306 Circadian activity rhythms and alertness among rapid-shift work female nurses

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A122-A122
Author(s):  
Xin Zhang ◽  
Shih-Yu Lee
Keyword(s):  
Reaction Time ◽  
Shift Work ◽  
Night Shift ◽  
Circadian Activity ◽  
Activity Rhythms ◽  
Saliva Cortisol ◽  
Before And After ◽  
Shift Rotation ◽  
Fatigue Severity ◽  
Rapid Shift

Abstract Introduction Circadian rhythms play an important role in regulating sleep. Sleep disturbances are prevalent in shift-work nurses, particularly for those work in rapid-shift rotation, including night shifts and day shifts. This study aimed to: 1) describe the characters of sleep-wake index (total sleep time [TST], wake after sleep onset [WASO], circadian activity rhythms [CAR]), psychomotor vigilance test (PVT), salivary cortisol, fatigue, and activity level during 8- and 12-hour rapid-shift work nurses; and 2) compare the parameters between two different shifts. Methods This exploratory study used registered nurses (RNs) from nine intensive care units in Beijing area. 7-days consecutive wrist actigraphy data, including TST and WASO were collected. Cosiner analysis was used for computing the CAR, including amplitude and mesor. PVT and saliva cortisol were used to assess alertness level, which measured before and after shift. Self-reported fatigue severity was measured by Lee Fatigue Scale-Short Form and assessed before and after shift. Results A total of 152 RNs (12-hour, n=82; 8-hour, n=70) participated this study, with a mean age of 31.81 (SD= 6.09). Compared with the 8-hour shift nurses, the 12-hour shift nurses were significantly higher in TST (456 vs. 364 minutes), median saliva cortisol level (before day shift, 0.54 vs. 0.31), and median PVT reaction time (before night shift). However, CAR were 0.53 (SD=0.13) and 0.50 (SD=0.18) for 12-hour and 8-hour shift RNs, respectively, and indicates desynchronized CAR in both groups. Regardless shift rotation, almost three-quarters of the RNs had a 500 ms PVT reaction time. For the 12-hour and 8-hour nurses, the level of activity during day shift was similar. However, during night shift work it was significantly lower in 12-hour nurses compared to the 8-hour nurses. All RNs experienced clinical significant fatigue severity (ranged 3.78 to 8.14) regardless before or after shift work; however, the 12-hour group reported lower fatigue severity than 8-hour group. Conclusion In this study, findings revealed shift-work RNs experienced fatigue and desynchronized CAR. The TST was low and reaction time was prolonged before and after shift work. Sleep intervention should be mandatorily included in clinical continue education. Support (if any) This project was supported by Chinese National Natural Science Foundation (71603279).

Circadian Activity Rhythms and Sleep in Nurses Working Fixed 8-hr Shifts

2014 ◽  
Vol 17 (3) ◽  
pp. 348-355 ◽  
Author(s):  
Jiunn-Horng Kang ◽  
Nae-Fang Miao ◽  
Ing-Jy Tseng ◽  
Trevor Sithole ◽  
Min-Huey Chung
Keyword(s):  
Shift Work ◽  
Night Shift ◽  
Circadian Activity ◽  
Subjective Sleep Quality ◽  
Shift Workers ◽  
Activity Rhythms ◽  
Time Frequency ◽  
Subjective Sleep ◽  
Adverse Health Outcomes ◽  
Evening Shift

Shift work is associated with adverse health outcomes. The aim of this study was to explore the effects of shift work on circadian activity rhythms (CARs) and objective and subjective sleep quality in nurses. Female day-shift ( n = 16), evening-shift ( n = 6), and night-shift ( n = 13) nurses wore a wrist actigraph to monitor the activity. We used cosinor analysis and time–frequency analysis to study CARs. Night-shift nurses exhibited the lowest values of circadian rhythm amplitude, acrophase, autocorrelation, and mean of the circadian relative power (CRP), whereas evening-shift workers exhibited the greatest standard deviation of the CRP among the three shift groups. That is, night-shift nurses had less robust CARs and evening-shift nurses had greater variations in CARs compared with nurses who worked other shifts. Our results highlight the importance of assessing CARs to prevent the adverse effects of shift work on nurses’ health.

