Circadian Profile of an Emergency Medicine Department: Scheduling Practices and Their Effects on Sleep and Performance

Harrison, E.; Walbeek, Thijs J.; Maggio, D.; Herring, Andrew A.; Gorman, Michael R.

doi:10.1016/j.jemermed.2019.10.007

Cited by 14 publications

(12 citation statements)

References 38 publications

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“…We sought to build upon their work by including one novel night sleep-scheduling strategy that had been subsumed under the Switch Sleeper category in Gamble’s studies 29 , 30 and had also been observed in our previous work. 7 This strategy involved taking a nap only on the first night shift in a series, which we called the “Switch Napper” strategy.…”

Section: Methodsmentioning

confidence: 99%

“…While this could theoretically include changes in shift scheduling practices, individuals often have little to no control over their work hours, particularly early on in their careers. 7 At an organizational level, institutions may be averse to changing the status quo for a variety of reasons, from financial or industry-specific concerns to simple inertia. 8 Thus, it is often more practical to focus on behavioral strategies and interventions.…”

Section: Introductionmentioning

confidence: 99%

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Sleep-Scheduling Strategies in Hospital Shiftworkers

Harrison¹,

Easterling²,

Yablonsky³

et al. 2021

NSS

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Introduction Shiftwork causes circadian disruption and results in impaired performance, sleep, and health. Often, individuals on non-standard shifts cannot modify work schedules. At-home sleep schedules are a potentially modifiable point of intervention, yet sleep-scheduling strategies remain relatively understudied. Specifically, the adoption of multiple strategies and the employment of strategies for not only night shifts, but also early starts on days, have yet to be formally examined to our knowledge. We studied how adoption of specific and/or multiple sleep-scheduling strategies for day and night shifts relates to measures of adaptation to shiftwork, self-reported on-shift sleepiness, and individual characteristics (eg, age, chronotype, education in circadian and sleep health). We hypothesized: 1) strategies would differ by shift type, 2) individuals would adopt multiple strategies, 3) strategies better aligned with circadian principles would relate to measures of adaptation, and 4) individual characteristics, such as having dependents, would relate to strategy selection. Methods A retrospective, online questionnaire (including items from the Survey of Shiftworkers and items related to sleep-scheduling strategies) was administered to both permanent and rotating hospital staff in four wards working 12-h day and/or night shifts (n=89). Additionally, reasons for strategy selection were explored. Results Level of adaptation varied by sleep-scheduling strategy, with the least adaptation for those utilizing the Incomplete Shifter strategies. For night shifts, Night Stay and Switch Sleeper-N strategies were related to lower mid-shift sleepiness. Many night workers reported using strategies that restricted sleep, and most reported using multiple strategies, both of which also related to lower adaptation. Domestic considerations were the most common rationale for strategy selection. Strategies varied by several individual characteristics, including chronotype, dependents, and level of sleep education. Discussion Future work should investigate sleep strategies and circadian interventions to help mitigate the effects of circadian and sleep disruption in hospital staff.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sleep-Scheduling Strategies in Hospital Shiftworkers

Harrison¹,

Easterling²,

Yablonsky³

et al. 2021

NSS

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“…Many non-job-related factors (demographics and lifestyle factors) have been shown to be associated with sleep disorders among healthcare workers [ 8 ]. However, there is a lack of consensus regarding the associations of some job-related factors and work schedule (eg, number of years of practice, total work time, work experience related to other infectious diseases, psychological stress regarding illness) with sleep disturbance [ [9] , [10] , [11] ]. Therefore, it is difficult for institutions to predict which members of their staff will experience sleep disorders.…”

Section: Introductionmentioning

confidence: 99%

Job-related factors associated with changes in sleep quality among healthcare workers screening for 2019 novel coronavirus infection: a longitudinal study

Zhao

Zhang

et al. 2020

Sleep Medicine

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Background Sleep disorders may exacerbate many physical and mental health conditions, causing difficulty function in a healthcare setting. Workers screening for the 2019 novel coronavirus (2019-nCoV) infection have a high risk of not only occupational exposure to the virus but also sleep disorders. However, the job-related factors associated with reduced sleep quality remain unclear. Methods All healthcare workers temporarily scheduled to screen the 2019-nCoV patients were asked to complete a self-administered questionnaire that included questions on demographics, job-related factors, and sleep quality as assessed using the Pittsburgh Sleep Quality Index (PSQI). Sleep quality was assessed over a one-month follow-up period. Results A total of 116 doctors and 99 nurses were recruited for this study. The total scheduled work time was 14.78 ± 6.69 days during follow-up. Some job-related factors, such as number of work days, years of work experience, and subjective psychological stress, were associated with changes in the PSQI score. During the study, some workers tried out cognitive behavioral therapy (CBT) for sleep disorders using methods that were available online and easily accessible. Adopting online CBT was shown to be associated with scores of components of sleep quality, sleep latency, and sleep disturbance (β = −0.152, P = 0.01; β = −0.175, P = 0.008; and β = −0.158, P = 0.011, respectively). Conclusions Healthcare workers involved in screening for 2019-nCoV experienced reduced sleep quality, and a reasonable work schedule may help with maintaining sleep quality. In addition, interventions for healthcare workers should target self-help sleep assistance.

