Polyphasic sleep strategies improve prolonged sustained performance: A field study on 99 sailors

In situations where continuous prolonged work demands exist, the habitual nocturnal monophasic (6-8h duration) sleep pattern can rarely be accomplished, and performance effectiveness may sometimes be severely compromised by accumulation of sleep debt. Several studies have shown that naps can be disproportionately effective in recovering functioning during continuous work (CW).

In this study, sleep-wake patterns and their relationship to performance were studied for 99 sailors involved in solo and double-handed ocean sailing races (a model of a highly demanding CW situation). Most sailors spontaneously adopted multiple nap sleep-wake schedules and adapted without major difficulties to such polyphasic patterns. 66.5% had mean sleep episode durations (SEDs) ranging from 20 min to 2h. Overall mean Total Sleep Time (TST) per 24h was reduced from a baseline of 7.5 to 6.3h. Race performance correlated negatively and significantly with mean SEDs and TSTs. Best performance results were obtained by those sleeping for periods of between 20 min and 1 h and for a total of 4.5 to 5.5h of sleep per day.

The results are discussed together with several chronobiological, phylogenetic and experimental studies and issues, all of which suggest that adult humans may have a damped polyphasic sleep-wake tendency. It is also proposed that polyphasic sleep schedules could become promising and feasible solutions for the management of sleep requirements under prolonged CW situations.     

The benefits of a nap during prolonged work and wakefulness

Prolonged work scenarios with demands for sustained performance are increasingly common. Because sleep loss inevitably compromises functioning in such situations, napping has been proposed as a countermeasure. The optimal timing of the nap relative to its benefits for performance and mood is not known, however. To address this issue, 41 healthy adults were permitted a two-hour nap at one of five times during a 56-hour period of intermittent work, with no other sleep. Naps were placed 12 hours apart, near the circadian peak (P) or trough (T), and were preceded by 6(P), 18(T), 30(P), 42(T), or 54(P) hours of wakefulness. Work test bouts occurred every few hours and consisted of a variety of psychomotor and cognitive tasks as well as mood scales completed at the beginning, middle and end of each bout. A total of eight performance and 24 mood parameters were derived from the bouts and compared between groups at all test points prior to and following the naps. An estimate of the extent to which each nap condition differed from the control (P54) condition was derived by totalling the proportion of test points that yielded statistically significant results relative to the total number of tests conducted both before and after naps.

Although all performance and most mood parameters displayed a circadian-modulated deterioration as the protocol progressed, a nap appeared to attentuate the extent of this change in all performance parameters but not in mood parameters. Overall, the timing of the nap across days and within the circadian cycle was irrelevant to its effect on performance, suggesting that it diminished the intrusion of sleepiness into behavioural functioning, even though subjects were phenomenally unaware of this benefit.     

The impact of shiftwork on personnel at a nuclear power plant: An exploratory survey study

Shiftwork may constitute an additional risk factor in high-hazard industries where system failure could exact heavy human, environmental and economic costs. This exploratory survey study examined the impact of shiftwork upon nuclear power plant workers' perceived health, sleep, and social problem, as well as levels of alertness. Overall, the night shik proved to be the most problematic in ternis of decreases in alertness, sleep duration and quality, and disruptions to health, social and family life. The permanent shift preferences of the shiftworkers were also explored to establish the practicability of introducing a theoretically safer permanent mght shdt at such a facility. Importantly, the small proportion of the sample who showed a preference for a pemianent night shift was insufficient to provide operational cover. Although these shtftworkers reported experiencing less disruption on the night shift than those who would choose to work a permanent day shift, their preference appeared to be based upon a greater esprit de corps on this shift rather than on any predisposing individual characteristics. These results have practical implications for work scheduling in high-hazard industries.

