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1.
Ital J Pediatr ; 45(1): 134, 2019 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675994

RESUMO

BACKGROUND: Around the age of 6 months, difficulties in settling to sleep and frequent night awakenings are generally occurring in 20 to 30% of infants. According to the transactional model parental factors can play a significant role in influencing infant sleep development. The purpose of the current study was to explore the combined effect of infants' factors (temperament and sleep onset problems), and parental factors (parental mental health in terms of post-partum affective disorders, consistent bedtime routines and fathers' involvement at bedtime), on infant bedtime difficulties (e.g. fussing, crying or protesting), including both maternal and paternal perspectives. METHODS: Sixty Italian intact two-parent families of infants (34 boys and 26 girls) ageing from 8 to 12 months (M = 10.73, SD = 2.54) were enrolled in the study. The parents filled out self-report questionnaires to measure the aforementioned variables. To investigate which infant and parental factors predicted infants' bedtime difficulties, two multiple linear regressions (MR), one for fathers and one for mothers, and relative weight analyses (RWA) were conducted. RESULTS: With regard to infants' bedtime difficulties reported by fathers (R2 = .35) they were explained by infant involvement in constant bedtime routines (ß = -.35, p = .030) and paternal involvement at bedtime (ß = -.45, p = .007). Instead infants' bedtime difficulties reported by mothers (R2 = .32) were explained by minutes the child taken to fall asleep (ß = .24, p = .04), infant involvement in constant bedtime routines (ß = -.31, p = .01) and bedtime paternal involvement (ß = -.27, p = .05). CONCLUSIONS: The main results of this study emphasized the protective role of consistent bedtime routines and bedtime paternal involvement in reducing infants' bedtime difficulties perceived both from mothers and fathers. Future research could help to raise awareness and improve understanding of the familial influences on children's sleep, providing recommendations for educating families, school professionals, healthcare providers, and the general public on risk and protective factors that could play a meaningful role in infants and children's developing sleep patterns.


Assuntos
Relações Pai-Filho , Pais/psicologia , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Adulto , Estudos Transversais , Choro , Feminino , Humanos , Lactente , Itália , Masculino , Inquéritos e Questionários , Vigília
3.
Ind Health ; 57(2): 228-244, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30700672

RESUMO

A substantial body of literature indicates that shift workers have a significantly higher risk of workplace accidents and injuries, compared to workers in regular daytime schedules. This can be attributed to work during nights which require workers to stay awake during normal sleeping hours and sleep during natural waking hours, leading to circadian desynchronization, sleep disruption and cognitive impairment. A fatigue-risk trajectory model developed by Dawson and McCulloch has been used to describe the series of events which may precede fatigue-related incidents. This includes insufficient sleep opportunities, impaired sleep, fatigue-behavioral symptoms, and fatigue-related errors. The purpose of this paper is to provide examples of control measures along each level of the fatigue-risk trajectory, which include: (i) work scheduling strategies to include breaks for adequate sleep opportunities; (ii) training and educational programs to help workers make best use of recovery times for quality sleep; (iii) fatigue-detection devices to alert workers and safety managers of fatigue-related behaviors and errors. A brief introduction to Fatigue-Risk Management systems is also included as a long-term sustainable strategy to maintain shift worker health and safety. The key statements in this paper represent a consensus among the Working Time Society regarding a multi-level approach to managing occupational sleep-related fatigue.


Assuntos
Fadiga/prevenção & controle , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Tolerância ao Trabalho Programado , Acidentes de Trabalho/prevenção & controle , Humanos , Jornada de Trabalho em Turnos/efeitos adversos
4.
J Sci Med Sport ; 22(7): 748-752, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30685228

RESUMO

OBJECTIVES: The primary aims of the present study were to assess the sleep hygiene knowledge of high performance team sport coaches and sports science support staff; the sleep practices these individuals implement with athletes; and the barriers to the more frequent use of these practices. DESIGN: Cross-sectional observational study. METHODS: A sample of 86 Australian coaches and sports science support staff working within high performance team sport volunteered to complete a four-part questionnaire, including the Sleep Beliefs Survey used to assess sleep hygiene knowledge. RESULTS: Overall sleep hygiene knowledge was adequate (15.3±2.9, score range 0-20; mean±SD), however knowledge of sleep-wake cycle behaviours (score 4.9±1.6 out of 7) and thoughts and attitudes about sleep (3.6±1.0 out of 5) were inadequate. Over half (56%) of coaches and support staff had monitored athlete sleep, while 43% had promoted sleep hygiene. Lack of resources (response range 44-60%) and knowledge (16-41%) were the two main barriers to the implementation of sleep monitoring and sleep hygiene practices. CONCLUSIONS: Team sport coaches and sports science support staff have adequate overall sleep hygiene knowledge, yet some specific areas (e.g. sleep-wake cycle behaviours) warrant improvement. There appear to be limited sleep practices implemented with athletes, particularly regarding the promotion of sleep hygiene. The development of educational sleep resources for coaches and support staff to implement with athletes may help address the identified barriers and improve sleep knowledge.


