The effect of chronotype on sleepiness, fatigue, and psychomotor vigilance of ICU nurses during the night shift

Abstract

PurposeIn general, sleeping and activity patterns vary between individuals. This attribute, known as chronotype, may affect night shift performance. In the intensive care unit (ICR), night shift performance may impact patient safety. We have investigated the effect of chronotype and social demographics on sleepiness, fatigue, and night shift on the performance of nurses.MethodsThis was a prospective observational cohort study which assessed the performance of 96 ICU night shift nurses during the day and night shifts in a mixed medical–surgical ICU in the Netherlands. We determined chronotype and assessed sleeping behaviour for each nurse prior to starting shift work and before free days. The level of sleepiness and fatigue of nurses during the day and night shifts was determined, as was the effect of these conditions on psychomotor vigilance and mathematical problem-solving.ResultsThe majority of ICU nurses had a preference for early activity (morning chronotype). Compared to their counterparts (i.e. evening chronotypes), they were more likely to nap before commencing night shifts and more likely to have young children living at home. Despite increased sleepiness and fatigue during night shifts, no effect on psychomotor vigilance was observed during night shifts. Problem-solving accuracy remained high during night shifts, at the cost of productivity.ConclusionsMost of the ICU night shift nurses assessed here appeared to have adapted well to night shift work, despite the high percentage of morning chronotypes, possibly due to their 8-h shift duration. Parental responsibilities may, however, influence shift work tolerance.

Chronotype and work shift in nursing workers of university hospitals

“…This result diverges from a study carried out on nurses in the region of Vale do Paraíba Paulista, São Paulo, Brazil (7) and a study on Dutch nurses (11) . In such research, there was prevalence of moderately morning and morning chronotypes, respectively.…”

“…Afternoon Night Indifferent Morning Evening years old. In this age group, children are usually dependent on their parents for supervision and school transport; this indicates that age limits the ability to sleep in preferred hours (11) . Significant differences were evidenced between the indifferent chronotype and the variable "use of medication" (p=0.018); and the morning chronotype and the "no use of medication."…”

“…Such aspects reinforce the possibility of negative implications on the worker's health and the nursing care in short-and long-term (6) . Although the relationship between the chronotype and the work shift of nursing has been investigated in national (6)(7)(8) and international studies (1,5,(9)(10)(11) , the scientific literature on this subject can still be considered incipient (12) . In addition, studies that investigate this relation in nursing workers in surgical clinics have not been identified so far.…”

Jet Lag and Shift Work Disorder

“…In a recent study of nurses in the intensive care unit in which the majority where morning chronotypes (64%), compared with evening types, the morning type nurses were more likely to nap before the night shifts, which is considered a good strategy to reduce homeostatic sleep load before work, and to have young children at home, which is often associated with short sleep in shift workers. 57 Evening chronotype and sleep disturbance are both associated with depressive symptoms, and in shift workers sleep disturbance is prevalent. Lee and colleagues 58 examined the complex interactions between chronotype, insomnia, and emotional disturbance.…”

Let them sleep: The effects of a scheduled nap during the night shift on sleepiness and cognition in hospital nurses

“…Additionally, night shift workers may experience cumulative sleep deprivation because of shorter and poorer quality daytime sleep than normal night-time sleep (Åkerstedt & Wright, 2009). These factors, when combined, may lead to increased sleepiness (Geiger-Brown et al, 2012;Reinke, Özbay, Dieperink, & Tulleken, 2015) and impaired cognitive functioning (Chang et al, 2011;Geiger-Brown et al, 2012) during night shifts and to adverse long-term sleep and health outcomes (Caruso, 2014). Furthermore, the negative consequences of shift work may affect not only nurses but also their patients.…”