Adithya Balasubramanian1, Taylor P Kohn2, Javier E Santiago3, John T Sigalos4, E Will Kirby5, Mark S Hockenberry5, Stephen M Pickett6, Alexander W Pastuszak7, Larry I Lipshultz8. 1. Baylor College of Medicine, Houston, TX. 2. Department of Surgery, Johns Hopkins School of Medicine, Baltimore, MD. 3. Department of Urology, University of Michigan, Ann Arbor, MI. 4. Department of Urology, University of California Los Angeles, Los Angeles, CA. 5. Scott Department of Urology, Baylor College of Medicine, Houston, TX; Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX. 6. Department of Economics, Rice University, Houston, TX. 7. Division of Urology, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT. 8. Scott Department of Urology, Baylor College of Medicine, Houston, TX; Center for Reproductive Medicine, Baylor College of Medicine, Houston, TX. Electronic address: larryl@bcm.edu.
Abstract
OBJECTIVE: To examine the association between shift work sleep disorder (SWSD), a primary circadian rhythm disorder characterized by excessive day-time sleepiness associated with shift work, and hypogonadal symptoms in shift workers. METHODS: Men presenting to an andrology clinic between July 2014 and June 2017 completed questionnaires assessing shift work schedule, SWSD risk, and hypogonadal symptoms ([quantitative] Androgen Deficiency in the Aging Male [qADAM, ADAM]). The impact of nonstandard shift work and SWSD on responses to qADAM and ADAM was assessed using ANOVA and linear regression. RESULTS: About 24.1% (619/2571) of men worked nonstandard shifts. Of those, 196 (31.7%) were considered to have SWSD. Controlling for age, comorbidities, and testosterone (T) levels, nonstandard shift workers had qADAM scores 1.12 points lower than day-time workers (P <.01). Subgroup analysis of nonstandard shift workers showed that those with SWSD had qADAM scores 5.47 points lower than men without SWSD (P <.01). In this same subgroup analysis, SWSD was independently associated with lower T levels (mean decrease 100.4 ng/dL, P <.01) when controlling for age, comorbidities, and prior T supplementation. CONCLUSION: Nonstandard shift workers with SWSD have even worse hypogonadal symptoms and lower T levels than day-time workers and nonstandard shift workers without SWSD. This suggests that poor sleep habits, as identified by SWSD, may contribute to the more severe hypogonadal symptoms seen in nonstandard shift workers.
OBJECTIVE: To examine the association between shift work sleep disorder (SWSD), a primary circadian rhythm disorder characterized by excessive day-time sleepiness associated with shift work, and hypogonadal symptoms in shift workers. METHODS: Men presenting to an andrology clinic between July 2014 and June 2017 completed questionnaires assessing shift work schedule, SWSD risk, and hypogonadal symptoms ([quantitative] Androgen Deficiency in the Aging Male [qADAM, ADAM]). The impact of nonstandard shift work and SWSD on responses to qADAM and ADAM was assessed using ANOVA and linear regression. RESULTS: About 24.1% (619/2571) of men worked nonstandard shifts. Of those, 196 (31.7%) were considered to have SWSD. Controlling for age, comorbidities, and testosterone (T) levels, nonstandard shift workers had qADAM scores 1.12 points lower than day-time workers (P <.01). Subgroup analysis of nonstandard shift workers showed that those with SWSD had qADAM scores 5.47 points lower than men without SWSD (P <.01). In this same subgroup analysis, SWSD was independently associated with lower T levels (mean decrease 100.4 ng/dL, P <.01) when controlling for age, comorbidities, and prior T supplementation. CONCLUSION: Nonstandard shift workers with SWSD have even worse hypogonadal symptoms and lower T levels than day-time workers and nonstandard shift workers without SWSD. This suggests that poor sleep habits, as identified by SWSD, may contribute to the more severe hypogonadal symptoms seen in nonstandard shift workers.