Assuntos
Atletas , Conhecimentos, Atitudes e Prática em Saúde , Tutoria , Higiene do Sono , Esportes/educação , Esportes/psicologia , Austrália , Estudos Transversais , Feminino , Humanos , Masculino , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Inquéritos e Questionários
5.
Int J Occup Saf Ergon ; 25(1): 123-137, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28675084

RESUMO

INTRODUCTION: Shift patterns, work hours, work arrangements and worker motivations have increasingly become key factors for job performance. The main objective of this article is to design an expert system that identifies the negative effects of shift work and prioritizes mitigation efforts according to their importance in preventing these negative effects. The proposed expert system will be referred to as the shift expert. METHODS: A thorough literature review is conducted to determine the effects of shift work on workers. Our work indicates that shift work is linked to demographic variables, sleepiness and fatigue, health and well-being, and social and domestic conditions. These parameters constitute the sections of a questionnaire designed to focus on 26 important issues related to shift work. The shift expert is then constructed to provide prevention advice at the individual and organizational levels, and it prioritizes this advice using a fuzzy analytic hierarchy process model, which considers comparison matrices provided by users during the prioritization process. An empirical study of 61 workers working on three rotating shifts is performed. After administering the questionnaires, the collected data are analyzed statistically, and then the shift expert produces individual and organizational recommendations for these workers.


Assuntos
Sistemas Especialistas , Saúde do Trabalhador , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Tolerância ao Trabalho Programado , Adulto , Idoso , Fadiga/prevenção & controle , Feminino , Lógica Fuzzy , Humanos , Masculino , Pessoa de Meia-Idade , Sono , Inquéritos e Questionários , Turquia
6.
Prehosp Emerg Care ; 23(4): 465-478, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30285519

RESUMO

Objective: The aims of this study were: 1) to determine the short-term impact of the SleepTrackTXT2 intervention on air-medical clinician fatigue during work shifts and 2) determine the longer-term impact on sleep quality over 120 days. Methods: We used a multi-site randomized controlled trial study design with a targeted enrollment of 100 (ClinicalTrials.gov NCT02783027). The intervention was behavioral (non-pharmacological) and participation was scheduled for 120 days. Participation was voluntary. All consented participants answered baseline as well as follow-up surveys. All participants answered text message queries, which assessed self-rated fatigue, sleepiness, concentration, recovery, and hours of sleep. Intervention participants received additional text messages with recommendations for behaviors that can mitigate fatigue. Intervention participants received weekly text messages that promoted sleep. Our analysis was guided by the intent-to-treat principle. For the long-term outcome of interest (sleep quality at 120 days), we used a two-sample t-test on the change in sleep quality to determine the intervention effect. Results: Eighty-three individuals were randomized and 2,828 shifts documented (median shifts per participant =37, IQR 23-49). Seventy-one percent of individuals randomized (n = 59) participated up to the 120-day study period and 52% (n = 43) completed the follow-up survey. Of the 69,530 text messages distributed, participants responded to 61,571 (88.6%). Mean sleep quality at 120 days did not differ from baseline for intervention (p > 0.05) or control group participants (p > 0.05), and did not differ between groups (p > 0.05). There was no change from baseline to 120 days in the proportion with poor sleep quality in either group. Intra-shift fatigue increased (worsened) over the course of 12-hour shifts for participants in both study arms. Fatigue at the end of 12-hour shifts was higher among control group participants than participants in the intervention group (p < 0.05). Pre-shift hours of sleep were often less than 7 hours and did not differ between the groups over time. Conclusions: The SleepTrackTXT2 behavioral intervention showed a positive short-term impact on self-rated fatigue during 12-hour shifts, but did not impact longer duration shifts or have a longer-term impact on sleep quality among air-medical EMS clinicians.


