Cooperative Research Centre for Alertness, Safety and Productivity, Melbourne, Victoria, Australia.
Monash Institute of Cognitive and Clinical Neurosciences and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia.
Sci Rep. 2019 Mar 15;9(1):4635. doi: 10.1038/s41598-019-40914-x.
Shift work is associated with impaired alertness and performance due to sleep loss and circadian misalignment. This study examined sleep between shift types (day, evening, night), and alertness and performance during day and night shifts in 52 intensive care workers. Sleep and wake duration between shifts were evaluated using wrist actigraphs and diaries. Subjective sleepiness (Karolinska Sleepiness Scale, KSS) and Psychomotor Vigilance Test (PVT) performance were examined during day shift, and on the first and subsequent night shifts (3, 4 or 5). Circadian phase was assessed using urinary 6-sulphatoxymelatonin rhythms. Sleep was most restricted between consecutive night shifts (5.74 ± 1.30 h), consecutive day shifts (5.83 ± 0.92 h) and between evening and day shifts (5.20 ± 0.90 h). KSS and PVT mean reaction times were higher at the end of the first and subsequent night shift compared to day shift, with KSS highest at the end of the first night. On nights, working during the circadian acrophase of the urinary melatonin rhythm led to poorer outcomes on the KSS and PVT. In rotating shift workers, early day shifts can be associated with similar sleep restriction to night shifts, particularly when scheduled immediately following an evening shift. Alertness and performance remain most impaired during night shifts given the lack of circadian adaptation to night work. Although healthcare workers perceive themselves to be less alert on the first night shift compared to subsequent night shifts, objective performance is equally impaired on subsequent nights.
轮班工作会导致睡眠不足和昼夜节律紊乱，从而损害警觉性和表现。本研究在 52 名重症监护工作人员中检查了不同班次（白天、傍晚、夜间）之间的睡眠情况，以及在白天和夜间班次期间的警觉性和表现。使用腕部活动记录仪和日记评估班次之间的睡眠和醒来持续时间。在白天班次、第一和随后的夜间班次（3、4 或 5 次）期间检查主观嗜睡（Karolinska 嗜睡量表，KSS）和精神运动警觉性测试（PVT）的表现。使用尿液 6-硫酸盐褪黑素节律评估昼夜节律相位。连续夜班之间（5.74±1.30 小时）、连续日班之间（5.83±0.92 小时）和傍晚与日班之间（5.20±0.90 小时）的睡眠限制最大。与白天班次相比，第一和随后的夜间班次结束时，KSS 和 PVT 的平均反应时间更高，而第一夜结束时 KSS 最高。在夜间，当尿液褪黑素节律的昼夜高峰期间工作时，KSS 和 PVT 的结果更差。在轮班工人中，早期的白天班次可能与夜班的睡眠限制相似，尤其是在傍晚班次之后立即安排时。由于缺乏对夜间工作的昼夜适应，警觉性和表现仍然在夜间班次期间受到最大影响。尽管医护人员认为自己在第一夜班次期间比随后的夜间班次期间警觉性较低，但在随后的夜间班次期间，客观表现同样受损。
