Differences in Daytime Activity Levels and Daytime Sleep Between Night and Day Duty: An Observational Study in Italian Orthopedic Nurses

Revitalizing your sleep: the impact of daytime physical activity and balneotherapy during a spa stay

Background

In modern society, achieving high-quality sleep is increasingly challenging. We conducted a study to explore the potential benefits of daytime physical activity and balneotherapy, including mud application and thermal-water bathing, on sleep quality.

Methods

To assess daytime physical activity and sleep parameters, we actigraphically monitored 127 healthy participants (34.6% male, average age 64.61 ± 0.89 years) during a one-week stay at a spa resort, where they received mud application and thermal-water bathings.

Results

Participants were divided into three groups based on the timing of mud application. Those receiving mud application before 8:30 a.m. tended to have shorter sleep durations compared to those with later application, especially if it occurred before 7:45 a.m. However, mud application did not significantly affect sleep quality. Three-way ANCOVA revealed a significant effect of daytime physical activity on delta Sleep Efficiency, but post-hoc tests were insignificant. Furthermore, analyzing the duration of daily thermal-water bathings, individuals bathing for over 75 min per day experienced a noteworthy improvement in sleep quality, particularly in terms of delta Sleep Efficiency (2.15 ± 0.9% vs. -0.34 ± 0.31%, p = 0.007).

Conclusion

Our findings suggest that extended thermal-water bathing may enhance objective aspects of sleep quality. Since balneotherapy is mainly prescribed for individuals with musculoskeletal pathologies or psychological disorders, these findings may encourage doctors to recommend bathing in thermal water also to healthy subjects. Future researchers need to investigate the role of daytime physical activity in depth.

Theoretical construct into blocks of actigraphic-derived sleep parameters

Actigraphic parameters can provide indication of people's sleep quality during their daily lives. However, there is a need for clear guidelines on the understanding of the different actigraphic parameters. The present study aims to propose a conceptual and theoretical framework for known actigraphic-derived parameters, which is able to describe the alternation between rest and wake phases during the nocturnal sleep, explaining their main characteristics and interrelations that can be replicated in future studies. Forty Sport Sciences students at the University of Milan (20 males; mean age ± SD, 22 ± 3 y) completed the validated Italian version of Morningness-Eveningness Questionnaire (MEQ) and wore an actigraph (Motion Watch 8®, Cambridge Neurotechnology, Cambridge, UK) for seven days. A framework was developed to depict the interactions between the actigraphic parameters and how they objectively describe sleep, according to which the parameters are organized into three different functional blocks related to different aspects of sleep. Correlations analyses were conducted to explore the relationships among the primary actigraphic parameters within and across the functional blocks. The proposed framework is a purely theoretical construct that provides a simple interpretation of known actigraphic parameters guiding researchers and practitioners in the use of these parameters either for research or clinical purposes.

Effect of sleep and fatigue on cardiovascular performance in young, healthy subjects

Physical performance could be negatively affected by sleep deficiency and fatigue. The present study assesses the role of sleep quality, fatigue and motivation on cardiovascular performance (VO₂peak, Wmax, and HRmax) in a sample of active young subjects. The current study is a cross-sectional design. Ninety-six university students (males 54.2%; 21.5 ± 2.9 yrs) completed an incremental exercise test on a bicycle ergometer. Sleep, fatigue, and motivation were assessed with the Pittsburgh Sleep Quality Index and two visual analogue scales, respectively. Differences in VO₂peak, Wmax, HRmax, self-perceived fatigue and motivation were compared between good and bad sleepers and sleep duration >/<7.5 h, while regression analysis defined the predictors of VO₂peak, Wmax, and HRmax_. In the male sample, good and bad sleepers' differences were significant only for self-perceived fatigue (p = 0.04). The female sample showed no statistically significant differences between good and bad sleepers and different sleep durations. In the male sample, linear regression analysis showed a significant inverse correlation between Wmax and the PSQI score (-0.4, p = 0.004). The stepwise regression model indicated that sleep (β = -0.3, p = 0.02) was a significant predictor of VO₂peak in males accounting for 20% of the variance, whereas physical performance seems more affected by fatigue (β = -0.4, p = 0.03) in females. In conclusion, chronic inadequate and self-reported sleep quality seems to be one of the factors compromising cardiovascular performance in males.

Health Behaviors and Health-Related Quality of Life in Female Medical Staff

The aim of this study was to evaluate the relationship between the intensity of health behaviors and health-related quality of life in female mid-level medical staff. The study group consisted of 153 female mid-level medical staff members. The intensity of health behaviors was examined with the Polish version of Health Behavior Inventory. Health-related quality of life was verified with the Short Form Health Survey questionnaire (SF 36v2). Among the participants, 33% had low, 39% average, and 28% high intensity of health behaviors. The mental component of health-related quality of life was rated higher (83.3 ± 15.3 points) compared to the physical one. The lowest health-related quality of life was observed in the domain of “bodily pain”, while the highest was found for the domain of “social functioning”. Both the physical and mental components of health-related quality of life were significantly positively correlated with health behavior prevalence in all its categories. The post-hoc tests revealed the variation in physical and mental components of HRQoL according to the level of health behavior intensity.

Effects of Shift Work in a Sample of Italian Nurses: Analysis of Rest-Activity Circadian Rhythm

Shift work can lead to circadian desynchronization due to temporary misalignment between working hours and physiological and behavioral functioning, resulting in compromised health, insomnia, worsening of sleep quality, reduced ability to work during waking hours, and increased cardiovascular risk. We evaluated the effects of shift work on the rest-activity circadian rhythm (RAR) and health status of Italian orthopaedic nurses. The study population was 59 nurses: 44 worked the night shift and 15 worked the day shift. All carried out continuous 5-day actigraphic monitoring to assess RAR, including both the working and the rest period. The rhythmometric analysis showed that, during the working period, the night shift nurses had a significantly lower amplitude than the day shift nurses (p < 0.001), and the acrophase was significantly different between the two groups (p < 0.01). When we stratified the two groups by median body mass index (<25 kg/m² normal weight and ≥25 kg/m² overweight), during the working period, we noted a significantly lower amplitude for both the normal weight and the overweight nurses who worked the night shift (p < 0.01 and p < 0.001, normal weight and overweight respectively). The current findings suggest the need for further study of the relationship between activity levels and shift work.