The menstrual cycle associated with insomnia in newly employed nurses performing shift work: a 12-month follow-up study.
PURPOSE
This study aimed to investigate whether insomnia among newly-employed shift-working nurses is associated with menstrual cycle irregularity.


METHODS
We followed 287 nurses employed between 2015 and 2016 for 12 months. An Insomnia Severity Index (ISI) was completed to determine levels of insomnia 6 months after beginning work. At baseline and at 12-month follow-up, menstrual cycle information was obtained using clinical interviews. We analyzed baseline data separately by prevalence (participants with menstrual irregularity, n = 287) and incidence (participants with no reported menstrual irregularity, n = 238).


RESULTS
In a multivariate logistic regression analysis, including age, body mass index, and physical activity, insomnia was associated with a 2.05-fold increase in the odds of newly developing menstrual cycle irregularity compared with not having insomnia [odds ratio (OR) 2.05, 95% confidence interval (CI) 1.12-3.77]. Insomnia was associated with a 3.05-fold increase in the prevalence of menstrual cycle irregularity compared with not having insomnia (OR 3.05, 95% CI 1.81-5.13). As the ISI score increased, both the incidence and prevalence odds of menstrual cycle irregularity tended to increase.


CONCLUSIONS
Insomnia can induce menstrual cycle irregularity among nurses working shifts, and insomnia may have an important role in the pathway from shift work to menstrual dysfunction, aside from the possible effects of circadian rhythm disruption.
['Kang|WonYang|W|', 'Jang|Keun-Ho|KH|', 'Lim|Hyeong-Min|HM|', 'Ahn|Ji-Sung|JS|', 'Park|Won-Ju|WJ|']
D000328:Adult D002940:Circadian Rhythm D005260:Female D005500:Follow-Up Studies D006801:Humans D015994:Incidence D008597:Menstrual Cycle D008599:Menstruation Disturbances D009726:Nurses D009741:Nursing Staff, Hospital D015995:Prevalence D000073577:Shift Work Schedule D007319:Sleep Initiation and Maintenance Disorders
Menstrual cycle irregularity Circadian rhythm Infertility Menstruation Shift worker Sleep disturbance