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Title: The Impact of Shift Work on Sleep, Alertness and Performance in Healthcare Workers.
Austin Authors: Ganesan, Saranea;Magee, Michelle;Stone, Julia E;Mulhall, Megan D;Collins, Allison L ;Howard, Mark E ;Lockley, Steven W;Rajaratnam, Shantha M W;Sletten, Tracey L
Affiliation: Institute for Breathing and Sleep, Austin Health, Heidelberg, Victoria, Australia
Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia
Issue Date: 15-Mar-2019
Date: 2019-03-15
Publication information: Scientific Reports 2019; 9(1): 4635
Abstract: Shift work is associated with impaired alertness and performance due to sleep loss and circadian misalignment. This study examined sleep between shift types (day, evening, night), and alertness and performance during day and night shifts in 52 intensive care workers. Sleep and wake duration between shifts were evaluated using wrist actigraphs and diaries. Subjective sleepiness (Karolinska Sleepiness Scale, KSS) and Psychomotor Vigilance Test (PVT) performance were examined during day shift, and on the first and subsequent night shifts (3rd, 4th or 5th). Circadian phase was assessed using urinary 6-sulphatoxymelatonin rhythms. Sleep was most restricted between consecutive night shifts (5.74 ± 1.30 h), consecutive day shifts (5.83 ± 0.92 h) and between evening and day shifts (5.20 ± 0.90 h). KSS and PVT mean reaction times were higher at the end of the first and subsequent night shift compared to day shift, with KSS highest at the end of the first night. On nights, working during the circadian acrophase of the urinary melatonin rhythm led to poorer outcomes on the KSS and PVT. In rotating shift workers, early day shifts can be associated with similar sleep restriction to night shifts, particularly when scheduled immediately following an evening shift. Alertness and performance remain most impaired during night shifts given the lack of circadian adaptation to night work. Although healthcare workers perceive themselves to be less alert on the first night shift compared to subsequent night shifts, objective performance is equally impaired on subsequent nights.
DOI: 10.1038/s41598-019-40914-x
Journal: Scientific Reports
PubMed URL: 30874565
Type: Journal Article
Appears in Collections:Journal articles

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