scholarly journals Sleep inertia in physicians working on‐call night shifts

2019 ◽  
Vol 28 (S1) ◽  
Author(s):  
I Amirian ◽  
AK Danielsen ◽  
J Rosenberg

It is well known that sleep deprivation induces fatigue and that fatigue induces impaired cognition. Studies have demonstrated that long work hours, restricted sleep, time pressure and high demands may cause impaired performance in physicians. Some studies have shown through laparoscopic simulation that surgeons, when deprived of sleep, take longer to perform the procedure, make more unnecessary movements with their instruments and significantly more mistakes. Surgeons with an opportunity for sleep of less than 6 hours on the previous on-call night shift had an 83% increase in risk of postoperative complications when working the following day.


Author(s):  
Tim Raine ◽  
George Collins ◽  
Catriona Hall ◽  
Nina Hjelde ◽  
James Dawson ◽  
...  

This chapter discusses life on the wards. It includes the medical team, the multidisciplinary team, daily ward duties, ward rounds, being on-call, night shifts, writing and common symbols in the notes, anatomical terms and planes, discharge summaries (TTOs/TTAs), fitness to work notes, referrals, referral letters, investigation requests, radiology, common ward dilemmas, pain, thinking about death, palliative care, the dying patient, death, nutrition, nutritional requirements, difficult patients, aggression and violence, needle-stick injuries, surgery, pre-op assessment, bowel preparation, surgical terminology, preparing in-patients for surgery, booking theatre lists, surgical instruments, the operating theatre, post-op care, post-op problems, wound management, common elective operations, and stomas.


2004 ◽  
Vol 38 (suppl) ◽  
pp. 32-37 ◽  
Author(s):  
Hidemaro Takeyama ◽  
Shun Matsumoto ◽  
Kensaburo Murata ◽  
Takeshi Ebara ◽  
Tomohide Kubo ◽  
...  

OBJECTIVE: To examine the effects of the length and timing of nighttime naps on performance and physiological functions, an experimental study was carried out under simulated night shift schedules. METHODS: Six students were recruited for this study that was composed of 5 experiments. Each experiment involved 3 consecutive days with one night shift (22:00-8:00) followed by daytime sleep and night sleep. The experiments had 5 conditions in which the length and timing of naps were manipulated: 0:00-1:00 (E60), 0:00-2:00 (E120), 4:00-5:00 (L60), 4:00-6:00 (L120), and no nap (No-nap). During the night shifts, participants underwent performance tests. A questionnaire on subjective fatigue and a critical flicker fusion frequency test were administered after the performance tests. Heart rate variability and rectal temperature were recorded continuously during the experiments. Polysomnography was also recorded during the nap. RESULTS: Sleep latency was shorter and sleep efficiency was higher in the nap in L60 and L120 than that in E60 and E120. Slow wave sleep in the naps in E120 and L120 was longer than that in E60 and L60. The mean reaction time in L60 became longer after the nap, and faster in E60 and E120. Earlier naps serve to counteract the decrement in performance and physiological functions during night shifts. Performance was somewhat improved by taking a 2-hour nap later in the shift, but deteriorated after a one-hour nap. CONCLUSIONS: Naps in the latter half of the night shift were superior to earlier naps in terms of sleep quality. However performance declined after a 1-hour nap taken later in the night shift due to sleep inertia. This study suggests that appropriate timing of a short nap must be carefully considered, such as a 60-min nap during the night shift.