Assuntos
Serviços Médicos de Emergência/organização & administração , Auxiliares de Emergência/psicologia , Fadiga/prevenção & controle , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Adulto , Auxiliares de Emergência/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Tempo , Tolerância ao Trabalho Programado
7.
Intensive Crit Care Nurs ; 51: 73-81, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30579828

RESUMO

AIM: To identify if complementary interventions impacted on conscious intensive care patients' perception of stress factors and quality of sleep. RESEARCH METHODOLOGY: A non-controlled clinical study was undertaken on conscious patients in an intensive care unit in central Italy. Patients perception of stress factors and quality of sleep during the first night with usual medical and nursing treatments was measured using two questionnaires: the Stress Factors in Intensive Care Unit Questionnaire and the Modified Richards-Campbell Sleep Questionnaire. During the second night two specific treatments were administered: (1) receptive musical sounds and (2) a massage using sweet lavender/lemon-scented almond oil. The same variables were measured on the third day using the same questionnaires. RESULTS: The data of 74 patients were analysed. The patients' main concerns were "hearing unusual noises" (n = 46, 62.2%), "having people continuously working around the bed" (n = 53, 71.6%), "being worried" (n = 60, 81.1%) and "being unable to sleep" (n = 47, 63.5%). Fifty-three patients (71.6%) reported waking up in the middle of the night and 21 (28.3%) of them were unable to fall asleep again. Receptive musical sounds and massage using aromatherapy improved the quality of patients' sleep (t = 2.01, p = 0.047). CONCLUSION: Complementary interventions may reduce patients' perception of stress and improve their sleep. Further research is now needed.


Assuntos
Percepção , Transtornos do Sono do Ritmo Circadiano/complicações , Adulto , Feminino , Humanos , Unidades de Terapia Intensiva/organização & administração , Unidades de Terapia Intensiva/normas , Unidades de Terapia Intensiva/estatística & dados numéricos , Itália , Masculino , Pessoa de Meia-Idade , Ruído/efeitos adversos , Relações Enfermeiro-Paciente , Sono/fisiologia , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Transtornos do Sono do Ritmo Circadiano/psicologia , Estresse Psicológico/complicações , Estresse Psicológico/psicologia , Inquéritos e Questionários , Visitas a Pacientes/psicologia , Visitas a Pacientes/estatística & dados numéricos
8.
Accid Anal Prev ; 126: 64-69, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-29397875

RESUMO

Canada's freight rail system moves 70% of the country's surface goods and almost half of all exports (RAC, 2016). These include dangerous goods. Anonymous survey of freight rail operating employees conducted by the Teamsters Canada Rail Conference (TCRC, 2014) revealed that many do not report getting enough sleep because of their work schedules, and that fatigue may be affecting their performance at work. Besides general impairments in attention and cognitive functioning, fatigue in railway operating employees slows reaction time to safety alarms and impairs conformance to train operating requirements. Shift scheduling practices can contribute to sleep-related fatigue by restricting sleep opportunities, requiring extended periods of wakefulness and by disrupting daily (circadian) rhythms. The primary goal of accident investigation is to identify causal and contributing factors so that similar occurrences can be prevented. A database search of Transportation Safety Board (TSB) rail investigation reports published in the 21-year period from 1995 to 2015 identified 18 that cited sleep-related fatigue of freight rail operating employees as a causal, contributing, or risk finding. This number represents about 20% of TSB rail investigations from the same period in which a human factors aspect of freight train activities was a primary cause. Exploration of accident themes suggests that management of fatigue and shift scheduling in the freight rail industry is a complex issue that is often not conducive to employee circadian rhythms and sleep requirements. It also suggests that current shift scheduling and fatigue management practices may be insufficient to mitigate the associated safety risk. Railway fatigue management systems that are based on the principles of modern sleep science are needed to improve scheduling practices and mitigate the ongoing safety risk.


Assuntos
Acidentes/estatística & dados numéricos , Fadiga/prevenção & controle , Ferrovias , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Tolerância ao Trabalho Programado/fisiologia , Canadá , Fadiga/complicações , Humanos , Admissão e Escalonamento de Pessoal/estatística & dados numéricos , Medição de Risco , Sono/fisiologia , Transtornos do Sono do Ritmo Circadiano/complicações , Inquéritos e Questionários
9.
Presse Med ; 47(11-12 Pt 1): 982-990, 2018.
Artigo em Francês | MEDLINE | ID: mdl-30446235

RESUMO

Night work is not only a work performed at night. It has also to be considered as a specifically organized work with its own duties and moving tasks in a different relational context. Primary preventive assessments regarding work schedules and occupational associated constraints have to be considered beside family potential consequences. Taking account of the consensually accepted impact of night-shift work on health, particularly on sleep, we recommend an annual medical visit for night-shift workers. We also recommend to declare the night shift diseases to the Regional committee of occupational diseases via the "alinea 4".