The present study investigates the dimensional structure of the psychosocial work environment as assessed by Karasek's job characteristics scales and a set of factorial scales derived from the Dictionary of Occupational Titles (DOT) observers' ratings of occupational characteristics for census occupations. Scale scores on the Karasek and DOT were linked to information on occupation from the Epidemiologc Catchment Area (ECA) study sample. Scale intercorreladons and factor analysis were performed on those ECA subjects who reported ever having a full-time job (n=11,789). DOT'sS Substantive Complexity scale was positively correlated with Karasek's Skill Discretion and Decision Authority scales, and DOT's Physical Demands and Hazards scale was positively correlated with Karasek's Physical Demands scale. In addition, the DOT system compared to the Karasek system seems to assess psychosocial work domains less characteristic of traditional industrial jobs (interpersonal stress, expressive work). The content validity of the Karasek scales might be increased with the assessment of these domains. Giving support to Karasek's Demand/Control Model, the factor structure of the psychosocial work enviromnent in the probability sample of five US metropolitan populations yielded two major dimensions: Control, and Physical Demands.     

Performance, alertness, and sleep after 3·5 years of 12 h shifts: A follow-up study

Control room operators at a continuous processing plant have been working a 12 h/3-4 day rotating shift schedule for over 3 years. After 7 months on this schedule, our initial assessment indicated decrements in performance and alertness, and a mild to moderate sleep debt, when the 12 h shift schedule was compared to the previously-worked 8 h shift schedule. In an effort to track long-term adaptation to the schedule, we conducted a 3 & 5 year follow-up evaluation using the same set of measures. Long-term follow-up testing revealed persistent decrements in performance and alertness attributable to 12 h shifts, and 1-3 h reductions in total sleep time after 12 h night shifts. Little deterioration in performance or alertness was observed across the workweek, which suggested day-to-day recovery from the extended workshift. The popularity of the 12 h shift schedule at this worksite indicates that the workers are willing to tolerate extra fatigue to derive other benefits from this schedule.     

Ten-hour days and eight-hour nights: Can the Ottawa Shift System reduce the problems of shiftwork?

Most research on condensed working weeks has concentrated either on daywork only or on 12-h shifts. The Police Force in Ottawa, Canada, have been reporting positive experiences with a shift system which retains an 8-h night shift but which extends the day shifts to 10-h, thus enabling a 6-day rest period following night shifts. In the present study, the effects on well-being, personal, social and work disruption, alertness and sleep were evaluated when the same system was adopted by a police force in the UK. A survey was conducted at four police stations prior to the change and again 6 months after the change. Two of the stations did not change to the Ottawa system and hence formed a control group. The stations originally worked 8-h shifts with blocks of seven consecutive shifts. The results suggest that, in contrast to the control group the 'Ottawa' group experienced a significant improvement in well-being, a significant reduction in personal, social and work disruption, and a significant increase in average sleep duration over a shift cycle. Self-rated alertness at the end of shifts was no worse under the Ottawa system. However, the values were still very low at the end of the night shift and, with an average sleep duration between night shifts of only 6-4-h it suggests that the block of seven nights in the Ottawa system may need review.     

Work satisfaction, health, and stress: A study of Dutch nurses

A study was conducted to compare nurses' work satisfaction and feelings of health and stress in five different nursing departments: a cardiac care unit and a general surgical ward in a general hospital; and an admissions department, a short-stay department, and a long-stay department in a psychiatric hospital. One hundred nurses took part in the study: the instruments used were questionnaires and structured interviews. The main results showed that:

(1) nurses in the cardiac care unit had the most positive satisfaction scores

(2) nurses in the general surgical ward had the most positive scores on the health and stress variables

(3) feelings of dissatisfaction and stress were most prominent in the short-stay department and, to a lesser extent, in the long-stay department.

The findings are interpreted in terms of the different work situations and die implications for hospital management are discussed.

Dr J. A. Landeweerd graduated in industrial and organizational psychology in 1968 (PhD in 1978). He has worked at Eindhoven University of Technology (Department of Industrial Engineering) and now holds a position as senior lecturer at Limburg University (Department of Health Sciences), where he is project-leader for a number of research projects on the relationships between work and health.

Nicolle Boumans, MA, graduated in health sciences in 1985 (specialization: nursing science) and is now a research assistant. She is working on a PhD thesis concerned with the relationship between task characteristics of nurses and their reaction in terms of job satisfaction, health and stress.     

