect the secretion of several neurotransmitters and hormones associated with premature ejaculation (PE). However, their specific influence on the regulation of male ejaculation remains unclear. This study explores the relationship between shift work, SWSD, and PE.
METHODS: From April to October 2023, a cross-sectional survey was conducted across five regions of China to explore the work schedules, sleep quality, and sexual function of male workers. Participants\' sleep quality was evaluated using a validated SWSD questionnaire, and their erectile function and ejaculatory control were assessed with the International Inventory of Erectile Function (IIEF-5) scores and Premature Ejaculation Diagnostic Tool (PEDT) scores, respectively. Univariate and multivariate linear regression analyses were employed to identify risk factors associated with PE. Confounders were controlled using multiple regression models, and clinical prediction models were developed to predict PE onset and assess the contribution of risk factors.
RESULTS: The study included 1239 eligible participants, comprising 840 non-shift workers and 399 shift workers (148 with SWSD and 251 without SWSD). Compared to non-shift working males, those involved in shift work (β 1.58, 95% CI 0.75 - 2.42, p < 0.001) and those suffering from SWSD (β 2.86, 95% CI 1.86 - 3.85, p < 0.001) they had significantly higher PEDT scores. Additionally, we identified daily sleep of less than six hours, depression, anxiety, diabetes, hyperlipidemia, frequent alcohol consumption (more than twice a week), and erectile dysfunction as risk factors for PE. The predictive model for PE demonstrated commendable efficacy.
CONCLUSIONS: Both shift work and SWSD significantly increase the risk of premature ejaculation, with the risk magnifying in tandem with the duration of shift work. This study reveals the potential impact of shift work and SWSD on PE and provides new theoretical foundations for the risk assessment and prevention of this condition.

To meet the demands of a 24/7 society, shift work is necessary. Shift work is outside the traditional regular 9-to-5 work schedule, is characterized by irregular working hours, and exists in various industries. However, this abnormal working time can disrupt the natural day and night rhythm, and if poorly adjusted, it can lead to shift work sleep disorder (SWSD). SWSD is associated with multiple health risks, including impaired cognitive function, increased risk of accidents, and various metabolic and cardiovascular diseases. The frontline nurses typically work shifts to provide comprehensive patient care. This article aims to discuss sleep physiology, apply existing literature to discuss the impact on nurses resulting from shift work, and further offer strategies to regulate sleep to promote physical and mental health. These strategies range from organizational interventions (e.g., optimizing shift schedules) to individual interventions (e.g., lifestyle changes) and the use of chronobiological techniques (e.g., light therapy) to promote the adjustment of circadian rhythms, etc.
BACKGROUND: 輪班護理人員之睡眠攻略.
為了滿足24/7社會的需求，輪班工作是有必要的。輪班工作是在傳統常態的朝九晚五工作的時間表之外，而且以不規則的工作時間為特點，存在各個行業之中。然而，這種非常態的工作時間會擾亂自然的日夜節律，若調節不良會導致輪班工作睡眠障礙（shift work sleep disorder）。輪班工作睡眠障礙與多種健康風險有關，包括認知功能受損、事故風險增加、以及各種新陳代謝和心血管疾病等。第一線的護理人員幾乎都必須執行輪班工作，病人方能獲得完整的照護。這篇文章旨在討論睡眠的生理學，應用現有文獻討論輪班工作對護理人員的影響，進而提供策略來調整睡眠，以促進身心健康。該些策略包括組織介入（例如優化輪班安排），也包括個人介入（例如改變生活方式），使用時間生物學技術（例如光療法），以促進日夜節律的調整等。.

