Smith-Coggins R, Rosekind M R, Hurd S, Buccino K R
Department of Surgery, School of Medicine, Stanford University, CA.
Ann Emerg Med. 1994 Nov;24(5):928-34. doi: 10.1016/s0196-0644(94)70209-8.
To document and analyze the quality and quantity of emergency physicians' sleep as a function of day and night shift work, and to compare cognitive and motor performance and mood during day and night shifts.
Six physicians were monitored for two 24-hour periods. One period consisted of daytime work and nocturnal sleep and the second consisted of daytime sleep and nighttime work.
The emergency department of Stanford University Medical Center and physicians' homes.
Six attending emergency physicians.
Ambulatory polysomnographic recorders continuously gathered EEG, electro-oculogram, and electromyograph data throughout each observation period. Physicians filled out hourly mood ratings and completed a set of two performance tests five times throughout the day.
Physicians had significantly less sleep (496.6 minutes versus 328.5 minutes, P = .02) when sleeping during the day as compared with sleeping at night. Significant performance decrements were also found. Physicians working nights were slower at intubating a mannequin (31.56 seconds versus 42.2 seconds, P = .04) and were more likely to commit errors as their shift progressed (P = .04). Physicians in both conditions were more likely to make errors during a simulated triage test toward the end of their shifts (P = .02). Subjects also rated themselves significantly less sleepy (P < .01), happier (P < .01), and more clear thinking (P < .01) when working day versus night shifts.
Attending emergency physicians get less sleep and are less effective when performing manual and cognitive tests while working night shifts with day sleep compared with working day shifts with night sleep.
记录并分析急诊医生的睡眠质量和数量与昼夜轮班工作的关系，并比较昼夜轮班期间的认知、运动表现及情绪。
对六位医生进行两个24小时时段的监测。一个时段包括白天工作和夜间睡眠，另一个时段包括白天睡眠和夜间工作。
斯坦福大学医学中心急诊科及医生家中。
六位急诊主治医生。
便携式多导睡眠记录仪在每个观察时段持续收集脑电图、眼电图和肌电图数据。医生每小时填写情绪评分，并在一天内完成五次两组性能测试。
与夜间睡眠相比，医生白天睡眠时的睡眠时间显著减少（496.6分钟对328.5分钟，P = 0.02）。还发现了显著的表现下降。值夜班的医生给人体模型插管的速度较慢（31.56秒对42.2秒，P = 0.04），并且随着轮班的进行更容易出错（P = 0.04）。在两种情况下，医生在轮班接近尾声时进行模拟分诊测试时更容易出错（P = 0.02）。与值夜班相比，受试者在值白班时自我评定的困倦程度显著降低（P < 0.01）、更快乐（P < 0.01）、思维更清晰（P < 0.01）。
与白天工作夜间睡眠的轮班相比，急诊主治医生在白天睡眠夜间工作的轮班期间睡眠较少，在进行手动和认知测试时效率较低。
