Recovery after three-shift work: relation to sleep-related cardiac neuronal regulation in nurses
Open accessAbstract
This study was to evaluate whether sleep-related autonomic function in nurses recovers during their days off following a rapidly rotating, clockwise shift schedule. Ten rotating-shift nurses and ten regular morning-shift nurses were included. Nurses slept at home and were allowed to sleep and wake spontaneously. For the rotating-shift workers, ambulatory polysomnographic recordings were taken during nighttime sleep (after the second morning shift, afternoon shift, and on days off) and during daytime sleep (after the second night shift). No significant differences were found between regular-shift nurses and rotating-shift nurses in terms of sleep patterns and cardiac autonomic functions during day shift. When comparing sleep patterns within shift groups, the total sleep time of night shift was lower than their other shifts. Controlling for the variable of total sleep time allowed us to compare cardiac autonomic functions following different shifts (for the rotating shift nurses). During the non-rapid eye movement and rapid eye movement periods, the high frequency (HF) value on rotating shift nurses' days off was found to be significantly higher than their other shifts. However, the low to high frequency ratio (LF/HF) on days off was found to be obviously lower than that during shift work. Two consecutive days off may be sufficient for nurses to recover sleep-related autonomic functions after a rapidly rotating, clockwise three-shift schedule. Sleep-related autonomic functions may be improved during days off to minimize health risks.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
For nurses, shift work and long work hours are related to adverse health outcomes and indicators of reduced functioning.
“For nurses, shift work and long work hours have been shown to be related to adverse health outcomes and indicators of reduced functioning.208–217”
From Sleep, Health, and Society (2017) · cites this paper as [211]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Heart Rate Variability: Standards of Measurement, Physiological Interpretation, and Clinical Use
Electrophysiology, T. F. O. T. E. S. O. C. T. N. A. (1996) · Circulation · doi:10.1161/01.cir.93.5.1043 · Cited by 17,159 · see citing works
Heart rate variability: Standards of measurement, physiological interpretation, and clinical use
Malik, M., Bigger, J. T., Camm, A. J., Kleiger, R. E., Malliani, A., Moss, A. J., & Schwartz, P. J. (1996) · European Heart Journal · doi:10.1093/oxfordjournals.eurheartj.a014868 · Cited by 15,289 · see citing works
Rechtschaffen, A. (1968) · Medical Entomology and Zoology · Cited by 11,772 · see citing works
Longitudinal Data Analysis for Discrete and Continuous Outcomes
Zeger, S. L., & Liang, K. (1986) · Biometrics · doi:10.2307/2531248 · Cited by 7,730 · see citing works
Shift work and disturbed sleep/wakefulness
Akerstedt, T. (2003) · Occupational Medicine · doi:10.1093/occmed/kqg046 · Cited by 1,101 · see citing works
The Research Manual: Design and Statistics for Applied Linguistics
Bailey, K. M., Hatch, E. M., & Lazaraton, A. (1994) · TESOL Quarterly · doi:10.2307/3587214 · Cited by 736 · see citing works
Effect of aging on gender differences in neural control of heart rate
Kuo, T. B. J., Lin, T., Yang, C. C. H., Li, C.-L., Chen, C.-F., & Chou, P. (1999) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.1999.277.6.h2233 · Cited by 558 · see citing works
Baharav, A., Kotagal, S., Gibbons, V., Rubin, B. K., Pratt, G., Karin, J., & AKSELROD, S. (1995) · Neurology · doi:10.1212/wnl.45.6.1183 · Cited by 290 · see citing works
Autonomic Modulation of the Cardiovascular System during Sleep
Mancia, G. (1993) · New England Journal of Medicine · doi:10.1056/nejm199302043280511 · Cited by 240 · see citing works
Ethics, Standards, and Procedures of Animal and Human Chronobiology Research
Touitou, Y., Smolensky, M. H., & Portaluppi, F. (2006) · Chronobiology International · doi:10.1080/07420520601055308 · Cited by 238 · see citing works
