Cappadona R, De Giorgi A, Boari B, Tiseo R, Lopez-Soto P J, Fabbian F, Manfredini R
Department of Medical Sciences, University of Ferrara, Ferrara, Italy.
Eur Rev Med Pharmacol Sci. 2021 Nov;25(22):6924-6933. doi: 10.26355/eurrev_202111_27241.
Nursing is a high-stress occupation, and recent research of circadian rhythm desynchronization has focused on its consequences for nurses' health. Moreover, shiftwork, sleep disturbances, nightmares, and health issues are closely related to individual circadian preferences ('chronotype'). The aim of this narrative mini-review was to check the available literature to collect findings on the interrelationships among these aspects, as well as to determine the possible consequences for performance.
We explored the PubMed, EMBASE and Google Scholar electronic databases using the search terms 'Nursing', 'Stress', 'Sleep disturbances', 'Nightmares', 'Circadian rhythm', 'Desynchronization', 'Chronotype', 'Performance', and 'Sex/Gender'. Due to the wide heterogeneity of studies, with most including only some of these terms, we proceeded to single data extractions after analyzing the studies case by case and decided to conduct a narrative mini-review.
Shift work, due to the regular alterations of the daily light profile, disrupts the normal circadian sleep-wake cycle and is associated with impaired health among rotational shift workers, with nurses on the frontline. Circadian desynchronization may be associated with adverse effects on nurses' health and may be a risk factor for stress, metabolic disorders, and sleep disturbances, including nightmares, and stress operates in a bidirectional fashion. Chronotype plays a crucial role as well, since the asynchrony between one's chronotype and social working hours (social jetlag) may generate problems, since the time-of-day and optimal performance are strongly connected.
Circadian rhythms, chronotype, sleep, health, and working performance are strongly connected. The assessment of chronotype could represent a tool to identify health care personnel at higher risk of circadian disruption, allowing for mitigation of work-related stress and sleep disturbances, and reducing the risk of making working errors.
护理是一项压力较大的职业，近期关于昼夜节律失调的研究聚焦于其对护士健康的影响。此外，轮班工作、睡眠障碍、噩梦及健康问题与个体的昼夜偏好（“生物钟类型”）密切相关。本叙述性小型综述的目的是查阅现有文献，收集这些方面之间相互关系的研究结果，并确定其对工作表现可能产生的影响。
我们使用“护理”“压力”“睡眠障碍”“噩梦”“昼夜节律”“失调”“生物钟类型”“工作表现”及“性别”等检索词，在PubMed、EMBASE和谷歌学术电子数据库中进行检索。由于研究的异质性较大，大多数研究仅包含其中部分检索词，我们在逐案分析研究后进行了单独的数据提取，并决定进行一次叙述性小型综述。
轮班工作由于日常光照模式的定期改变，扰乱了正常的昼夜睡眠 - 清醒周期，与轮班工作的一线护士健康受损有关。昼夜节律失调可能对护士健康产生不利影响，可能是压力、代谢紊乱和包括噩梦在内的睡眠障碍的危险因素，且压力以双向方式起作用。生物钟类型也起着关键作用，因为个体生物钟类型与社会工作时间之间的不同步（社会时差）可能会产生问题，因为一天中的时间与最佳工作表现密切相关。
昼夜节律、生物钟类型、睡眠、健康和工作表现紧密相连。对生物钟类型的评估可作为一种工具，用于识别昼夜节律紊乱风险较高的医护人员，从而减轻与工作相关的压力和睡眠障碍，并降低工作失误的风险。
