Sleep Quality, Insomnia, Sleep Apnea, and the Assessment of Risk Factors in Shift Workers

Introduction: Shift work organization has become increasingly prevalent in industry. This work modality presents considerable challenges to workers' health and quality of life. One critical factor that deserves attention is the impairment of sleep quality, which can lead to increased sleepiness, fatigue, and other disorders that impact productivity and worker safety. Sleep disorders, such as insomnia, sleep apnea, and excessive sleepiness, are directly associated with a higher risk of workplace accidents and reduced performance, making the identification of these factors crucial to ensuring worker health and safety in their work environment. However, due to the variety of questionnaires, inventories, and tests available for assessing these sleep disorders, this activity must be conducted cautiously, as the methodology used may be redundant or fail to address the proposed objectives.

Methods: The aim of this study was to evaluate the relationship between the Pittsburgh Sleep Quality Index (PSQI), Berlin Questionnaire (BERLIN), and Insomnia Severity Index (ISI), administered between 2022 and 2024, assessing 3,220 shift workers in Brazilian mining companies. The correlations between these questionnaires were analyzed using the Spearman correlation coefficient.

Results: The Spearman correlation coefficient (Rho) between the PSQI and the BERLIN was 0.268, with an associated p-value less than 0.001 (p < 0.001). A Rho value of 0.268 suggests a weak to moderate positive correlation, indicating that as sleep quality (evaluated by the PSQI) deteriorates, the score on the BERLIN questionnaire tends to increase. On the other hand, the Spearman correlation coefficient (Rho) between the PSQI and the ISI was 0.651, with an associated p-value less than 0.001 (p < 0.001). A Rho value of 0.651 suggests a moderate to strong positive correlation, indicating that a worsening in sleep quality, as evaluated by the PSQI, is associated with an increase in the severity of insomnia.

Conclusion: The moderate to high correlation between the PSQI and ISI suggests a strong link between perceived sleep quality and the occurrence of insomnia symptoms. However, the weaker correlation observed between the PSQI and BERLIN suggests that, while there is a relationship, other factors besides sleep quality may influence the risk of sleep apnea. Examples of these factors include the structure of the questionnaire itself and the disorder, which tends to be less perceptible than insomnia. Thus, the BERLIN questionnaire does not seem to be a good predictor for evaluating sleep quality in the studied population. Support: UFMG, FEPE, CEPE, CEMSA, CAPES, CNPq;

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Artikel online veröffentlicht:
08. Oktober 2025