Stress factors among lecturers in a college of further education

This article presents some of the findings of a pilot study of sources of stress among lecturers working in a college of further education. The empirical work was carried out over a four-week period, with lecturers, chosen at random, being asked to participate using one or all of the three research methods employed: personal interviews, completing a questionnaire, and keeping a diary.

The study set out to address two broad questions. First, 'What are the experiences that can give rise to stress and, having identified them, how often do these experiences occur?' Second, 'Having identified the sources of stress, did the lecturers feel that such experiences affected their teaching, their preparation for teaching or their assessments as a result of teaching?'

The data highlighted the fact that mere were four broad problem areas or sources of stress within this college of further education and that some were seen to occur 'frequently'. However, whether such sources of stress affected actual teaching was not dear, but mere was some support for the notion that the preparation for teaching and the assessment as a result of teaching were affected.     

The benefits of a nap during prolonged work and wakefulness

Abstract

Prolonged work scenarios with demands for sustained performance are increasingly common. Because sleep loss inevitably compromises functioning in such situations, napping has been proposed as a countermeasure. The optimal timing of the nap relative to its benefits for performance and mood is not known, however. To address this issue, 41 healthy adults were permitted a two-hour nap at one of five times during a 56-hour period of intermittent work, with no other sleep. Naps were placed 12 hours apart, near the circadian peak (P) or trough (T), and were preceded by 6(P), 18(T), 30(P), 42(T), or 54(P) hours of wakefulness. Work test bouts occurred every few hours and consisted of a variety of psychomotor and cognitive tasks as well as mood scales completed at the beginning, middle and end of each bout. A total of eight performance and 24 mood parameters were derived from the bouts and compared between groups at all test points prior to and following the naps. An estimate of the extent to which each nap condition differed from the control (P54) condition was derived by totalling the proportion of test points that yielded statistically significant results relative to the total number of tests conducted both before and after naps.

Although all performance and most mood parameters displayed a circadian-modulated deterioration as the protocol progressed, a nap appeared to attentuate the extent of this change in all performance parameters but not in mood parameters. Overall, the timing of the nap across days and within the circadian cycle was irrelevant to its effect on performance, suggesting that it diminished the intrusion of sleepiness into behavioural functioning, even though subjects were phenomenally unaware of this benefit.     

On-shift and daily variations in self-report and performance measures in rotating-shift and permanent night nurses

An intensive study was conducted of the influence of type of shift system, type of shift, and time-into-shift on a battery of on-shift and daily measures obtained from 61 female nurses over a 28-day period. Thirty-two rotating-shift nurses and 28 permanent night nurses recorded data on a hand-held computer at the start and end of each day, and every 2-h during their shifts. The measures included a sleep diary, self-ratings of mood, workload, and personal disruption, and two cognitive performance tasks. These results suggest that the permanent night nurses were no worse off and for some measures were actually better off than the rotating-shift nurses after controlling for differences in age and shiftwork experience; the night-shift was problematic for the rotating-shift nurses but so was the early shift; mood deteriorated and reaction time got slower over the course of the night-shift but extra long responses (which may correspond to lapses of attention) and rated workload were lower on the night-shift. The relatively large number of consecutive night-shifts worked by the rotating-shift nurses, the uneven distribution of workload between shifts, and the long night-shift may have contributed to these results.     

On-shift and daily variations in self-report and performance measures in rotating-shift and permanent night nurses

Abstract

An intensive study was conducted of the influence of type of shift system, type of shift, and time-into-shift on a battery of on-shift and daily measures obtained from 61 female nurses over a 28-day period. Thirty-two rotating-shift nurses and 28 permanent night nurses recorded data on a hand-held computer at the start and end of each day, and every 2-h during their shifts. The measures included a sleep diary, self-ratings of mood, workload, and personal disruption, and two cognitive performance tasks. These results suggest that the permanent night nurses were no worse off and for some measures were actually better off than the rotating-shift nurses after controlling for differences in age and shiftwork experience; the night-shift was problematic for the rotating-shift nurses but so was the early shift; mood deteriorated and reaction time got slower over the course of the night-shift but extra long responses (which may correspond to lapses of attention) and rated workload were lower on the night-shift. The relatively large number of consecutive night-shifts worked by the rotating-shift nurses, the uneven distribution of workload between shifts, and the long night-shift may have contributed to these results.     

