Abstract
Background: Shift working is associated with a profound desynchronization of circadian rhythm and in particular, night-shift work disrupts normal circadian physiology. Sleep deprivation affects the functioning of certain brain areas and thus impairs cognitive performance. The purpose of this study was to investigate the effects of the night shift on cognitive performance and cerebral oxygenation/haemodynamics. Methods: A prospective, observational, comparative, randomized and cross-over study was carried out. A total of 74 intensive care unit nurses in Spain were included in the study. The following variables were measured: sociodemographic, burnout, anxiety, baseline cerebral oxygenation levels on night and day shift using a near-infrared spectroscopy system and cognitive task performance during a verbal fluency task to evaluate the alterations in the prefrontal cortex, assessed as changes in regional saturation index. Results: The average regional saturation index decreased significantly in the night shift (r = 0.560, p < 0.001). The ICU nurses showed a significant decrease in the verbal fluency test on average (8.53 ± 8.49, p < 0.001) and, in general, there was also a significant increase in anxiety score (3.17 ± 7.56, p = 0.001). Conclusions: Sleep deprivation during the night shift was considered to be related to decreased dorsolateral PFC reactivity. After the night shift, the nurses showed a decrease in prefrontal cortex activity and in cognitive performance.
Highlights
Nursing care provision is always organized in shift work to guarantee the healthcare of patients
We examined psychological stress and anxiety related to the night shift experience, in addition to that probably associated with the conditions of sleep deprivation that this shift entails
Our results demonstrate a negative correlation between the State-Trait Anxiety Inventory (STAI) scores and the verbal fluency tasks (VFT), with worse verbal fluency (VF) results in nurses with higher anxiety scores, mainly on the night shift
Summary
Nursing care provision is always organized in shift work to guarantee the healthcare of patients. Sleep deprivation and chronic tiredness related to long working hours are common among health services, mainly intensive care unit (ICU) nurses. This problem is increased by night-shift-related acute fatigue and sleep deprivation. It has been clearly established that chronic tiredness, fatigue and sleep deprivation have negative impacts on the health status of nurses and can jeopardize patient safety [1,2]. The main reasons for medical errors are stress, fatigue, increased workload, night shifts, and workflow interruptions. Shift working is associated with a profound desynchronization of circadian rhythm [3]
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