Short sleep duration among Thai nurses: Influences on fatigue, daytime sleepiness, and occupational errors

Sleep Deprivation and Fatigue among Nurses Working Consecutive Night Shifts: A Prospective Observational Study

PURPOSE

This study aimed to identify changes in sleep patterns and fatigue levels during consecutive night shifts among shift nurses and to determine the association between sleep parameters and increased fatigue levels during work.

METHODS

This prospective observational study employing ecological momentary assessments was conducted using data collected from 98 shift nurses working in Korean hospitals between June 2019 and February 2021. The sleep patterns were recorded using actigraphy. The participants reported their fatigue levels at the beginning and end of each night shift in real time via a mobile link. Linear mixed models were used for the analysis.

RESULTS

Nurses spent significantly less time in bed and had shorter sleep durations during consecutive night shifts than on off-duty days, whereas their wake times after sleep onset were much longer on off-duty days than on on-duty days. Fatigue levels were higher on the second and third night-shift days than on the first night-shift days. A shorter time spent in bed and asleep was associated with a greater increase in fatigue levels at the end of the shift than at the beginning.

CONCLUSION

Nurses experience significant sleep deprivation during consecutive night shifts compared with off-duty days, and this sleep shortage is associated with a considerable increase in fatigue levels at the end of shifts. Nurse managers and administrators must ensure sufficient intershift recovery time during consecutive night shifts to increase the time spent in bed and sleeping.

Exposure to needle stick injuries among health care workers in hemodialysis units in the southwest of Iran: a cross-sectional study

BACKGROUND

Needle stick injury (NSI) is the most common cause of infection with blood-borne pathogens (BBP) among healthcare workers (HCWs). This study aimed to assess the prevalence of NSI and it's contributing factors among HCWs of hemodialysis (HD) units in southwest Iran.

METHODS

A cross-sectional study was performed in 13 HD centers in Shiraz, Iran. A total of 122 employees were enrolled in our study. We used self-administrated questionnaires to collect data about demographics, experiences regarding NSIs, and general health status. The statistical tests used in this study were Chi-square and Independent T-test. A P-value < 0.05 is considered significant.

RESULTS

The mean age of the study population was 36.1 ± 7.8 years (72.1%: women). Exposure to NSIs was reported by 23.0% of them at least once during the previous six months. NSI prevalence was significantly higher among those with higher age (p = 0.033), work experience > 10 years (p = 0.040), and those who graduated earlier (p = 0.031). The intravenous injection was the most common procedure leading to NSI, and being in a hurry was the most common cause. The average general health was 3.7 ± 3.2, higher among those not exposed to NSI (p = 0.042).

CONCLUSION

NSI is a prevalent hazard in HCWs of HD units. The high rate of NSI and unreported cases, besides the lack of adequate information, indicates the necessity of implementing protocols and strategies for improving the safety of this personnel. It is difficult to compare the result of this study with those performed among HCWs in other settings; hence, further studies are needed to determine whether HCWs of these units are more exposed to NSIs.

Physical activity, sedentary behaviour, and sleep in the Thai population: A compositional data analysis including 135,824 participants from two national time-use surveys

PURPOSE

To determine the amounts of time spent in physical activity (PA), sedentary behaviour (SB), and sleep in the Thai population, as well as their sociodemographic correlates and changes over time.

METHODS

We analysed cross-sectional data collected in a population-representative, stratified random sample of 135,824 Thais aged 10 years and over as part of the two most recent Thai National time-use surveys (2009 and 2015). Daily activities reported by the participants were coded using the International Classification of Activities for Time-Use Statistics (ICATUS) and categorised as PA, SB, or sleep.

RESULTS

In the latest survey, participants spent on average the largest amount of time sleeping (geometric mean [g] = 9.44 h/day; 95% confidence interval [CI]: 9.42, 9.47), followed by PA (g = 8.60 h/day; 95% CI: 8.55, 8.64) and SB (g = 5.96 h/day; 95% CI: 5.93, 6.00). The time spent in PA was higher on weekdays, while the amounts of SB and sleep were higher on weekends (p < 0.05). Males, older age groups, and unemployed people spent less time in PA and more time in SB, compared with other population groups (p < 0.05). We found a relatively large increase in SB (mean difference [d] = 39.64 min/day; 95% CI: 36.18, 42.98) and decrease in PA (d = 54.33 min/day; 95% CI: -58.88, -49.30) over time. These findings were consistent across most sociodemographic groups, with the most concerning shifts from active to sedentary lifestyle found among people with a higher education degree and on weekends.