Is there an optimum number of night shifts? Relationship between sleep, health and well-being

By concentrating on the impact of a specific shift-system feature on the well-being of those concerned, rather than on the impact of the shift system as a whole, one might be able to offer more meaningful suggestions as to what constitutes a better form of shift system. The present study focused on the impact of the number of consecutive night shifts worked on the health and well-being of two groups of nurses (permanent night and rotating shift). All nurses completed a copy of the Standard Shiftwork Index, which is a set of questionnaires designed for comparing the effects of different types of shift system on large groups of workers. It includes measurements of psychological ill-health, physical ill-health, chronic fatigue, social and domestic disruption, attitudes towards shiftwork, sleep quality and sleep habits. Results showed clearly the impact of the number of consecutive nights worked on health and well-being, not directly, but indirectly through the impact on sleep duration and sleep quality. Sleep duration was shown to increase with more consecutive nights worked. This in turn was found to predict sleep quality, which in turn was found to be the stronger direct predictor of psychological and physical ill-health: i.e. better health was associated with longer and better quality sleeps. Explanations in terms of circadian adaptation are discussed.     

Sleep and napping in young shiftworkers: A 5-year follow-up

Abstract

The present study examined sleep characteristics in young workers who entered rapidly rotating shiftwork for the first time and stayed on shifts for 5 years. Data were collected when the subjects had shiftwork experience of approximately 1.5, 3.5 and 5.5 years and a mean age of 22, 24 and 26 years. Data are presented showing significant differences in the main sleep durations between situations within the shift cycle and a small reduction in overall sleep over the observed period, primarily due to a sleep reduction on afternoon shift days. Data on sleep quality did not show any change over this early period of shiftwork exposure. In addition, napping strategies did not change, with the exception of a small increase in those taking naps on night-shift days between 1.5 years and 3.5 years of shiftwork exposure. At all the observed phases there were more young shiftworkers taking a nap on the morning shift days than on the night-shift days. The data suggested that reduced sleeps on morning and night-shift days were not compensated by taking a nap, but rather with an increase in main sleep duration on afternoon shift days and days off. A weak tendency for individuals to be relatively long or short sleepers irrespective of sleep conditions could be seen.     

Is there an optimum number of night shifts? Relationship between sleep,health and well-being

Abstract

By concentrating on the impact of a specific shift-system feature on the well-being of those concerned, rather than on the impact of the shift system as a whole, one might be able to offer more meaningful suggestions as to what constitutes a better form of shift system. The present study focused on the impact of the number of consecutive night shifts worked on the health and well-being of two groups of nurses (permanent night and rotating shift). All nurses completed a copy of the Standard Shiftwork Index, which is a set of questionnaires designed for comparing the effects of different types of shift system on large groups of workers. It includes measurements of psychological ill-health, physical ill-health, chronic fatigue, social and domestic disruption, attitudes towards shiftwork, sleep quality and sleep habits. Results showed clearly the impact of the number of consecutive nights worked on health and well-being, not directly, but indirectly through the impact on sleep duration and sleep quality. Sleep duration was shown to increase with more consecutive nights worked. This in turn was found to predict sleep quality, which in turn was found to be the stronger direct predictor of psychological and physical ill-health: i.e. better health was associated with longer and better quality sleeps. Explanations in terms of circadian adaptation are discussed.     

