Heart rate variability changes in physicians working on night call

Purpose  

Adverse effects by night-call duty have become an important occupational health issue. The aim of this study was to investigate whether the heart rate variability (HRV) differed during recovery from day work and night-call duty between distinct physician specialities.     

Impaired sleep affects quality of life in children during maintenance treatment for acute lymphoblastic leukemia: an exploratory study

Background  

With the increase of pediatric cancer survival rates, late effects and quality of life (QoL) have received more attention. Disturbed sleep in pediatric cancer is a common clinical observation, but research on this subject is sparse. In general, sleep problems can lead to significant morbidity and are associated with impaired QoL. Information on sleep is essential to develop interventions to improve QoL.     

Working conditions and psychosocial risk factors of employees in French electricity and gas company customer support departments

Objective  

Little is known about the real impact of working conditions on the health of call center employees. The aim of this article is to describe the working conditions of French electricity and gas company customer service teams, especially those spending more than 75% of their working time handling calls in order to determine their subjective experience of their work and identify situations at risk of psychosocial constraints.     

Glucose intolerance and gestational diabetes risk in relation to sleep duration and snoring during pregnancy: a pilot study

Background  

Insufficient sleep and poor sleep quality, considered endemic in modern society, are associated with obesity, impaired glucose tolerance and diabetes. Little, however, is known about the consequences of insufficient sleep and poor sleep quality during pregnancy on glucose tolerance and gestational diabetes.     

Ill-lighting syndrome: prevalence in shift-work personnel in the anaesthesiology and intensive care department of three Italian hospitals

Background  

Light is one of the most important factors in our interaction with the environment; it is indispensable to visual function and neuroendocrine regulation, and is essential to our emotional perception and evaluation of the environment. Previous studies have focussed on the effects of prolonged anomalous exposure to artificial light and, in the field of work-related illness. Studies have been carried out on shift-work personnel, who are obliged to experience alterations in the physiological alternation of day and night, with anomalous exposure to light stimuli in hours normally reserved for sleep. In order to identify any signs and symptoms of the so-called ill-lighting syndrome, we carried out a study on a sample of anaesthesiologists and nurses employed in the operating theatres and Intensive Care Departments of three Italian hospitals. We measured the subjective emotional discomfort (stress) experienced by these subjects, and its correlation with environmental discomfort factors, in particular the level of lighting, in their workplace.     

Impact of nutritional status and sleep quality on hospital utilisation in the oldest old with heart failure

Objectives

To describe three-year trends in nutritional status and sleep quality and their impact on hospital utilisation in the oldest old (80 +) with heart failure (HF).

Design

Single-centred longitudinal observational study.

Setting

South-eastern Sweden.

Participants

90 elderly (80+) with objectively verified HF.

Measurements

Baseline data from the Mini Nutritional Assessment (MNA) and on sleep quality were collected through structured interviews following the HF diagnosis (n=90) and at a three-year follow-up (n=41). Data on hospital utilisation during the three years following the HF diagnosis were also collected.

Results

Nineteen percent of the participants were found to have impaired nutritional status, a condition that increased hospital utilisation by four bed days per year. A majority (85%) had impaired sleep quality, but no impact on hospital utilisation was found. Nutritional status and sleep quality were stable over the three-year period.

Conclusion

In the oldest old with HF, impaired nutritional status and impaired sleep quality are already common at HF diagnosis. Impaired nutritional status increases hospital utilisation significantly. Therefore, it is of supreme importance to systematically evaluate nutritional status and sleep quality in the oldest old when they are diagnosed with HF, as well as to take action if impairments are present.

     

Public health burden of sleep disorders: underreported problem

Background

Sleep is a naturally reversible process that plays an essential role in human wellbeing. Sleep enables optimal functioning of physical and mental health and contributes to quality of life and safety. There are many individuals among the general public who do not realize they are sleep deficient and are not aware of the effects of sleep deprivation on their health and on the safety of their peers. The National Highway Traffic Safety Administration estimates that drowsy drivers cause between 10 and 30% of all traffic accidents.

Purpose

Many believe that sleep is a luxury and that by decreasing sleep they can maximize their productivity. In this article, we emphasize that sleep is a necessity and the only way to pay the sleep debt is to sleep. This review article aims to increase awareness of early signs of sleep deficiency, consequences of poor sleep, and proper sleep hygiene for healthcare professionals to influence practice in educating patients about needed changes in sleep behaviors.

Conclusions

Sleep deficiency not only has side effects on the personal level, but also can cause harm on a larger scale through chronic disease, motor vehicle accidents, and workplace accidents. A better understanding of sleep and its effects encourages a better quality of life and fewer hazardous behaviors.