CONCLUSIONS

Our findings revealed a shift to a more sedentary lifestyle in the Thai population. Public health interventions should focus on improving time use among males, older age groups, and unemployed people, while preventing the rapid decrease in PA and increase in SB among those with a higher education degree and on weekends.

Physical and mental fatigue in post-COVID syndrome and their associations over time: A small-sample ESM-study to explore fatigue, quality of sleep and behaviours

OBJECTIVE

Post-COVID syndrome leaves millions of people with severe fatigue, yet little is known about its nature in daily life. In this exploratory study, momentary associations between physical and mental fatigue, quality of sleep and behaviours over two weeks in patients with post-COVID syndrome were assessed.

METHOD

Data on fatigue levels, quality of sleep and behaviours was collected for 14 consecutive days using the experience sampling method in ten ex-hospitalised patients with post-COVID syndrome.

RESULTS

Multilevel linear regression modelling showed strong associations between physical and mental fatigue (β = 0.61, p ≤0.001), significant both between and within individuals. Sleeping more hours at night was associated with less physical and mental fatigue the following day (β = -0.35, p = .001; β = -0.27, p = .008). Strenuous relaxation (B = 0.45, p ≤0.001; B = 0.28, p = .004) and social contacts (B = -0.33, p = .003; B = -0.22, p = .02) were associated with physical and mental fatigue at the same measurement point. Performing household chores decreased physical and mental fatigue (B = -0.29, p = .02; B = -0.30, p = .006) two hours later on the same day, whereas eating and drinking increased physical fatigue (B = 0.20, p = .05) two hours later on the same day.

CONCLUSION

Physical fatigue and mental fatigue were strongly associated and revealed fluctuations in fatigue levels between individuals, which might suggest potentially different post-COVID subgroups. Indications for potential risk and beneficial behaviours for fatigue were found.

Salivary Biomarker Profiles and Chronic Fatigue among Nurses Working Rotation Shifts: An Exploratory Pilot Study

Although nurses’ fatigue affects their well-being and patient safety, no effective objective measurements exist. We explored the profiles of salivary biomarkers associated with nurses’ chronic fatigue across several shifts. This longitudinal study involved 45 shiftwork nurses and collected their saliva samples before two night and two day shifts for a month. Chronic fatigue was measured using the Cumulative Fatigue Symptom Index before the first night shift. Biomarker profiles were analyzed using hierarchical cluster analysis, and chronic fatigue levels were compared between the profiles. Cortisol profiles were classified into high- and low-level groups across two day shifts; the low-level group presented significantly higher irritability and unwillingness to work. Secretory immunoglobulin A (s-IgA) profiles across the four shifts were classified into high- and low-level groups; the high-level group had significantly higher depressive feelings, decreased vitality, irritability, and unwillingness to work. Cortisol (two day shifts) and s-IgA (four shifts) profiles were combined, and (i) cortisol low-level and s-IgA high-level and (ii) cortisol high-level and s-IgA low-level groups were identified. The former group had significantly higher chronic fatigue sign and irritability than the latter group. The profiles of salivary cortisol and s-IgA across several shifts were associated with nurses’ chronic fatigue.

Unique and cumulative effects of lifestyle-related behaviors on depressive symptoms among Chinese adolescents

BACKGROUND

It is well known that some lifestyle-related behaviors are related to depressive symptoms, but the unique and cumulative effects of lifestyle-related behaviors on depressive symptoms among Chinese adolescents are still controversial.

AIMS

The aims of this study were to examine the unique and cumulative effects of lifestyle-related behaviors on depressive symptoms among Chinese adolescents, and explored the potential influences of gender difference on these associations.

METHODS

We conducted a cross-sectional study among 3967 Chinese adolescents aged 11 to 19 from Jilin, China during September and October of 2018. Students reported their lifestyle factors including sleep duration, time spent on computer, time spent on television, time spent on homework, eating breakfast, smoking, drinking, physical activity, and outdoor activity. Depressive symptoms were measured using the Center for Epidemiologic Studies Depression Scale (CES-D).