Health, well-being and burnout of ICU nurses on 12- and 8-h shifts

It is generally agreed that some features of shift systems can influence the extent of well-being and health problems experienced by the workers involved. Extended working days (9-12 h) have been found to aggravate some problems associated with shiftwork, especially when the work is mentally and emotionally demanding. The aim of the study was to compare measures of health, sleep, psychological and social well-being, job satisfaction and burnout of ICU nurses on 12- and 8-h shifts. The groups of subjects were matced for age, length of shiftwork experience, marital status and number of hours worked. the 12-h shift nurses, when compared to their 8-h shift colleagues, experienced more chronic fatigue, cognitive anxiety, sleep disturbance and emotional exhaustion. Job satisfaction seems to be independent of the shift duration. The nurses on 12-h shifts reported less social and domestic disruption than those on 8-h shifts. The 12-h shift nurses showed worse indices of health, well-being and burnout tan the 8-h shift nurses. It is suggested that this may be associated with their longer daily exposure to the stress of work. The increased number of rest days of 12-h shift nurses seems tobe insufficient to dissipate the adverse health and well-being effects that built up over their longer shifts.     

Is there an optimum number of night shifts? Relationship between sleep, health and well-being

By concentrating on the impact of a specific shift-system feature on the well-being of those concerned, rather than on the impact of the shift system as a whole, one might be able to offer more meaningful suggestions as to what constitutes a better form of shift system. The present study focused on the impact of the number of consecutive night shifts worked on the health and well-being of two groups of nurses (permanent night and rotating shift). All nurses completed a copy of the Standard Shiftwork Index, which is a set of questionnaires designed for comparing the effects of different types of shift system on large groups of workers. It includes measurements of psychological ill-health, physical ill-health, chronic fatigue, social and domestic disruption, attitudes towards shiftwork, sleep quality and sleep habits. Results showed clearly the impact of the number of consecutive nights worked on health and well-being, not directly, but indirectly through the impact on sleep duration and sleep quality. Sleep duration was shown to increase with more consecutive nights worked. This in turn was found to predict sleep quality, which in turn was found to be the stronger direct predictor of psychological and physical ill-health i.e. better health was associated with longer and better quality sleeps. Explanations in terms of circadian adaptation are discussed.     

Psychophysical conditions and hormonal secretion in nurses on a rapidly rotating shift schedule and exposed to bright light during night work

The psychophysical conditions of 15 young female nurses, working in a rapidly-rotating shift system (2-2-2-2), modified according to some psychophysiological criteria, and exposed to short period (4 × 20 min) of bright light (2350 Lux) during their night duty, were studied in order to evaluate their adaptation to night work and to test a possible positive effect on it of bright light. Subjective evaluations of work load and psychophysical conditions, performance measures, hormonal excretion (cortisol, 6-sulphatoxymelatonin and catecholamines), oral temperature and activity-sleep logs were taken during the shiftwork cycle, comprising one morning, one afternoon and two consecutive nights under normal and bright light. The results showed that this rapidly-rotating shift system had little effect upon the normal circadian rhythms of the body. Moreover, the lengthening of the night shift to 10 h can be considered to be acceptable, provided that work load is reduced and there are sufficient rest pauses available. On the other hand, the reduction to 7 h of the length of the day shifts and delayed start of the morning shift to 07:00 h appeared to be convenient both in relation to the work load and sleep duration. Some positive effects of bright light upon psychophysical conditions and performance efficiency were noted, while hormonal excretion and body temperature did not show any effect of bright light; in particular, melatonin excretion was not suppressed appreciably by the bright light used.     

Combined work stresses: Effect of reduced air renewal on psychological performance during 72h sustained operations

Human tolerance limits for sustained operations under the combined stress of stale air and sleep loss were studied in two groups often male volunteers over a 72 h period, with only 1h of sleep permitted after 32, 48 and 60h. The experiment investigated whether such sustained performance might be additionally influenced by mild hypoxia (15 vol% O₂) together with correspondingly increased carbon dioxide levels (5 vol%).

Performance on various psychological tests showed the expected decrease with increasing duration of sleep loss. However, there were no clear cut differences in performance between the control and the hypoxia groups. There were, however, more pronounced decreases with time in either group in the more complex tasks as compared to simple reaction time and vigilance tasks. Short-term memory improved probably due to learning. The missing effect of hypoxia could be attributed to a hyperventilation response in the experimental subjects and an increase in cerebral blood flow initiated by the hypercapnia.     

