Schlafstörungen bei Ärzten im Schichtdienst

Abstract

Sleep disorders in physicians who perform shift work can result in increased risks of health problems that negatively impact performance and patient safety. Even those who cope well with shift work are likely to suffer from sleep disorders. The aim of this manuscript is to discuss possible causes, contributing factors and consequences of sleep disorders in physicians and to identify measures that can improve adaptation to shift work and treatment strategies for shift work-associated sleep disorders. The risk factors that influence the development of sleep disorders in physicians are numerous and include genetic factors (15 % of the population), age (> 50 years), undiagnosed sleep apnea,, alcohol abuse as well as multiple stress factors inherent in clinical duties (including shift work), research, teaching and family obligations. Several studies have reported an increased risk for medical errors in sleep-deprived physicians. Shift workers have an increased risk for psychiatric and cardiovascular diseases and shift work may also be a contributing factor to cancer. A relationship has been reported not only with sleep deprivation and changes in food intake but also with diabetes mellitus, obesity, hypertension and coronary heart disease. Nicotine and alcohol consumption are more frequent among shift workers. Increased sickness and accident rates among physicians when commuting (especially after night shifts) have a socioeconomic impact. In order to reduce fatigue and to improve performance, short naps during shiftwork or naps plus caffeine, have been proposed as coping strategies; however, napping during adverse circadian phases is less effective, if not impossible when unable to fall asleep. Bright and blue light supports alertness during a night shift. After shiftwork, direct sunlight exposure to the retina can be avoided by using dark sunglasses or glasses with orange lenses for commuting home. The home environment for daytime sleeping after a night shift should be very dark to allow endogenous melatonin secretion, which is a night signal and supports continuous sleep. Sleep disorders can be treated with timed light exposure, as well as behavioral and environmental strategies to compensate for sleep deprivation. Fatigue due to sleep deprivation can only be systematically treated with sleep.

Sleep Characteristics of the Staff Working in a Pediatric Intensive Care Unit Based on a Survey

“…New protocols, prevention programs, and strategies should be adopted to improve sleep quality and to optimize the resting time of workers ( 10 , 26 ).…”

Are Insomnia Type Sleep Problems Associated With a Less Physically Active Lifestyle? A Cross-Sectional Study Among 7,700 Adults From the General Working Population

“…A total of 10,605 (~53%) replied (26). The present study included currently employed wage earners on daytime schedule ( N = 7,706) and thereby excluded shift workers (27), because shift workers experience higher frequencies of sleep problems (28) and the level of leisure-time physical activity may be influenced by levels of light (29, 30). Because not all participants filled in all questions, the exact number of participants for each analysis varies.…”

Sleep disorders and their consequences for doctors

“…According to Schlafer et al [15], the most important risk factors of sleep disorders in doctors are numerous and include: genetic factors (15% of the population), age over 50, undiagnosed sleep apnoea, alcohol abuse as well as numerous stressors related to clinical duties, including night shift work, research work, medical education and family responsibilities. According to other studies, sleep disorders are more common among medical professionals [10,14].…”