RESULTS

The prevalence of depressive symptoms was 28.2% among Chinese adolescents. Multivariate logistic regression analysis revealed that sleep duration <8 hour/day, time spent on homework ⩾3 hour/day, skipping breakfast, alcohol use, physical activity <3 days/week, and outdoor activity <2 hour/day were positively associated with depressive symptoms in both girls and boys. Time spent on computer ⩾2 hour/day was an independent risk predictor for depressive symptoms in males, while smoking only showed higher risk of depressive symptoms in females. There was an additive relationship between the lifestyle risk index scores and the risk of depressive symptoms for both genders, the relationship being strongest among females.

CONCLUSION

The important role of lifestyle factors should be taking into consideration when create intervention programs to prevent and reduce depressive symptoms among adolescents. In addition, preventive interventions may need to focus on gender-informed approaches when targeting multiple lifestyle factors.

Reiki for promotion of health and sleep quality in hospital nursing professionals

ABSTRACT Objectives: to know the repercussions of a Reiki therapy intervention on the sleep quality of nursing professionals working in a general hospital. Methods: a qualitative-quantitative study conducted with 16 professionals from the nursing team of a hospital in northwest Paraná, who participated in an intervention consisting of six weekly Reiki sessions. Data collected from September, 2019 to March, 2020 through semi-structured interviews and application of the Pittsburgh Sleep Quality Index before and after the intervention. Results: better sleep quality, characterized by a reduction in the time to fall asleep and in nightmares, and an increase in sleeping hours. Conclusions: reiki intervention had a positive impact on the sleep quality of participants.

Reiki para promoção da saúde e qualidade do sono em profissionais de enfermagem de hospital

RESUMO Objetivos: conhecer as repercussões de intervenção com sessões de reiki na qualidade do sono de profissionais de enfermagem atuantes em um hospital geral. Métodos: estudo de abordagem quali-quantitativa realizado com 16 profissionais da equipe de enfermagem de um hospital no noroeste do Paraná que participaram de uma intervenção constituída por seis sessões semanais de reiki. Dados coletados de setembro/2019 a março/2020, mediante entrevista semiestruturada e aplicação do Índice de Qualidade do Sono de Pittsburgh antes e após o término da intervenção. Resultados: melhora na qualidade do sono, caracterizada por redução do tempo para adormecer e dos pesadelos e aumento nas horas dormidas. Conclusões: a intervenção com reiki repercutiu de forma positiva sobre a qualidade do sono das participantes.

Effect of occupation on sleep duration among daytime Japanese workers: A cross-sectional study

Occupation is one of the factors contributing to the loss of sleep. Although many studies have investigated sleep loss due to irregular and nighttime shifts, the causes of sleep loss in daytime workers remain unknown. The aims of the present study were to determine whether occupation is a dependent factor for sleep duration and whether working status and lifestyle are related to sleep duration.We examined the health check results of 17,519 (9028 men and 8491 women) workers who had at least 1 health check between the fiscal years 2013 and 2019. We asked about the workers' occupation, bedtime, dinner time, overtime work, and commuting time, using a self-administered questionnaire at their health check. The occupations were classified into 4 categories: high white-collar, low white-collar, pink-collar, and blue-collar. We conducted a linear regression model and analysis of covariance to investigate the effect of occupation on sleep duration.As a result of linear regression analysis, bedtime, overtime work and occupation were significantly associated with decreased sleep duration in males, and bedtime, age, and occupation were significantly associated with decreased sleep duration in females. Analysis of covariance revealed that both male and female blue-collar tended to sleep for significantly shorter durations than those in the other occupations.The results of the current study indicate that sleep duration is affected by occupation. When determining the cause of loss of sleep, medical personnel should consider their patient's lifestyles and how they have been affected by their occupation.

Work schedule characteristics and occupational fatigue/recovery among rotating-shift nurses: A cross-sectional study

AIMS

To determine the effects of work schedule characteristics on occupational fatigue and recovery among rotating-shift nurses in South Korea.

BACKGROUND

Understanding the effects of work schedule characteristics on occupational fatigue is important to prevent adverse nurse outcomes and to ensure patient safety.

