Actigraph estimates of the sleep of Australian midwives: the impact of shift work

Abstract

Midwives often work night and rotating shift schedules, which can lead to sleep disturbances, increased fatigue, and greater likelihood of accidents or errors. This study investigated the sleep of midwives (n = 17) in an Australian metropolitan hospital. Midwives completed work and sleep logbooks and wore wrist actigraphs for 28 days. Midwives worked combinations of morning, afternoon, and/or night shifts on constant (n = 6) or rotating schedules (n = 11). They obtained less than recommended amounts of sleep, getting only 6-7 hr per 24-hr period. Morning shifts were associated with the lowest sleep durations, lowest subjective sleep quality, and highest postsleep fatigue ratings. Despite the significantly higher amount of wake after sleep onset (51 min), the sleep before afternoon shifts had significantly lower postsleep fatigue ratings and was rated as significantly higher quality than sleep before other shifts or days off. Those who were married or living with a partner reported significantly more sleep and lower postsleep fatigue than those who were separated or divorced (p < .05). Seventy-one percent of midwives took naps, primarily before night shifts, with nearly 40% of nightshifts preceded by a nap. Average nap durations were nearly 1.5 hr. Midwives reported feeling moderately to very physically or mentally exhausted on 22-50% of all shifts and days off. Exhaustion was most common on night shift. This study suggests that midwives may be suffering from chronic sleep loss and as a consequence may be at risk of impairments in functioning that accompany fatigue.