Assuntos
Serviços de Saúde do Trabalhador , Guias de Prática Clínica como Assunto , Medicina Preventiva , Transtornos do Sono do Ritmo Circadiano/diagnóstico , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Conduta Expectante , Humanos , Monitorização Fisiológica/métodos , Monitorização Fisiológica/normas , Serviços de Saúde do Trabalhador/métodos , Serviços de Saúde do Trabalhador/normas , Medicina Preventiva/métodos , Medicina Preventiva/normas , Jornada de Trabalho em Turnos/efeitos adversos , Jornada de Trabalho em Turnos/psicologia , Conduta Expectante/métodos , Conduta Expectante/normas
10.
Travel Med Infect Dis ; 24: 59-64, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29787851

RESUMO

OBJECTIVES: We reviewed Jetlag, particularly in view of its effects on sleep and how it can be managed. METHODS: The Proquest Central database of Kirikkale University, PubMed and Google scholar were used while searching for the following key words: "Jetlag", "symptoms", "sleep", "melatonin" and "treatment". RESULTS: Flight dysrhythmia, otherwise known as jetlag, is caused by flying globally over various time zones. Most passengers who fly over six or more different time zones generally require 4-6 days after travelling to resume their usual sleep patterns and to feel less lethargic during the day. Signs of jet lag can vary between debilitated awareness, insomnia, feeling tired during the day and frequent waking during the night. During the night our pineal glands excrete a hormone called melatonin; dim lights cause the continuation of excretion of these hormones whereas any exposure to bright lights stems the flow of release. Common precautionary measures are specific diets, bright lights and melatonin agonists (Ramelteon, Agomelatine). CONCLUSION: Sleep issues derived from jetlag were found to be most common in passengers who flew through various time belts. Melatonin assumes a critical part in adjusting the body's circadian rhythms and has been utilized restoratively to re-establish irritated circadian rhythms.


Assuntos
Ritmo Circadiano , Síndrome do Jet Lag/complicações , Síndrome do Jet Lag/prevenção & controle , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Viagem , Dietoterapia , Feminino , Humanos , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/uso terapêutico , Síndrome do Jet Lag/fisiopatologia , Síndrome do Jet Lag/terapia , Iluminação , Masculino , Melatonina/agonistas , Transtornos do Sono do Ritmo Circadiano/dietoterapia , Transtornos do Sono do Ritmo Circadiano/tratamento farmacológico , Transtornos do Sono do Ritmo Circadiano/etiologia , Distúrbios do Início e da Manutenção do Sono/etiologia , Distúrbios do Início e da Manutenção do Sono/prevenção & controle , Fatores de Tempo
11.
Med Lav ; 109(2): 144-150, 2018 02 20.
Artigo em Inglês | MEDLINE | ID: mdl-29701630

RESUMO

BACKGROUND: Shift work disorder (SWD) is a major concern for both healthcare workers (HCWs) employed in hospital wards and healthcare organizations. The consequences of SWD may lead to increased service costs and lower standards of care. OBJECTIVES: To identify and evaluate the latest developments in assessing and managing the occupational risk of SWD in shift-HCWs through a search of the literature published in the last five years. METHODS: We performed a search of the literature starting from June 2012, using MEDLINE/Pubmed. The articles were reviewed and categorized into one or more of the following categories based on their subject matter: Risk assessment, Risk management, Occurrence rates. RESULTS: A total of 25 publications matched the inclusion criteria. The topics discussed, in order of frequency (from the highest to the lowest), were: "Risk Assessment" (84%), "Occurrence Rates" (64%) and "Risk Management" (48%). Number of nights worked per year, long night-time working hours, frequent missing of nap opportunities during night-shift, quick returns and unhealthy workplace were found as organizational determinants of SWD that should be prioritized in the risk assessment of shift work in the healthcare sector. CONCLUSIONS: Organizational interventions targeted on both healthy shift-work scheduling and improvement of the workplace safety are proposed to moderate the occurrence of SWD and, consequently, to ensure HCWs' wellness and suitable standards of patient care. Further studies aimed to investigate the effectiveness of such interventions in minimizing SWD occurrence are needed.


