The DOI matches its Crossref record; 53 of the 53 references it cites were found in a registry or an index.
Sleep, Sleepiness, Fatigue, and Performance of 12-Hour-Shift Nurses
Abstract
Nurses working 12-h shifts complain of fatigue and insufficient/poor-quality sleep. Objectively measured sleep times have not been often reported. This study describes sleep, sleepiness, fatigue, and neurobehavioral performance over three consecutive 12-h (day and night) shifts for hospital registered nurses. Sleep (actigraphy), sleepiness (Karolinska Sleepiness Scale [KSS]), and vigilance (Performance Vigilance Task [PVT]), were measured serially in 80 registered nurses (RNs). Occupational fatigue (Occupational Fatigue Exhaustion Recovery Scale [OFER]) was assessed at baseline. Sleep was short (mean 5.5 h) between shifts, with little difference between day shift (5.7 h) and night shift (5.4 h). Sleepiness scores were low overall (3 on a 1-9 scale, with higher score indicating greater sleepiness), with 45% of nurses having high level of sleepiness (score > 7) on at least one shift. Nurses were progressively sleepier each shift, and night nurses were sleepier toward the end of the shift compared to the beginning. There was extensive caffeine use, presumably to preserve or improve alertness. Fatigue was high in one-third of nurses, with intershift fatigue (not feeling recovered from previous shift at the start of the next shift) being most prominent. There were no statistically significant differences in mean reaction time between day/night shift, consecutive work shift, and time into shift. Lapsing was traitlike, with rare (39% of sample), moderate (53%), and frequent (8%) lapsers. Nurses accrue a considerable sleep debt while working successive 12-h shifts with accompanying fatigue and sleepiness. Certain nurses appear more vulnerable to sleep loss than others, as measured by attention lapses.
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In the citing paper
“For nurses, shift work and long work hours have been shown to be related to adverse health outcomes and indicators of reduced functioning.208–217”
From Sleep, Health, and Society (2017) · cites this paper as [216]
In the citing paper
“there are reports that many nurses prefer the compressed working week that results from working fewer shifts. 7-10”
From Nurses’ Shift Length and Overtime Working in 12 European Countries: The Association With Perceived Quality of Care and Patient Safety (2014) · cites this paper as [10]
In the citing paper
“Patients in hospitals where a higher proportion of nurses worked longer shifts also reported lower satisfaction. 10”
From Nurses’ Shift Length and Overtime Working in 12 European Countries: The Association With Perceived Quality of Care and Patient Safety (2014) · cites this paper as [10]
In the citing paper
“Overtime has previously been associated with increased nurse turnover 10,46”
From Nurses’ Shift Length and Overtime Working in 12 European Countries: The Association With Perceived Quality of Care and Patient Safety (2014) · cites this paper as [10]
In the citing paper
“and have been associated with poorer quality ratings. 10,15”
From Nurses’ Shift Length and Overtime Working in 12 European Countries: The Association With Perceived Quality of Care and Patient Safety (2014) · cites this paper as [10]
Citations
Cites
Nylund, K. L., Asparouhov, T., & Muthén, B. O. (2007) · Structural Equation Modeling: A Multidisciplinary Journal · doi:10.1080/10705510701575396 · Cited by 11,415
Van Dongen, H. P. A., Maislin, G., Mullington, J. M., & Dinges, D. F. (2003) · Sleep · doi:10.1093/sleep/26.2.117 · Cited by 3,173
Subjective and objective sleepiness in the active individual
Åkerstedt, T., & Gillberg, M. (1990) · International Journal of Neuroscience · doi:10.3109/00207459008994241 · Cited by 3,088
The Role of Actigraphy in the Study of Sleep and Circadian Rhythms
Ancoli-Israel, S., Cole, R., Alessi, C., Chambers, M., Moorcroft, W., & Pollak, C. P. (2003) · Sleep · doi:10.1093/sleep/26.3.342 · Cited by 2,751 · cited 2×
“Actigraphy is a reliable and valid measure for detecting sleep in normal, healthy adult populations (Littner et al., 2003), and has been used to study sleep/wake patterns for more than 30 yrs (Ancoli-Israel et al., 2003).”
