Nurses working overnight support the need for a restorative nap during the night shift

A research abstract that will be presented on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS), identifies a number of personal health, safety, and patient care issues that support the need for a restorative nap during the night shift among nurses. Currently, barriers exist both within the organization and work environment for achieving naps. A strategy to assist nurses to promote sleep health within the complex context of their own sleep needs, organizational demands, and domestic responsibilities is greatly needed for both critical care nurses and the patients in their care, the abstract noted. The study, co-authored by Drs. Diana McMillan, Wendy Fallis, and Marie Edwards, of the University of Manitoba in Winnipeg, Manitoba, Canada, focused on 13 critical care nurses who met individually with one of the researchers and completed a tape-recorded semi-structured interview exploring demographics, work schedule and environment, and napping/non-napping experiences, perceptions, barriers, and preferences.

According to the results, participants identified a number of personal health, safety, and patient safety factors that support the need for a restorative nap during night shift. Staff shortages, unstable patients, and emergency situations were some of the reasons leading to a forfeited nap.

“Critical care nurses are trained to provide specialized nursing care, to make rapid decisions, and to perform advanced assessments and motor skills. Night shift work can lead to sleep deprivation, which in turn can threaten the health and safety of both patients and nurses,” said Dr. McMillan. “Napping has been suggested as a strategy to improve performance, reduce fatigue and increase vigilance in other shift work environments. Surprisingly, little work has been done to support effective napping strategies in critical care nurses.

This qualitative study aimed to address this gap by first understanding the experiences, barriers, and preferences related to napping or not napping during breaks on night shift, said Dr. McMillan.

“When deprived of a nap, the nurses involved in our study reported experiencing nausea, irritability, decreased alertness, and severe fatigue. A brief nap revived and energized many nurses. A few nurses felt tired but were afraid to nap, suggesting that nap duration and a recovery period may be important nap strategy components. The study findings support the development of napping strategies that take into consideration the complex organizational, domestic and individual demands of these front line care givers; their health and the health of their patients depend on it,” added Dr. McMillan.

It is recommended that adults get between seven and eight hours of nightly sleep.

The American Academy of Sleep Medicine (AASM) offers the following tips on how to get a good night’s sleep:

• Follow a consistent bedtime routine.

• Establish a relaxing setting at bedtime.

• Get a full night’s sleep every night.

• Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.

• Do not bring your worries to bed with you.

• Do not go to bed hungry, but don’t eat a big meal before bedtime either.

• Avoid any rigorous exercise within six hours of your bedtime.

• Make your bedroom quiet, dark and a little bit cool.

• Get up at the same time every morning.

Those who suspect that they might be suffering from a sleep disorder are encouraged to consult with their primary care physician or a sleep specialist.

Source: American Academy of Sleep Medicine