Perceived physical work capacity, stress, sleep disturbance and occupational accidents among firefighters working during a strike

Fire-fighting and rescue work are arranged in such a way that various kinds of accidents and catastrophes can be handled. In an understaffed situation, such as a strike, this goal may not be met. The objective of this study was to investigate factors associated with perceived physical work capacity, stress, sleep disturbance, and occupational accidents among firefighters who remained at work during an extended strike. A cross-sectional questionnaire study was carried out among 543 firefighters (83% of the target group) in 71 fire brigades in Finland. After the strike had lasted for 9 to 11 weeks, most of the firefighters perceived their physical work capacity to be rather good or very good. Stress increased along with a decreasing number of personnel in a crew (OR= 2.3, CI= 1.0-5.3, for less than 75% of a normal crew vs. normal crew) and with decreasing number of personnel in a shift (OR= 2.4, CI= 1.1-5.4, for less than 25% of normal shift vs. normal shift). Sleep disturbance was reported to occur as soon as the total working time exceeded 50 h/week. Working more than 70 h/week increased the risk of occupational accidents almost 4-fold compared with working no more than 50 h/week. These results suggest that exceptional situations, such as a strike, are a challenge to human capacity. With time, increased stress and sleep disturbance may lead to serious consequences.     

Psychophysical conditions and hormonal secretion in nurses on a rapidly rotating shift schedule and exposed to bright light during night work

Abstract

The psychophysical conditions of 15 young female nurses, working in a rapidly-rotating shift system (2-2-2-2), modified according to some psychophysiological criteria, and exposed to short period (4 × 20 min) of bright light (2350 Lux) during their night duty, were studied in order to evaluate their adaptation to night work and to test a possible positive effect on it of bright light. Subjective evaluations of work load and psychophysical conditions, performance measures, hormonal excretion (cortisol, 6-sulphatoxymelatonin and catecholamines), oral temperature and activity-sleep logs were taken during the shiftwork cycle, comprising one morning, one afternoon and two consecutive nights under normal and bright light. The results showed that this rapidly-rotating shift system had little effect upon the normal circadian rhythms of the body. Moreover, the lengthening of the night shift to 10 h can be considered to be acceptable, provided that work load is reduced and there are sufficient rest pauses available. On the other hand, the reduction to 7 h of the length of the day shifts and delayed start of the morning shift to 07:00 h appeared to be convenient both in relation to the work load and sleep duration. Some positive effects of bright light upon psychophysical conditions and performance efficiency were noted, while hormonal excretion and body temperature did not show any effect of bright light; in particular, melatonin excretion was not suppressed appreciably by the bright light used.     

Perceived physical work capacity,stress, sleep disturbance and occupational accidents among firefighters working during a strike

Fire-fighting and rescue work are arranged in such a way that various kinds of accidents and catastrophes can be handled. In an understaffed situation, such as a strike, this goal may not be met. The objective of this study was to investigate factors associated with perceived physical work capacity, stress, sleep disturbance, and occupational accidents among firefighters who remained at work during an extended strike. A cross-sectional questionnaire study was carried out among 543 firefighters (83% of the target group) in 71 fire brigades in Finland. After the strike had lasted for 9 to 11 weeks, most of the firefighters perceived their physical work capacity to be rather good or very good. Stress increased along with a decreasing number of personnel in a crew (OR= 2.3, CI= 1.0-5.3, for less than 75% of a normal crew vs. normal crew) and with decreasing number of personnel in a shift (OR= 2.4, CI= 1.1-5.4, for less than 25% of normal shift vs. normal shift). Sleep disturbance was reported to occur as soon as the total working time exceeded 50 h/week. Working more than 70 h/week increased the risk of occupational accidents almost 4-fold compared with working no more than 50 h/week. These results suggest that exceptional situations, such as a strike, are a challenge to human capacity. With time, increased stress and sleep disturbance may lead to serious consequences.