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Trastornos del sueño asociados al trabajo nocturno del personal de salud de la Clínica Praxxel - Cuenca

Sleep problems associated with night work by health personnel at the Praxxel Clinic – Cuenca

3D"Interfaz

= ¹	Diana Carolina Parra Siguenza	https://orcid.org/0000-0002-6085-5161
	Universidad Cat&oa= cute;lica de Cuenca, Cuenca, Ecuador. diana.parra.68@est.ucacue.edu.ec
= ²	José Antonio Baculima Suarez	https://orcid.org/0000-0002-6695-665X
	Universidad Cat&oa= cute;lica de Cuenca, Cuenca, Ecuador. jbaculima@ucacue.edu.ec
= ³	Henry Geovanny Mariño Andrade	https://orcid.org/0000-0003-0105-5516
	Universidad Cat&oa= cute;lica de Cuenca, Cuenca, Ecuador. henry.ramino@ucacue.edu.ec

	Art&ia= cute;culo de Investigación Científica y Tecnológica= Enviado: 23/08/2023= Revisado: 20/09/2023 Aceptado: 02/10/2023 Publicado:03/11/2023 &= nbsp; DOI: <= span style=3D'mso-ascii-font-family:Calibri;mso-fareast-font-family:"Times New= Roman"; mso-hansi-font-family:Calibri;mso-bidi-font-family:"Times New Roman"; mso-fareast-language:ES'> &nbs= p; https://doi= .org/10.33262/anatomiadigital.v6i4.1.2740 <= /span>

&= nbsp; C&iacu= te;tese:	&= nbsp;	Parra Siguenza , D. C., Baculima Suarez , J. A., & Mariño Andrade , H. G. (2023). Trastornos del sueño asociados al trabajo nocturno del personal de salud de la Clínica Praxxel - Cuenca. Anatomía Digital, 6(4.1), 6-22. https://doi= .org/10.33262/anatomiadigital.v6i4.1.2740 &= nbsp;
	&= nbsp;	ANATOMÍA DIGITAL, es una Revista Electrónica, Trimestral,= que se publicará en soporte electrónico tiene como misión contribuir a la formación de profesionales competentes= con visión humanística y crítica que sean capaces de exponer sus resultados investigativos y científicos en la misma medida que se promueva mediante su intervención cambios positivos en la sociedad. https://anatomia= digital.org La revista es editada por la Editorial Ciencia Digital (Editorial de prestigio registrada en la Cámara Ecuatoriana de Libro con No de Afiliación 663) www.celibro.org.ec
	&= nbsp;	Esta revista está protegida bajo una licencia Crea= tive Commons Atribución-NoComercial-CompartirIgual 4.0 International. Copia de la licen= cia: https://creative= commons.org/licenses/by-nc-sa/4.0/deed.es
Palabras claves:= Trasto= rnos del sueño; Personal Médico; Escala Epw= orth; Trabajo Nocturno; Factores de Riesgo<= /o:p>		Resumen El trabajo nocturno representa una doble alteración como es trabajar de noche y dormir= de día. Los profesionales de la salud, son uno de los grupos afectados por el trabajo en turnos nocturnos, aspecto que puede tener repercusi&oac= ute;n en la calidad asistencial, el objetivo del presente trabajo busca evaluar= los trastornos del sueño asociados al trabajo nocturno en 20 profesion= ales de salud de la clínica Praxxel en el p= eriodo 2021-2022. Para lo cual se utiliza la investigación analíti= ca, con universo conocido que correspondió con la muestra y lo constituyer= on 20 trabajadores del personal de salud de la Clínica Praxxe= l de la ciudad de Cuenca. A quienes se les aplicó la escala Epworth, y un cuestionario para recolectar información adicional, los resultados demuestran que el 75% del personal tienen trastornos del sueño ligero y solo el 20% de los profesionales de la salud de la Clínica Praxx= el de la ciudad de Cuenca entrevistados, mostró afectación del sueño moderada o grave, en conclusión las condiciones labor= ales fueron buenas según refieren la mayoría de los entrevistado= s, aunque las dificultades en las condiciones laborales de algunos participa= ntes hacen que presenten trastornos del sueño. Área de estudio general: <= /b>Medicina. Área de estudio específica: Medicina Ocupacional. Tipo de estudio:= Artículos originales / Original articles
Keywords: Sleep disorders; health-care professionals; Epworth scale; night shift; risk factors<= /o:p>	&= nbsp;	Abstract Night work represents a double alteratio= n as it is working at night and sleeping during the day. Health professionals = are one of the groups affected by night shift work, an aspect that may have an impact on the quality of care. The objective of this paper seeks to evalu= ate sleep disorders associated with night work in 20 health professionals from the Praxxel clinic in the period 2021-2022. F= or which analytical research is used, with a known universe that corresponde= d to the sample and was made up of 20 health personnel workers from the Praxxel Clinic in the city of Cuenca. To whom the E= pworth scale was applied, and a questionnaire to collect additional information,= the results show that 75% of the staff have light sleep disorders and only 20= % of the health professionals of the Praxxel Clini= c in the city of Cuenca interviewed, showed moderate or severe sleep impairmen= t, in conclusion the working conditions were good according to the majority = of the interviewees, although the difficulties in the working conditions of = some participants cause them to present sleep disorders.

