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核心体温节律紊乱会影响倒班护士的认知表现。

Misaligned core body temperature rhythms impact cognitive performance of hospital shift work nurses.

机构信息

Department of Psychology, University of Alabama at Tuscaloosa, Tuscaloosa, AL, USA.

UAB School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA.

出版信息

Neurobiol Learn Mem. 2019 Apr;160:151-159. doi: 10.1016/j.nlm.2019.01.002. Epub 2019 Jan 3.

Abstract

Circadian rhythms greatly influence 24-h variation in cognition in nearly all organisms, including humans. Circadian clock impairment and sleep disruption are detrimental to hippocampus-dependent memory and negatively influence the acquisition and recall of learned behaviors. The circadian clock can become out of sync with the environment during circadian misalignment. Shift work represents a real-world model of circadian misalignment that can be studied for its physiological implications. The present study aimed to test the hypothesis that circadian misalignment disrupts vigilance and cognitive performance on occupationally relevant tasks using shift work as a model. As such, we sought to (1) explore the general effects of night- and day-shift worker schedules on sleep-wake parameters and core body temperature (CBT) phase, and (2) determine whether shift-type and CBT phase impact cognitive performance and vigilance at the end of a 12-h shift. We observed a sample of day-shift and night-shift hospital nurses over a 10-day period. At the end of three, consecutive, 12-h shifts (7 pm-7am or 7am-7 pm), participants completed a cognitive battery assessing vigilance, cognitive throughput, and medication calculation fluency (via an investigator developed and tested metric). Night-shift nurses exhibited significantly greater sleep fragmentation as well as a greater disparity between their wake-time and time of CBT minimum compared to day-shift nurses. Night-shift nurses exhibited significantly slower cognitive proficiency at the end of their shifts, even after adjustment for CBT phase. These results suggest that circadian disruption and reduced sleep quality both contribute to cognitive functioning and performance.

摘要

昼夜节律极大地影响了包括人类在内的几乎所有生物体 24 小时的认知变化。昼夜节律紊乱和睡眠中断对海马体依赖的记忆有害,并对习得行为的获取和回忆产生负面影响。昼夜节律时钟在昼夜节律错位时可能会与环境失去同步。轮班工作代表了一种昼夜节律错位的真实世界模型,可以研究其生理意义。本研究旨在通过轮班工作来测试昼夜节律错位是否会破坏警觉性和与职业相关任务的认知表现的假设。因此,我们试图:(1)探索夜班和白班工人轮班计划对睡眠-觉醒参数和核心体温(CBT)相位的一般影响;(2)确定轮班类型和 CBT 相位是否会在 12 小时轮班结束时影响认知表现和警觉性。我们观察了 10 天内连续 3 个 12 小时轮班的日间和夜间医院护士样本。在连续三个 12 小时轮班(7pm-7am 或 7am-7pm)结束时,参与者完成了一项认知测试,评估警觉性、认知吞吐量和药物计算流畅性(通过开发和测试的指标)。与白班护士相比,夜班护士的睡眠碎片化程度更高,醒来时间与 CBT 最小值之间的差距也更大。即使调整了 CBT 相位,夜班护士在轮班结束时的认知能力也明显较慢。这些结果表明,昼夜节律紊乱和睡眠质量下降都会影响认知功能和表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d316/6486423/dcb26699e8b7/nihms-1518582-f0001.jpg

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