In shift work disorder (SWD), disturbed sleep acutely impairs employees\' recovery, but little attention has been paid to sleep during longer recovery periods. We examined how holidays affect self-estimated sleep length, sleep debt, and recovery in cases of SWD. Twenty-one shift workers with questionnaire-based SWD and nine reference cases without SWD symptoms completed a questionnaire on recovery and sleep need. They also reported sleep length on two separate occasions: during a work period and after ≥ 2 weeks of holidays. Sleep debt was calculated by subtracting sleep length from sleep need. We used parametric tests to compare the groups and the periods. The groups reported shorter sleep on workdays than during holidays (median difference: SWD group 1.7 h, p<0.001; reference group 1.5 h; p<0.05). The SWD group\'s self-estimated sleep during holidays increased less above the sleep need (median 0.0 h) than the reference group\'s sleep (1.0 h, p<0.05). In addition, the SWD group reported good recovery from irregular working hours less often (14%) than the reference group (100%, p<0.001). Although holidays were generally associated with longer sleep estimates than workdays, employees with SWD experienced consistently less efficient recovery than those without SWD.

To examine the effect of sleep timing intervention on sleep quality, attention, and sleepiness at work among night shift workers with shift work disorder.
We recruited 60 real-life night shift workers through advertisements to participate this cross-over clinical trial. Shift work disorder was confirmed with interview and sleep log. Participants were designated to follow evening sleep (15:00-23:00) and morning sleep (09:00-17:00) schedules in a randomized order. Chronotype was confirmed by the Munich Chronotype Questionnaire. Sleep behaviors and light exposure were recorded using actigraphy. Outcome measures were sleepiness evaluated by the Karolinska Sleepiness Scale, sleep quality evaluated by the Pittsburgh Sleep Quality Index, and attention performance assessed with psychomotor vigilance test. Differences in outcome between the morning and evening sleep schedules were compared using repeated measures ANOVA.
The participants slept for longer durations during evening sleep schedules compared with morning sleep schedules. Lower sleepiness scores, higher sleep quality, and shorter reaction times and less lapse numbers in the psychomotor vigilance test were observed for participants during evening sleep schedules than morning sleep schedules after adjustment for light exposure and sleep duration. Significant interaction effects were observed for reaction time and lapse number between chronotype and sleep schedule, where the differences between sleep schedules were most prominent among those with late chronotypes.
It is recommended that night shift workers with shift work disorder arrange to sleep in the evening instead of the morning for better sleep and attention performance, especially those with late chronotypes.
Sleep Schedule Intervention Study Among Night Shift Workers, https://clinicaltrials.gov/ct2/show/NCT04160572, ClinicalTrials.gov Identifier: NTC04160572.

Background: Nurses have a high incidence of shift work sleep disorder, which places their health and patient safety in danger. Thus, exploring the factors associated with shift work sleep disorder in nurses is of great significance in improving their sleep health, nursing personnel staffing, and scheduling during the COVID-19 pandemic. Objectives: The purpose of this study was to investigate the incidence of shift work sleep disorder during the COVID-19 pandemic and explore the factors associated with shift work sleep disorder in Chinese nurses. Methods: This was a multicenter cross-sectional study using an online survey. Stratified cluster sampling was used to include 4,275 nurses from 14 hospitals in Shandong, China from December 2020 to June 2021. Stepwise multivariate logistic regression analysis and random forest were used to identify the factors associated with shift work sleep disorder. Results: The prevalence of shift work sleep disorder in the sampled shift nurses was 48.5% during the COVID-19 pandemic. Physical fatigue, psychological stress, shift work more than 6 months per year, busyness during night shift, working more than 40 h per week, working more than four night shifts per month, sleeping more than 8 h before night shift, using sleep medication, irregular meals, and high-intensity physical activity were associated with increased odds of shift work sleep disorder. Good social support, good work-family balance, napping two or three times per week, resting more than one day after shifts, intervals of 8 days or more between shifts, and taking turns to rest during the night shift were associated with decreased odds of shift work sleep disorder. Conclusions: Shift work sleep disorder may be associated with scheduling strategies and personal behavior during the COVID-19 pandemic. To reduce the incidence of shift work sleep disorders in nurses, nursing managers should increase night shift staffing, extend rest days after shift, increase night shift spacing, and reduce overtime, and nurses need to seek more family and social support and control their sleep schedules and diet.