Author(s):  
D. V. Alpaev ◽  
V. V. Serikov ◽  
D. V. Sitovich ◽  
O. E. Chernov

Introduction. Work of locomotive crew members (engine drivers and engine driver assistants) in railway transport is associated with exposure to complex of occupational hazards including psychoemotional stress and shiftwork (with night shifts) along with noise and vibration.Objective. To study influence of shift work (with irregular alternation of day and night shifts) on biorhythms disturbances in locomotive crew workers.Materials and methods. Polls, simulators of occupational activities with training complex «Cabin of engine driver EP1M», daily monitoring of blood pressure, statistic data processing by SPSS–20 software.Results. Findings are that 953 locomotive crew workers (94%) experienced sensations of temporary disorientation, slight dizziness, sleepiness, interpreted as monotony and sensor deprivation. 61% of the examinees demonstrated frustration signs, in 30% of the cases there were certain manifestations of mental ill-being — irritability, fatigue, weariness, absent-mindedness, anxiety; 27.2% of the testees experiences various sleep disorders; 13.8% of the workers complained of «light sleep», 2% of those — restless sleep, 0.6% — sleeplessness. In occupationally related biorhythms disturbance, the body undergoes occupational adaptation, with partial transformation for atypical schedule of sleep and wakefulness.Results. To preserve health, efforts should be aimed at adaptation to shifted occupational activities with safe adaptogenic medications, low-caloric diet for individuals working at irregular shifts, create conditions for adequate physical activity of the workers between shifts. Necessities also are individual norms for blood pressure parameters in engine drivers with night shiftwork, specification of antihypertensive treatment for patients with irregular shifted work.


2017 ◽  
Author(s):  
Team DFTB
Keyword(s):  

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A201-A202
Author(s):  
Kristina Puzino ◽  
Susan Calhoun ◽  
Allison Harvey ◽  
Julio Fernandez-Mendoza

Abstract Introduction The Sleep Inertia Questionnaire (SIQ) was developed and validated in patients with mood disorders to evaluate difficulties with becoming fully awake after nighttime sleep or daytime naps in a multidimensional manner. However, few data are available regarding its psychometric properties in clinical samples with sleep disorders. Methods 211 patients (43.0±16.4 years old, 68% female, 17% minority) evaluated at the Behavioral Sleep Medicine (BSM) program of Penn State Health Sleep Research & Treatment Center completed the SIQ. All patients were diagnosed using ICSD-3 criteria, with 111 receiving a diagnosis of chronic insomnia disorder (CID), 48 of a central disorder of hypersomnolence (CDH), and 52 of other sleep disorders (OSD). Structural equation modelling was used to conduct confirmatory factor analysis (CFA) of the SIQ. Results CFA supported four SIQ dimensions of “physiological”, “cognitive”, “emotional” and “response to” (RSI) sleep inertia with adequate goodness-of-fit (TLI=0.90, CFI=0.91, GFI=0.85, RMSEA=0.08). Internal consistency was high (α=0.94), including that of its dimensions (physiological α=0.89, cognitive α=0.94, emotional α=0.67, RSI α=0.78). Dimension inter-correlations were moderate to high (r=0.42–0.93, p<0.01), indicating good construct validity. Convergent validity showed moderate correlations with Epworth sleepiness scale (ESS) scores (r=0.38) and large correlations with Flinders fatigue scale (FFS) scores (r=0.65). Criterion validity showed significantly (p<0.01) higher scores in subjects with CDH (69.0±16.6) as compared to those with CID (54.4±18.3) or OSD (58.5±20.0). A SIQ cut-off score ≥57.5 provided a sensitivity/specificity of 0.77/0.65, while a cut-off score ≥61.5 provided a sensitivity/specificity of 0.71/0.70 to identify CDH vs. ESS<10 (AUC=0.76). Conclusion The SIQ shows satisfactory indices of reliability and construct validity in a clinically-diverse sleep disorders sample. Its criterion validity is supported by its divergent association with hypersomnia vs. insomnia disorders, as well as its adequate sensitivity/specificity to identify patients with CDH. The SIQ can help clinicians easily assess the complex dimensionality of sleep inertia and target behavioral sleep treatments. Future studies should confirm the best SIQ cut-off score by including good sleeping controls, while clinical studies should determine its minimal clinically important difference after pharmacological or behavioral treatments. Support (if any):


Author(s):  
Tomohide Kubo ◽  
Shun Matsumoto ◽  
Takeshi Sasaki ◽  
Hiroki Ikeda ◽  
Shuhei Izawa ◽  
...  