Effects of sleepiness on clinical decision making among paramedic students: a simulated night shift study

2021 ◽  
pp. emermed-2019-209211
Author(s):  
Danielle Bartlett ◽  
Sara Hansen ◽  
Travis Cruickshank ◽  
Timothy Rankin ◽  
Pauline Zaenker ◽  
...  
Keyword(s):  
Decision Making ◽  
Reaction Time ◽  
Shift Work ◽  
Clinical Decision Making ◽  
Clinical Performance ◽  
Night Shift ◽  
Clinical Decision ◽  
Night Shift Work ◽  
Clinical Scenarios ◽  
Perceived Workload

ObjectiveParamedics are at the forefront of emergency healthcare. Quick and careful decision making is required to effectively care for their patients; however, excessive sleepiness has the potential to impact on clinical decision making. Studies investigating the effects of night shift work on sleepiness, cognitive function and clinical performance in the prehospital setting are limited. Here, we aimed to determine the extent to which sleepiness is experienced over the course of a simulation-based 13-hour night shift and how this impacts on clinical performance and reaction time.MethodsTwenty-four second year paramedic students undertook a 13-hour night shift simulation study in August 2017. The study consisted of 10 real-to-life clinical scenarios. Sleepiness, perceived workload and motivation were self-reported, and clinical performance graded for each scenario. Reaction time, visual attention and task switching were also evaluated following each block of two scenarios.ResultsThe accuracy of participants’ clinical decision making declined significantly over the 13-hour night shift simulation. This was accompanied by an increase in sleepiness and a steady decline in motivation. Participants performed significantly better on the cognitive flexibility task across the duration of the simulated night shift and no changes were observed on the reaction time task. Perceived workload varied across the course of the night.ConclusionOverall, increased sleepiness and decreased clinical decision making were noted towards the end of the 13-hour simulated night shift. It is unclear the extent to which these results are reflective of practising paramedics who have endured several years of night shift work, however, this could have serious implications for patient outcomes and warrants further investigation.

scholarly journals Association between Shift Work and Neurocognitive Function among Firefighters in South Korea: A Prospective before–after Study

2020 ◽  
Vol 17 (13) ◽  
pp. 4647 ◽  
Author(s):  
Kyeongmin Kwak ◽  
Bong-Kyu Kim ◽  
Tae-Won Jang ◽  
Chang Sun Sim ◽  
Yeon-Soon Ahn ◽  
...  
Keyword(s):  
South Korea ◽  
Shift Work ◽  
Verbal Memory ◽  
Visual Memory ◽  
Night Shift ◽  
Neurocognitive Function ◽  
Night Work ◽  
Motor Speed ◽  
Before And After ◽  
Fire Stations

Background: Recent research indicates that shift work is associated with neurocognitive function. However, studies that examine the association between shift work and neurocognitive function in firefighters have not yet been performed. We examined the effect of shift work on neurocognitive function in firefighters by measuring and comparing neurocognitive function before and after night shift. Methods: 352 firefighters from eight fire stations in South Korea were included in this study. We performed neurocognitive function test using central nervous system vital signs (CNSVS) during daytime work and on the next day after night work. We performed paired t-tests to assess differences between neurocognitive function before and after night work. We also compared neurocognitive function in insomnia and depression. We used a general linear model to analyze the associations between shiftwork schedule and the changes in neurocognitive function. Results: The neurocognitive function significantly decreased in six domains (composite memory, verbal memory, visual memory, complex attention, psychomotor speed, and motor speed) as did the neurocognitive index on the next day after night work compared with during day work. These decreased domains were the same following night work regardless of the type of shift work. Conclusion: Night work in firefighters may cause neurocognitive decline.

scholarly journals Sleep, fatigue, depression, and circadian activity rhythms in women with breast cancer before and after treatment: a 1-year longitudinal study

2014 ◽  
Vol 22 (9) ◽  
pp. 2535-2545 ◽  
Author(s):  
Sonia Ancoli-Israel ◽  
Lianqi Liu ◽  
Michelle Rissling ◽  
Loki Natarajan ◽  
Ariel B. Neikrug ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Longitudinal Study ◽  
Circadian Activity ◽  
Activity Rhythms ◽  
Before And After

scholarly journals O4A.2 Joint effects of night work and shift rotation on treated depression in a longitudinal cohort of manufacturing workers

