Nurses Working Extended Shifts Tired at Work, Sleep Little Are Likely to Drive Drowsy

Hospital staff nurses who work extended hours, work at night, struggle to remain awake at work, or obtain less sleep are more likely to experience a drowsy driving episode, according to a study published in the Dec. 1 issue of the journal Sleep.

The study, authored by Linda Scott, of Grand Valley State University in Grand Rapids, Mich., focused on data that were collected from 895 full-time hospital staff nurses, who completed logbooks on a daily basis for four weeks providing information concerning work hours, sleep duration, drowsy and sleep episodes at work, and drowsy driving occurrences.

According to the results, almost 67 percent of the nurses reported at least one episode of drowsy driving, and three percent reported experiencing drowsy driving following every shift worked. On average, nurses reported experiencing an episode of drowsy driving one out of every four shifts they worked.

Two-hundred eighty-one episodes of motor vehicle crashes/near-motor vehicle crashes were reported during the study period. The majority of these incidents occurred following shifts that exceeded 12.5 hours in duration. The likelihood of a motor vehicle crash/near-motor vehicle crash significantly increased with longer shift durations. The risk for a motor vehicle crash/near-motor vehicle crash almost doubled when driving following shifts that exceeded 12.5 hours.

The risk for a drowsy driving episode doubled when nurses worked 12.5 or more consecutive hours. Working at night also significantly increased the risk for drowsy driving incident. In fact, 79.5 percent of the nurses who worked only night shifts reported at least one episode of drowsy driving.

Almost two-thirds of the nurses reported struggling to stay awake at work at least once during the study period, and 16.9 percent of the nurses actually fell asleep at least one during their work shift. Nurses who struggled to stay awake at work were significantly more likely to report struggling to stay awake driving home after work. In particular, the likelihood of a drowsy driving incident was tripled when nurses experienced episodes of drowsiness at work. The risk for a drowsy driving episode was also increased when nurses reported falling asleep on duty.

Although research on the effects of chronic sleep restriction has revealed that most adults require at least seven to eight hours of sleep each night to avoid developing chronic sleep debt with its accompanying performance deficits, the hospital staff nurses in this study frequently obtained less sleep than this critical threshold. Only 20.8 percent of the participants reported obtaining at least six hours of sleep prior to every shift they worked. The risk for a drowsy driving episode increased by nine percent for each hour of sleep lost.

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