Clinical implications

Sleep is an active state of recovery during which the optimal function of all body systems is reinstated. Sleep repairs and prevents occurrence of chronic diseases such as cancer, diabetes, and obesity.

     

Multimorbidity and quality of life: a closer look

Background  

The presence of multiple chronic conditions is associated with lower health related quality of life (HRQOL). Disease severity also influences HRQOL. To analyse the effects of all possible combinations of single diseases along with their severity on HRQOL seems cumbersome. Grouping diseases and their severity in specific organ domains may facilitate the study of the complex relationship between multiple chronic conditions and HRQOL. The goal of this study was to analyse impaired organ domains that affect the most HRQOL of patients with multiple chronic conditions in primary care and their possible interactions.     

Napping during the night shift and recovery after work among hospital nurses

OBJECTIVE:

To analyze the association between the length of napping during the night shift and the recovery after work among nurses.

METHOD:

Cross-sectional epidemiological study involving 1940 nurses from 18 public hospitals in the City of Rio de Janeiro. A multidimensional and self-applied questionnaire was used with information about health, sociodemographic and occupational characteristics, health-related behaviors and housework. Multiple logistic regression was applied to identify the association, adjusted for confounding variables.

RESULTS:

The gross analyses showed 44%, 127% and 66% higher chances of a high level of recovery after work for nurses who sleep up to two hours, between 2.1 and 3 hours and 3.1 hours or more, respectively, when compared to the nurses who do not sleep. After adjusting for confounding variables, the association only continues significant for the group that sleeps 2.1 to 3 hours during the night shift (OR=1.79; 95%CI=1.33-2.41).

CONCLUSION:

The association between the length of napping and the high level of recovery after work, confirmed in the present results, can be included in the studies that aim to support more appropriate policies aimed at improving the workers'' work, life and health conditions, not only in nursing, but night-shift workers in general.     

Identifying patterns of recovery experiences and their links to psychological outcomes across one year

Purpose  

The main aim of this study was to examine patterns of recovery experiences (i.e., psychological detachment, relaxation, mastery and control during off-job time) and their links to psychological outcomes (job burnout, work engagement and sleep problems) across 1 year.     

Effects of night duty events on blood pressure and autonomic modulation in physicians

Background

The dynamic effects of duty events on the blood pressure (BP) and heart rate variability (HRV) of physicians on duty are unknown.

Methods

A study was conducted among 12 physicians on night duty. BP and HRV with and without the effect of a duty event were compared. The risk of higher BP and impaired HRV after a phone call were calculated.

Results

Physicians had higher mean BP (122.4 ± 11.1; 76.9 ± 7.1 mmHg) within 30 min after a phone calls than without a phone call (113.5 ± 5.3; 69.0 ± 3.8) and higher sympathetic tone (low frequency normalized units (LFnu) 68.5 ± 8.9; high frequency normalized units (HFnu) 27.7 ± 8.7) within 10 min of a phone call than without a phone call (62.9 ± 8.51; 33.5 ± 8.4). Elevated BP and sympathetic tone recovered to baseline levels 30 min after a phone call.

Conclusions

Among physicians on night duty, sympathetic tone and BP might be elevated by clinical events, and these effects last for 30 min.

     

The impact of shift work induced chronic circadian disruption on IL-6 and TNF-α immune responses

AIM  

Sleep disturbances induce proinflammatory immune responses, which might increase cardiovascular disease risk. So far the effects of acute sleep deprivation and chronic sleep illnesses on the immune system have been investigated. The particular impact of shift work induced chronic circadian disruption on specific immune responses has not been addressed so far.     

Associations between the macronutrient composition of the evening meal and average daily sleep duration in early childhood

Background & aims

Short sleep duration in early childhood may increase the risk for chronic diseases in later life. Strategies to improve sleep duration are thus of interest. We investigated whether the nutritional composition of the evening meal is associated with children’s sleep duration in the 2nd year of life.

Methods

Multivariable regression models included 594 participants of the DONALD Study with 3-days weighed dietary records and average daily sleep duration at age 1.5 and 2 years.

Results

Higher energy intakes with the evening meal were associated with a longer sleep duration (1 min/10 kcal, p = 0,01). With respect to absolute intakes, carbohydrates (0.8 min/g, p < 0.0001), especially from high GI foods (1.3 min/g, p < 0.01), and a higher GL (1.5 min/g GL, p < 0.01) were accompanied by longer sleeping time. A qualitative exchange of energy from protein by energy from carbohydrates from high GI foods was only associated with increased sleep duration in toddlers without (1.9 min/%E, p < 0.05), but not with nightly eating occasions (p > 0.4).