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A32.2-A32
Author(s):  
Jacqueline Ferguson ◽  
Holly Elser ◽  
Sadie Costello ◽  
Mark Cullen ◽  
Ellen Eisen
Keyword(s):  
Shift Work ◽  
Proportional Hazards ◽  
Night Shift ◽  
Past Research ◽  
Cox Proportional Hazards ◽  
Night Work ◽  
First Episode ◽  
High Exposure ◽  
Joint Effects ◽  
Shift Rotation

Past research consistently identifies shift work – a type of scheduled work that includes both night work and schedule rotations – as risk factor for depression. However, relatively few studies have examined whether people working more nights or rotations are more likely to seek treatment for depression.A total of 5848 workers across 33 plants in the American Manufacturing Cohort (AMC) were followed 2003–2013. The first observed episode of treated depression was defined from insurance claims as two depression-related outpatient visits or two prescribed antidepressants within 365 days. Using detailed timeclock data, night work (≥3 hours between 23:00 and 6:00) was defined as the percent of shifts that included a night shift and was categorized into non-night work 0%; low >0%–30%; medium >30%–70%; and high 70%–100%. Shift rotations (≥6 hours between subsequent shift start times), were similarly defined and classified as none 0%, infrequent <10%, and frequent rotations≥10%. We examined the joint effects of night work and shift rotation on the time to first episode of treated depression using Cox proportional hazards regression.Shift workers were more likely to be treated for depression compared with non-rotating, non-night workers. Workers with medium exposure to night work had the highest association with treated depression compared with permanent non-night workers, and the joint effects were similar between those with frequent rotations (HR: 1.64, 95% CI: 1.00–2.67) and infrequent rotations (1.53, 0.99–2.37). Associations were slightly elevated among permanent night workers (1.27, 0.72–2.25) and workers with high exposure to night work regardless of rotations (1.36, 0.86–2.17).Recent shift work exposure may be associated with higher rates of treated depression, and night work, rather than rotation, may be driving the association. However, there may be selection out of night work due to underlying depression and we were unable to differentiate new-onset from preexisting disease.

scholarly journals Fatigue and circadian activity rhythms in breast cancer patients before and after chemotherapy: a controlled study

2013 ◽  
Vol 1 (1-2) ◽  
pp. 12-26 ◽  
Author(s):  
Lianqi Liu ◽  
Michelle Rissling ◽  
Ariel Neikrug ◽  
Lavinia Fiorentino ◽  
Loki Natarajan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
Controlled Study ◽  
Circadian Activity ◽  
Breast Cancer Patients ◽  
Activity Rhythms ◽  
Before And After

scholarly journals 0264 The Effects of Previous Night’s Sleep, 12-Hour Shift, and Workload on Sleepiness in Emergency Medical Service Providers

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A101-A101
Author(s):  
H Pavuluri ◽  
W M Schmidt ◽  
A Amalean ◽  
L Fowler
Keyword(s):  
Shift Work ◽  
Service Providers ◽  
Night Shift ◽  
Pupillary Response ◽  
Negative Effects ◽  
Previous Night ◽  
Emergency Medical ◽  
Before And After ◽  
Stanford Sleepiness Scale ◽  
Call Volume

Abstract Introduction Shift-work has been shown to be detrimental to workers in many ways, including having negative effects on sleep. Many factors related to shift-work can contribute to these negative effects, including increased workload and less sleep the previous night. The effects of shift-work on sleep have been studied extensively in nurses and physicians, but this research is lacking in paramedics and emergency medical technicians (EMTs). This study assessed the effects of previous night’s sleep, day- versus night-shift, and workload on sleepiness in paramedics and EMTs. Methods Thirty-three EMTs and paramedics were tested before and after their 12-hour (either day- or night-) shift. Testing consisted of questions about previous night’s sleep, pupillometry to assess pupillary response for physiological sleepiness, and the Stanford Sleepiness Scale for subjective sleepiness. The number of calls made per shift was used to quantify workload/call volume. Results An analysis of variance assessed the effect of shift (day/night), previous night’s sleep, and workload on post-shift sleepiness. Pupillometry demonstrated that participants were sleepier after 12-hour shifts, but those who slept 8–9 hours the night before were less affected. Pupillary response indicated higher levels of sleepiness following the night-shift compared to the day-shift. This was contrary to perceived sleepiness, which was higher after the day-shift than the night-shift. Higher call volume resulted in a sleepier physiological response, and this effect was shown to be dependent upon the shift. Conclusion Performing shift-work results in increased sleepiness in workers, especially after a night shift. However, physiological sleepiness does not always correspond to perceived sleepiness. In addition, increased workload results in increased sleepiness, especially during the day shift. This highlights the importance of obtaining 8–9 hours of sleep before a 12-hour shift to protect against the effects of sleepiness on patient care and EMS workers themselves. Support This was funded in part by a UofSC Provost Grant.