METHODS

This study used secondary data analysis with a cross-sectional design. Data were collected on 436 rotating-shift nurses in 2018. Nurses' occupational fatigue and recovery were measured using the Occupational Fatigue Exhaustion/Recovery Scale. We used quantile regression models.

RESULTS

The scores for acute and chronic fatigue and intershift recovery were 70.40, 73.39, and 29.82, respectively. Overtime hours, number of night shifts, number of consecutive days off, and breaks were significant influential factors in some quantiles of acute fatigue, chronic fatigue, and intershift recovery, while total working hours was only associated with chronic fatigue in the 25th quantile.

CONCLUSIONS

The quantile and linear regression models revealed different results for work schedule factors that affect occupational fatigue and intershift recovery among rotating-shift nurses.

IMPLICATION FOR NURSING MANAGEMENT

These findings have important implications for developing targeted strategies and policies to reduce occupational fatigue and improve intershift recovery for rotating-shift nurses with different levels of occupational fatigue and recovery.

Associations between health indicators and sleep duration of American adults: NHANES 2011-16

BACKGROUND

This study aimed to investigate associations between health indicators and sleep duration in the general population.

METHODS

This cross-sectional data from the National Health and Nutrition Examination Survey. Self-reported sleep duration was classified into short sleep (<7 h/day), regular sleep (7-8 h/day) and long sleep duration (>8 h/day). Health indicators included lifestyle indicators (smoking, alcohol use and physical inactivity), general health indicators (waist circumference and self-reported health condition) and chronic conditions [overweight/obesity, hypertension, diabetes, high cholesterol, chronic low back pain (CLBP) and oral health problems]. A series of multinomial logistic regression analysis were performed, controlling for confounders (age, sex, marital status, ethnic background, education level and poverty-to-income ratio).

RESULTS

Data of 12 835 participants were analyzed. The mean (SD) age of participants was 50.0 (±17.4) years, and 50.6% were women. After adjusting for all health indicators, current smoking (OR: 1.37; 95% CI: 1.17-1.61), a poor (OR: 1.52; 95% CI: 1.23-1.88) health condition, CLBP (OR: 1.40; 95% CI: 1.16-1.69) and oral health problems (OR: 1.28; 95% CI: 1.10-1.49) were associated with short sleep duration. No independent association with long sleep duration was observed in this study.

CONCLUSIONS

The results confirm that lifestyle indicators (current smoking and physical inactivity), general health indicators (self-reported health condition) and presence of some chronic conditions (CLBP and oral health problems) are associated with short sleep duration. The results did not confirm that any health indicator was associated with long sleep duration.

Sleep, fatigue and alertness during working hours among rotating-shift nurses in Korea: An observational study

AIMS

To determine the effects of sleep parameters and fatigue on the decline in alertness of nurses across shifts.

BACKGROUND

Shift work can lead to nurse fatigue owing to insufficient sleep and inadequate recovery time between shifts. Nurse fatigue has adverse effects on alertness and can affect provision of quality care.

METHODS

An observational study using wrist actigraphs was conducted from 2019 to 2020. Participants were 82 rotating-shift nurses who provided direct nursing care in acute hospitals in South Korea. They wore actigraphs for 14 days to measure sleep parameters and predict hourly alertness and reported subjective fatigue before and after every shift.

RESULTS

Nurses demonstrated shorter sleep hours, lower sleep efficiency and longer sleep latency before night shifts compared with other shifts. Fatigue was the highest before day shifts. Sleep parameters and fatigue significantly affected the steep decline in alertness in participants with alertness scores below 70.

CONCLUSIONS

Sleep parameters and fatigue level contributed to the differences in decline in alertness across shifts.

IMPLICATION FOR NURSING MANAGEMENT

Findings inform nurse managers, administrators to develop interventions to reduce fatigue, improve sleep quantity and quality and increase alertness among rotating-shift nurses. Management, institutional and individual factors should be considered when developing interventions.