Conclusions

The observed associations are in line with suggested sleep-improving effects of carbohydrates. Effect sizes suggest that the clinical relevance of nutritional composition for sleep duration is limited in healthy young toddlers. These observations and their possible importance for more vulnerable groups need to be confirmed in clinical trials.     

Association of the combination of sleep duration and sleep quality with quality of life in type 2 diabetes patients

Purpose

Sleep problems are very common in people with diabetes. The aim of this study was to assess the association of the combination of self-reported sleep duration and sleep quality on quality of life (QOL) in Chinese patients with type 2 diabetes mellitus (T2DM).

Methods

We analyzed the community-based cross-sectional data of 798 patients with T2DM in Xiamen, China, in 2016. Sleep duration was measured as self-reported average sleep time during the previous month. Sleep quality was evaluated as self-rated reports. QOL was assessed by the Diabetes-specific Quality of Life (DSQL), with scores?<?40 and ≥?80 set as cut-off values for differentiating good, fair, and poor QOL. Ordinal logistic regression was performed to model the associations of QOL with sleep duration, sleep quality, and their combined effects by adjusting for certain covariates.

Results

The separate associations of sleep duration and sleep quality in relation to QOL in T2DM patients were significant (P?<?0.05). After controlling for sleep quality, there was no significant correlation between sleep duration and QOL. The combined analysis suggested that the association of sleep duration with QOL in T2DM patients was sleep quality-dependent. Longer sleep duration was associated with higher odds ratios (ORs) of better QOL for patients who reported fair sleep quality and good sleep quality, but no such trend was observed for patients who reported poor sleep quality (P> 0.05). Excessive sleep duration (≥?9 h per day) was detrimental to QOL in T2DM only when they reported poor sleep quality.

Conclusions

Specific disparities exist in the association of sleep quality with sleep duration and QOL in T2DM patients. Failures to take into account the effect of sleep quality when evaluating the impact of sleep on QOL significantly bias the results. It is important to integrate duration and quality of sleep as a composite sleep index when assessing sleep of patients with T2DM.

     

Participant observation of time allocation, direct patient contact and simultaneous activities in hospital physicians

Background  

Hospital physicians' time is a critical resource in medical care. Two aspects are of interest. First, the time spent in direct patient contact – a key principle of effective medical care. Second, simultaneous task performance ('multitasking') which may contribute to medical error, impaired safety behaviour, and stress. There is a call for instruments to assess these aspects. A preliminary study to gain insight into activity patterns, time allocation and simultaneous activities of hospital physicians was carried out. Therefore an observation instrument for time-motion-studies in hospital settings was developed and tested.     

Population density,call-response interval,and survival of out-of-hospital cardiac arrest

Background  

Little is known about the effects of geographic variation on outcomes of out-of-hospital cardiac arrest (OHCA). The present study investigated the relationship between population density, time between emergency call and ambulance arrival, and survival of OHCA, using the All-Japan Utstein-style registry database, coupled with geographic information system (GIS) data.     

Perspectives of staff nurses of the reasons for and the nature of patient-initiated call lights: an exploratory survey study in four USA hospitals

Background  

Little research has been done on patient call light use and staff response time, which were found to be associated with inpatient falls and satisfaction. Nurses' perspectives may moderate or mediate the aforementioned relationships. This exploratory study intended to understand staff's perspectives about call lights, staff responsiveness, and the reasons for and the nature of call light use. It also explored differences among hospitals and identified significant predictors of the nature of call light use.     

Short sleep duration and obesity among Australian children

Background  

There is limited information on sleep duration and obesity among Australian children. The objective of the study is to cross-sectionally examine the relationship between sleep duration and obesity in Australian children aged 5 to 15 years.     

Relation between sleep quality and quantity,quality of life,and risk of developing diabetes in healthy workers in Japan: the High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) Study

Background  

The effect of sleep on the risk of developing diabetes has not been explored in an Asian population. The objective of this study is to investigate the effect of self-reported sleep duration and sleep quality on the risk of developing diabetes in a prospective cohort in Japan.     

Development and psychometric assessment of the COPD and Asthma Sleep Impact Scale (CASIS)

Background  

Patients with respiratory disease experience disturbed sleep, but there is no widely accepted measure of sleep impairment due to respiratory disease. We developed and evaluated the psychometric performance of a patient-reported measure to assess the impact on sleep due to respiratory disease, the COPD and Asthma Sleep Impact Scale (CASIS).