Introducción<= /span>

La Organización Internacional del Trabajo (OIT) denomina “trabajo nocturno” a t= oda actividad laboral que se ejecuta durante un periodo mínimo de siete horas consecutivas y que abarque el intervalo que está entre la medi= anoche y las cinco de la mañana. (1)

En el ámbito de l= os profesionales de la salud, este sistema de turnos es habitual, ya que por la actividad que desarrollan se brinda una atención continua a los pacientes las 24 horas del día incluyendo días festivos y no = laborables, durante los 365 días del año. Es por esta razón que la= s 24 horas del día se divide en dos turnos de 12 horas, el diurno y el nocturno (2)

Según algunos autores, el trabajo por turnos es una forma de organización del trab= ajo en equipo en la que los trabajadores realizan el mismo trabajo en sucesión, según un ritmo, ya sea de forma consecutiva o discontinua, lo que significa que los trabajadores están obligados a prestar servicios en diferentes momentos en un período determinado durante varios días o semanas (3). Los turnos de noche están asociados con efectos adversos para la salud. Se mencionaron diversas dolen= cias como trastornos del sueño, problemas metabólicos, fatiga crónica y ocupacional y accidentes laborales. Los profesionales de la salud son uno de los grupos afectados por el trabajo nocturno, lo que puede afectar la calidad de la atención (4).

La Organización Mundial de la salud (OMS), sostiene que cada quince años de trabajo nocturno, se añade un envejecimiento adicional de cinco años,= y es debido a que nuestra salud física y mental desciende. Esto agrava= la situación a futuro y se ha comprobado que un tercio de las personas = que lo realiza sufre diversas molestias como: fatiga, neurosis, úlceras gastrointestinales y cambios en el sistema cardiovascular (5).

La turnicidad laboral ge= nera importantes repercusiones en los rangos normales de presión arterial, frecuencia cardiaca, así como alteraciones gastrointestinales. Por o= tra parte, se encuentra las implicaciones de tipo social y familiar, al verse afectadas por la rotación nocturna, acarreando múltiples afecciones de tipo emocional. Varios autores sostienen que los trabajos nocturnos tienen un impacto importante desde lo fisiológico, sino psicológico y social, lo que hace necesario la implementación= de políticas en salud que mitiguen los factores de riesgo asociados (6)= .

En este artículo = la pregunta de investigación es: ¿Qué trastornos del sueño se producen por el trabajo nocturno del personal de salud de la Clínica Praxxel?

El objetivo de esta inve= stigación es evaluar los trastornos del sueño asociados al trabajo nocturno en= el profesional de salud de la clínica Praxxel en el periodo 2021-2022. La elaboración de esta investigación so= bre los trastornos del sueño asociados al trabajo nocturno es de gran utilidad ya q no existe mucha información ni estudios acerca de este tema por lo que es poco conocido, con lo que se dará un gran aporte = a la comunidad científica, ya que se espera que con los resultados obteni= dos se pueda tomar medidas preventivas y correctivas en este grupo de trabajado= res de la salud.

Cabe mencionar que esta entidad tiene un funcionamiento de 24 horas diarias para satisfacer la dema= nda paciente que acuden a esta casa de salud para ser atendidos por sus diferen= tes patologías.

Metodología

El diseño de investigación fue no experimental, descriptivo, transversal.