Efficacy of bright light and sleep/darkness scheduling in alleviating circadian maladaptation to night work

2001 ◽  
Vol 281 (2) ◽  
pp. E384-E391 ◽  
Author(s):  
Todd S. Horowitz ◽  
Brian E. Cade ◽  
Jeremy M. Wolfe ◽  
Charles A. Czeisler
Keyword(s):  
Shift Work ◽  
Night Shift ◽  
Bright Light ◽  
Night Work ◽  
Sleep Episode ◽  
Work Related ◽  
Before And After ◽  
Dim Light ◽  
Night Shifts ◽  
Better Than

We tested the hypothesis that circadian adaptation to night work is best achieved by combining bright light during the night shift and scheduled sleep in darkness. Fifty-four subjects participated in a shift work simulation of 4 day and 3 night shifts followed by a 38-h constant routine (CR). Subjects received 2,500 lux ( Bright Light) or 150 lux ( Room Light) during night shifts and were scheduled to sleep (at home in darkened bedrooms) from 0800 to 1600 ( Fixed Sleep) or ad libitum ( Free Sleep). Dim light melatonin onset (DLMO) was measured before and after the night shifts. Both Fixed Sleepand Bright Light conditions significantly phase delayed DLMO. Treatments combined additively, with light leading to larger phase shifts. Free Sleep subjects who spontaneously adopted consistent sleep schedules adapted better than those who did not. Neither properly timed bright light nor fixed sleep schedules were consistently sufficient to shift the melatonin rhythm completely into the sleep episode. Scheduling of sleep/darkness should play a major role in prescriptions for overcoming shift work-related phase misalignment.

scholarly journals All night long: an assessment of the cognitive effects of night shift work in anaesthesiology trainees

2020 ◽  
pp. 287-292
Author(s):  
TP Adams ◽  
S Venter
Keyword(s):  
Reaction Time ◽  
Shift Work ◽  
Medical Training ◽  
Statistical Significance ◽  
Night Shift ◽  
Cognitive Test ◽  
Related Factors ◽  
Cognitive Domains ◽  
South African Society ◽  
Work Related

Background: Excessive working hours and fatigue in medical training are a source of concern. Practitioner fatigue manifests itself in both risks to the patient and the medical trainee. This study aimed to quantify the effect of shift work on multiple cognitive function domains in anaesthesiology trainees at Tygerberg Academic Hospital. Secondary outcomes were to identify strategies to ameliorate shift work-related fatigue. Methods: An analytical observational study was conducted using mixed methods. The participants, anaesthesiology registrars and medical officers, completed an electronic cognitive test battery consisting of four tests, and a paper-based questionnaire prior to and following a 14-hour night shift. Results: Twenty-nine participants engaged in the study; including 14 males and 15 females with an age range 29–58 years. The study demonstrated a statistically significant impairment in reaction time in two of the four cognitive domains tested, ranging from 13.4–17.8%. No statistically significant change in accuracy was seen in any of the cognitive tests. A subjective increase in fatigue was also demonstrated using the Karolinska Sleepiness Scale. Further, no statistically significant correlation was found between the decline in reaction time and the individual and work-related factors which were assessed in the paper-based questionnaires. Conclusion: Fatigue in anaesthesiology trainees after a 14-hour night shift results in a decline in reaction time in the cognitive domains of psychomotor function and attention. Accuracy, however, remained unchanged. The study was unable to identify strategies which ameliorated these effects with statistical significance. Nevertheless, the recommendations and guidelines of various anaesthesiology bodies, including the South African Society of Anaesthesiologists, are supported. Further studies using a larger and more diverse study population are suggested.

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