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意大利医院医生队列中睡眠障碍的流行情况及其嗜睡的决定因素:PRESOMO 研究。

Prevalence of sleep disruption and determinants of sleepiness in a cohort of Italian hospital physicians: The PRESOMO study.

机构信息

Interdepartmental Sleep Research Centre, Department of Medical Sciences and Public Health, University of Cagliari, Monserrato, Italy.

Section of Neurology, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

出版信息

J Sleep Res. 2022 Feb;31(1):e13377. doi: 10.1111/jsr.13377. Epub 2021 Jun 27.

Abstract

Nightshift work can cause daytime somnolence and decreased alertness, and can increase risk of medical errors, occupational injuries and car accidents. We used a structured questionnaire, including the Epworth Sleepiness Scale (ESS), to assess the prevalence and the determinants of sleep disruption in 268 Italian University hospital physicians from Cagliari (N = 57), Milan (N = 180) and Pisa (N = 31), who participated in the multicentre study on the prevalence of sleep disturbance among hospital physicians (PRESOMO); 198 of them (74%) were engaged in nightshift work. We explored the association between history of nightshift work and poor sleep quality and daytime somnolence with multivariate logistic regression, adjusting by personal and lifestyle covariates. Age, female gender, taking medication interfering with sleep and an elevated ESS score were significant predictors of poor sleep quality and daytime somnolence. Nightshift work was associated with a higher prevalence of unrestful sleep (84% versus 70%; odds ratio [OR] = 2.4, 95% confidence interval [CI] 1.18-5.05) and daytime dozing (57% versus 35%; OR = 1.9, 95% CI 1.03-3.64), with an upward trend by years of engagement in nightshift work for both conditions (p = .043 and 0.017, respectively), and by number of nightshifts/year for unrestful sleep (p = .024). Such an association was not detected with the ESS scale. Our results suggest that nightshift work significantly affects sleep quality and daytime somnolence in hospital physicians, who might underestimate their daytime dozing problem, when asked to subjectively scale it.

摘要

夜班工作会导致白天嗜睡和警觉性下降,并增加医疗失误、职业伤害和车祸的风险。我们使用了一份结构化问卷,包括 Epworth 嗜睡量表(ESS),来评估来自卡利亚里(Cagliari,N=57)、米兰(Milan,N=180)和比萨(Pisa,N=31)的 268 名意大利大学医院医生的睡眠障碍发生率及其决定因素,他们参加了多中心医院医生睡眠障碍患病率研究(PRESOMO);其中 198 名(74%)从事夜班工作。我们通过多变量逻辑回归,调整个人和生活方式因素,探索了夜班工作史与睡眠质量差和白天嗜睡之间的关系。年龄、女性、服用影响睡眠的药物和 ESS 评分升高是睡眠质量差和白天嗜睡的显著预测因素。夜班工作与睡眠不安(84%比 70%;比值比 [OR] = 2.4,95%置信区间 [CI] 1.18-5.05)和白天瞌睡(57%比 35%;OR = 1.9,95% CI 1.03-3.64)的发生率较高相关,随着从事夜班工作年限的增加,这两种情况的发生率均呈上升趋势(分别为 p = 0.043 和 0.017),而与每年夜班次数与睡眠不安相关(p = 0.024)。ESS 量表未检测到这种关联。我们的结果表明,夜班工作会显著影响医院医生的睡眠质量和白天嗜睡,当要求他们主观评估白天瞌睡问题时,他们可能会低估自己的白天瞌睡问题。

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