Effect of Sleep Quality and Depression on Married Female Nurses' Work-Family Conflict

Married female nurses experience work–family conflict (WFC) as they manage excessive work and various working-hour types while rearing children and tending household chores, and as a result, they continuously constantly deliberate over quitting their job or moving to a different workplace. Married nurses were found to have shorter sleep duration and sleep latency compared to single nurses, and high job stress not only hinders their family life but also causes sleep problems. Depression is a classic negative emotion experienced by married working women who must manage both work and family. This study aims to examine WFC in married female nurses and investigate its predictors, namely depression and sleep quality. A total of 229 married female nurses completed a Google questionnaire link consisting of the Work–Family Conflict Scale, Sleep-Quality Scale, and the Center for Epidemiologic Studies Depression Scale (CES-D). Data were analyzed by descriptive statistics, t-test, ANOVA, LSD post hoc test, Pearson’s correlation coefficients, and multiple regression using the SPSS/WIN 26.0 program. The average WFC score was 4.84 ± 1.12 (range 1–7); WFC showed a statistical difference according to a stage of the lifecycle (F = 7.12, p = 0.001) and perceived health (F = 12.01, p < 0.001). WFC was low among those in the non-parenthood stage of the lifecycle (β = −0.26, p < 0.001), those with good (β = −0.18, p = 0.011) or moderate perceived health (β = −0.15, p = 0.023), and those without turnover intention (β = −0.13, p = 0.016). On the other hand, WFC was high among those who were extremely dissatisfied with their job (β = 0.16, p = 0.008) and those who had a high level of depression (β = 0.22, p = 0.002); these variables explained 20.2% of WFC (F = 7.663, p < 0.001). Based on these results, subsequent studies should develop and implement coping programs that help reduce WFC and improve depression and sleep quality in married female nurses.

Fatigue is associated with depression independent of excessive daytime sleepiness in the general population

PURPOSE

This study aimed to investigate sleep problems and comorbid conditions associated with fatigue in the general population.

METHODS

The data were obtained from a nationwide cross-sectional survey conducted in 2018. The Fatigue Severity Scale was used to assess fatigue. We examined sleep habits, such as workday sleep duration, chronotype, and free-day catch-up sleep, excessive daytime sleepiness (EDS), depression, and other comorbid conditions. We conducted multiple logistic regression analysis with the presence of fatigue as a dependent variable.

RESULTS

Of 2,493 adults aged 19 to 92 years, 50% men, mean age was 47.9 ± 16.4 years. The average workday sleep duration was 7.1 ± 1.1 h, and the prevalence of fatigue was 31%. After adjusting for potential confounders, fatigue was associated with EDS (odds ratio [OR] 3.751, 95% confidence interval [CI] 2.928-4.805), depression (OR 3.736, 95% CI 2.701-5.169), perceived insufficient sleep (OR 1.516, 95% CI 1.249-1.839), free-day catch-up sleep (OR 1.123, 95% CI 1.020-1.235), less alcohol intake (OR 0.570, 95% CI 0.432-0.752), and physical inactivity (OR 0.737, 95% CI 0.573-0.948). On subgroup analysis, fatigue was additionally associated with short workday sleep duration (OR 0.899, 95% CI 0.810-0.997) in individuals without EDS. However, among those with EDS, only depression (OR 2.842, 95% CI 1.511-5.343) and less alcohol intake (OR 0.476, 95% CI 0.247-0.915) were associated with fatigue.

CONCLUSION

Fatigue was significantly associated with depression independent of EDS. Further research is warranted to better understand the pathophysiological relationship between fatigue, depression, and sleep.

The Prevalence and Associated Factors of Short Sleep Duration Among Nurses in Tertiary Public Hospitals in China: Findings from a National Survey

Background

Sleep is an essential component of health and well-being. Short sleep duration may negatively affect nurses’ health and patients’ safety.

Objective

To investigate the sleep duration and subjective satisfaction with sleep duration among nurses in tertiary public hospitals in China and to explore the associated factors.

Methods

This cross-sectional study was conducted between December 18 and 31, 2017 in 136 major public hospitals from 31 provinces in mainland China. An online anonymous questionnaire was delivered through WeChat. Totally 27,575 nurses completed the survey.

Results

The response rate was 95.46%. The mean reported total sleep duration was 6.67±0.97 hours per day. About 46.87% (n=12,924) reported having short sleep duration (SSD, less than 7 hours per day), and 27.63% (n=7618) were not satisfied with their sleep duration. In the SSD group, 45.67% (n=5902) were dissatisfied with their sleep duration. SSD was significantly associated with sociodemographic factors, including an older age, having more than one child, being divorced or separated, and job-related factors, including longer working hours, more night shifts and heavy workload.

