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Study objectives To describe sleep characteristics of shift workers compared with day workers from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) Sueno ancillary study and test the hypothesis that shift work is associated with shorter sleep duration, worse sleep quality, greater sleep variability, and other sleep/health-related factors. Methods Employed adults (N = 1253, mean age 46.3 years, 36.3% male) from the Sueno study were included. Measures of sleep duration, timing, regularity, and continuity were calculated from 7 days of wrist-activity monitoring. Participants provided information on demographics, employment, work schedule (day, afternoon, night, split, irregular, and rotating), sleepiness, depressive symptoms, medications, caffeine, and alcohol use. Survey linear regression adjusting for age, sex, background, site, number of jobs, and work hours was used. Results In age and sex-adjusted models, all shift work schedules were associated with delayed sleep timing. Night and irregular schedules were associated with shorter sleep duration, greater napping, and greater variability of sleep. Afternoon and rotating shifts were associated with lower sleep regularity. In fully adjusted models, night and irregular schedules remained associated with shorter sleep duration, later sleep midpoint, and greater variability in sleep measures compared with day schedules. Split schedules were associated with, less time in bed, less sleep fragmentation, and less wake during the sleep period than day schedules. Conclusions Work schedule significantly affects sleep-wake with substantial differences between day work and other types of schedule. Detailed assessment of work schedule type not just night shift should be considered as an important covariate when examining the association between sleep and health outcomes.

Study ObjectivesHome sleep apnea testing (HSAT) is increasingly used as an alternative to laboratory-based polysomnography (PSG) for the diagnosis of obstructive sleep apnea. Patient satisfaction with sleep testing performed at home or in the lab has been sparsely assessed, despite its potentially pivotal role in determining patients’ acceptance of sleep apnea treatment. We hypothesize that satisfaction in clinical practice may differ from what has been previously reported within the research setting.MethodsWe analyzed survey data including responses to questions regarding diagnostic sleep study type and sleep study experience satisfaction from 2563 sleep apnea patients enrolled in the Sleep Apnea Patient-Centered Outcomes Network.ResultsPatients (mean age 57 years; 54% male) who underwent in-lab PSG were more likely to be satisfied with their study experience than patients who had a HSAT (71% vs 60%; p < 0.01). Furthermore, the 38 per cent diminished odds of satisfaction in patients having HSAT (OR: 0.62; 95% CI: 0.49–0.77) persisted after adjustment for potential confounders (OR: 0.41, 95% CI; 0.27–0.63). Greater sleep apnea symptom burden and satisfaction with CPAP therapy were associated with greater study satisfaction. Effect modifications on study types by college degree education and tiredness as a study trigger were detected.ConclusionsPatients receiving care in the community who underwent PSG reported greater satisfaction with study experience than patients who underwent HSAT in contrast to findings from randomized controlled trials. Our findings, based on data from contemporary “real-world” settings, suggest that assumptions about the generalizability of early reports comparing in-lab PSG to home-based paradigms need to be revisited.

Sleep duration is implicated in the etiologies of chronic diseases and premature mortality. However, the genetic basis for sleep duration is poorly defined. We sought to identify novel genetic components influencing sleep duration in a multi-ethnic sample. Meta-analyses were conducted of genetic associations with self-reported, habitual sleep duration from seven Candidate Gene Association Resource (CARe) cohorts of over 25 000 individuals of African, Asian, European and Hispanic American ancestry. All individuals were genotyped for ∼50 000 SNPs from 2000 candidate heart, lung, blood and sleep genes. African-Americans had additional genome-wide genotypes. Four cohorts provided replication. A SNP (rs17601612) in the dopamine D2 receptor gene (DRD2) was significantly associated with sleep duration (P = 9.8 × 10(-7)). Conditional analysis identified a second DRD2 signal with opposite effects on sleep duration. In exploratory analysis, suggestive association was observed for rs17601612 with polysomnographically determined sleep latency (P = 0.002). The lead DRD2 signal was recently identified in a schizophrenia GWAS, and a genetic risk score of 11 additional schizophrenia GWAS loci genotyped on the IBC array was also associated with longer sleep duration (P = 0.03). These findings support a role for DRD2 in influencing sleep duration. Our work motivates future pharmocogenetics research on alerting agents such as caffeine and modafinil that interact with the dopaminergic pathway and further investigation of genetic overlap between sleep and neuro-psychiatric traits.