Dru Michel, Bruge Philippe, Benoit Odile, Mason Nicholas P, Combes Xavier, Margenet Alain, Dhonneur Gilles, Marty Jean
Service d'Anesthésie-Réanimation Chirurgicale-SAMU 94, Hôpital Henri Mondor-AP-HP, Créteil, France.
Eur J Emerg Med. 2007 Aug;14(4):199-203. doi: 10.1097/MEJ.0b013e3280bef7b0.
The impact of prolonged work cycles among senior doctors remains disputed. We evaluated the effects of overnight duty on awake activity and sleep quality in senior doctors in emergency medical specialties.
Thirty-six healthy doctors were monitored during a 2-week period including three separate 84 h on-call cycles. An on-call cycle consisted of the night and the day before night duty; the night duty itself and the subsequent 2 days and nights after night duty. The first day after night duty could either be worked or not. Actigraphy was used to measure physical activity and to evaluate sleep duration and quality. A standardized questionnaire was used to assess daytime performance and night sleep quality.
Night actigraphy demonstrated that on-call work induced a significant reduction in sleep duration that was not recovered during the subsequent two nights. Sleep during the night duty itself was fragmented and of poor quality. Awake activity was significantly impaired on the day after night duty. Although subjectively night sleep quality did not differ between the nights before and after night duty, all subjective daytime parameters were impaired the day after night duty, and mood, fatigue and concentration remained altered on the second day. Working the day after night duty impaired objective measurements of daytime activity and sleep quality during the subsequent two nights.
On-call night work in acute specialties induces sleep debt associated with prolonged impairment of awake activity, sleep quality and performance. Not working the following day after an on-call night allows partial recovery of sleep quality to begin.
资深医生长时间工作周期的影响仍存在争议。我们评估了通宵值班对急诊医学专业资深医生清醒活动和睡眠质量的影响。
在为期2周的时间内对36名健康医生进行监测，包括三个独立的84小时值班周期。一个值班周期包括值夜班前的晚上和白天；值夜班本身以及值夜班后的随后两天两夜。值夜班后的第一天可以工作也可以不工作。使用活动记录仪测量身体活动，并评估睡眠时间和质量。使用标准化问卷评估白天的表现和夜间睡眠质量。
夜间活动记录仪显示，值班工作导致睡眠时间显著减少，在随后的两个晚上并未恢复。值夜班期间的睡眠断断续续且质量很差。值夜班后的第二天清醒活动明显受损。尽管主观上夜间值班前后的睡眠质量没有差异，但所有主观白天参数在值夜班后的第二天都受到损害，并且情绪、疲劳和注意力在第二天仍然受到影响。值夜班后的第二天工作会损害随后两晚白天活动和睡眠质量的客观测量。
急性专科的值班夜班工作会导致睡眠债，伴有清醒活动、睡眠质量和表现的长期受损。值夜班后的第二天不工作可使睡眠质量开始部分恢复。
