App helps shift workers get more and better sleep

Sleep problems are one of the many stressors facing the already overworked health workforce. According to a 2016 review on sleep studies, 55% of nurses work more than 40 hours a week, with 30–70% reporting fewer than six hours of sleep per night.

With an aim to improve sleep and overall mood of shift workers, researchers from the Turner Institute for Brain and Mental Health, Monash University, have developed SleepSync, an app that personalises sleep–wake cycles.

The research, led by Dr Jade Murray, saw 27 shift workers trial the app over a two-week period; mainly intensive care and emergency department nurses at high risk of shift work disorder, commonly experienced as insomnia and excessive sleepiness.

SleepSync improved total sleep time, ability to fall asleep, sleep quality and perception of recovery on days off. With the app considering each individual’s daily routine, 70% reported it was easier to fall asleep, and more than 80% reported better quality sleep. Participants slept an average 29 minutes longer each night.

“SleepSync aims to aid behavioural change and provide practical advice to shift workers by providing personalised sleep scheduling recommendations and education,” Murray said.

“This has the potential to improve shift workers’ health and wellbeing and how they function day to day. It also has the potential for development and integration with wearable devices, such as smartwatches, and to further help minimise the health costs associated with shift work to society.”

SleepSync, a mobile phone app, is said to be entirely tailored to the individual user by: incorporating a calendar for work and personal commitments; providing biologically viable recommendations for sleep timing that account for work and social obligations based on the information users enter into the calendar, such as work shifts and important personal activities; and daily logging of actual sleep/wake times and mood.

Users receive a ‘recovery score’ based on their level of adherence with the recommended sleep times.

Murray said work hours outside the 9 to 5 regime play havoc with the body’s circadian clock. “Shift workers report an increased functional impact of sleep disturbance and misalignment, including impaired alertness and increased sleepiness during wakefulness compared to the general population,” she said.

“Shift workers are also at greater risk of a range of long-term adverse health consequences such as gastrointestinal problems, cardiovascular disease, mood disorders and cancer, as well as the short-term increase in the risk of errors, accidents and injuries.”

To date, helping a shift worker to sleep well has largely relied on workplace interventions such as adjusting workplace lighting, scheduled workplace napping, sleep hygiene programs, wellness programs and workplace fatigue management programs.

Co-author Dr Tracey Sletten, of the Turner Institute, said individual workers needed evidence-backed ways to optimise their sleep around their work schedule. “Each person has different underlying biology and specific work patterns, which need to be accommodated in a personalised schedule to help them sleep better,” Sletten said.

Sletten said 67% of participants reported how influential SleepSync was for modifying their behaviour and habits, while 82% found the app easy to incorporate into their daily lives. “They also reported improvements in mood (depression, anxiety and stress), insomnia symptom severity, sleep hygiene and sleep-related daytime impairments,” she said.

Findings have been published in the journal Digital Health.

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