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Sleep, sleepiness, fatigue, and performance of 12-hour-shift nurses.

Geiger-Brown J; Rogers VE; Trinkoff AM; Kane RL; Bausell RB; Scharf SM
Chronobiol Int 2012 Mar; 29(2):211-219
Nurses working 12-h shifts complain of fatigue and insufficient/poor-quality sleep. Objectively measured sleep times have not been often reported. This study describes sleep, sleepiness, fatigue, and neurobehavioral performance over three consecutive 12-h (day and night) shifts for hospital registered nurses. Sleep (actigraphy), sleepiness (Karolinska Sleepiness Scale [KSS]), and vigilance (Performance Vigilance Task [PVT]), were measured serially in 80 registered nurses (RNs). Occupational fatigue (Occupational Fatigue Exhaustion Recovery Scale [OFER]) was assessed at baseline. Sleep was short (mean 5.5 h) between shifts, with little difference between day shift (5.7 h) and night shift (5.4 h). Sleepiness scores were low overall (3 on a 1-9 scale, with higher score indicating greater sleepiness), with 45% of nurses having high level of sleepiness (score > / = 7) on at least one shift. Nurses were progressively sleepier each shift, and night nurses were sleepier toward the end of the shift compared to the beginning. There was extensive caffeine use, presumably to preserve or improve alertness. Fatigue was high in one-third of nurses, with intershift fatigue (not feeling recovered from previous shift at the start of the next shift) being most prominent. There were no statistically significant differences in mean reaction time between day/night shift, consecutive work shift, and time into shift. Lapsing was traitlike, with rare (39% of sample), moderate (53%), and frequent (8%) lapsers. Nurses accrue a considerable sleep debt while working successive 12-h shifts with accompanying fatigue and sleepiness. Certain nurses appear more vulnerable to sleep loss than others, as measured by attention lapses.
Shift-work; Shift-workers; Health-care; Health-care-personnel; Nurses; Nursing; Work-intervals; Work-performance; Worker-health; Sleep-deprivation; Sleep-disorders; Fatigue; Fatigue-properties; Circadian-rhythms; Task-performance; Neurological-reactions; Behavior; Physiological-fatigue; Physiopathology; Physiological-effects; Physiology; Physiological-measurements; Humans; Women; Men; Age-factors; Author Keywords: Attention; Extended work hours; Fatigue; Neurocognition; Nurses; Sleep deprivation; Sleepiness; Vigilance; Work schedule tolerance
Dr. Jeanne Geiger-Brown, University of Maryland School of Nursing, 655 W Lombard Street, Suite 575, Baltimore, MD 21201, USA
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Fiscal Year
Identifying No.
Grant-Number-R21-OH-008392; B06202012
Issue of Publication
Source Name
Chronobiology International
Performing Organization
University of Maryland - Baltimore
Page last reviewed: September 2, 2020
Content source: National Institute for Occupational Safety and Health Education and Information Division