El universo de estudio se correspondió con la muestra y lo constituyó el 100% del personal de salud de la Clínica Praxxel de la ciudad de Cuenca integrado por 20 trabajadores en el periodo enero a diciembre del año 2022, que laboró en turnos nocturnos de 12 horas, 24 horas a la sema= na por un tiempo de 1 año o más.

Dentro de las téc= nicas e instrumentos de recolección de datos, se realizó un cuestionario con el objetivo de realizar caracterización socio demográfica e identificar efectos del trabajo nocturno. Este cuestionario adaptó tres elementos del Cuestionario aplicado por Mon= cada en el 2017, los cuales fueron: condiciones laborales, efectos que produce el trabajo y efectos del trabajo nocturno (7).

También se empleó la Escala de Somnolencia de Epworth (ESE). Elaborada en 1991, en Melbourne, Australia, por el doctor Murray Joh= ns del Hospital Epworth. Esta escala de auto respu= esta evalúa la probabilidad de que el paciente se quede dormido en difere= ntes circunstancias de la vida cotidiana, la escala es de 0 a 24 puntos. Aunque = se considera que una puntuación por encima de 12 es sugestiva de padecer trastornos del sueño. Es usada en su versión en españo= l en varios estudios de este tipo en países como Perú, Chile y en Ecuador, con el fin de evidenciar problemas del sueño (8).

Para la interpretación del cuestionario de somnolencia de Epworth se tiene en cuenta el número asignado a las respuestas, y la sumator= ia de estos determina si puede o no presentar SAHOS. (0 =3D nunca se ha dormid= o, 1 =3D escasa posibilidad de dormirse, 2 =3D moderada posibilidad de dormirse, 3 = =3D Elevada posibilidad de dormirse). Se clasifica la somnolencia en ligera, moderada, o grave dependiendo de la puntuación: Ninguna 0-2, Ligera:= 3 – 13, Moderada: 14 – 19, Grave: 20 – 24=

Lo cuestionarios fueron aplicados bajo la supervisión de un investigador en el ambiente labo= ral en condiciones adecuadas de confort y privacidad con un tiempo de duración de 20 minutos.

Plan de procesamiento y análisis de datos

Se recopiló la información de los cuestionarios en un formulario de recolecci&oacut= e;n de datos. Estos se organizaron en tablas de distribución de frecuenc= ias, empleando el programa estadístico SPSS, versión 22.0. Para la evaluación y el análisis de datos se utilizaron frecuencias y porcentajes, así como los estadígrafos Chi cuadrado (X2), con= su intervalo de confianza al 95%, para determinar la asociación de los trastornos del sueño y los factores de riesgo.

Aspectos bioético= s

La información qu= e se derivó de los métodos y técnicas fue utilizada con responsabilidad y se mantuvo confidencialidad de los datos relacionados al personal, los cuáles fueron utilizados por el investigador solo para= el presente estudio. A los participantes se les solicitó su consentimie= nto informado y se les comunicó los objetivos de la investigación= y que la misma no constituye riesgo para la salud física ni mental.

Resultados

Tabla 1. Características sociodemográficas y laborales de los 20 profesionales de salud<= /o:p>

Variables sociodemográficas	N	%
Sexo	Femenino	17	85
Masculino	3	15
Edad (años)	20 a 39	18	90
40 o más	2	10
Media	32,37
Desviación Estándar	5,89
Grado de instrucción	Secundaria	1	5
Bachiller	2	10
Universitario	17	85

Tabla 1. Características sociodemográficas y laborales de= los 20 profesionales de salud (continuación)

Variables sociodemográficas	N<= /span>	%<= /span>
Estado civil	Soltero(a)	11	55
Casado(a)	7	35
Divorciado(a)	2	10
Experiencia laboral	1 a 3 años	7	35
4 a 5 años	8	40
6 a 10 años	1	5
Más de 10 años	4	20
TOTALES	20	100

<= /o:p>

La tabla 1 muestra que en el estudio predominó el sexo femenino, menore= s de 40 años, con nivel universitario, casados y de poca experiencia labo= ral.