Callister, R., Suwarno, N. O., & Seals, D. R. (1992) · The Journal of Physiology · doi:10.1113/jphysiol.1992.sp019269 · Cited by 232 · see citing works
Effects of rotating night shifts: literature review
Muecke, S. (2005) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.2005.03409.x · Cited by 220 · see citing works
Modifications of Cardiac Autonomic Profile Associated With a Shift Schedule of Work
Furlan, R., Barbic, F., Piazza, S., Tinelli, M., Seghizzi, P., & Malliani, A. (2000) · Circulation · doi:10.1161/01.cir.102.16.1912 · Cited by 151 · see citing works
Occupational determinants of heart rate variability
van Amelsvoort, L. G. P. M., Schouten, E. G., Maan, A. C., Swenne, C. A., & Kok, F. J. (2000) · International Archives of Occupational and Environmental Health · doi:10.1007/s004200050425 · Cited by 123 · see citing works
Intraindividual validation of heart rate variability indexes to measure vagal effects on hearts
Martinmäki, K., Rusko, H. K., Kooistra, L., Kettunen, J., & Saalasti, S. (2005) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00054.2005 · Cited by 116 · see citing works
Manifest Sleepiness and the Spectral Content of the EEG during Shift Work
Åkerstedt, T., Kecklund, G., & Knutsson, A. (1991) · SLEEP · doi:10.1093/sleep/14.3.221 · Cited by 109 · see citing works
The impact of shift patterns on healthcare professionals
Wilson, J. L. (2002) · Journal of Nursing Management · doi:10.1046/j.1365-2834.2002.00308.x · Cited by 109 · see citing works
Yang, C. C. H., Lai, C., Hsien Yong, L. A. I., & Kuo, T. B. J. (2002) · Neuroscience Letters · doi:10.1016/s0304-3940(02)00661-4 · Cited by 107 · see citing works
Continuous, on-line, real-time spectral analysis of systemic arterial pressure signals
Kuo, T. B. J., & Chan, S. H. H. (1993) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.1993.264.6.h2208 · Cited by 106 · see citing works
Yang, C. C. H., Shaw, F., Lai, C. J., Lai, C., & Kuo, T. B. J. (2002) · Neuroscience Letters · doi:10.1016/s0304-3940(02)01200-4 · Cited by 102 · see citing works
Effects of timing of shifts on sleepiness and sleep duration
Kecklund, G., & Åkerstedt, T. (1995) · Journal of Sleep Research · doi:10.1111/j.1365-2869.1995.tb00226.x · Cited by 100 · see citing works
Chung, M., Kuo, T. B. J., Hsu, N., Chu, H., Chou, K., & Yang, C. C. H. (2009) · Scandinavian Journal of Work Environment & Health · doi:10.5271/sjweh.1324 · Cited by 85 · see citing works
Barry, R. J., Clarke, A. R., Johnstone, S. J., & Rushby, J. A. (2007) · Biological Psychology · doi:10.1016/j.biopsycho.2007.11.002 · Cited by 82 · see citing works
Chuang, C.-Y., Han, W.-R., Li, P., & Young, S.-T. (2010) · Complementary Therapies in Medicine · doi:10.1016/j.ctim.2010.08.003 · Cited by 81 · see citing works
Shift work modifies the circadian patterns of heart rate variability in nurses
Ito, H., Nozaki, M., Maruyama, T., Kaji, Y., & Tsuda, Y. (2001) · International Journal of Cardiology · doi:10.1016/s0167-5273(01)00439-9 · Cited by 74 · see citing works
Design and statistics for applied linguistics : the research manual
Hatch, E. M., & Lazaraton, A. (1991) · Newbury House Publishers eBooks · Cited by 71 · see citing works
Sleep-related sympathovagal imbalance in SHR
Kuo, T. B. J., Lai, C. J., Shaw, F., Lai, C., & Yang, C. C. H. (2004) · American Journal of Physiology-Heart and Circulatory Physiology · doi:10.1152/ajpheart.00418.2003 · Cited by 71 · see citing works
Endo, S., Kobayashi, T., Yamamoto, T., Fukuda, H., Sasaki, M., & Ohta, T. (1981) · SLEEP · doi:10.1093/sleep/4.3.319 · Cited by 69 · see citing works
Changes in Sleep Patterns in Spontaneously Hypertensive Rats
Kuo, T. B. J., Shaw, F., Lai, C. J., Lai, C., & Yang, C. C. H. (2004) · SLEEP · doi:10.1093/sleep/27.3.406 · Cited by 66 · see citing works
Differences in Day and Night Shift Clinical Performance in Anesthesiology
Cao, C. G. L., Weinger, M. B., Slagle, J. M., Zhou, C., Ou, J. P., Gillin, S., Sheh, B., & Mazzei, W. (2008) · Human Factors The Journal of the Human Factors and Ergonomics Society · doi:10.1518/001872008x288303 · Cited by 48 · see citing works
Chao, A., Chern, C. M., Kuo, T. B. J., Chou, C.-H., Chuang, Y.-M., Wong, W.-J., & Hu, H. H. (2003) · Cerebrovascular Diseases · doi:10.1159/000070595 · Cited by 45 · see citing works