Assuntos
Pessoal de Saúde/estatística & dados numéricos , Unidades Hospitalares/estatística & dados numéricos , Saúde do Trabalhador , Qualidade de Vida , Transtornos do Sono do Ritmo Circadiano/epidemiologia , Tolerância ao Trabalho Programado , Prevenção de Acidentes , Depressão/epidemiologia , Fadiga/epidemiologia , Pessoal de Saúde/psicologia , Humanos , Itália/epidemiologia , Medição de Risco , Fatores de Risco , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Transtornos do Sono do Ritmo Circadiano/psicologia , Inquéritos e Questionários , Tolerância ao Trabalho Programado/psicologia
13.
Prehosp Emerg Care ; 22(sup1): 58-68, 2018 02 15.
Artigo em Inglês | MEDLINE | ID: mdl-29324059

RESUMO

BACKGROUND: Fatigue training may be an effective way to mitigate fatigue-related risk. We aimed to critically review and synthesize existing literature on the impact of fatigue training on fatigue-related outcomes for Emergency Medical Services (EMS) personnel and similar shift worker groups. METHODS: We performed a systematic literature review for studies that tested the impact of fatigue training of EMS personnel or similar shift workers. Outcomes of interest included personnel safety, patient safety, personnel performance, acute fatigue, indicators of sleep duration and quality, indicators of long-term health (e.g., cardiovascular disease), and burnout/stress. A meta-analysis was performed to determine the impact of fatigue training on sleep quality. RESULTS: Of the 3,817 records initially identified for review, 18 studies were relevant and examined fatigue training in shift workers using an experimental or quasi-experimental design. Fatigue training improved patient safety, personal safety, and ratings of acute fatigue and reduced stress and burnout. A meta-analysis of five studies showed improvement in sleep quality (Fixed Effects SMD -0.87; 95% CI -1.05 to -0.69; p < 0.00001; Random Effects SMD -0.80; 95% CI -1.72, 0.12; p < 0.00001). CONCLUSIONS: Reviewed literature indicated that fatigue training improved safety and health outcomes in shift workers. Further research is required to identify the optimal components of fatigue training programs to maximize the beneficial outcomes.


Assuntos
Auxiliares de Emergência/educação , Fadiga/terapia , Educação em Saúde/métodos , Jornada de Trabalho em Turnos/efeitos adversos , Tolerância ao Trabalho Programado , Esgotamento Profissional/epidemiologia , Esgotamento Profissional/etiologia , Serviços Médicos de Emergência , Auxiliares de Emergência/estatística & dados numéricos , Fadiga/complicações , Fadiga/prevenção & controle , Humanos , Projetos de Pesquisa , Segurança/estatística & dados numéricos , Sono , Transtornos do Sono do Ritmo Circadiano/epidemiologia , Transtornos do Sono do Ritmo Circadiano/prevenção & controle
15.
Rev. Col. Méd. Cir. Guatem ; 156(2): 75-78, nov. 2017. graf, tab
Artigo em Espanhol | LILACS | ID: biblio-995468

RESUMO

Determinar niveles de ruido mediante técnicas de sonometría, que resultan propicios parala contaminación acústica en el ambiente quirúrgico de los servicios de Sala de Operaciones de Adultos, Sala de Operaciones de la Emergencia de Adultos, Sala de Operaciones de Pediatría, Sala de Operaciones de Ginecología y Sala de Labor y Partos del Hospital Roosevelt, durante abril ­ mayo de 2017. Material y método: Estudio descriptivo transversal realizado en quirófanos del Hospital Roosevelt donde se utilizó la tercera estrategia de la NTG ­ ISO 9612 para determinar exposición al ruido ocupacional con la participación de 26 médicos residentes de anestesiología a quienes se les aplicó diversos test para identificar efectos cognitivos, trastornos del sueño y de la conducta relacionados a niveles altos de ruido. Resultados: Existe una media energética del sonido en quirófanos de entre 69.8 y 95.4 decibelios. El departamento quirúrgico con más ruido es Labor y Partos con 95.4 decibelios, el tipo de procedimiento con mayor contaminación acústica es la cirugía abdominal. El 53.85% de médicos presenta resultado anormal en pruebas cognitivas, 61.54% posee dificultad media para dormir. No existe evidencia de trastornos conductuales. Conclusiones: Los niveles de ruido en quirófanos sobrepasan al doble de lo recomendado por OMS provocando efectos cognitivos y trastornos del sueño en residentes de anestesiología. El horario fijo de labores es la jornada con mayor polución sonora en quirófanos. La fuente con mayor emisión de ruido dentro del área quirúrgica es el sistema de aspiración (AU)


