Sleep issues of ICU workforce

 Q: ICU workforce at night can eliminate sleepiness by daytime sleep? 

A) True 

B) False 

Answer: B

Intensivists, mid-levels, nurses, respiratory therapists, pharmacists, and all other healthcare workers who work at night or on schedule with rotating day/night shifts struggle with sleep cycles. 

Unfortunately, daytime sleep does not fully eliminate sleepiness during the nocturnal hours. 

One effective trick is to take a short (power) nap either just before or during the shift. Nap is recommended to be restricted below an hour to avoid entering the deep-sleep phase and disorientation from sleep inertia. 

Coffee: Coffee helps! but should be limited to the early half of the night shift to avoid insomnia later in the day. One study showed that one single cup/dose of coffee/caffeine at the beginning of the night shift is better than the intermittent or divided doses throughout the shift 6. This prevents tolerance to caffeine. 

Wake-promoting agent i.e., modafinil or armodafinil has been suggested during the shift but should be monitored and prescribed by an experienced clinician.

#sleep

#ICU-work

References:

1. Schweitzer PK, Randazzo AC, Stone K, et al. Laboratory and field studies of naps and caffeine as practical countermeasures for sleep-wake problems associated with night work. Sleep 2006; 29:39. 

2. Sallinen M, Härmä M, Akerstedt T, et al. Promoting alertness with a short nap during a night shift. J Sleep Res 1998; 7:240. 

3. Purnell MT, Feyer AM, Herbison GP. The impact of a nap opportunity during the night shift on the performance and alertness of 12-h shift workers. J Sleep Res 2002; 11:219. 

4. Bonnefond A, Muzet A, Winter-Dill AS, et al. Innovative working schedule: introducing one short nap during the night shift. Ergonomics 2001; 44:937. 

5. Ker K, Edwards PJ, Felix LM, et al. Caffeine for the prevention of injuries and errors in shift workers. Cochrane Database Syst Rev 2010; :CD008508. 

6. Walsh JK, Muehlbach MJ, Schweitzer PK. Hypnotics and caffeine as countermeasures for shiftwork-related sleepiness and sleep disturbance. J Sleep Res 1995; 4:80.