Tabla 2. Condiciones laborales referidas por los 20 profesionales de sa= lud

Condiciones laborale= s	Malas (1)=	Regulares (2)	Buenas (3)
N (%)	N (%)	N (%)
Relación con = otro personal de la salud	-<= /p>	2 (10)	18 (90)
Información q= ue recibe sobre su trabajo	-<= /p>	10 (50)	10 (50)
Relación con superiores	-<= /p>	9 (45)	11 (55)
Condiciones material= es	1 (5)	7 (35)	12 (60)
Equipami= ento	1 (5)	9 (45)	10 (50)

La tabla 2 indica un predominio de las buenas condiciones laborales.

Tabla 3. Trastornos del sueño de 20 profesionales de sal= ud, según la Escala de Somnol= encia de Epworth.

Trastorno del sueño<= /span>	N	%
Ninguno	1	5
Ligero	15	75
Moderado	2	10
Grave	2	10
Media de la Puntuación	8,80
Desviación Estándar=	5,67
Totales	20	100

<= /o:p>

La tabla 3 refleja que generalmente los trastornos del sueño fueron lig= eros en la población de estudio.

Tabla 4. Efectos del trabajo nocturno sobre 20 profesionales de salud

Efectos del trabajo nocturno	Nunca	Solo algunas veces	Algunas veces	Casi siempre	Siempre
N (%)	N (%)	N (%)	N (%)	N (%)
Trastornos gastrointestinales	1 (5)	4 (20)	11 (55)	3 (15)	1 (5)
Pérdida del ape= tito	8 (40)	5 (25)	4 (20)	2 (10)	1 (5)
Alteraciones del sueño	2 (10)	2 (10)	7 (35)	5 (25)	4 (20)
Trastornos nerviosos	3 (15)	5 (25)	8 (40)	4 (20)	-
Accidentes<= /span>	10 (50)	6 (30)	2 (10)	1 (5)	1 (5)
Insatisfacción con el trabajo	3 (15)	12 (60)	4 (20)	-	1 (5)
Empobrecimiento de las relaciones sociales y familiares<= /span>	5 (25)	8 (40)	4 (20)	2 (10)	1 (5)
Pérdida de amistades	8 (40)	6 (30)	3 (15)	2 (10)	1 (5)
Dificultad para disfrutar del ocio	1 (5)	11 (55)	4 (20)	3 (15)	1 (5)
Incremento del número de errores en el trabajo	4 (20)	9 (45)	5 (25)	1 (5)	1 (5)

Tabla 4. Efectos del trabajo nocturno sobre 20 profesionales de salud (continuación)

Efectos del trabajo nocturno	Nunca	Solo algunas veces	Algunas veces	Casi siempre	Siempre
N (%)	N (%)	N (%)	N (%)	N (%)
Reducción del rendimiento	7 (35)	5 (25)	7 (35)	-	1 (5)
Disminución de la capacidad de control	8 (40)	6 (30)	5 (25)	-	1 (5)
Ausentismo	11 (55)	4 (20)	2 (10)	2 (10)	1 (5)

Nota:= Formulario de Recolección de datos

En la tabla 4 se puede apreciar que el efecto más marcado del trabajo nocturno fue la alteración del sueño.

Para facilitar el análisis de las relaciones entre el trastorno del sueño con los factores de riesgo, se redujeron los parámetros= de las variables a dos categorías de la siguiente manera:

· Tenencia de pareja: SI y NO.

· Nivel de Instrucción: Universit= ario y (Secundaria / Bachiller)

· Experiencia Laboral: 1 a 5 años= y Más de 5 años.

· Condiciones laborales: MR (Malas / Regulares) y Buenas.

·= ; = Trastornos del sueño: NL (Ningu= no / Leve) y MG (Moderado / Grave).

Tabla 5. Relación entre los trastornos del sueño y los factores sociodemográficos, en 20 profesionales de salud.=

<= span style=3D'font-size:12.0pt;line-height:106%;font-family:"Times New Roman",= serif'>Factores de riesgo	Trastorno del sueño	Estadígrafos
Ninguno / Ligero	Moderado / Grave
Edad	N (%)	N (%)
20-39 años	14 (77,8)	4 (22,2)	p=3D0,456
40 años o más	2 (100)	0 (0)
Sexo	<= /o:p>	<= /o:p>		Masculino	3 (100)	0 (0)	p=3D0,348
Femenino	13 (76,5)	4 (23,5)
Tenencia de Pareja

Tabla 5. Relación entre los trastornos del sueño y los factores sociodemográficos, en 20 profesionales de salud. (continuación)

