Department of Emergency Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
Division of Community Health Services, Emergency Medicine Program, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania.
Am J Ind Med. 2020 Oct;63(10):843-850. doi: 10.1002/ajim.23164. Epub 2020 Aug 6.
Fatigue and sleep deficiency among public safety personnel are threats to wellness, public and personal safety, and workforce retention. Napping strategies may reduce work-related fatigue, improve safety and health, yet in some public safety organizations it is discouraged or prohibited. Our aim with this commentary is to define intra-shift napping, summarize arguments for and against it, and to outline potential applications of this important fatigue mitigation strategy supported by evidence. We focus our discussion on emergency medical services (EMS); a key component of the public safety system, which is comprised of police, fire, and EMS. The personnel who work in EMS stand to benefit from intra-shift napping due to frequent use of extended duration shifts, a high prevalence of personnel working multiple jobs, and evidence showing that greater than half of EMS personnel report severe fatigue, poor sleep quality, inadequate inter-shift recovery, and excessive daytime sleepiness. The benefits of intra-shift napping include decreased sleepiness and fatigue, improved recovery between shifts, decreased anxiety, and reduced feelings of burnout. Intra-shift napping also mitigates alterations in clinician blood pressure associated with disturbed sleep and shift work. The negative consequences of napping include negative public perception, acute performance deficits stemming from sleep inertia, and the potential costs associated with reduced performance. While there are valid arguments against intra-shift napping, we believe that the available scientific evidence favors it as a key component of fatigue mitigation and workplace wellness. We further believe that these arguments extend beyond EMS to all sectors of public safety.
公共安全人员的疲劳和睡眠不足对健康、公共和个人安全以及劳动力保留构成威胁。打盹策略可以减少与工作相关的疲劳,提高安全性和健康水平,但在一些公共安全组织中,这种做法受到限制甚至禁止。我们撰写这篇评论的目的是定义轮班内打盹,总结支持和反对它的论点,并概述这种重要的疲劳缓解策略的潜在应用,该策略有证据支持。我们将讨论重点放在紧急医疗服务(EMS)上;它是公共安全系统的一个关键组成部分,公共安全系统由警察、消防和 EMS 组成。由于频繁使用长时间轮班、大量人员从事多份工作,以及有证据表明超过一半的 EMS 人员报告严重疲劳、睡眠质量差、轮班之间恢复不足和过度日间嗜睡,因此 EMS 人员从轮班内打盹中受益最大。轮班内打盹的好处包括减少困倦和疲劳、改善轮班之间的恢复、减少焦虑和减少倦怠感。轮班内打盹还可以减轻与睡眠障碍和轮班工作相关的临床医生血压变化。打盹的负面影响包括公众负面看法、睡眠惯性引起的急性表现缺陷,以及与表现下降相关的潜在成本。虽然有反对轮班内打盹的合理论点,但我们认为现有的科学证据支持将其作为疲劳缓解和工作场所健康的关键组成部分。我们进一步认为,这些论点不仅适用于 EMS,也适用于所有公共安全领域。