A new study from the University of Pennsylvania School of Medicine shows that a lack of sleep can cause the brain to temporarily shut down. For nurses working long shifts and limiting their sleep, these lapses in functionality could be detrimental to patient care.

For nurses working long shifts, lack of sleep can cause the brain to temporarily shut down—a serious detriment to patient care.

Using brain imaging technology such as functional magnetic resonance imaging (fMRI), researchers measured the neurological activity of 24 adults who performed tasks that required visual attention when well rested and again when sleep deprived.

The results showed changes in brain activity between when the subjects were rested and when they performed the same activity with limited sleep. When tired, brain activity and blood flow showed a flickering between sleep and wakefulness that mirrored "shutdowns."

For the average individual, these lapses in brain activity could slow their productivity. For a nurse, the consequences of momentary lapses in attention could be far greater.

"A lack of sleep affects your concentration and mood," said Ann E. Rogers Ph.D., RN, FAAN, associate professor of the Division of Sleep Medicine at the University of Pennsylvania. "When you're tired you are less attentive. Your problem-solving skills are diminished. You can still accomplish routine activities, but anything that's novel you're going to have more trouble with. For example, if you have to calculate a drug dose or drip rate, your accuracy could go down, especially for calculations you have to make rapidly. That could be a problem in high acuity areas."

In a recent study, Rogers analyzed the shift schedules of 895 registered nurses for 28 days. Each day the nurses were asked to log the hours they worked and slept as well as their mood. When nurses logged shifts that were over 12.5 hours, the risk of errors more than doubled.

"With shifts that are 12 or more hours, they weren't getting enough sleep," said Rogers. "That 12-hour shift is the predominant mode for nurses, and most do not leave at the end of their shift. I think one nurse out of 895 managed to get off work on time every day. The rest stayed longer than 12 hours at least once to finish their work. In reality, they stayed late almost every day."

Rogers notes that the average commute to work for a nurse in the U.S. is 23 minutes each way. Added to the 12.5-hour shift and an extra hour of time spent finishing work, a nurse is left with ten hours in the day to sleep, to spend with family, eat, run errands and live their lives. Very few of the nurses used eight of those 10 hours for sleep.

"Nurses are not likely to give up their 12-hour workdays. They want to take the days off," said Rogers. "By the time people work three, 12-hour shifts in a row, they are quite sleep deprived."

Aside from lapses in brain activity, insufficient sleep can increase appetite hormones and is associated with insulin resistance. There are also changes in some immune functions and a lowered ability to tolerate stress. In addition, night shift workers have a higher risk of driving accidents associated with lack of sleep.

Rogers notes that adding even a small amount of sleep to a schedule can prevent some of the effects of sleep deprivation. She suggests nurses work with management to allow naps during lunch breaks.

"At most places, if you take a nap, even on your lunch break, you will be fired. Yet that is the most effective strategy to combat sleep-related problems," noted Rogers. "That requires working with management to deal with a policy change. That also assumes that a nurse will get a break free of patient care, which is not something you can necessarily assume. Two-thirds of the time, they did not get a break in patient care during their shift and they worked through their break."

For more information on the study on sleep deprivation and associated mental lapses, visit the Journal of Nueroscience Web site.

To read Rogers' study,"The Working Hours Of Hospital Staff Nurses And Patient Safety," visit the Health Affairs Web site.

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this Article reprinted from NurseZone.com