Sleepiness in critical care nurses: results of a pilot study

Nurses' level of sleepiness during night shift

AIMS

This study aimed to determine the peak hours of sleepiness and the factors affecting the sleepiness levels of nurses.

BACKGROUND

Sleepiness is commonly seen in individuals working night shifts. However, in case of nurses, this sleepiness can be a major threat to patient and staff safety.

METHOD

This was a prospective cross-sectional study. Data were collected between July and September 2023, and a stratified sampling method was used according to the departments in which the nurses worked. Data were collected using the Personal Information Form and Visual Analog Scale. Nurses reported their sleepiness levels at the beginning of each hour between midnight and 8:00 am.

EQUATOR CHECKLIST

The study adhered to the STROBE checklist for reporting.

RESULTS

The mean sleepiness levels of emergency department nurses, intensive care nurses, internal or surgical clinic nurses, and all nurses were 59.75 ± 15.50, 43.53 ± 20.49, 44.67 ± 18.88, and 49.15 ± 19.67, respectively. The highest sleepiness level of the nurses was at 05:00 am. A significant correlation was found between the variables of age, gender, marital status, sleep quality, number of patients cared, working style and satisfaction with working in the department, and sleepiness level (P < 0.05).

CONCLUSION

Nurses working night shifts experience sleepiness (highest at 5:00 am). In addition, the sleepiness levels of nurses are affected by some personal and clinical factors.

IMPLICATIONS FOR NURSING AND NURSING POLICY

Based on the results, there is a need for necessary policies regarding nurses' working hours and working conditions. To protect patient and employee safety, necessary strategies should be devised regarding the hours when nurses experience the highest sleepiness and the factors affecting sleepiness levels.

Shift Work Disorder, Insomnia, and Depression among Offshore Oil Rig Workers

Objective: Numerous offshore jobs require 24-hour tasks, such as in industrial workplaces (eg, oil rigs). The purpose of this study was to assess shift work disorder (SWD), insomnia, daytime sleepiness, and depression among Iranian offshore oil rig workers in different shift schedules. Method : This cross-sectional study was conducted on Iranian offshore oil workers at the Persian Gulf. A questionnaire package consisted of Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Beck Depression Inventory (BDI- II), and SWD filled. The scores were calculated among different groups of shift schedules (fixed-day, fixed-night, swing and standby shift workers). ISI, BDI-II, and ESS scores were also compared between individuals with or without SWD. Results: A total of 188 participants were recruited in the study, and all were male. The mean age was 37.06 ± 9.2 years. Among different shift schedules, the highest and lowest ISI and ESS scores were related to fixed-night shifts workers and fixed-day shift workers, respectively. ISI, ESS, and BDI mean scores in different shift schedules were not significantly different (p values = 0.14, 0.57, and 0.93, respectively). SWD was diagnosed in 57 (30.3%) of studied shift workers. The difference between SWD prevalence was not significant between different shift schedules (P value =0.13). Workers with SWD had higher ISI, ESS, and BDI-II score (P values <0.0001, <0.0001, and <0.0001, respectively) and workers without SWD had higher job satisfaction (p value = 0.04). Conclusion: SWD is considered as a serious health-related issue in Persian Gulf oil rig shift workers. Insomnia, daytime sleepiness, and depression are associated with SWD.

The Impact of Daily Sleep Hours on the Health of Korean Middle-Aged Women

This study aimed to examine the association between sleep and health in order to provide useful information to manage the health of obese women in the future. One hundred fifty-five Korean women aged 40-60 years without a previous diagnosis of abnormal glucose metabolism or other health problems and with body fat percentages greater than 30 percent were classified into two groups: a non-obese group and an obese group. Sleep hours exhibited a significant positive correlation with weight, body mass index, muscle mass, and glucose levels in the obese group. Significant differences were found for the body composition except the muscle mass. For physical fitness, all factors were significantly different between two groups. Additionally, there were correlations between sleep hours and weight, body mass index, muscle mass, and glucose level in the obese group. However, sleep hours did not exhibit these correlations in the non-obese group.

