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Sleep, sleepiness and neurocognition in 12-hour nurses: prelilminary results.

Geiger-Brown-J; Rogers-V; Trinkoff-AM; Kane-R; Scharf-S
Sleep 2008 Jun; 31(Abstract Suppl):A115
Introduction: Shifts of 12 hours or more are common among ICU nurses, combined with a compressed workweek to maximize time off. Such schedules may cause fatigue-related decrements in nurses' attention, vigilance and executive functioning. Partial sleep deprivation and associated neurocognitive decline over successive workdays has been studied under laboratory conditions, but real-world studies of nurses performance are lacking. This paper presents early findings of a study examining achieved sleep, sleepiness, and neurocognitive performance in nurses over 3 successive 12-hour workdays. Methods: We recruited a convenience sample of female RNs working 3 consecutive 12-hour shifts preceded by 2 days off. Sleep was measured by actigraphy, with alarms cueing input of the Karolinska Sleepiness Score every two hours during their work shift. Neurocognitive tests (Walter Reed PVT, ARES battery) were delivered post shift using a personal digital assistant. Nurses with a high prior probability of sleep apnea were excluded (Berlin Scale). Results: 46 nurses were screened and 26 qualified for the study, with 65% of disqualifiers for elevated Berlin score. Twenty nurses completed the protocol. Mean age of those enrolled was 40.1 (24-57) years. Total sleep times (TST) were short, with 39% below 6 hours between shifts, and the shortest sleepers having sleep broken into segments. TST did not influence cognitive throughput during the first two shifts, but had a significant influence on the third consecutive 12-hour shift. Overall, sleepiness scores were low, showed circadian variation, and did not correlate with TST. Yet catch-up sleep was seen at the end of the work cycle. Data collection is ongoing and data will be provided incorporating additional results. Conclusion: Sustained shifts with compressed schedules resulted in partial sleep deprivation over work days, with some decrements in neurocognition observed.
Circadian-rhythms; Work-environment; Sleep-deprivation; Sleep-disorders; Stimulants; Work-intervals; Training; Neurophysiological-effects; Shift-work; Shift-workers; Age-groups; Health-care-personnel; Medical-personnel; Nurses; Nursing
J. Geiger-Brown PhD, RN, School of Nursing, University of Maryland, 655 W Lombard St, Ste 575, Baltimore, MD 21201
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Grant-Number-R21-OH-008392; Cooperative-Agreement-Number-U60-OH-008460
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University of Maryland - Baltimore