Abstract

Abstract Introduction Circadian rhythms play an important role in regulating sleep. Sleep disturbances are prevalent in shift-work nurses, particularly for those work in rapid-shift rotation, including night shifts and day shifts. This study aimed to: 1) describe the characters of sleep-wake index (total sleep time [TST], wake after sleep onset [WASO], circadian activity rhythms [CAR]), psychomotor vigilance test (PVT), salivary cortisol, fatigue, and activity level during 8- and 12-hour rapid-shift work nurses; and 2) compare the parameters between two different shifts. Methods This exploratory study used registered nurses (RNs) from nine intensive care units in Beijing area. 7-days consecutive wrist actigraphy data, including TST and WASO were collected. Cosiner analysis was used for computing the CAR, including amplitude and mesor. PVT and saliva cortisol were used to assess alertness level, which measured before and after shift. Self-reported fatigue severity was measured by Lee Fatigue Scale-Short Form and assessed before and after shift. Results A total of 152 RNs (12-hour, n=82; 8-hour, n=70) participated this study, with a mean age of 31.81 (SD= 6.09). Compared with the 8-hour shift nurses, the 12-hour shift nurses were significantly higher in TST (456 vs. 364 minutes), median saliva cortisol level (before day shift, 0.54 vs. 0.31), and median PVT reaction time (before night shift). However, CAR were 0.53 (SD=0.13) and 0.50 (SD=0.18) for 12-hour and 8-hour shift RNs, respectively, and indicates desynchronized CAR in both groups. Regardless shift rotation, almost three-quarters of the RNs had a 500 ms PVT reaction time. For the 12-hour and 8-hour nurses, the level of activity during day shift was similar. However, during night shift work it was significantly lower in 12-hour nurses compared to the 8-hour nurses. All RNs experienced clinical significant fatigue severity (ranged 3.78 to 8.14) regardless before or after shift work; however, the 12-hour group reported lower fatigue severity than 8-hour group. Conclusion In this study, findings revealed shift-work RNs experienced fatigue and desynchronized CAR. The TST was low and reaction time was prolonged before and after shift work. Sleep intervention should be mandatorily included in clinical continue education. Support (if any) This project was supported by Chinese National Natural Science Foundation (71603279).

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