Purpose: To determine noise levels using sonometric techniques, which are conducive to acoustic contamination in the surgical environment of the Adult Operating Room, Adult Emergency Operating Room, Pediatric Operating Room, Operating Room of Gynecology and Labor and Delivery Room of the Hospital Roosevelt in Guatemala, during the months of April and May, 2017. Population and methods: A cross - sectional descriptive study performed in operating rooms of the Hospital Roosevelt where the third strategy of NTG - ISO 9612 was used to determine exposure to occupational noise with the participation of 26 resident physicians of anesthesiology who were given different tests to identify cognitive effects, sleep disorders and behavior related to high noise levels. Results: There is an energetic mean of the sound in operating rooms between 69.8 and 95.4 decibels. The surgical department with the most noise is Labor and Delivery Room with 95.4 decibels, the procedure with the highest noise emission is abdominal surgery. 53.85% of physicians present abnormal results in cognitive tests, 61.54% have medium difficulty sleeping. There is no evidence of behavioral disorders. Conclusion: Noise levels in operating rooms are more than twice that recommended by whom, causing cognitive effects and sleep disorders in residents of anesthesiology. The fixed work schedule is the day with the greatest sound pollution in operating theaters. The source with the highest noise emission within the surgical area is the aspiration system (AU)


Assuntos
Humanos , Masculino , Feminino , Efeitos do Ruído/efeitos adversos , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Audiômetros/métodos , Hospitais , Ruído/efeitos adversos , Salas Cirúrgicas
16.
FP Essent ; 460: 33-36, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28845960

RESUMO

Shift work sleep disorder is a common problem in industrialized countries because of the need for occupations and services to continue to function 24 hours/day. Approximately 20% of employed adults in the United States are engaged in shift work. Shift work sleep disorder is diagnosed if there is a report of insomnia or excessive sleepiness for at least 3 months associated with a recurring work schedule that overlaps the usual time for sleep. Shift work is associated with an increased occurrence of metabolic disorders, such as insulin resistance, diabetes, dyslipidemia, and metabolic syndrome, and it has been implicated in weight gain and cognitive impairment. There is evidence of increased absenteeism in night workers compared with day workers. A planned sleep schedule, timed bright light exposure, timed melatonin administration, and stimulants or drugs promoting alertness can be used to manage shift work sleep disorder. Jet lag is characterized by a misalignment between internal circadian rhythms and local time caused by rapid travel across at least two time zones. Not all travelers experience jet lag; risk factors include age, number of time zones crossed, and circadian preference. Management includes timed melatonin along with optional timed and dosed bright light exposure.


Assuntos
Ritmo Circadiano/fisiologia , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Transtornos do Sono do Ritmo Circadiano/fisiopatologia , Higiene do Sono , Tolerância ao Trabalho Programado/fisiologia , Humanos , Melatonina/metabolismo , Sono , Vigília
17.
Am J Ind Med ; 60(9): 762-765, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28744881

RESUMO

OBJECTIVES: Napping has known benefits for fatigue mitigation and improved alertness. However the Accreditation Council for Graduate Medical Education (ACGME) New Common Program Requirements recently removed the 16 h work limit for PGY1 residents and removed any suggestions of napping. METHODS: We utilized a cross-sectional study design to administer a 44-item questionnaire in June 2016 to 858 residents and fellows at one large urban academic medical center. We assessed: 1) resident physician sentiment of work environment supportiveness for napping at work; and 2) agreement with 2011 ACGME guidelines on workweek hour limitations and strategic napping recommendations. RESULTS: While 89% of residents reported access to an on-call room at work, only 20% felt their work environment supported a culture of napping while at work. Over 76% expressed agreement with the 2011 ACGME work-hour restrictions. CONCLUSIONS: Strategies to support napping and well-being within the resident physician workforce and organizational setting are warranted.


