University of Pittsburgh, School of Medicine, Department of Emergency Medicine, 3600 Forbes Avenue, Iroquois Bldg., Suite 400A, Pittsburgh, PA 15261, USA; University of Pittsburgh, Department of Rehabilitation Science & Technology, Program in Emergency Medicine, 230 McKee Place, Pittsburgh, PA 15261, USA.
University of Pittsburgh, School of Medicine, Department of Emergency Medicine, 3600 Forbes Avenue, Iroquois Bldg., Suite 400A, Pittsburgh, PA 15261, USA; University of Pittsburgh, Department of Rehabilitation Science & Technology, Program in Emergency Medicine, 230 McKee Place, Pittsburgh, PA 15261, USA.
Sleep Health. 2019 Aug;5(4):359-369. doi: 10.1016/j.sleh.2019.03.001. Epub 2019 Apr 26.
Sleep deprivation is common in shift work occupations, including safety-sensitive occupations. While extending sleep prior to scheduled shifts (i.e., "banking sleep") may be an intuitive strategy for fatigue mitigation, the evidence behind this strategy is unclear.
We performed a systematic review of literature retrieved in searches of four databases. We examined agreement between two independent screeners, abstracted key findings, reviewed and synthesized findings, and evaluated the quality of evidence using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. The Cochrane Collaboration's risk of bias tool was used to evaluate bias of individual studies. We reported findings as prescribed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
Of the 3007 records screened, five met inclusion criteria. The inter-rater agreement for inclusion/exclusion was high (κ = 0.87). One study addressed patient safety outcomes. Four studies assessed the impact of banking sleep on performance, five assessed measures of acute fatigue, and three evaluated banking sleep on indicators of health. All five studies presented a very serious risk of bias and the quality of evidence was very low. Given these caveats, the findings, in aggregate, support banking sleep as a strategy to improve indicators of performance and acute fatigue.
This systematic review identifies gaps in research of shift workers on the efficacy of banking sleep as a fatigue risk management strategy. The available evidence supports banking sleep prior to shiftwork as a strategy for improved patient safety, performance, and reducing acute fatigue.
睡眠剥夺在轮班工作中很常见，包括对安全敏感的职业。虽然在预定班次之前延长睡眠时间（即“储存睡眠”）可能是缓解疲劳的直观策略，但该策略的证据尚不清楚。
我们对四个数据库中检索到的文献进行了系统评价。我们检查了两名独立筛查员之间的一致性，提取了关键发现，审查并综合了研究结果，并使用 Grading of Recommendations，Assessment，Development，and Evaluation (GRADE) 方法评估证据质量。个体研究的偏倚使用 Cochrane 协作风险偏倚工具进行评估。我们按照系统评价和荟萃分析的首选报告项目 (PRISMA) 声明报告发现。
在筛选的 3007 条记录中，有 5 条符合纳入标准。纳入/排除的两名审查员之间的一致性很高（κ=0.87）。一项研究涉及患者安全结果。四项研究评估了储存睡眠对性能的影响，五项研究评估了急性疲劳的测量指标，三项研究评估了储存睡眠对健康指标的影响。五项研究均存在非常严重的偏倚风险，证据质量非常低。考虑到这些注意事项，总体而言，这些发现支持储存睡眠作为改善性能和急性疲劳的策略。
这项系统评价确定了关于轮班工人储存睡眠作为疲劳风险管理策略的疗效的研究中的空白。现有证据支持在轮班前储存睡眠作为提高患者安全性、绩效和减少急性疲劳的策略。
