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Short total sleep time in 12-hour shift nurses: slow unwinding, circadian disruption, or time allocated to sleep?

Geiger-Brown J; Rogers V; Brubaker A; Scharf S; Trinkoff A
Sleep 2009 Jun; 32(Abstract Suppl):A138
Introduction: Short total sleep time (TST) (< 6 hours) is common in 12-hour shift nurses. Three plausible reasons may account for this. Extended exposure to stressful work may produce slow unwinding, with delayed sleep or poor sleep efficiency (SE). Night nurses' sleep can be disrupted if lights out time is delayed. Insufficient time between shifts may reduce sleep opportunity (shift overruns, parenting, little time allocated to sleep). The aim is to describe the association of job stress, delay to bed, and limited sleep opportunity on sleep. We hypothesized that (1) higher job stress would reduce TST and SE, (2) delaying lights out would increase waking after sleep onset (WASO) after night shift, (3) loss of sleep opportunity would modify the effect of time at home to total sleep time. Methods: Registered nurses working consecutive 12-hour shifts were studied using accelerometry (TST, SE, WASO), diary (actual hours worked, commute time, home responsibilities), and job stress survey (job demands, satisfaction, performance barriers, frustration) post shift (N=73). Correlations were done to test hypotheses 1-2. Regression was used to test hypothesis 3. Results: TST averaged 5.5 hours between 12-hour shifts. Correlation between job stress scales and TST/SE was low. Later lights out was associated with increased WASO. Shift overruns were common. Parents showed no relationship of time at home to TST, whereas those without children had longer TST with more time at home. Nurses with two jobs got less sleep with longer time at home. Conclusion: 12-hour shift nurses have significant partial sleep deprivation. Stronger relationships exist between circadian disruption, lack of sleep opportunity, and achieved sleep between 12-hour shifts than between job stress and sleep. Interventions to improve sleep should focus on creating individual work schedules that allow sufficient time at home for restorative rest.
Sleep-disorders; Sleep-deprivation; Education; Fatigue; Fatigue-properties; Humans; Public-health; Statistical-analysis; Demographic-characteristics; Epidemiology; Stress; Exposure-levels; Shift-work; Shift-workers; Health-care-personnel; Medical-personnel; Nurses
J. Geiger-Brown PhD, RN, School of Nursing, University of Maryland, 655 W Lombard St, Ste 575, Baltimore, MD 21201
Publication Date
Document Type
Email Address
Funding Type
Grant; Cooperative Agreement
Fiscal Year
Identifying No.
Grant-Number-R21-OH-008392; Cooperative-Agreement-Number-U60-OH-008460
Priority Area
Services; Wholesale and Retail Trade; Healthcare and Social Assistance
Source Name
Performing Organization
University of Maryland - Baltimore
Page last reviewed: May 11, 2023
Content source: National Institute for Occupational Safety and Health Education and Information Division