The menstrual cycle associated with insomnia in newly employed nurses performing shift work: a 12-month follow-up study

  • WonYang Kang
  • Keun-Ho Jang
  • Hyeong-Min Lim
  • Ji-Sung Ahn
  • Won-Ju ParkEmail author
Original Article



This study aimed to investigate whether insomnia among newly-employed shift-working nurses is associated with menstrual cycle irregularity.


We followed 287 nurses employed between 2015 and 2016 for 12 months. An Insomnia Severity Index (ISI) was completed to determine levels of insomnia 6 months after beginning work. At baseline and at 12-month follow-up, menstrual cycle information was obtained using clinical interviews. We analyzed baseline data separately by prevalence (participants with menstrual irregularity, n = 287) and incidence (participants with no reported menstrual irregularity, n = 238).


In a multivariate logistic regression analysis, including age, body mass index, and physical activity, insomnia was associated with a 2.05-fold increase in the odds of newly developing menstrual cycle irregularity compared with not having insomnia [odds ratio (OR) 2.05, 95% confidence interval (CI) 1.12–3.77]. Insomnia was associated with a 3.05-fold increase in the prevalence of menstrual cycle irregularity compared with not having insomnia (OR 3.05, 95% CI 1.81–5.13). As the ISI score increased, both the incidence and prevalence odds of menstrual cycle irregularity tended to increase.


Insomnia can induce menstrual cycle irregularity among nurses working shifts, and insomnia may have an important role in the pathway from shift work to menstrual dysfunction, aside from the possible effects of circadian rhythm disruption.


Sleep disturbance Menstruation Menstrual cycle irregularity Infertility Shift worker Circadian rhythm 



We thank all of the members of the health promotion center at Chonnam National University Hwasun Hospital. We also thank the company and workers for their participation. WY and WJ designed the study, and analyzed and interpreted the data. WY drafted the first manuscript, and WJ made revisions. WY had the initial idea for this study. HM and JS recruited study participants and obtained medical data. KH was involved in data management and data interpretation. The authors have no competing interests to declare. This study received no funding.


This study received no funding.

Compliance with ethical standards

Conflict of interest

The authors have no competing interests to declare.

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Supplementary material

420_2018_1371_MOESM1_ESM.pdf (152 kb)
Supplementary material 1 (PDF 152 KB)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • WonYang Kang
    • 1
  • Keun-Ho Jang
    • 2
  • Hyeong-Min Lim
    • 1
  • Ji-Sung Ahn
    • 1
  • Won-Ju Park
    • 1
    Email author
  1. 1.Department of Occupational and Environmental MedicineChonnam National University Hwasun HospitalHwasun-gunRepublic of Korea
  2. 2.Department of Occupational and Environmental MedicineMokpo Christian HospitalMokpoRepublic of Korea

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