Nurses working on fast rotating shifts overestimate cognitive function and the capacity of maintaining wakefulness during the daytime after a rotating shift

Chang, Yu Chi; Chen, Hsiang‐Lan; Hsu, Chia Yang; Su, Shu-Fang; Liu, Ching-Kuan; Hsu, Chiung‐Wen

doi:10.1016/j.sleep.2013.03.011

Cited by 30 publications

(33 citation statements)

References 16 publications

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“…Therefore, after consecutive night shifts, the nurses’ performance on attentive tasks decreased significantly, and their daytime levels of alertness were also lower, even though there was no difference in subjective sleepiness among the groups. This finding is compatible with previous studies [18,19] that suggest people frequently underestimate the impact of sleep restriction on cognitive function. In addition, night shift work has been linked to chronic partial sleep deprivation [20], and chronically deprived persons frequently have the subjective impression that they have adapted to this situation because they do not feel particularly sleepy [21].…”

Section: Discussionsupporting

confidence: 93%

“…This may explain why the 2NS group had higher state anxiety scale scores than did the 4NS group and showed persistent elevation of state anxiety throughout the day. Two consecutive night shifts following sleep restriction may be more emotionally stressful than four, and may result in a state of hyperarousal that could contribute to decreases in both performance of attentional tasks and the learning effect [18,23]. …”

Section: Discussionmentioning

confidence: 99%

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Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and impact prolactin levels during the subsequent day: a case control study

Chang

Chen

et al. 2014

BMC Psychiatry

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BackgroundWe investigated circadian changes and effects on mood, sleep-related hormones and cognitive performance when nurses worked consecutive night shifts in a rapidly rotating shift system. Daytime cognitive function, sleep propensity and sleep-related hormones (growth hormone, cortisol, prolactin, thyrotropin) were compared after participants worked two and four consecutive night shifts.MethodsTwenty-three off-duty nurses, 20 nurses working two consecutive night shifts and 16 nurses working four consecutive night shifts were enrolled. All participants completed the Maintenance of Wakefulness Test, State-Trait Anxiety Inventory, Stanford Sleepiness Scale, visual attention tasks (VAT), Wisconsin Card Sorting Test, and modified Multiple Sleep Latency Test. Hormone levels were also measured four times throughout the day, at 2-h intervals.ResultsDuring the day, the participants in the night shift groups were less able to maintain wakefulness, had poor performance on VAT, and higher thyrotropin levels than did those in the off-duty group. Participants who worked two night shifts were better able to maintain wakefulness, had higher anxiety scale scores, poorer initial performance and lack of learning effect on VAT, and higher prolactin levels compared with those who worked four night shifts. There were no differences in cortisol levels between the two- and four- shift groups.ConclusionsRotating night shifts too quickly may cause anxiety and decreased attentional performance, and may impact daytime prolactin levels after night shifts. It is possible that the two-shift group had a higher cortisol level than did the four-shift group, which would be consistent with the group’s higher state anxiety scores. The negative findings may be due to the small sample size. Further studies on the effects of consecutive night shifts on mood and cortisol levels during the daytime after sleep restriction would be valuable.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and impact prolactin levels during the subsequent day: a case control study

Chang

Chen

et al. 2014

BMC Psychiatry

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“…Overall, our search retrieved a total of 13 articles suitable for review ( Figure 1). Most of the reviewed studies assessed the association between shift-work and night-work and thyroid hormonal changes in different occupational settings [20][21][22][23][24][25][26][27][28][29] ( Table 1). Only a few publications focused on possible clinical adverse outcomes [26,[30][31][32].…”

Section: Resultsmentioning

confidence: 99%

“…Several studies investigated changes in TSH levels in relation to night shift-work in the healthcare sector and found a positive correlation between such working schedule and increased hormonal concentrations [21,26,27]. Chang et al [21] in a cohort of nurses enrolled in the largest psychiatric center in southern Taiwan, demonstrated that TSH levels were significantly higher in those who had sleep restriction for two consecutive night shifts compared to those who had been free of duty for at least 3 days before entering the study day.…”

Section: Healthcare Sectormentioning

confidence: 99%

The Impact of Shift-Work and Night Shift-Work on Thyroid: A Systematic Review

Leso

Vetrani

Sicignano

et al. 2020

IJERPH

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Thyroid hormones are regulated by the pituitary thyroid stimulating hormone (TSH), whose secretion presents a circadian rhythmicity. Indeed, it is conceivable that shift- and night shift-work, affecting sleep-wake rhythms, may impact thyroid functionality. Therefore, the aim of the present review was to provide an overview on the association between shift- and night shift-work and thyroid hormonal changes and disease development. A systematic review of studies available in PubMed, Scopus, and ISI Web of Science databases was performed. A positive association between night shift-work and increased TSH concentrations was reported by most of the reviewed investigations. Inconclusive evidence was available on thyroid diseases. However, the limited number of studies, the noticeable heterogeneity in the shift-work scheduling, in terms of amount, duration, type of shift- or night shift-work, prevents easily integrating findings and extrapolating definite conclusions. Further investigation seems necessary to better define the relationship between shift schedules and different thyroid outcomes, and possible long-term implications of early functional changes. Overall, this may support the adoption of advanced risk assessment and management strategies aimed to achieve a safer workplace organization and a timely, responsible realization of all the benefits of a 24-h economy.

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“…Most health care workers are subject to chronic sleep restriction and shift work. [4][5][6] Restricted sleep is a factor associated with metabolic disorders such as obesity, metabolic syndrome, insulin resistance, and type 2 diabetes. 7 Due to exposure to light at night, the bodies of these workers secrete a lower concentration of the hormone melatonin, which participates in control of biological rhythms, including regulation of sleep.…”

Section: Lack Of Sleep Can Jeopardize Vaccine Effectivenessmentioning

confidence: 99%

Response to Lim et al regarding “In-flight transmission of measles: Time to update the guidelines?”

Lochlainn

Ruijs

Swaan

et al. 2017

American Journal of Infection Control

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Nurses working on fast rotating shifts overestimate cognitive function and the capacity of maintaining wakefulness during the daytime after a rotating shift

Cited by 30 publications

References 16 publications

Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and impact prolactin levels during the subsequent day: a case control study

Rotating night shifts too quickly may cause anxiety and decreased attentional performance, and impact prolactin levels during the subsequent day: a case control study

The Impact of Shift-Work and Night Shift-Work on Thyroid: A Systematic Review

Response to Lim et al regarding “In-flight transmission of measles: Time to update the guidelines?”

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