Effect of altered sleep rhythm on body mass index

Objective: To assess the influence of de-synchronized sleep rhythm caused by rotatory shift work on Body Mass Index [BMI] in health care providers

Methodology: This cross-sectional study was conducted in Dow university hospital Karachi, from November 2013 to May 2015. To outline underlying risk factor for obesity, a universal sample of all eligible health care providers working in split shifts [service across 24 hours of the clock, each day of the week][n=91] were enlisted. We used the BMI calculator of heart foundation Australia. However, Asian cutoff points by WHO were also taken into consideration [BMI classification Global data base on BMI, WHO 2006] whereby BMI above 25 was considered to be obese in the Asian countries [WPRO criteria]. BMI was determined by using metric system. Height was recorded in centimeters and weight was obtained in kilograms. Gender based BMI was calculated for adult men and women. The healthy range of BMI was 18.5-25. Exclusion criteria included pregnant women, age less than 18 years and chronic illness

Results: Results revealed an increased BMI amongst the shift workers. However, female health care providers far outnumber the male health care providers as it was observed that 16 women [43.2%] were found to have BMI more than 25 as compared to 9 [16.7%] men

Conclusion: Split shift work was identified as independent risk factor for obesity. Identification of irregular sleep cycle as an underlying mechanism leading to obesity necessitates further evaluation.

Nonstandard shift work and subsequent health hazards

Present age has moved into twenty four hours a day; seven days a week economy. Concept of 24-hour economy is based on the pattern of work; that for a given work, eight-hour working day can be carried out at any time during twenty-four hour day/night period, which is achievable by shift work [routine method being three shifts of eight hours each per day]. According to international labor organization, shift work is defined [1990] as placement of an employee in schedule where workers succeed one another at job, hence the management can function more than the hours of work. The other term often available in 24- economy is shift sharing, and flexi-time. Over the years scientific research has been focused to explore relationship between organism and its environment to establish link between disease and man-made environment. The current review has addressed how de- synchronized physiological rhythm could lead to human pathophysiology by un- standardized shift work

Predicting wellbeing in irregular shift workers

Objective of the study was to assess wellbeing and its relationship with sleep pattern from the biological rhythm science aspect. Cross sectional study. This study was carried out at Dow University Hospital. Dow university of Health Sciences Karachi from November 2013 to January 2014. This was a non-interventional cross sectional study. Wellbeing was measured in the study subjects [health care provider] working in irregular shift .To profile wellbeing, the instrument used was an integrated questionnaire. This measuring tool has a established scale based on subjective feeling of wellbeing [happiness] where higher score suggested a higher level of wellbeing, low scores suggested a fragile level of wellbeing. Subjects were interviewed and their reply was documented. Influences of a misaligned sleepcycle was measured on positive emotion scale quantitatively. Results revealed a decreased strength of wellbeing amongst rotatory shift workers. Mean scores inferred from happiness scale in the present study was 3.75 +/- 1.02. It was concluded that sleep/wake misalignment is associated with emotional fatigue. With the introduction of biofeedback as an intervention in certain stress related disease. It has become mandatory to open new windows and option which has become essential in experimental research for applied purpose

Effect of sleep/wake cycle on autonomic regulation

To evaluate the association between irregular sleep/wake cycle in shift workers and autonomic regulation. Cross-sectional, analytical study. Dow University Hospital, Karachi, from August to November 2013. All healthcare providers working in rotating shifts making a total [n=104] were included. Instrument was an integrated questionnaire applied to assess autonomic regulation, taken from Kroz et al. on scoring criteria, ranging from 18 - 54, where higher rating signifies strong autonomic regulation, indicating a stable Autonomic Nervous System [ANS] and vice versa. Participants were interviewed and their response was recorded by the investigator. Influence of sleep misalignment was measured quantitatively to extract index of autonomic activity. There was a reduced trend in autonomic strength amongst shift workers. The mean score obtained on the Autonomic Scale was 37.8 +/- 5.9. Circadian misalignment has an injurious influence on ANS which might be valuable in controlling autonomic dysfunction that leads to fatal triggers in rotating shift workers

Present trend in eveningness amongst medical students in the east

To analyze individual preference in organizing their behavior within 24 hours[Human chronotypes] also referred to as morningness/ eveningness. Dow Medical College, Dow university of Health Sciences Karachi. From September 2012 to December 2013. Cross-sectional. Subjects [Medical students] from first semester to final semester were invited to participate in this study, A total of 710 subjects were included. Their demographic data such as age, gender was obtained. Instrument is an integrated questionnaire [Horne JA and Ostberg O Morningness- Eveningness questionnaire MEQ original 1976] designed to assess chronotype of young adult population. Out of different existing chronotypes, biggest group which dominated the current study was intermediate type. Present study determined, chronotype of young population [medical students] of this region. The assessment of individual chronotype is important not only for the diagnosis and treatment of sleep disorders, additionally to evaluate ability to adapt for specific work schedule

Academic accomplishment; influence of diurnal preference in medical students

To evaluate sleep hygiene and its relationship with academic performance in adults. Cross sectional. The study was conducted at Dow Medical College, Dow university of Health sciences Karachi from December 2012 to November 2013. Subjects were students from first year to final year. Instrument was an integrated questionnaire [Horne JA and Ostberg O Morningness- Eveningness questionnaire MEQ original 1976] designed to assess chronotype of young adult population. Subjects [N = 690] completed a questionnaire packet and provided their GPA. It was observed that students organizing their activities closer to the morning reported higher GPA whereas students with lower grades reported evening type personality. This study may help universities to decrease the prevalence of poor sleep hygiene by developing interventions programs that target adolescents with low academic achievement

Delayed sleep phase syndrome: a forerunner of psychiatric distress

To determine the association of extrinsic delayed sleep phase syndrome [DSPS] and psychiatric distress. Cross-sectional, analytical study. Dow University of Health Sciences, Karachi, from July 2009 to September 2010. Sales personnel employed in different shopping malls in Karachi operating from 2 pm afternoon to 12.00 mid-night were inducted. The instrument used to define DSPS included difficulty in falling sleep timely at night and early rising in the morning. The proven DSPS subjects were studied by the Aga Khan University Anxiety Depression Scale [AKUADS] to explore the association of extrinsic [motivational] DSPS with anxiety and depression syndrome along with a survey questionnaire having twelve questions based on the criteria of ICSD [International Classification of Sleep Disorder] on DSPS, to study different characteristics of these subjects and its relationship with psychiatric illness. Eight hundred and eleven subjects were inducted, majority were male [n = 757, 93.3%]. Three hundred and forty-five [42.5%] subjects scored > 19 with mean value of 41.4 +/- 15.90. Result supported an association between DSPS and psychiatric distress. Extrinsic DSPS prevention necessitates attention because of its positive relationship with psychiatric distress.