Objectives: No systematic review or meta-analysis concerning the prevalence of shift work disorder (SWD) has been conducted so far. The aim was thus to review prevalence studies of SWD, to calculate an overall prevalence by a random effects meta-analysis approach and investigate correlates of SWD prevalence using a random-effects meta-regression. Methods: Systematic searches were conducted in ISI Web of Science, PsycNET, PubMed, and Google Scholar using the search terms \"shift work disorder\" and \"shift work sleep disorder.\" No restrictions in terms of time frame were used. Included studies had to present original data on the prevalence of SWD in an occupational sample published in English. A total of 349 unique hits were made. In all, 29 studies were finally included from which two authors independently extracted data using predefined data fields. The meta-regression included four predictors (diagnostic criteria, study country, type of workers, and sample size). Results: The overall prevalence of SWD was 26.5% (95% confidence interval = 21.0-32.8). Cochran Q was 1,845.4 (df = 28, p < 0.001), and the I 2 was 98.5%, indicating very high heterogeneity across the observed prevalence estimates. Diagnostic criteria (International Classification of Sleep Disorders-2 = 0, International Classification of Sleep Disorders-3 = 1) and sample size were inversely related to SWD prevalence. Conclusions: The prevalence of SWD was high across the included studies. The between-study disparity was large and was partly explained by diagnostic criteria and sample size. In order to facilitate comparative research on SWD, there is a need for validation and standardization of assessment methodology as well as agreement in terms of sample restrictions.

A considerable proportion of shift workers have work schedule-related insomnia and/or excessive sleepiness, a phenomenon described as shift work disorder (SWD). There is yet a lack of evidence on whether or not employees recover from symptoms of SWD between work shifts. We studied whether SWD and its subtypes are associated with insomnia and excessive sleepiness during weekly non-work days and with 24-h sleep time. Hospital employees answered a survey on SWD, insomnia and excessive sleepiness on weekly non-work days, and 24-h sleep. To identify shift workers with night shifts (n=2,900, 18% with SWD) and SWD, we linked survey responses to employers\' register on working hours. SWD included three subtypes: insomnia only (SWD-I, 4%, n=102), excessive sleepiness only (SWD-Es, 8%, n=244), and both insomnia and excessive sleepiness (SWD-IEs, 6%, n=183). Based on regression analyses, SWD was associated with excessive sleepiness on non-work days (OR: 1.42, 95% CI: 1.07-1.88) and with insomnia on non-work days (0.53, 0.31-0.91). SWD-I was associated with excessive sleepiness on non-work days (2.25, 1.31-3.87) and with shorter sleep (7-7.5 h: 1.96, 1.06-3.63; ≤6.5h: 2.39, 1.24-4.59; reference: ≥8 h). The results suggest that especially employees with SWD-I may need longer time to overcome excessive sleepiness than allowed by their roster.

