Feasibility, Effectiveness and Acceptability of an Afternoon-Evening Sleep Schedule in Older Nightshift Workers

To explore the feasibility, effectiveness, and acceptability of an afternoon-evening sleep schedule in older (age 50-65 years) nightshift workers. We used a 3-part strategy: a screening survey to identify individuals who said they could adopt an 8-hour afternoon-evening sleep schedule; a field study where daily diary and actigraphy data were collected during a baseline week and intervention week, with randomization to self-selected sleep, 8-hour afternoon-evening time in bed (TIB), or 8 hour self-selected TIB; and follow-up focus groups to understand the acceptability of the intervention. Gender (p<0.001), Hispanic ethnicity (p=0.023), the care of children (p=0.014), and chronotype (p=0.012), predicted the reported ability to spend 8 hours in bed in the afternoon-evening. Participants assigned to the 8-hour self-selected and 8-hour afternoon-evening groups significantly increased their TIB and sleep duration compared to baseline (p<0.05), while the control group did not. Although spending 8 hours in bed was feasible for the participants during the study, focus group discussions indicated participants would not continue an 8 hour TIB schedule after the study due to family responsibilities and other activities of daily living. Spending 8 hours in bed between successive night shifts, initiated at both a self-selected time and in the afternoon-evening, increased the sleep duration of older shiftworkers, but most would not continue such a schedule on their own. Additional research is needed to find countermeasures for the reduced sleep duration experienced by most shiftworkers that are not only effective, but also compatible with shiftworkers’ lifestyles.