Issue Navigator

Volume 14 No. 06
Earn CME
Accepted Papers

Scientific Investigations

The Differential Effects of Regular Shift Work and Obstructive Sleep Apnea on Sleepiness, Mood and Neurocognitive Function

Jennifer M. Cori, PhD1; Melinda L. Jackson, PhD1,2; Maree Barnes, MBBS1,3; Justine Westlake, BA/BAppSci (Hons)1; Paul Emerson, BSocSc1; Jacen Lee, DPsych1,4; Rosa Galante, DPsych1,5; Amie Hayley, PhD1,6,7; Nicholas Wilsmore, MBBS (Hons)1,8; Gerard A. Kennedy, PhD1,2; Mark Howard, MBBS, PhD1,3
1Institute for Breathing and Sleep and Austin Health, Heidelberg, Victoria, Australia; 2School of Health & Biomedical Sciences, RMIT University, Bundoora, Victoria, Australia; 3Department of Medicine, University of Melbourne, Parkville, Victoria, Australia; 4Hong Kong Clinical Neuropsychology Service, Hong Kong SAR, China; 5Department of Psychology, Victoria University, St. Albans, Victoria, Australia; 6Centre for Human Psychopharmacology, Faculty of Health Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia; 7School of Clinical Sciences at Monash Health, Faculty of Medicine Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia; 8Department of Respiratory and Sleep Medicine, Eastern Health, Melbourne, Victoria, Australia

Study Objectives:

To assess whether poor sleep quality experienced by regular shift workers and individuals with obstructive sleep apnea (OSA) affects neurobehavioral function similarly, or whether the different etiologies have distinct patterns of impairment.


Thirty-seven shift workers (> 24 hours after their last shift), 36 untreated patients with OSA, and 39 healthy controls underwent assessment of sleepiness (Epworth Sleepiness Scale [ESS]), mood (Beck Depression Index, State Trait Anxiety Inventory [STAI], Profile of Mood States), vigilance (Psychomotor Vigilance Task [PVT], Oxford Sleep Resistance Test [OSLER], driving simulation), neurocognitive function (Logical Memory, Trails Making Task, Digit Span Task, Victoria Stroop Test) and polysomnography.


Sleepiness (ESS score; median, interquartile range) did not differ between the OSA (10.5, 6.3–14) and shift work (7, 5–11.5) groups, but both had significantly elevated scores relative to the control group (5, 3–6). State anxiety (STAI-S) was the only mood variable that differed significantly between the OSA (35, 29–43) and shift work (30, 24–33.5) groups, however both demonstrated several mood deficits relative to the control group. The shift work and control groups performed similarly on neurobehavioral tasks (simulated driving, PVT, OSLER and neurocognitive tests), whereas the OSA group performed worse. On the PVT, lapses were significantly greater for the OSA group (3, 2–6) than both the shift work (2, 0–3.5) and control (1, 0–4) groups.


Shift workers and patients with OSA had similar sleepiness and mood deficits relative to healthy individuals. However, only the patients with OSA showed deficits on vigilance and neurocognitive function relative to healthy individuals. These findings suggest that distinct causes of sleep disturbance likely result in different patterns of neurobehavioral dysfunction.


Cori JM, Jackson ML, Barnes M, Westlake J, Emerson P, Lee J, Galante R, Hayley A, Wilsmore N, Kennedy GA, Howard M. The differential effects of regular shift work and obstructive sleep apnea on sleepiness, mood and neurocognitive function. J Clin Sleep Med. 2018;14(6):941–951.

Please login to continue reading the full article

Subscribers to JCSM get full access to current and past issues of the JCSM.

Login to JCSM

Not a subscriber?

Join the American Academy of Sleep Medicine and receive a subscription to JCSM with your membership

Subscribe to JCSM:  $75/volume year for individuals or $140/volume year for institutions to access all current articles and archives published in JCSM.

Download this article*:   $20 to access a PDF version of a specific article from the current issue of JCSM.

*Purchase of an electronic download of JCSM provides permission to access and print the issue/article for personal scholarly, research and educational use. Please note: access to the article is from the computer on which the article is purchased ONLY. Purchase of the article does not permit distribution, electronic or otherwise, of the article without the written permission of the AASM. Further, purchase does not permit the posting of article text on an online forum or website.