Conclusion

Nearly half of the nurses in the public hospitals in China reported sleeping less than 7 hours, and more than one quarter were dissatisfied with their sleep duration. Interventions are needed to improve Chinese nurses’ sleep, including reducing working hours, night shifts or workload.

Predictors of sleep disturbances in caregivers of patients with advanced cancer receiving home palliative care: A descriptive cross-sectional study

PURPOSE

To evaluate the quality of sleep in caregivers of patients with advanced cancer receiving home palliative care, basing the analysis on subjective and objective measures, and to develop a predictive model of sleep disturbances among this population.

METHOD

A descriptive cross-sectional study was conducted in six clinical management units within primary healthcare centres. Data were obtained during a period of six months, from a sample population of 41 caregivers. The Pittsburgh Sleep Quality Index (PSQI) and a 7-day accelerometry evaluation were performed to assess sleep quality. Daytime sleepiness, caregiver strain and quality of life were also evaluated.

RESULTS

According to the PSQI, 90.2% of participants had poor sleep quality. The average duration of night-time sleep, measured by accelerometry and the PSQI, was 6 h. Taking PSQI as the dependent variable, the study model predicted 40.7% of the variability (p < 0.01). The variables "Caregiver strain" and "Daily hours dedicated to care" produced the following results: B coefficient 0.645; p = 0.001; and B coefficient 0.230; p = 0.010, respectively.

CONCLUSIONS

The caregivers presented significant health-related alterations, including sleep disturbances, which were directly related to two variables: the index of caregiver strain and the number of hours per day dedicated to providing care.

Vigilance and sleepiness in nurses working 12-hr shifts and their coping strategies

AIM

To describe the progression of vigilance and sleepiness over the shift and the coping strategies of nurses working 12-hr day or night shifts.

BACKGROUND

The spread of 12-hr shift work in nursing raises the question of whether sufficient vigilance can be maintained to ensure quality of care.

METHOD

18 nurses working 12-hr shifts filled out a Karolinska Sleepiness Scale questionnaire and a Brief Psychomotor Vigilance Test, at the beginning of the shift and then every 3 hr. Coping strategies and quality of care were assessed on self-administered questionnaires, filled out at 3 hr, 6 hr, 9 hr and 12 hr after the start of the shift.

RESULTS

The present investigation did not show significantly excessive sleepiness or vigilance impairment or poor self-perception of quality of work during 12-hr nursing work shifts, although Psychomotor Vigilance Test results gradually deteriorated slightly over duty time (from start to end of shift). Certain coping strategies were preferred such as 'having a nap' later in the night shift.

CONCLUSION

Attention needs to be paid to the health status of nurses working 12-hr shifts, with regular medical monitoring by the occupational health service.

IMPLICATIONS FOR NURSING MANAGEMENT

Coping strategies to maintain sufficient vigilance to ensure quality of care should be facilitated.

[Predictors of Blood and Body Fluid Exposure and Mediating Effects of Infection Prevention Behavior in Shift-Working Nurses: Application of Analysis Method for Zero-Inflated Count Data]

PURPOSE

This study aimed to identify the predictors of blood and body fluid exposure (BBFE) in multifaceted individual (sleep disturbance and fatigue), occupational (occupational stress), and organizational (hospital safety climate) factors, as well as infection prevention behavior. We also aimed to test the mediating effect of infection prevention behavior in relation to multifaceted factors and the frequency of BBFE.

METHODS

This study was based on a secondary data analysis, using data of 246 nurses from the Shift Work Nurses' Health and Turnover study. Based on the characteristics of zero-inflated and over-dispersed count data of frequencies of BBFE, the data were analyzed to calculate zero-inflated negative binomial regression within a generalized linear model and to test the mediating effect using SPSS 25.0, Stata 14.1, and PROCESS macro.

RESULTS

We found that the frequency of BBFE increased in subjects with disturbed sleep (IRR = 1.87, p = .049), and the probability of non-BBFE increased in subjects showing higher infection prevention behavior (IRR = 15.05, p = .006) and a hospital safety climate (IRR = 28.46, p = .018). We also found that infection prevention behavior had mediating effects on the occupational stress-BBFE and hospital safety climate-BBFE relationships.

