LAUSR

OBJECTIVE To examine the association between shift work sleep disorder (SWSD), a primary circadian rhythm disorder characterized by excessive daytime 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 non-standard shift work and SWSD on responses to qADAM and ADAM was assessed using ANOVA and linear regression. RESULTS 24.1% (619/2571) of men worked non-standard shifts. Of those, 196 (31.7%) were considered to have SWSD. Controlling for age, comorbidities and testosterone (T) levels, non-standard shift workers had qADAM scores 1.12 points lower than daytime workers (p<0.01). Sub-group analysis of non-standard shift workers showed that those with SWSD had qADAM scores 5.47 points lower than men without SWSD (p<0.01). In this same sub-group analysis, SWSD was independently associated with lower T levels (mean decrease 100.4 ng/dL, p<0.01) when controlling for age, comorbidities and prior T supplementation. CONCLUSIONS Non-standard shift workers with SWSD have even worse hypogonadal symptoms and lower T levels than daytime workers and non-standard shift workers without SWSD. This suggests that poor sleep habits, as identified by SWSD, may contribute to the more severe hypogonadal symptoms seen in non-standard shift workers.