Sleep Quality and Vigilance Differ Among Inpatient Nurses Based on the Unit Setting and Shift Worked

OBJECTIVES

Sleepiness in nurses has been shown to impact patient care and safety. The objectives of this study are to measure sleep quality, sleepiness, fatigue, and vigilance in inpatient nurses and to assess how setting (intensive care unit versus the general floor) and shift worked (day versus night) affect these measures.

METHODS

Nurses from both the ICU and floor were included in the study. Participants completed questionnaires assessing self-reported sleep quality (Pittsburgh Sleep Quality Index, PSQI), sleepiness (Stanford Sleepiness Scale and Epworth Sleepiness Scale, ESS), and fatigue (Fatigue Severity Scale, FSS). Vigilance was measured by means of the psychomotor vigilance test (PVT), before and after a 12-hour duty shift.

RESULTS

The ESS was abnormal in 22% of all nurses, the FSS was abnormal in 33%, and the global PSQI was abnormal in 63%. More ICU nurses than floor nurses reported abnormal sleep quality (component 5) on the PSQI. Sleep medication use (PSQI component 6) was higher in night shift nurses. The FSS was greater in night shift nurses. On preshift PVT testing, day-shift nurses overall provided faster mean reaction time (RT) than night-shift nurses. ICU nurses working the day shift made more than twice as many total errors and false starts than day shift floor nurses. Floor nurses demonstrated a significant decrease from preshift to postshift in the mean of the fastest 10% RT.

CONCLUSIONS

Our data indicate that a significant number of inpatient nurses have impaired sleep quality, excessive sleepiness, and abnormal fatigue, which may place them at a greater risk of making medical errors and harming patients; these problems are especially pronounced in night shift workers. PVT results were inconsistent, but floor and day shift nurses performed better on some tasks than ICU and night shift nurses.

Effect of diabetes mellitus on sleep quality

Diabetes mellitus (DM) is a highly prevalent condition affecting about 347 million people worldwide. In addition to its numerous clinical implications, DM also exerts a negative effect on patient’s sleep quality. Impaired sleep quality disrupts the adequate glycemic control regarded as corner stone in DM management and also lead to many deleterious effects causing a profound impact on health related quality of life. This article outlines various factors leading to impaired sleep quality among diabetics and delineates how individual factor influences sleep. The article also discusses potential interventions and lifestyle changes to promote healthy sleep among diabetics.

Self-reported sleep and health among Norwegian hospital nurses in intensive care units

AIM AND BACKGROUND

Shift work, and especially night work, is associated with poor health. Nurses, work a variety of work schedules including night work. So far, few studies have specifically investigated sleep and health among intensive care nurses.

DESIGN AND METHODS

We investigated sleep, sleepiness, fatigue, subjective health complaints, anxiety and depression in 150 intensive care nurses (convenience sample representing a response rate of 56·2%). The nurses worked at two major University hospitals in Norway and answered a questionnaire survey.

RESULTS

The intensive care nurses reported poorer sleep, more sleepiness, more fatigue, more anxiety and more depression compared to normative data. Poor sleep was reported by 70% and excessive sleepiness by 25% of the nurses; however, the design of the study did not allow us to determine the causes underlying these findings. Multiple linear regression analyses showed that age was positively associated with sleep problems, fatigue, subjective health complaints and anxiety and depression. In contrast, shift work experience was negatively associated with sleep problems, suggesting better coping with shift work over time.

CONCLUSIONS

Nurses working in intensive care units reported poorer sleep, more sleepiness, more fatigue, more anxiety and more depression compared to Norwegian norm groups. Age was positively related to these complaints, whereas shift work experience was negatively related to poor sleep. More studies are needed on strategies to improve sleep and health in nurses.

Nurses' work schedule characteristics, nurse staffing, and patient mortality

BACKGROUND

Although nurse staffing has been found to be related to patient mortality, there has been limited study of the independent effect of work schedules on patient care outcomes.