Factores de riesgo	Trastorno del sueño	Estadígrafos
Ninguno / Ligero	Moderado / Grave
Si	5 (71,4)<= /span>	2 (28,6)<= /span>	OR=3D 2,20 IC95 (0,237-20,396) p=3D0,264
No	11 (84,6)	2 (15,4)
Instrucción
Universitario=	13 (76,5)	4 (23,5)	p=3D0,348<= /p>
Secundaria / Bachiller	3 (100)	0 (0)
Experiencia Laboral<= /span>	<= /o:p>	<= /o:p>
1 a 5 años	11 (73,3)	4 (26,7)	p=3D0,197
Más de 5 años	5 (100)=	0 (0)
Totales	16 (80)	4 (20)

Nota<= /b> Formulario de Recolección de datos

En la tabla 5 se constató que, los factores sociodemográficos no mostraron relación significativa con la presencia de trastornos del sueño.

Tabla 6. Relación entre los trastornos del sueño y las condiciones laborales, en 20 profesionales de salud

<= span style=3D'font-size:12.0pt;line-height:106%;font-family:"Times New Roman",= serif'>Condiciones laborales

Trastorno del sueño

Estadígrafos<= /span>

Ninguno / Ligero

Moderado / Grave

Relación con otro person= al de la salud.

N (%)

N (%)

Malas / Regulares

2 (100)

0 (0)

p=3D0.456

Buenas

14 (77,8)

4 (22,2)

Información que recibe sobre su trabajo

Malas / Regulares

7 (70)<= /span>

3 (30)<= /span>

OR=3D 3.857

IC95 (0,326-45,57)

p=3D0,264<= /p>

Buenas

9 (90)<= /o:p>

1 (10)<= /o:p>

Relación con superiores=

Tabla 6. Relación entre los trastornos del sueño y las condiciones laborales, en 20 profesionales de salud (continuació= n)

Condiciones laborales

Trastorno del sueño

Estadígrafos

Ninguno / Ligero

Moderado / Grave

Malas / Regulares

7 (77,8)

2 (22,2)

OR=3D 1,286

IC95 (0,143-11,543)

p=3D0,822<= /p>

Buenas

9 (81,8)

2 (18,2)

Condiciones materiales

Malas / Regulares

5 (62,5)

3 (37,5)

OR=3D 6,60

IC95 (0,543-80,235)

p=3D0,11

Buenas

11 (91,7)

1 (8,3)

Equipamiento<= /p>

<= /o:p>

<= /o:p>

Malas / Regulares

7 (70)<= /span>

3 (30)<= /span>

OR=3D 3.857

IC95 (0,326-45,57)

p=3D0,264<= /p>

Buenas

9 (90)<= /o:p>

1 (10)<= /o:p>

Totales

16 (80)
4 (20)

Nota:= Formulario de Recolección de datos

En la tabla 6 se observa que, las condiciones laborales no mostraron relación significativa con la presencia de trastornos del sueñ= ;o.

Discus= ión

El estudio de los trastornos del sue&ntild= e;o en los profesionales de la salud, teniendo en cuenta variables relacionadas= con aspectos sociodemográficos y laborales, es importante a la hora de analizar la salud laboral de una entidad, ya que cuando se presentan alteraciones del sueño esto repercute en la actividad diaria del personal de la salud.

Estudios previos indican un predominio de sujetos femeninos, como una investigación brasileña, donde el 73,8% eran mujeres, en esto influye principalmente que mayormente el person= al de enfermería son mujeres (9). Predominaron los sujetos menores de 40 años, similar a lo reportado por Silva (10), además que refie= ren un 59,5% de su muestra menor de 40 años con un promedio de 40,2 años, ligeramente superior a lo encontrado en el presente estudio.

Los profesionales de la salud con sujetos = que por lo general muestran un nivel académico alto, de ahí los resultados en esta esfera. En relación con la tenencia de pareja, en= la investigación predominaron los sujetos sin pareja (65%), esto contra= dice lo reportado por otros estudios donde generalmente predominan individuos con pareja (11). En el grupo de estudio prevalecen los profesionales con 5 años o menos de experiencia, a diferencia de otras investigaciones d= onde la experiencia en el trabajo es mucho mayor, como otras del continente según expresan Caballero y Silva en su artículo.

