Sleep Outcomes in Shift Workers, Pregnant Women, and Patients in the ICU

An editorial published in the Journal of Sleep Research highlighted recent findings on sleep disturbances in the ICU, the impact shift-scheduling rules have on shift workers’ sleep, and the link between prenatal maternal sleep, long-term anxiety, and depression.

In an editorial published in the Journal of Sleep Research, sleep researcher Dieter Riemann, PhD, highlighted recent study findings regarding sleep disturbances in the intensive care unit (ICU), the effects of wind turbine sounds on sleep quality, the impact shift-scheduling rules have on shift workers’ sleep, and the association between prenatal maternal sleep, long-term anxiety, and postpartum depression.

The first study examined the effects of nocturnal nursing interventions, such as the assessment of vital signs, on sleep quality in patients admitted to the ICU. Nursing interventions were not found to be the most frequent cause of sleep disruptions in these patients, suggesting other factors in the ICU may contribute to poor sleep. As such, the study researchers noted that additional analyses are needed to determine which nocturnal nursing interventions are necessary and which interventions can be reserved for daytime hours.

In another study, researchers evaluated weather sleeping near wind turbines impacted objective and subjective sleep assessments. The study, which was a meta-analysis of 5 studies and systematic review of 9 studies, found wind turbine noise did not significantly impact objective sleep continuity parameters, including sleep onset latency, total sleep time, sleep efficiency, or post-sleep waking. Despite these findings, the study researchers concluded the heterogeneous methodology in the assessed studies may limit the overall interpretation of the results.

Additionally, Dr. Riemann summarized another study that looked at the effects of ergonomic shift scheduling rules on the sleep and work hour characteristics of aging shift workers. The ergonomic shift scheduling rule reduced work hours to 50 hours per week, featured a maximum of 5 night shifts in a row, provided workers 2 days off after a night shift, featured a maximum night shift length of 10 hours, and reduced the number of quick returns from evening to morning shifts.

A total of 253 workers were in the intervention group, while 1234 people were in the control group. The ergonomic rules led to only minor changes in objective working hours; however, the intervention exerted a “buffering effect against worsening of sleep,” according to the study researchers.

In another long-term study, researchers examined prenatal maternal sleep and the associated trajectories of anxiety symptoms and postpartum depression. The study included 215 women who were examined from the third trimester to 18 months postpartum. Study researchers obtained measurements of depression and anxiety symptoms via self-reports at the third trimester, as well as at 3, 6, 12, and 18 months postpartum. The pregnancy study demonstrated that mothers who had shorter durations of sleep during pregnancy had a higher long-term risk of belonging to a high-comorbidity trajectory.

Riemann emphasized that these studies were “dealing with different, however very important, topics in sleep medicine,” critical to the future of sleep research and sleep quality among patients.


Riemann D. Systematic reviews and meta-analyses: Sleep in the intensive care unit and near wind turbines. J Sleep Res. 2021;30(4):e13427. doi:10.1111/jsr.13427