Abstract Purpose We aimed to cross-sectionally investigate how work and sleep conditions could be associated with excessive fatigue symptoms as an early sign of Karoshi (overwork-related cerebrovascular and cardiovascular diseases; CCVDs). Methods We distributed a questionnaire regarding work, sleep, and excessive fatigue symptoms to 5410 truck drivers, as the riskiest occupation for overwork-related CCVDs, and collected 1992 total samples (response rate: 36.8%). The research team collected 1564 investigation reports required for compensation for Karoshi. Of them, 190 reports listed the prodromes of Karoshi, which were used to develop the new excessive fatigue symptoms inventory. Results One-way analyses of variance showed that the excessive fatigue symptoms differed significantly by monthly overtime hours (p < 0.001), daily working time (p < 0.001), work schedule (p = 0.025), waiting time on-site (p = 0.049), number of night shifts (p = 0.011), and sleep duration on workdays (p < 0.001). Multivariate mixed-model regression analyses revealed shorter sleep duration as the most effective parameter for predicting excessive fatigue symptoms. Multiple logistic regression analysis confirmed that the occurrences of CCVDs were significantly higher in the middle [adjusted ORs = 3.56 (1.28–9.94)] and high-score groups [3.55 (1.24–10.21)] than in the low-score group. Conclusion The findings suggested that shorter sleep duration was associated more closely with a marked increase in fatigue, as compared with the other work and sleep factors. Hence, ensuring sleep opportunities could be targeted for reducing the potential risks of Karoshi among truck drivers.


2021 ◽  
Vol 11 (1) ◽  
pp. 111
Author(s):  
Farzad V. Farahani ◽  
Magdalena Fafrowicz ◽  
Waldemar Karwowski ◽  
Bartosz Bohaterewicz ◽  
Anna Maria Sobczak ◽  
...  

Significant differences exist in human brain functions affected by time of day and by people’s diurnal preferences (chronotypes) that are rarely considered in brain studies. In the current study, using network neuroscience and resting-state functional MRI (rs-fMRI) data, we examined the effect of both time of day and the individual’s chronotype on whole-brain network organization. In this regard, 62 participants (39 women; mean age: 23.97 ± 3.26 years; half morning- versus half evening-type) were scanned about 1 and 10 h after wake-up time for morning and evening sessions, respectively. We found evidence for a time-of-day effect on connectivity profiles but not for the effect of chronotype. Compared with the morning session, we found relatively higher small-worldness (an index that represents more efficient network organization) in the evening session, which suggests the dominance of sleep inertia over the circadian and homeostatic processes in the first hours after waking. Furthermore, local graph measures were changed, predominantly across the left hemisphere, in areas such as the precentral gyrus, putamen, inferior frontal gyrus (orbital part), inferior temporal gyrus, as well as the bilateral cerebellum. These findings show the variability of the functional neural network architecture during the day and improve our understanding of the role of time of day in resting-state functional networks.


2021 ◽  
pp. 074873042110060
Author(s):  
Dorothee Fischer ◽  
Till Roenneberg ◽  
Céline Vetter

The study aimed to explore chronotype-specific effects of two versus four consecutive morning or night shifts on sleep-wake behavior. Sleep debt and social jetlag (a behavioral proxy of circadian misalignment) were estimated from sleep diary data collected for 5 weeks in a within-subject field study of 30 rotating night shift workers (29.9 ± 7.3 years, 60% female). Mixed models were used to examine whether effects of shift sequence length on sleep are dependent on chronotype, testing the interaction between sequence length (two vs. four) and chronotype (determined from sleep diaries). Analyses of two versus four morning shifts showed no significant interaction effects with chronotype. In contrast, increasing the number of night shifts from two to four increased sleep debt in early chronotypes, but decreased sleep debt in late types, with no change in intermediate ones. In early types, the higher sleep debt was due to accumulated sleep loss over four night shifts. In late types, sleep duration did not increase over the course of four night shifts, so that adaptation is unlikely to explain the observed lower sleep debt. Late types instead had increased sleep debt after two night shifts, which was carried over from two preceding morning shifts in this schedule. Including naps did not change the findings. Social jetlag was unaffected by the number of consecutive night shifts. Our results suggest that consecutive night shifts should be limited in early types. For other chronotypes, working four night shifts might be a beneficial alternative to working two morning and two night shifts. Studies should record shift sequences in rotating schedules.


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