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.     

论《眠空》的三重意蕴

分析了《眠空》具备的三重意蕴：深邃、空静、超离——宗教哲学与修行意蕴;冷峻、理性、深切——现实观察与剖析意蕴;紧迫、及时、投入——爱的践行与承担意蕴.认为,某种程度上《眠空》是一本有关修行的书,体现了作为精神修行者对心灵平衡自足道路的执着探索.     

Relationship Satisfaction,Sexual Satisfaction,and Sexual Problems in Sexsomnia

ABSTRACT

Relationship and sexual satisfaction, sexual functioning, and sexual desire were examined in an Internet sample of 32 individuals reporting engagement of sexual behavior during sleep (i.e., sexsomnia). Individuals with sexsomnia reported lower levels of sexual satisfaction, lower levels of relationship satisfaction, and similar levels of sexual desire compared with controls. More frequent incidence of sexsomnia resulted in lower sexual satisfaction; however, frequency was not found to impact relationship satisfaction or level of sexual desire. Individuals with sexsomnia reported high instances of sexual problems with 81% reporting at least one problem.     

间歇低氧对大鼠血管内皮细胞生长因子表达的影响

目的观察慢性间歇低氧对大鼠血管内皮细胞生长因子（VEGF）表达的影响。方法72只雄性Wistar大鼠随机均分为间歇低氧组（IH组）、实验对照组（SC组）和空白对照组（UC组）。IH组大鼠循环给予充入氮气和压缩空气（每一次循环60秒,使舱内最低氧浓度达4%～6%,然后恢复至21%,8h/d）;向SC组舱内循环充入压缩空气,UC组不予任何干预。应用免疫组化法（ELASA）检测各组大鼠分别在3,6,9周末血清VEGF的表达水平。结果IH组大鼠3、6、9周VEGF表达均增加,并且随间歇低氧时间的延长而VEGF水平逐渐升高,从第3周[（193.16±102.13）pg/ml]开始高于SC组[（154.08±89.79）pg/ml]和UC组[（118.13±64.26）pg/ml]水平（P〈0.05,P〈0.01）,第9周末IH组[（256.15±113.58）pg/ml]显著高于SC组[（154.36±90.32）pg/ml]（P〈0.01）,两组均明显高于UC组（P〈0.05）,IH组大鼠VEGF水平与间歇低氧时间呈正相关（P〈0.05）。结论慢性间歇低氧可以诱导大鼠VEGF表达增强,血清VEGF表达增强与血管内皮功能受损有关,提示VEGF对慢性间歇低氧有内皮保护作用。     

“Sleep is on the back burner”: Working students and sleep

The current study examines on a potential high-risk sleep loss population: working students at a metropolitan university in a mid-sized Midwestern city in the United States. Open-ended interviews with nineteen working university students provide insight into their beliefs and behaviors regarding how they think about and “do” work, attend university and sleep. Sleep diaries provide information on perceived sleep duration, latency and quality. While students value sleep and recognize the connection between sleep loss and ill health, they accept tiredness as “normal” for their situation. For many students sleep is the one demand that can be “put off”, in the struggle to balance work, school and family demands, “until the bill comes due” when they fall ill. Exchanging sleep loss for educational progress is explored through “health capital” as part of a human capital conceptual framework.     

文化的囚徒:《就说是睡着了》的新精神分析阐释

亨利.罗思的代表作《就说是睡着了》对主人公戴维的心理刻画和性格描写,与卡伦.霍妮的新精神分析学人格理论有着异曲同工之妙。在家庭暴力、社会歧视等巨大压力下,戴维形成典型的神经症。该神经症由紊乱的人际关系诱发,实际根植于特定文化固有的矛盾之中。罗思通过戴维的遭遇,隐喻犹太民族在异族强势文化下无以摆脱的困境,以探讨整个犹太人的命运与处境。《就说是睡着了》本质上可以说是关于每个犹太人的文化寓言,是一个文化囚徒的故事。     

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.     

Effects of age and domestic commitment on the sleep and alertness of female shiftworkers

Abstract

In this study, the combined effects of age and domestic commitment on sleep duration, sleep difficulties and alertness in a sample of female shiftworkers were studied. A total of 572 nurses working in general hospitals in England completed a questionnaire. Two main shift systems were worked by the nurses: permanent nights or rotating shifts. Initial analysis revealed significant differences between these two groups of nurses, resulting in separate analysis of each group. Regression analysis showed that although older nurses had shorter sleep duration they did not report more sleep difficulties, in addition, their overall on-shift alertness was higher compared to younger nurses. Domestic commitment, defined as the number of dependants in the household and the level of perceived work-home conflict, not only reduced sleep duration, but also resulted in more sleep difficulties and lower on-shift alertness for most of the shifts. Two implications with regards to the relationship between age and sleep are discussed. First, the study points to the relevance of considering both biological and social factors when looking at age and sleep. Secondly, the study shows that the effects of age on sleep duration and sleep difficulties are not similar. This finding requires further research, especially in the light of the higher levels of alertness reported by older nurses.     

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.     

Auditory evoked potentials as a function of sleep deprivation

Event-related brain potentials (ERPs) were studied in subjects deprived of sleep over a 48-h test period to assess the effects of different durations of continuous wakefulness on ERP components and to determine whether changes in the ERP components were related to changes in performance. Forty subjects were randomly assigned to either an experimental (sleep deprived) group (n = 30) or a control (not sleep deprived) group (n = 10). For the experimental subjects, ERP and performance measures were obtained in four-h test blocks throughout the 48-h period. Performance was assessed using the Walter Reed performance assessment battery. The control subjects were tested at the same times except during designated sleep periods. Both performance and evoked potential measures showed systematic changes over the experimental test period in association with sleep deprivation, time of day, and repeated testing. The latency of the N2 component of the evoked potential covaried with throughput measures on the performance assessment battery across the 12 four-h test blocks of the experiment. These data suggest that ERPs reflect central processes that change across the sleep deprivation period and that ERP measures might be useful in assessment and prediction of performance degradation under adverse conditions such as sleep loss.