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“…It has been well-established that the aforementioned negative effects of shift work are attributable to disrupting the circadian rhythms and reducing the daytime recovery sleep of the ED staff. 5 As per a study in the United States, the night-shift ED residents experienced a higher frequency of difficulties in sleeping, shorter sleep duration, and decreased performance than that of their peers working in other shifts. 5 Similarly, in Saudi Arabia, the ED physicians who worked in shifts experienced a poorer sleep quality and higher Epworth sleepiness scale scores than that of their non-shift work healthcare professionals.…”

Section: Introductionmentioning

confidence: 95%

“… 5 As per a study in the United States, the night-shift ED residents experienced a higher frequency of difficulties in sleeping, shorter sleep duration, and decreased performance than that of their peers working in other shifts. 5 Similarly, in Saudi Arabia, the ED physicians who worked in shifts experienced a poorer sleep quality and higher Epworth sleepiness scale scores than that of their non-shift work healthcare professionals. 6 Other investigations concerning nurses have demonstrated increased risks of reduced periods of sleep, insomnia, and excessive daytime sleepiness and fatigue when doing shift work, 7 working night shifts, 8 , 9 and working a three-shift pattern, 10 respectively.…”

Section: Introductionmentioning

confidence: 95%

Exploring the Prevalence and Patterns of Use of Sleep Aids and Stimulants Among Emergency Physicians and EMS Providers in Saudi Arabia

Kentab

Ibrahim

Soliman

et al. 2021

OAEM

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Purpose This study explores the prevalence and patterns of the use of pharmacologic sleep aids and stimulants among Saudi Arabia’s emergency physicians (EPs) and emergency medical services (EMS) providers. Patients and Methods We adopted a descriptive, cross-sectional design. To collect data on the types and frequencies of sleep aids and stimulants used, we distributed a semi-structured, anonymous, web-based questionnaire to registered EPs, paramedics, and emergency medicine technicians (EMTs) in the Saudi Commission for Health Specialties. An internal consistency analysis showed good reliability (Cronbach’s alpha=0.667) of the questionnaire. A subscale analysis confirmed the results—alpha values were 0.720 and 0.618 for the use of sleep aids and stimulants, respectively. Results Males and females represented 81.8% and 18.2%, respectively, of the valid sample of 669 participants. Respondents aged 25–34, 35–44, and 45–55 years represented 51.9%, 32.7%, and 10.2% of the sample, respectively. Results showed that a majority of the respondents (67.1%) used stimulants. Caffeine was the most common stimulant; caffeine and energy drinks were used by 65.9% and 17.2% of the respondents, respectively. Caffeine, energy drinks, nicotine, and ephedrine were used by 65.9%, 17.2%, 18.5%, and 17.3% of the respondents, respectively. The respondents who used at least one sleeping aid and those using only one and two sleeping aids accounted for 36.6%, 15.6%, and 9.7%, respectively. The most common sleeping aids antihistamines and marijuana were used on most days by 13.4% and 13.3% of the respondents, respectively. The average monthly number of night shifts (P = 0.025) significantly influenced sleep aid use. Respondents working in night shifts for 3–5 months or more than 7 days were more likely to use sleeping aids. Conclusion Future research should enhance health workers’ knowledge of the efficacy and safety of these medications and guide strategies to organize and reduce night shift work.

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Circadian Profile of an Emergency Medicine Department: Scheduling Practices and Their Effects on Sleep and Performance

Cited by 14 publications

References 38 publications

Sleep-Scheduling Strategies in Hospital Shiftworkers

Sleep-Scheduling Strategies in Hospital Shiftworkers

Job-related factors associated with changes in sleep quality among healthcare workers screening for 2019 novel coronavirus infection: a longitudinal study

Exploring the Prevalence and Patterns of Use of Sleep Aids and Stimulants Among Emergency Physicians and EMS Providers in Saudi Arabia

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