A systematic review of the sleep, sleepiness, and performance implications of limited wake shift work schedules

Abstract

This paper reviews the implications of limited wake shift work schedules, such as the 6hr-on/6hr-off and 4hr-on/8hr-off watchkeeping schedules employed by mariners and the 8hr-on/8hr-off schedules of long-haul train drivers. These schedules are reviewed within a chronobiological framework and recommendations are made to optimize sleep and performance.

Jet Lag and Shift Work Disorder

“…For example, there may be optimal shift start times and shift durations that are better than others. Some recent laboratory studies have examined the impact of split work/sleep schedules (2 equal work periods per 24 hours), that are common in the maritime industry, 105 on sleep and performance, and indicate that both sleep and performance may be better compared with a single night shift. 106 This is thought to be owing to the ability of the person to dissipate their homeostatic sleep load, which builds up the longer they are awake, with 2 sleep periods per day rather than a single consolidated sleep period.…”

Review article: Staff perception of the emergency department working environment: Integrative review of the literature

“…Studies were included if they were published in English between 1993 and 2015 and focused on staff perception of working environment. Literature was excluded if it covered ED staff perception of violence against staff, assessment of compassion fatigue and burnout, communication difficulties in ED, shift work , internal cultural diversity and staff undergoing training processes (e.g. specific ED clinical training), as these have already been explored in highly focused reviews (see also Fig.…”

“…EDs are often cited as particularly stressful environments, with increasing numbers and acuity of ED presentations resulting in high pressure and high volume workloads . These factors, combined with varied staff skill‐mix, burnout, difficulties with recruitment and retention, decreased morale and job satisfaction, personality factors, aggression and violence, interpersonal conflicts, limited recognition of quality work and disempowerment could all impact on staff and patients in terms of perception of environment, safety and risk of adverse events . Some of these factors relate to the health workforce overall, while some pertain more specifically to the ED.…”

“…Current literature suggests that ED staff are also subject to many external pressures around patient waiting times and the deleterious impacts of shift work . Despite this, emergency is often identified as a ‘prestigious and high value’ area of clinical work, which is known to enable development of high personal levels of clinical skills and the development of positive supportive team working environments .…”

Association Between Sleep Quality and Subjective Fatigue in Night-Shift Nurses with Good and Poor Sleep

“…In particular, rotational-shift workers, including those who work night shifts (e.g., nurses, police officers, airline pilots, and truck drivers), have been reported to experience greater life-or work-related problems relative to day-shift workers [4][5][6]. The problems related to rotational-shift work affect sleep [4][5][6][7] and work performance [4][5][6]8]; furthermore, they lead to an increase in lifestyle-related health [9] risks such as obesity, diabetes [10], heart disease [11], depression, hypertension [12][13][14], and cancer [15]. Therefore, the improvement of rotationalshift workers' sleep quality and quality of life is important.…”