Circadian and Sleep Health Interventions in Nurses and Hospital Corpsmen

Thebroad long-term objective of thisstudy is toameliorate the known negative outcomes of rotating shiftwork hospital schedules in U.S. Navy nurses and corpsmen. Shiftwork results in circadian disruption, with negative consequences for physiological and psychological health and increased rates of accidents and errors; (2) identify and assess the efficacy of individual sleep strategies for management of circadian and sleep disruption;(3) introduce evidence-based light and circadian interventions in shift working Navy Nurses and Corpsmen.

InPhase 1, subjective circadian disruption will be quantified utilizing self-reported measures of sleep and alertness across the two shift types, and sleep strategies will be identified and compared.

InPhase 2, objective circadian disruption will be quantified with actigraphy, sleep diaries, hormonal assays and cognitive batteries. In addition, further subjective information will be obtained via health and quality of life indices.

In Phase 3, the efficacy of light and scheduling manipulations which have shown promise under laboratory conditions will be compared relative to baseline metrics utilizing the same measures from Phase 2. In addition to comparison of direct outcomes, intervention science will be employed to further assess the feasibility and practicality of interventions across phases.

At the conclusion of these studies, we will have evaluated as-yet untested and novel shiftwork interventions, as well as developed new tools for investigating the efficacy of different scheduling practices. This work has the potential to directly affect nursing competencies and practice by increasing quality of care and on-the-job safety. Results may thus inform nursing policies and future practice.

Current interventions for circadian disruption are complex, largely impractical, and result in incomplete adjustment, at best. We hypothesize that three distinct circadian interventions, each a manipulation of light exposure and sleep patterns, may mitigate the known adverse effects of shiftwork on sleep, alertness, performance, and quality of life in Navy hospital Nurses and Corpsmen.

Our proposed study aimsto(1) quantify both subjective and objective circadian disruption in nurses and corpsmen based on current scheduling practices.