Assuntos
Educação de Pós-Graduação em Medicina/normas , Internato e Residência/normas , Corpo Clínico Hospitalar/normas , Tolerância ao Trabalho Programado , Carga de Trabalho/normas , Adulto , Estudos Transversais , Educação de Pós-Graduação em Medicina/métodos , Feminino , Humanos , Masculino , Corpo Clínico Hospitalar/psicologia , Doenças Profissionais/prevenção & controle , Doenças Profissionais/psicologia , Sono , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Transtornos do Sono do Ritmo Circadiano/psicologia , Carga de Trabalho/psicologia
18.
Trials ; 18(1): 254, 2017 06 05.
Artigo em Inglês | MEDLINE | ID: mdl-28583143

RESUMO

BACKGROUND: Most air medical Emergency Medical Services (EMS) clinicians work extended duration shifts, and more than 50% report inadequate sleep, poor sleep quality, and/or poor recovery between shifts. The SleepTrackTXT pilot trial (ClinicalTrials.gov, NCT02063737) showed that use of mobile phone text messages could impact EMS clinician self-reported fatigue and sleepiness during long duration shifts. The purpose of the SleepTrackTXT2 trial is to leverage lessons learned from the first SleepTrackTXT study and test an enhanced intervention targeting air medical EMS clinicians. METHODS/DESIGN: We will conduct a multi-site randomized trial with a sample of adult EMS clinicians recruited from four air medical EMS systems located in the midwest, northeastern, and southern USA. Participants will be allocated to one of two possible arms for a 4-month (120-day) study period. The intervention arm will involve text-message assessments of sleepiness, fatigue, and difficulty concentrating at the beginning, every 4 hours during, and at the end of scheduled shifts. Participants reporting high levels of sleepiness, fatigue, or difficulty with concentration will receive one of nine randomly selected intervention messages to promote behavior change during shift work to improve alertness. Intervention participants will receive a text-message report on Friday of each week that shows their sleep debt over the previous 7 days followed by a text message to promote paying back sleep debt recovery when feasible. Participants in the control group receive text messages that only include assessments. Both arms will receive text-message assessments of perceived recovery since last shift, sleepiness, fatigue, or difficulty with concentration at noon (1200 hours) on days between scheduled shifts (off-duty days). We have two aims for this study: (1) to determine the short-term impact of the enhanced SleepTrackTXT2 intervention on air medical clinician fatigue reported in real time during and at the end of shift work, and (2) to determine the long-term impact of the SleepTrackTXT2 intervention on sleep quality and sleep health indicators including hours of sleep and recovery between shift work. DISCUSSION: The SleepTrackTXT2 trial may provide evidence of real-world effectiveness that would support widespread expansion of fatigue mitigation interventions in emergency care clinician shift workers. The trial may specifically support use of real-time assessments and interventions delivered via mobile technology such as text messaging. TRIAL REGISTRATION: ClinicalTrials.gov, NCT02783027 . Registered on 23 May 2016.


Assuntos
Resgate Aéreo , Telefone Celular , Serviços Médicos de Emergência , Auxiliares de Emergência/psicologia , Fadiga/prevenção & controle , Comportamentos Relacionados com a Saúde , Jornada de Trabalho em Turnos , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Sono , Envio de Mensagens de Texto , Atenção , Atitude do Pessoal de Saúde , Fadiga/etiologia , Fadiga/fisiopatologia , Fadiga/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Sistemas de Alerta , Projetos de Pesquisa , Fatores de Risco , Método Simples-Cego , Transtornos do Sono do Ritmo Circadiano/etiologia , Transtornos do Sono do Ritmo Circadiano/fisiopatologia , Transtornos do Sono do Ritmo Circadiano/psicologia , Fatores de Tempo , Estados Unidos , Tolerância ao Trabalho Programado
19.
Occup Environ Med ; 74(11): 792-801, 2017 11.
Artigo em Inglês | MEDLINE | ID: mdl-28630378

RESUMO

OBJECTIVES: Night workers often experience high levels of sleepiness due to misalignment of the sleep-wake cycle from the circadian pacemaker, in addition to acute and chronic sleep loss. Exposure to light, in particular short wavelength light, can improve alertness and neurobehavioural performance. This randomised controlled trial examined the efficacy of blue-enriched polychromatic light to improve alertness and neurobehavioural performance in night workers. DESIGN: Participants were 71 night shift workers (42 males; 32.8±10.5 years) who worked at least 6 hours between 22:00 and 08:00 hours. Sleep-wake logs and wrist actigraphy were collected for 1-3 weeks, followed by 48-hour urine collection to measure the circadian 6-sulphatoxymelatonin (aMT6s) rhythm. On the night following at least two consecutive night shifts, workers attended a simulated night shift in the laboratory which included subjective and objective assessments of sleepiness and performance. Workers were randomly assigned for exposure to one of two treatment conditions from 23:00 hours to 07:00 hours: blue-enriched white light (17 000 K, 89 lux; n=36) or standard white light (4000 K, 84 lux; n=35). RESULTS: Subjective and objective sleepiness increased during the night shift in both light conditions (p<0.05, ηp2=0.06-0.31), but no significant effects of light condition were observed. The 17 000 K light, however, did improve subjective sleepiness relative to the 4000 K condition when light exposure coincided with the time of the aMT6s peak (p<0.05, d=0.41-0.60). CONCLUSION: This study suggests that, while blue-enriched light has potential to improve subjective sleepiness in night shift workers, further research is needed in the selection of light properties to maximise the benefits. TRIAL REGISTRATION NUMBER: The Australian New Zealand Clinical Trials Registry ACTRN12610000097044 (https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=320845&isReview=true).


