TY - JOUR
T1 - Effects of Nocturnal Sleep Quality on Diurnal Cortisol Profiles and Attention in Nurses
T2 - A Cross-Sectional Study
AU - Tsai, Jui Chen
AU - Chou, Kuei Ru
AU - Tsai, Hsiu Ting
AU - Yen, Yu Chun
AU - Niu, Shu Fen
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Ministry of Science and Technology, Taiwan (MOST 107-2314-B-038-008) and Taipei Medical University, Taiwan (TMU106-AE1-B11).
Publisher Copyright:
© The Author(s) 2019.
PY - 2019/10/1
Y1 - 2019/10/1
N2 - Objective: Low sleep quality (LSQ) activates the hypothalamic–pituitary–adrenal (HPA) axis and is related to arousal. Nursing staff, who work in shifts, tend to exhibit LSQ, which affects the level of vigor after awakening. This study investigated the effects of nocturnal sleep quality on diurnal cortisol profiles and sustained attention in day-shift nurses. Method: This study adopted a prospective cross-sectional design. Participants were recruited from a university-affiliated hospital in northern Taiwan. In the initial stage of this study, the Chinese Pittsburgh Sleep Quality Index (PSQI) Questionnaire was administered to 199 participants to categorize them as either LSQ (PSQI > 5) or high sleep quality (HSQ; PSQI ≤ 5). Participants were then randomly sampled from the two groups. Nocturnal sleep data and four diurnal saliva samples were collected for each participant. Sustained attention was measured before they started work. A total of 32 and 29 participants in the HSQ and LSQ groups, respectively, completed the data collection process. Results: Compared with the HSQ group, the LSQ group exhibited earlier wake-up times (p =.02), a flatter cortisol awakening response (CAR) slope (p <.01), a flatter morning-to-evening slope (p <.01), and prolonged reaction speed and mean reaction time before starting work (p <.01). Conclusion: Compared with the HSQ group, the LSQ group exhibited impaired HPA-axis regulation, with a flatter CAR and diurnal cortisol slope and poor sustained attention in the morning. Nursing staff are advised to achieve HSQ to improve attention and performance levels and maintain optimum work safety.
AB - Objective: Low sleep quality (LSQ) activates the hypothalamic–pituitary–adrenal (HPA) axis and is related to arousal. Nursing staff, who work in shifts, tend to exhibit LSQ, which affects the level of vigor after awakening. This study investigated the effects of nocturnal sleep quality on diurnal cortisol profiles and sustained attention in day-shift nurses. Method: This study adopted a prospective cross-sectional design. Participants were recruited from a university-affiliated hospital in northern Taiwan. In the initial stage of this study, the Chinese Pittsburgh Sleep Quality Index (PSQI) Questionnaire was administered to 199 participants to categorize them as either LSQ (PSQI > 5) or high sleep quality (HSQ; PSQI ≤ 5). Participants were then randomly sampled from the two groups. Nocturnal sleep data and four diurnal saliva samples were collected for each participant. Sustained attention was measured before they started work. A total of 32 and 29 participants in the HSQ and LSQ groups, respectively, completed the data collection process. Results: Compared with the HSQ group, the LSQ group exhibited earlier wake-up times (p =.02), a flatter cortisol awakening response (CAR) slope (p <.01), a flatter morning-to-evening slope (p <.01), and prolonged reaction speed and mean reaction time before starting work (p <.01). Conclusion: Compared with the HSQ group, the LSQ group exhibited impaired HPA-axis regulation, with a flatter CAR and diurnal cortisol slope and poor sustained attention in the morning. Nursing staff are advised to achieve HSQ to improve attention and performance levels and maintain optimum work safety.
KW - attention
KW - cortisol
KW - cortisol awakening response
KW - nurses
KW - psychomotor vigilance test
KW - sleep quality
UR - http://www.scopus.com/inward/record.url?scp=85069038094&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85069038094&partnerID=8YFLogxK
U2 - 10.1177/1099800419861695
DO - 10.1177/1099800419861695
M3 - Article
AN - SCOPUS:85069038094
SN - 1099-8004
VL - 21
SP - 510
EP - 518
JO - Biological Research for Nursing
JF - Biological Research for Nursing
IS - 5
ER -