CONCLUSION

Sleep disturbance is an important risk factor related to frequency of BBFE, whereas preventive factors are infection prevention behavior and hospital safety climate. We suggest individual and systemic efforts to improve sleep, occupational stress, and hospital safety climate to prevent BBFE occurrence.

Napping and cognitive performance during night shifts: a systematic review and meta-analysis

Study Objectives

To examine the benefits of napping during night shifts on cognitive performance.

Methods

Medline, Cochrane Library, Science direct, and Embase databases were searched up to July 1, 2019. Cognitive performance during night shifts, both before and following napping or under control conditions (no nap), in working-aged adults, were analyzed by time and by type of cognitive function (executive function, attention, instrumental function, and memory). Estimates were pooled using random-effects meta-analysis.

Results

A total of 18 articles (6 in real-work and 12 in laboratory) with a total of 494 participants were included. The mean nap duration was 41.6 ± 28.3 min, occurring between 12.00 am and 4.10 am, with a mean time set at 2.12 am. Cognitive performance did not differ at baseline between the groups (effect size 0.02, 95% CI −0.09 to 0.13). There was an overall improvement in performance following a nap compared to the control condition without a nap (0.25, 0.10 to 0.41). Positioning naps early in the night and activity (simulated work tasks) tended to improve cognitive performance (−0.57, −1.16 to 0.002, and 0.082, −0.04 to 0.33, respectively). The improvements were primarily seen 30 min after awakening. Only memory deteriorated immediately after awakening without an overall change in global cognitive performance.

Conclusion

Napping during night shifts seems to improve cognitive performance. Napping early in the night and activity may benefit cognitive performance over time. Considering lack of data in real work environments, further studies are warranted before preconizing napping during night shifts as a preventive strategy (safety, health, and economic outcomes).

Sleep disturbances and related factors among nurses

The aim of this study was to describe patterns and potential risk factors for sleep disturbances, including that of sleep apnea, among Thai registered nurses. A descriptive, cross-sectional design was implemented. A sample of 233 registered nurses was recruited from 10 nursing departments from a tertiary hospital. Participants completed a one-time, self-report questionnaire and a 1 week-long sleep diary. Descriptive and logistic regression statistics were used for the analysis. Approximately 76% of nurses slept less than 7 h, 12.3% had difficulty initiating sleep, and 5% had difficulty maintaining sleep. Short sleep duration was prevalent, and night shift work schedules that exceeded 10 episodes/month were perceived as contributing to difficulties with initiating sleep. After excluding males from the analysis, the risk for depression related to short sleep duration becomes statistically significant. Organizational policies for registered nurses' shift work should include effective management of night shift assignments, as well as interventional strategies and policy directions, to promote sleep quality and mental health to ensure nurse well-being and patient safety.

Sleep quality among industrial workers: related factors and impact

Purpose

The purpose of this paper is to explore the prevalence and determinants of poor sleep quality among industrial workers in Thailand. Additionally, the authors assess the risk of work-related injuries associated with poor sleep quality.

Design/methodology/approach

A descriptive correlational research was implemented. A total of 472 workers from the northern region of Thailand contributed to this study. Sleep quality was assessed by the Thai version of the Pittsburgh Sleep Quality Index (Thai-PSQI). The score of more than five indicated poor sleep quality. Participants completed self-administered demographic, work characteristics and work-related injury questionnaires. Data were analyzed by applying descriptive and logistic regression statistical techniques.

Findings

More than one-third of the workers had reported poor sleep quality. Results from multivariable logistic regression analysis yielded male gender (OR = 2.74, 95% CI 1.46–5.17), alcohol drinking (OR=2.1, 95% CI 1.24–3.35), pain (OR=2.05, 95% CI 1.32–3.17) and rotating shift work (OR=1.94, 95% CI 1.23–3.05) increased the risk of poor sleep quality. Furthermore, poor sleep quality was statistically significantly associated with the risk of work-related injuries (OR = 3.98, 95% CI = 2.39–6.66).

Originality/value

Findings of this study indicate that the prevalence of poor sleep quality is high among industrial workers. Work characteristics and health behaviors were associated with poor sleep quality which increases the risk of work-related injuries. Modification of work environment and personal life style choices can improve quality of sleep among workers and consequently lower incidence of work-related injuries.