Assuntos
Atenção , Ritmo Circadiano , Luz , Transtornos do Sono do Ritmo Circadiano/prevenção & controle , Sono , Vigília , Tolerância ao Trabalho Programado , Adulto , Feminino , Humanos , Masculino , Melatonina/análogos & derivados , Melatonina/urina , Resultado do Tratamento , Adulto Jovem
20.
Pediatr. aten. prim ; 18(71): e129-e139, jul.-sept. 2016. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-156616

RESUMO

El trastorno de retraso de la fase del sueño y del despertar o síndrome de retraso de fase (SRF) es la alteración del ritmo circadiano de sueño más frecuente y suele manifestarse en la adolescencia. Se caracteriza por un retraso estable, habitualmente de más de dos horas, del inicio y del final del sueño respecto a los horarios convencionales. Clínicamente los pacientes presentan insomnio a la hora de acostarse, con gran dificultad para levantarse por la mañana en la hora deseada. Entre semana, debido a las obligaciones escolares o sociales, los niños con SRF duermen pocas horas, generándose una privación crónica de sueño que se manifestará con somnolencia diurna, fatiga, falta de atención, afectación del rendimiento escolar o absentismo escolar. Característicamente, el fin de semana o durante las vacaciones, cuando están libres de horarios, retrasan el sueño, siendo este de características normales y levantándose descansados. Es importante realizar un diagnóstico precoz para iniciar un tratamiento temprano que minimice las consecuencias del SRF. Por la imposibilidad de seguir unos horarios regulares de estudio ni de trabajo, son jóvenes a los que se califica de noctámbulos o de vagos, a pesar de sus esfuerzos repetidos por adaptarse a unos horarios convencionales, lo que aboca en altos índices de depresión, ansiedad y abuso de sustancias. El retraso de fase de sueño se confirma mediante las agendas de sueño, la actigrafía y los marcadores de fase circadianos. La higiene del sueño, la cronoterapia, la fototerapia y la administración de melatonina son los posibles tratamientos del SRF (AU)


Delayed sleep wake phase disorder (DSWPD) or delayed sleep phase disorder is the most frequent circadian rhythm sleep disorder and is commonly seen in adolescents. DSWPD is characterized by habitual by sleep onset and wake times that are usually delayed more than two hours relative to conventional sleep-wake times. Clinically, affected subjects experience difficulty falling asleep and arising at socially acceptable wake time. Enforced conventional wake times (during the school or working days), may result in chronically insufficient sleep manifested as excessive daytime sleepiness, fatigue, repetitive school absences with negative impact on their attention and academic performance. When allowed to follow their preferred schedule (during the weekends or vacation periods), the patient’s timing of sleep is delayed with normal and restoring sleep. It is very important to make an early diagnosis to initiate treatments that minimize consequences of DSWPD. Although their repetitive attempts to adapt to conventional times, their difficulties to maintain regular school or work timings leads these adolescents to be seen as lazy and not motivated, which usually results in an increase in mood disorders and drug abuse. Delay sleep phase is demonstrated by sleep log, actigraphy monitoring and in the timing of other circadian rhythms. Sleep hygiene, chronotherapy, bright light therapy or melatonin administration are the most habitual treatment of the DSWPD (AU)


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Transtornos do Despertar do Sono/epidemiologia , Transtornos do Despertar do Sono/prevenção & controle , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Distúrbios do Início e da Manutenção do Sono/prevenção & controle , Actigrafia/instrumentação , Actigrafia/métodos , Transtornos da Transição Sono-Vigília/complicações , Transtornos do Sono do Ritmo Circadiano/complicações , Transtornos do Sono do Ritmo Circadiano/epidemiologia , Transtornos do Sono do Ritmo Circadiano/prevenção & controle
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