The prevalence of shift work disorder (SWD) has been studied using self-reported data and the International Classification of Sleep Disorders, Second Edition (ICSD-2) criteria. We examined the prevalence in relation to ICSD-2 and ICSD-3 criteria, work schedules and the number of non-day shifts (work outside 06:00-18:00 hours) using objective working-hours data. Secondly, we explored a minimum cut-off for the occurrence of SWD symptoms. Hospital shift workers without (n = 1,813) and with night shifts (n = 2,917) and permanent night workers (n = 84) answered a survey (response rate 69%) on SWD and fatigue on days off. The prevalence of SWD was calculated for groups with ≥1, ≥3, ≥5 and ≥7 monthly non-day shifts utilizing the working hours registry. ICSD-3-based SWD prevalence was 2.5%-3.7% (shift workers without nights), 2.6%-9.5% (shift workers with nights) and 6.0% (permanent night workers), depending on the cut-off of non-day shifts (≥7-1/month, respectively). The ICSD-2-based prevalence was higher: 7.1%-9.2%, 5.6%-33.5% and 16.7%, respectively. The prevalence was significantly higher among shift workers with than those without nights (p-values <.001) when using the cut-offs of ≥1-3 non-day shifts. Shift workers with nights who had ≥3 days with ICSD-3-based SWD symptoms/month more commonly had fatigue on days off (49.3%) than those below the cut-off (35.8%, p < .05). The ICSD-3 criteria provided lower estimates for SWD prevalence than ISCD-2 criteria, similarly to exclusion of employees with the fewest non-day shifts. The results suggest that a plausible cut-off for days with ICSD-3-based SWD symptoms is ≥3/month, resulting in 3%-6% prevalence of SWD.

BACKGROUND: Previous research has shown that emergency physicians have an increased risk of shift work sleep disorder, potentially compromising their health, wellness, and effectiveness as a physician.
OBJECTIVE: This study explores the effect of shift work on sleep in emergency doctors. The hypothesis of the evaluation is that daytime sleep onset would lead to the poorest sleep, implying poor recovery after a night shift.
METHODS: Sleep patterns were examined in emergency physicians in an academic emergency department. Twenty-seven individuals completed data collection, wearing wrist actigraphy devices over 3 months. Time of sleep onset was categorized as falling into 1 of 3 ranges: interval 1-day sleepers (6:00 am-2:00 pm), interval 2-evening sleepers (2:00 pm-10:00 pm), or interval 3-night sleepers (10:00 pm-6:00 am). Data from each interval were analyzed for median duration, sleep latency, and night-time interruptions.
RESULTS: Daytime sleep sessions had a median total sleep duration of 5.3 ± 2 h, much less than 7.3 ± 1.8 h (interval 2-evening), and 7.0 ± 1.1 h (interval 3-night). Interval 2 sleepers experienced the highest number of nightly awakenings (1.5) and the longest sleep latency (36.5 min). Day sleepers (interval 1), assumed to be predominantly physicians recovering from night shifts, had significantly less sleep than both evening and night sleepers (p < 0.01), experiencing a 23.0% decrease in overall median sleep duration.
CONCLUSIONS: This study provides statistical findings that those working the night shift experience significantly less sleep than emergency physicians working other shifts.

BACKGROUND: Shift work can disturb circadian homeostasis and result in fatigue, excessive sleepiness, and reduced quality of life. Light therapy has been shown to impart positive effects in night shift workers. We sought to determine whether or not prolonged exposure to bright light during a night shift reduces sleepiness and enhances psychomotor performance among ICU nurses.
METHODS: This is a single-center randomized, crossover clinical trial at a surgical trauma ICU. ICU nurses working a night shift were exposed to a 10-h period of high illuminance (1500-2000 lx) white light compared to standard ambient fluorescent lighting of the hospital. They then completed the Stanford Sleepiness Scale and the Psychomotor Vigilance Test. The primary and secondary endpoints were analyzed using the paired t test. A p value <0.05 was considered significant.
RESULTS: A total of 43 matched pairs completed both lighting exposures and were analyzed. When exposed to high illuminance lighting subjects experienced reduced sleepiness scores on the Stanford Sleepiness Scale than when exposed to standard hospital lighting: mean (sem) 2.6 (0.2) vs. 3.0 (0.2), p = 0.03. However, they committed more psychomotor errors: 2.3 (0.2) vs. 1.7 (0.2), p = 0.03.
CONCLUSIONS: A bright lighting environment for ICU nurses working the night shift reduces sleepiness but increases the number of psychomotor errors.
BACKGROUND: ClinicalTrials.gov, NCT03331822 . Retrospectively registered on 6 November 2017.