Associations between being overweight, variability in heart rate, and well-being in the young men
Schmid, K., Schönlebe, J., Drexler, H., & Müeck‐Weymann, M. (2010) · Cardiology in the Young · doi:10.1017/s1047951109992009 · Cited by 30 · see citing works
Recovery after Shift Work: Relation to Coronary Risk Factors in Women
Axelsson, J., Löwden, A., & Kecklund, G. (2006) · Chronobiology International · doi:10.1080/07420520601091949 · Cited by 27 · see citing works
Sleep-related vagotonic effect of zolpidem in rats
Chen, H. Y., Kuo, T. B. J., Shaw, F. Z., Lai, C. J., & Yang, C. C. H. (2005) · Psychopharmacology · doi:10.1007/s00213-005-2236-0 · Cited by 20 · see citing works
Isah, E., Iyamu, O., & Imoudu, G. (2008) · PubMed · Cited by 13 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- Van Amelsvoort LG, Schouten EG, Maan AC, Swenne CA, Industrial Health 2012, 50, 24-30
Cited by
Sorted by citations
Grandner, M. A. (2017) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2016.10.012 · Cited by 720 · see citing works
Short sleep duration and cardiometabolic risk: from pathophysiology to clinical evidence
Tobaldini, E., Fiorelli, E. M., Solbiati, M., Costantino, G., Nobili, L., & Montano, N. (2019) · Nature Reviews Cardiology · doi:10.1038/s41569-018-0109-6 · Cited by 357 · see citing works
Grandner, M. A. (2022) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2022.03.001 · Cited by 179 · see citing works
Grandner, M. A. (2020) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2020.02.017 · Cited by 139 · see citing works
Boudreau, P., Dumont, G. A., & Boivin, D. B. (2013) · PLoS ONE · doi:10.1371/journal.pone.0070813 · Cited by 128 · see citing works
Effects of Filtering Visual Short Wavelengths During Nocturnal Shiftwork on Sleep and Performance
Rahman, S. A., Shapiro, C. M., Wang, F., Ainlay, H., Kazmi, S. K., Brown, T. J., & Casper, R. F. (2013) · Chronobiology International · doi:10.3109/07420528.2013.789894 · Cited by 69 · see citing works
Shift Work and Heart Rate Variability Coherence: Pilot Study Among Nurses
Burch, J. B., Alexander, M. S., Balte, P., Sofge, J., Winstead, J., Kothandaraman, V., & Ginsberg, J. P. (2018) · Applied Psychophysiology and Biofeedback · doi:10.1007/s10484-018-9419-z · Cited by 38 · see citing works
Kalkanis, A., Demolder, S., Papadopoulos, D., Testelmans, D., & Buyse, B. (2023) · Frontiers in Neurology · doi:10.3389/fneur.2023.1270043 · Cited by 32 · see citing works
Exploratory Study of Heart Rate Variability and Sleep among Emergency Medical Services Shift Workers
Neufeld, E. V., Carney, J., Dolezal, B. A., Boland, D. M., & Cooper, C. B. (2016) · Prehospital Emergency Care · doi:10.1080/10903127.2016.1194928 · Cited by 28 · see citing works
Effects of sleep deprivation on heart rate variability: a systematic review and meta-analysis
Zhang, S., Niu, X., Ma, J., Wei, X., Zhang, J., & Du, W. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1556784 · Cited by 36 · see citing works
Working Conditions and Fatigue in Japanese Shift Work Nurses: A Cross-sectional Survey
Kida, R., & Takemura, Y. (2022) · Asian Nursing Research · doi:10.1016/j.anr.2022.03.001 · Cited by 19 · see citing works
Job strain and vagal recovery during sleep in shift working health care professionals
Karhula, K., Henelius, A., Härmä, M., Sallinen, M., Lindholm, H. J., Mika Kivimaki, B., Vahtera, J., & Puttonen, S. (2014) · Chronobiology International · doi:10.3109/07420528.2014.957294 · Cited by 18 · see citing works
The relationship between self-awareness of fatigue symptoms and working conditions in female nurses
Kikuchi, Y., & Ishii, N. K. (2015) · SANGYO EISEIGAKU ZASSHI · doi:10.1539/sangyoeisei.e14005 · Cited by 16 · see citing works
Supporting nurses’ recovery during and following the COVID-19 pandemic
Jackson, J. (2021) · Nursing Standard · doi:10.7748/ns.2021.e11661 · Cited by 12 · see citing works
Jelmini, J. D., Ross, J. A., Whitehurst, L. N., & Heebner, N. R. (2023) · Journal of Occupational Health · doi:10.1002/1348-9585.12409 · Cited by 12 · see citing works
Attitudes towards rotating shift work in clinical nurses: a Q‐methodology study