OBJECTIVE

To determine if, in hospitals where nurses report more adverse work schedules, there would be increased patient mortality, controlling for staffing.

METHODS

A cross-sectional design was used, with multilevel data from a 2004 survey of 633 nurses working in 71 acute nonfederal hospitals in North Carolina and Illinois. Mortality measures were the risk-adjusted Agency for Healthcare Research and Quality Inpatient Quality Indicators, and staffing data were from the American Hospital Association Annual Survey of hospitals. Principal components analysis was conducted on the 12 work schedule items to create eight independent components. Generalized estimating equations were used to examine the study hypothesis.

RESULTS

Work schedule was related significantly to mortality when staffing levels and hospital characteristics were controlled. Pneumonia deaths were significantly more likely in hospitals where nurses reported schedules with long work hours (odds ratio [OR] = 1.42, 95% confidence interval [CI] = 1.17-1.73, p < .01) and lack of time away from work (OR = 1.24, 95% CI = 1.03-1.50, p < .05). Abdominal aortic aneurysm was also associated significantly with the lack of time away (OR = 1.39, 95% CI = 1.11-1.73, p < .01). For patients with congestive heart failure, mortality was associated with working while sick (OR = 1.39, 95% CI = 1.13-1.72, p < .01), whereas acute myocardial infarction was associated significantly with weekly burden (hours per week; days in a row) for nurses (OR = 1.33, 95% CI = 1.09-1.63, p < .01).

DISCUSSION

In addition to staffing, nurses' work schedules are associated with patient mortality. This suggests that work schedule has an independent effect on patient outcomes.

Relationship between sleeping on the night shift and recovery from work among nursing workers - the influence of domestic work

AIM

This paper is a report of a study on the association between sleep patterns during work nights and recovery from work among nursing workers, considering domestic work hours.

BACKGROUND

Several hospitals allow nursing workers to sleep during the night shift, but this is rarely evaluated from the workers' health perspective. The need for recovery from work concept can be useful for testing the impact of night work on sleep. Recovery is not a problem if workers have enough time to recover between periods of work. Therefore, domestic work would be likely to interfere in the recovery process.

METHODS

This cross-sectional study was carried out at three hospitals in 2005-2006, through a comprehensive questionnaire. All nursing teams engaged in assistance to patients were invited to participate. Analyses included female night workers with no incidence of insomnia. Participants (n = 396) were classified into those who did not sleep during night shifts, those who slept for up to 2 hours and those who slept for 2-3 hours.

RESULTS

Binomial logistic regression analysis showed that sleeping on the job for 2-3 hours during night shifts is related to a better recovery from work provided the workers do not undergo long domestic work hours.

CONCLUSIONS

Being allowed to sleep at work during night shifts seemed to contribute to, but was not enough to guarantee, a good recovery from work in the studied population. Recommendations to deal with sleep-deprivation among night workers should consider the complexity of gender roles on the recovery process.

Estresse e qualidade do sono entre enfermeiros que utilizam medicamentos para dormir

OBJETIVOS: Identificar os níveis de estresse, analisar a utilização de medicamentos para dormir e correlacionar níveis de estresse, qualidade do sono e uso de medicamentos. MÉTODOS: Estudo quantitativo, transversal, descritivo e comparativo, realizado com 203 enfermeiros de uma instituição hospitalar da cidade de Campinas, São Paulo, Brasil. Foi utilizado um questionário de identificação, Escala Bianchi de Stress modificada (EBSm) e o Índice de Qualidade do Sono de Pittsburgh. RESULTADOS: Dentre 203 enfermeiros, 17,7% utilizavam medicamentos para dormir. Dos enfermeiros que utilizaram medicamentos para dormir 48,6% demonstraram estado de alerta e alto nível de estresse (p = 0, 016) e apresentaram na sua totalidade (n=36) uma qualidade de sono ruim. CONCLUSÃO: Os enfermeiros que utilizaram medicamentos para dormir apresentaram níveis de estresse mais elevados e prejuízos que comprometem a qualidade do sono.