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轮班小睡与夜间工作护理专业人员的收缩压和舒张压水平有关。

On-shift naps are associated with systolic and diastolic blood pressure level among night working nursing professionals.

机构信息

Laboratory of Health and Environmental Education, Oswaldo Cruz Institute - Fiocruz, Rio de Janeiro, RJ, Brazil.

Department of Collective Health, Federal University of Triangulo Mineiro - Uberaba, MG, Brazil.

出版信息

Chronobiol Int. 2020 Sep-Oct;37(9-10):1365-1372. doi: 10.1080/07420528.2020.1819114. Epub 2020 Sep 17.

Abstract

Few studies have analyzed on-shift naps with regard to shift workers' health. The aim of this study was to examine the association between exposure to night work (intensity and length of exposure to night work) and blood pressure (BP), considering the impact of on-shift naps. A cross-sectional study was carried out at a hospital based on a questionnaire and measurement of BP. The outcomes were systolic blood pressure (SBP), diastolic blood pressure (DBP), and casual hypertension (HTN), i.e., SBP > 140 mmHg, or DBP > 90 mmHg, or reporting a prescription of antihypertensive medication. The sample comprised 449 fixed 12 h night workers who were (unofficially) allowed to nap during the night shift for up to 3 h. Approximately 42% of the sample reported napping. Among non-nappers (but not among nappers), those exposed to more work nights (≥5/fortnight) showed a DBP that was 3.66 mmHg higher than that of the reference group. The likelihood of casual HTN was more than three-fold greater among non-nappers working more nights/fortnight than among those working fewer nights/fortnight. A similar tendency was observed in a subsample of workers who did not take antihypertensive medication. The results were less consistent regarding length of exposure to night work (in years). A possible explanation is that workers who usually take on-shift naps could experience suppression of the BP increase derived from the many nights worked, while the non-nappers did not experience this suppression. The results may be explained by the relationship between napping, melatonin secretion, and attenuation of circadian misalignment. Napping likely contributes to creating a "physiologically nocturnal environment" that tends to favor the circadian system and, therefore, health. Possible negative effects related to sleep inertia deserve attention. The findings encourage new studies on this topic to improve the management of night work at hospitals in regard to workers' health.

摘要

很少有研究分析轮班工人的健康与轮班小睡之间的关系。本研究旨在检验夜间工作(夜间工作的强度和时间长短)与血压(BP)之间的关联,同时考虑到轮班小睡的影响。这是一项在医院进行的横断面研究,通过问卷调查和血压测量来评估相关数据。研究结果包括收缩压(SBP)、舒张压(DBP)和偶发性高血压(HTN),即 SBP > 140mmHg 或 DBP > 90mmHg,或报告使用抗高血压药物。该样本包含 449 名固定 12 小时夜间工作者,他们(非官方)允许在夜班期间小睡长达 3 小时。大约 42%的样本报告有小睡。在非小睡者中(而非小睡者中),那些暴露于更多夜班(≥5/两周)的人,其 DBP 比参照组高 3.66mmHg。与每周工作较少夜班的人相比,每周工作更多夜班的非小睡者发生偶发性 HTN 的可能性要高出三倍以上。在未服用抗高血压药物的工人亚样本中也观察到了类似的趋势。关于夜间工作时间(年)的暴露长度,结果不太一致。一种可能的解释是,通常进行轮班小睡的工人可能会抑制由于工作多晚而导致的血压升高,而不进行小睡的工人则不会经历这种抑制。这些结果可能与小睡、褪黑素分泌和昼夜节律失调的衰减有关。小睡可能有助于创造一个“生理上的夜间环境”,有利于昼夜节律系统,从而有利于健康。与睡眠惯性相关的潜在负面影响值得关注。这些发现鼓励对这一主题进行新的研究,以改善医院夜间工作对工人健康的管理。

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