Ha, E. (2015) · Journal of Clinical Nursing · doi:10.1111/jocn.12833 · Cited by 10 · see citing works
Haque, M., & Adamu, Y. (2019) · Medeniyet Medical Journal · doi:10.5222/mmj.2019.54775 · Cited by 10 · see citing works
Jensen, M. A., Hansen, Å. M., Nabe‐Nielsen, K., Garde, A. H., & Kristiansen, J. (2022) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-022-01873-5 · Cited by 9 · see citing works
Chang, W., & Jen, H. (2020) · Chronobiology International · doi:10.1080/07420528.2020.1800027 · Cited by 8 · see citing works
Sleep quality of urban public transport drivers in a city in the Western Amazon, Brazil
Ferreira, C. R. T., de Deus, M. B. B., Morais, M. J. D. D., Silva, R. P. M., & Schirmer, J. (2022) · Journal of Human Growth and Development · doi:10.36311/jhgd.v32.12613 · Cited by 6 · see citing works
Gedor, M., Bourgkard, È., Dziurla, M., Ribet, C., Goldberg, M., Grzebyk, M., Hédelin, G., & Boini, S. (2024) · International Archives of Occupational and Environmental Health · doi:10.1007/s00420-024-02053-3 · Cited by 3 · see citing works
Night Shift Work and Weight Gain among Female Filipino Nurses
Apellido, R. (2018) · Journal of Obesity and Overweight · doi:10.15744/2455-7633.4.106 · Cited by 3 · see citing works
Delgado-Aranda, R., Dorantes-Méndez, G., Bianchi, A. M., Kortelainen, J., Coelli, S., Cruz, J. J., & Méndez, M. O. (2024) · Frontiers in Neuroergonomics · doi:10.3389/fnrgo.2024.1382919 · Cited by 2 · see citing works
Watanabe, R., Kida, R., & Takemura, Y. (2022) · Journal of Japan Academy of Nursing Science · doi:10.5630/jans.42.63 · Cited by 2 · see citing works
Assiry, Z. S. A., Alhazmi, A. H., Al-Ahmari, S. M., Asiri, F. S., Alshomrani, A. A., Ahmary, W. S. H. A., Alwadani, S. A. J., Alshamrani, K. A., Al-Shahrani, B. F., & Almusa, A. A. (2023) · World Family Medicine Journal/Middle East Journal of Family Medicine · doi:10.5742/mewfm.2023.952562441 · Cited by 2 · see citing works
Self-Similarity Analysis of Heartbeat Fluctuations in Sleep Among Female Shift Workers
Delgado-Aranda, R., Dorantes-Méndez, G., Bianchi, A. M., Kortelainen, J. M., & Méndez, M. O. (2024) · Fluctuation and Noise Letters · doi:10.1142/s0219477525500221 · Cited by 1 · see citing works
Karhula, K. (2015) · Työväentutkimus Vuosikirja
5) HEART RATE VARIABILITY IN DELAYED SLEEP PHASE SYNDROME
Manzar, M. D., Hameed, U. A., Sethi, M., & Hussain, M. E. (2013) · Indian journal of applied basic medical sciences
Toyama, H., & Mauno, S. (2017) · Japanese Psychological Research · doi:10.1111/jpr.12163
Harrington, M. (2021) · UVic’s Research and Learning Repository (University of Victoria)
Delgado-Aranda, R., Dorantes-Méndez, G., Méndez, M. O., Bianchi, A. M., & Kortelainen, J. (2022) · World Congress on Medical Physics and Biomedical Engineering, September 7 - 12, 2009, Munich, Germany · doi:10.1007/978-3-031-18256-3_36
杜, 卓. (2024) · Advances in Clinical Medicine · doi:10.12677/acm.2024.14112993
- Authors
- CHUNG, M.-H., KUO, T. B. J., HSU, N., CHU, H., CHOU, K.-R., & YANG, C. C. H.
- Affiliations
- Taipei Medical University (TW)
- National Yang Ming University (TW)
- Yuanpei University (TW)
- National Defense Medical Center (TW)
- Venue
- Industrial Health
- Published
- 2012
- Volume
- 50
- Issue
- 1
- Pages
- 24-30
- ISSN
- 0019-8366 (ISSN-L)
- 1880-8026
- OpenAlex
- W2168273490
- Cited by
- 32
- References
- 35
- Citations by year
- 2025: 1 · 2024: 4 · 2023: 3 · 2022: 6 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 1 · 2016: 2 · 2015: 3 · 2014: 1 · 2013: 3
- FWCI
- 1.64
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Industrial Health (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Rate Variability and Autonomic Control
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- shift work, rotating shifts, nurses, cardiac autonomic function, total sleep time, nocturnal sleep, daytime sleep, heart rate variability, LF/HF ratio, cardiovascular health
- MeSH terms
- Adult, Autonomic Nervous System, Cardiovascular Physiological Phenomena, Electrocardiography, Female, Heart, Humans, Nurses, Sleep, Sleep, REM, Work Schedule Tolerance, Case-Control Studies, Polysomnography
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
