SWD

Q: For ICU night shift workers, studies have shown that a short nap during the shift improves efficacy. The nap during the night shift is preferred in? - select one

A) early part of the shift

B) later part of the shift

Answer: B

ICU is a 24/7 business! It requires nurses, physicians, and other staff to work night shifts. The situation becomes tricky for staff who frequently alternate day and night shifts. It markedly disturbs their circadian rhythm. Over decades, staff have tried various strategies, including sleep hygiene, avoiding light exposure, sleep diaries, actigraphy, caffeine, and pharmacological interventions, including over-the-counter options (like melatonin) and prescription medications (like zolpidem and others).  The International Classification of Sleep Disorders now officially defines it as shift work disorder (SWD) (reference # 1). Many hospitals now officially allow staff to take these breaks.

Various studies (see references 2-5) show that naps help improve SWD. That said, it is important that:

1. Naps can be limited to under an hour. This minimizes the risk of entering deep sleep and reduces disorientation from sleep inertia upon waking.

2. Naps should be planned either prior to the shift as much as possible, considering time to get ready, commuting, and getting a hand-off report, or preferably in the later part of the shift. This also helps prevent car accidents, which occur more frequently among night-shift staff.

#sleep

#administrative

References:

1. American Academy of Sleep Medicine. International Classification of Sleep Disorders, 3rd ed, text revision, American Academy of Sleep Medicine, 2023.

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. Garbarino S, Mascialino B, Penco MA, et al. Professional shift-work drivers who adopt prophylactic naps can reduce the risk of car accidents during night work. Sleep 2004; 27:1295.

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