MethodBehavioral and Physiological Consequences of Sleep Restriction
Banks, S., & Dinges, D. F. (2007) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.26918 · Cited by 1,505
Sleep Deprivation and Vigilant Attention
Lim, J., & Dinges, D. F. (2008) · Annals of the New York Academy of Sciences · doi:10.1196/annals.1417.002 · Cited by 1,213
Keeping patients safe: transforming the work environment of nurses
(2005) · Choice Reviews Online · doi:10.5860/choice.42-2844 · Cited by 1,140
ETHICS AND METHODS FOR BIOLOGICAL RHYTHM RESEARCH ON ANIMALS AND HUMAN BEINGS
Portaluppi, F., Smolensky, M. H., & Touitou, Y. (2010) · Chronobiology International · doi:10.3109/07420528.2010.516381 · Cited by 1,125
The Working Hours Of Hospital Staff Nurses And Patient Safety
Rogers, A. E., Hwang, W.-T., Scott, L. D., Aiken, L. H., & Dinges, D. F. (2004) · Health Affairs · doi:10.1377/hlthaff.23.4.202 · Cited by 952 · cited 2×
“The risk for patient-care errors and near errors was increased in two studies of 12-h-shift nurses (Rogers et al., 2004; Scott et al., 2006), and was associated with shorter sleep in another (Dorrian et al., 2006).”
BackgroundLittner, M. R., Kushida, C. A., Anderson, W. M., Bailey, D. R., Berry, R. B., Davila, D., Hirshkowitz, M., Kapen, S., KRAMER, M. L., Loube, D. I., et al. (2003) · SLEEP · doi:10.1093/sleep/26.3.337 · Cited by 702
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Grandner, M. A. (2017) · Sleep Medicine Clinics · doi:10.1016/j.jsmc.2016.10.012 · Cited by 720
Negative Impacts of Shiftwork and Long Work Hours
Caruso, C. C. (2014) · Rehabilitation Nursing · doi:10.1002/rnj.107 · Cited by 639
Smith, M. T., McCrae, C., Cheung, J., Martin, J. L., Harrod, C. G., Heald, J. L., & Carden, K. (2018) · Journal of Clinical Sleep Medicine (JCSM) · doi:10.5664/jcsm.7228 · Cited by 458
Dall'Ora, C., Griffiths, P., Ball, J., Simon, M., & Aiken, L. H. (2015) · BMJ Open · doi:10.1136/bmjopen-2015-008331 · Cited by 408
Monitoring fatigue in construction workers using physiological measurements
Aryal, A., Ghahramani, A., & Becerik-Gerber, B. (2017) · Automation in Construction · doi:10.1016/j.autcon.2017.03.003 · Cited by 404
Metadata
- Authors
- Geiger-Brown, J., Rogers, V. E., Trinkoff, A. M., Kane, R. L., Bausell, R. B., & Scharf, S. M.
- Affiliations
- University of Maryland, Baltimore (US)
- University of Pennsylvania (US)
- Corresponding author
- Geiger-Brown, Jeanne
- Venue
- Chronobiology International
- Publisher
- Informa UK Limited
- Published
- 2012-02-10
- Volume
- 29
- Issue
- 2
- Pages
- 211-219
- ISSN
- 0742-0528 (ISSN-L)
- 1525-6073
- OpenAlex
- W1975400017
- Semantic Scholar
- 77d82a852929f554d8e45eacfece34f2cc457e84
- Cited by
- 382
- References
- 53
- Citations by year
- 2026: 8 · 2025: 32 · 2024: 21 · 2023: 19 · 2022: 41 · 2021: 54 · 2020: 32 · 2019: 33 · 2018: 36 · 2017: 27 · 2016: 25 · 2015: 20 · 2014: 23 · 2013: 10 · 2012: 1
- FWCI
- 23.13
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Chronobiology International (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5k12rr023250-05)
- National Center for Research Resources (1K12RR023250)
- National Institute for Occupational Safety and Health (R21OH008392)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Keywords
- shift work, 12-hour shifts, nurses, sleep deprivation, sleepiness, occupational fatigue, neurobehavioral performance, sustained attention, reaction time, attentional lapses, caffeine consumption, sleep debt, night shift work, day shift, actigraphy, Karolinska Sleepiness Scale
- MeSH terms
- Adult, Circadian Rhythm, Fatigue, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Neuropsychological Tests, Sleep, Task Performance and Analysis, Wakefulness, Work, Work Schedule Tolerance, Young Adult
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