Las relaciones con los superiores, la información que recibe sobre su trabajo las condiciones materiales y= el equipamiento deben mejorar, pues no todos los participantes están del todo satisfechos con éstas. Las referencias de los entrevistados ind= ican que en su mayoría tienen buenas relaciones entre ellos.

El porcentaje de entrevistados con afectación del sueño moderada o grave es el mismo porcentaje = que refirió alteraciones del sueño al aplicar la Escala de Epworth. Estos resultados son similares a los reporta= dos por un estudio murciano, donde el 16,7% de los funcionarios públicos estudiados presentaban este nivel de trastorno. También un estudio peruano donde el 17% de los profesionales salubristas presentaba estos trastornos para dormir según Caballero.

Otros estudios han mostrado resultados que difieren, en una investigación con 40 médicos guatemaltecos, = los autores reflejaron que el 47,5% de éstos mostraban alteraciones del sueño (12). Por otro lado, una mayor afectación se ha evidenc= iado en otras investigaciones, sobre todo en personal de la salud que enfrentó a la pandemia, donde los porcentajes de trastornos del sueño se elevaron a valores superiores al 50% en un estudio polaco (= 13), e incluso mayores como el 65,6% de los médicos con cambios en el sueño, refiriendo un 73,1% con mala calidad de este y un 80,8% con insomnio, en una investigación desarrollada en Brasil (14).

Los efectos del trabajo nocturno en estos profesionales de la salud, según refieren los mismos, no son muy marcados (ver tabla 4), el que predomina es la alteración del sueño, no así la ocurrencia de accidentes, errores en el trab= ajo, pérdida de control, reducción del rendimiento y ausentismo, Aunque puede haber cierto sesgo teniendo en cuenta que el trabajador pueda = no referirlos. Por otro lado, tampoco se han visto muy afectadas las relaciones personales en el trabajo y en la familia.

Ninguno de los factores analizados, reflej= aron relación significativa con la aparición de dificultades al dormir. Es bueno señalar que, todos los trabajadores están en= las mismas condiciones laborales de nocturnidad, lo que es un sesgo de la investigación ya que no se puede demostrar la influencia del trabajo= por turnos y nocturnos específicamente.

La edad se considera un factor que altera = los patrones de sueño y, por ende, su calidad. (15). Un estudio plantea = que, a mayor edad mayor aumenta la afectación, pero en este caso la población de estudio es principalmente menor de 40 años (16),= y no se apreció estadísticamente la diferencia. En el presente estudio, así como en otro estudio brasileño, a pesar del pred= ominio de mujeres, que pueden padecer trastornos del sueño debido a factores hormonales (17), no se constató incidencia significativa en alterar = el sueño.

Se plantea que las mujeres tienen menor calidad de sueño (18), y un mayor riesgo de tener trastornos en este sentido que los hombres (19). Las exigencias laborales y familiares a las q= ue se ven sometidas muchas mujeres pueden exponerlas a altos niveles de estrés y fatiga, favoreciendo el déficit de sueño.

Un estudio de especialistas cubanos realiz= ado en Brasil, reflejó que las mujeres tenían 1,41 veces mayor ri= esgo de sufrir insomnio en comparación con los hombres (10). Las causas la afectación del sueño en mujeres pueden ser múltiples, y van desde cambios hormonales, sedentarismo, nicturia, hasta la depresi&oacu= te;n (20).

La tenencia de pareja tampoco tuvo significación estadística, lo mismo ocurrió con el may= or nivel académico y una menor experiencia laboral. En cuanto a la vida= en familia con pareja pueda estar vinculado además con las responsabilidades del hogar, hijos, etc., como refiere un estudio brasile&n= tilde;o (21).

Por lo general los sujetos con mayor nivel académico asumen responsabilidades mayores de ahí que tengan mayor nivel de preocupaciones y estrés lo que pueda afectar el sueño. En el caso de los de menor experiencia laboral, están menos acostumbrados a este nivel de trabajo nocturno y los afecta más generalmente que a los más experimentados, pero reiteramos que la diferenciación no llegó a ser estadísticamente signifi= cativa.

