Napping during the night shift and recovery after work among hospital nurses

Cross-sectional epidemiological study involving 1940 nurses from 18 public hospitals in the City of Rio de Janeiro. A multidimensional and self-applied questionnaire was used with information about health, sociodemographic and occupational characteristics, health-related behaviors and housework. Multiple logistic regression was applied to identify the association, adjusted for confounding variables.

RESULTS:

The gross analyses showed 44%, 127% and 66% higher chances of a high level of recovery after work for nurses who sleep up to two hours, between 2.1 and 3 hours and 3.1 hours or more, respectively, when compared to the nurses who do not sleep. After adjusting for confounding variables, the association only continues significant for the group that sleeps 2.1 to 3 hours during the night shift (OR=1.79; 95%CI=1.33-2.41).

CONCLUSION:

The association between the length of napping and the high level of recovery after work, confirmed in the present results, can be included in the studies that aim to support more appropriate policies aimed at improving the workers' work, life and health conditions, not only in nursing, but night-shift workers in general.

Descriptors
Nurses, Male; Nurses; Night Work; Sleep; Occupational Health

Variables		n	%
Sex
	Female	1644	84.7
	Male	296	15.3
Age
	From 23 till 35 years	853	44.6
	From 36 till 45 years	642	33.5
	From 46 till 67 years	419	21.9
Marital Situation
	Married	1091	56.9
	Separated, Divorced and Widowed	343	17.9
	Single	482	25.2
Per capita income
	Up to R$ 1,394.83	561	32.7
	Between R$ 1,400.90 and R$ 2,324.50	614	35.9
	From R$ 2,324.83 till R$ 7,440.00	537	31.4
Presence of children under 6 years of age
	Yes	362	19.1
	No	1537	80.9
Weekly hour load of professional work
	Up to 30 hours	160	8.6
	31 till 60 hours	838	44.9
	61 hours or more	869	46.5
Domestic burden
	Low	1364	70.5
	High	570	29.5
Length of nighttime work in Nursing
	Less than 1 year	174	9.2
	1 to 5 years	666	35.2
	6 to 10 years	449	23.6
	11 to 20 years	416	22
	21 years or more	189	10
Permission to sleep during the night shift
	Yes	1869	97.6
	No	45	2.4
During the permitted sleep time
	Sleeps	994	53.4
	Rests only (unable to sleep)	819	44
	Neither sleeps nor rests	47	2.6
Length of napping
	Does not sleep	866	46.6
	Sleeps up to 2 hours (120 minutes)	353	19.4
	Sleeps between 2.1 and 3 hours (126 till 180 minutes)	497	26.9
	Sleeps 3.1 hours or more (186 minutes or more)	131	7.1
Alcohol consumption
	Does not drink	722	38
	Low risk	549	28.8
	Medium risk	547	28.7
	High risk	85	4.5
Complaints of insomnia
	Yes	639	33.2
	No	1284	66.8
Physical exercise in the past two weeks
	Yes	584	30.3
	No	1344	69.7

Variables	Model 1		Model 2		Model 3
Variables	Loadings	Uniqueness	Loadings	Uniqueness	Loadings	Uniqueness
a- I find it difficult to relax at the end of a workday	0.578	0.666	0.626	0.608	0.634	0.598
b- At the end of the workday I really feel exhausted	0.92	0.153	0.713	0.491	0.736	0.459
c- Because of my work, I feel very tired at the end of the day	0.924	0.146	0.713	0.492	0.735	0.460
d- I find it difficult to pay attention or concentrate during my free time after a workday	0.756	0.429	0.820	0.327	0.847	0.283
e- I find it difficult to take interest in other people as soon as I get home from work	0.763	0.418	0.812	0.341	0.748	0.441
f- When I get home after work I need to be left in peace for some time	0.686	0.53	0.731	0.466	0.653	0.573
Inter-item correlation
b ßà c			0.770		0.754
e ßà f			-----		0.363
Adjustment Indices
Comparative fit index (CFI)	0.959		0.990		0.997
Tucker-Lewis index (TLI)	0.931		0.981		0.994
Root mean square error of approximation(RMSEA)	0.223 (0.213; 0.233)		0.118 (0.108; 0.128)		0.064 (0.054; 0.076)
Convergent Validity Measures
Compound reliability (CR)	0.90		0.88		0.92
Mean extracted variance	0.61		0.55		0.66

Length of napping	Model 1	Model 2	Model 3
	Gross OR	Adjusted OR*	Adjusted OR^†
	(95%CI)	(95%CI)	(95%CI)
Does not sleep	1	1	1
Sleeps up to 2 hours	1.44 (1.07-1.93)	1.42 (1.05-1.90)	1.33 (0.98-1.81)
Sleeps between 2.1 and 3 hours	2.27 (1.71-3.00)	2.20 (1.65-2.93)	1.79 (1.33-2.41)
Sleeps more than 3.1 hours	1.66 (1.06-2.60)	1.91 (1.21-3.02)	1.50 (0.94-2.40)

Escola de Enfermagem de Ribeirão Preto / Universidade de São Paulo Av. Bandeirantes, 3900, 14040-902 Ribeirão Preto SP Brazil, Tel.: +55 (16) 3315-3451 / 3315-4407 - Ribeirão Preto - SP - Brazil
E-mail: rlae@eerp.usp.br

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[1] Corresponding Author: Thaís Aparecida de Castro Palermo Universidade Federal do Rio de Janeiro. Escola de Enfermagem Anna Nery Rua Afonso Cavalcanti, 275 Bairro: Cidade Nova CEP: 20211-110, Rio de Janeiro, RJ, Brasil E-mail: thaisacpalermo@gmail.com