Melatonin, sleep, and shift work adaptation.

Abstract

BACKGROUND: Night work is associated with disrupted circadian rhythms, fatigue, accidents, and chronic disease. Melatonin secretion helps regulate sleep and circadian rhythms. OBJECTIVE: Melatonin, sleep disturbances, and symptoms (sleep, fatigue, mental) were compared among workers on permanent day, swing, and night shifts. METHODS: Urinary 6-hydroxymelatonin sulfate (6-OHMS) was measured in postwork and postsleep samples. Disrupted circadian melatonin production was evaluated using the sleep:work 6-OHMS ratio. Wrist actigraphy characterized light exposures and sleep characteristics. RESULTS: Night workers had altered melatonin, disrupted sleep, and elevated symptom prevalence. Subjects grouped by their sleep:work 6-OHMS ratio rather than shift had even greater symptom prevalence. Risks for two or more symptoms were 3.5 to 8 times greater among workers with sleep:work ratios < or =1 compared to those with ratios >1. CONCLUSIONS: This ratio may help identify workers at increased risk for accidents or injuries.