El aspecto de las condiciones laborales mostró divergencias en los resultados, existió una mayor afectación del sueño en los profesionales más afectado= s. Los que tienen condiciones laborales y equipamiento no idóneo mostra= ron OR superiores a los que no tienen estos impedimentos, aunque no tuvo significación estadística por lo que se acotaba del tama&ntil= de;o de la muestra. También la información que recibe sobre su tra= bajo mostró un resultado similar. Todo esto indica que los trastornos del= sueño pueden tener un origen multifactorial y no dependen de un solo factor.

En el estudio hay algunas limitaciones que deben ser abordadas. Primeramente, el tamaño de la muestra có= mo se refería anteriormente impidió obtener resultados estadísticos fiables.

La escala de Somnolencia de Epworth es un método bastante subjetivo, por l= o que podría resultar útil emplear algunas pruebas objetivas actigrafía o la polisomno= grafía.

La elaboración de esta investigación sobre los trastornos del sueño asociados al tra= bajo nocturno es de gran utilidad ya q no existe mucha información ni estudios acerca de este tema en Ecuador, por lo que es poco conocido, con lo que se dará un gran aporte a la comunidad científica, ya que = se espera que con los resultados obtenidos se pueda tomar medidas preventivas y correctivas en este grupo de trabajadores de la salud.

Conclu= siones

·= ;      =    Los trastornos del sueño no son aspectos que afecten a los profesionales= de la salud de la Clínica Praxxel de la ciu= dad de Cuenca. A pesar de esto siempre se debe dar un seguimiento a los trabajador= es más afectados y estudiar los factores de riesgo que favorecen estos trastornos, aunque el origen parece ser multifactorial. <= /p>
·= ;      =    Las dificultades en las condiciones laborales de algunos participantes hacen que presenten trastornos del sueño, lo que unido al estrés laboral pueden afectar el funcionamiento de la entidad, además es importante saber que en el caso de haber sido un grupo muestral más amplio pudi= eran haber arrojado resultados estadísticamente significativos. En este estudio se tuvo un universo pequeño, no se tuvieron grupos para comp= arar y no se tomó en cuenta otros factores de riesgo importantes, como la tenencia de hijos, horas de trabajo diarias, padecimiento de enfermedades crónicas o tener responsabilidades administrativas importantes, que = en próximos estudios pudieran tenerse en cuenta.

Conflicto de intereses

Los autores declaran que no existe conflicto de intereses en relación co= n el artículo presentado.

Declaración de contribución de los autores

Los autores DCPS, JABS, y HGMA, contribuyeron en el desarrollo del articulo completo.

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El artículo que se publica es de exclusiva responsabilidad de los autores y no necesariamente reflejan el pensamiento = de la Revista Anatomía Digital= .

El artículo queda en propiedad d= e la revista y, por tanto, su publicación parcial y/o total en otro medio tiene que ser autorizado por el director de la Revista Anatomía Digital.

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<= span style=3D'font-size:12.0pt;line-height:106%;font-family:"Times New Roman",= serif'>Condiciones laborales	Trastorno del sueño	Estadígrafos<= /span>
Ninguno / Ligero	Moderado / Grave
Relación con otro person= al de la salud.	N (%)	N (%)
Malas / Regulares	2 (100)	0 (0)	p=3D0.456
Buenas	14 (77,8)	4 (22,2)
Información que recibe sobre su trabajo
Malas / Regulares	7 (70)<= /span>	3 (30)<= /span>	OR=3D 3.857 IC95 (0,326-45,57) p=3D0,264<= /p>
Buenas	9 (90)<= /o:p>	1 (10)<= /o:p>
Relación con superiores=

Condiciones laborales	Trastorno del sueño	Estadígrafos
Ninguno / Ligero	Moderado / Grave
Malas / Regulares	7 (77,8)	2 (22,2)	OR=3D 1,286 IC95 (0,143-11,543) p=3D0,822<= /p>
Buenas	9 (81,8)	2 (18,2)
Condiciones materiales
Malas / Regulares	5 (62,5)	3 (37,5)	OR=3D 6,60 IC95 (0,543-80,235) p=3D0,11
Buenas	11 (91,7)	1 (8,3)
Equipamiento<= /p>	<= /o:p>	<= /o:p>
Malas / Regulares	7 (70)<= /span>	3 (30)<= /span>	OR=3D 3.857 IC95 (0,326-45,57) p=3D0,264<= /p>
Buenas	9 (90)<= /o:p>	1 (10)<= /o:p>
Totales	16 (80)	4 (20)