How the chance of missing the alarm during an on-call shift affects pre-bed anxiety, sleep and next day cognitive performance
Jay, Sarah M
Vincent, Grace E
Lack, Leon Colburn
Ferguson, Sally A
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This study investigated how the likelihood of missing an alarm affects pre-bed anxiety, sleep and next day cognitive performance during on-call shifts. Participants (n=24) completed one adaptation night, one control night and two on-call nights in a time-isolated sleep laboratory. On one of the on-call nights, participants were informed that they would be woken by a loud alarm that they would definitely not be able to sleep through (low likelihood of missing the alarm). On the other on-call night, participants were informed that they would be woken by a quiet alarm that they may sleep through (high likelihood of missing the alarm). The two on-call nights were counterbalanced. Pre-bed anxiety was measured using the State Trait Anxiety Inventory x-1, while sleep macro- and micro-architecture was examined via routine polysomnography and power spectral analyses respectively. Following each sleep, cognitive performance was assessed four times (0930, 1200, 1430, 1700) using the 10-min psychomotor vigilance task (PVT). Results indicated that while pre-bed anxiety was similarly increased during both high and low likelihood of missing the on-call alarm conditions compared with control, only in the high likelihood condition was total sleep time shorter and sleep efficiency lower compared with the control condition. However, more wake after sleep onset was found in the low likelihood condition compared with control. PVT data indicate that response times (mean reciprocal and mean fastest 10% of reaction time) were fastest in the low likelihood condition, indicating better performance when compared with both other conditions. However, there were significantly more lapses in the low likelihood condition compared with control. No significant EEG power spectral differences were observed. As such, it appears that there are detrimental effects of both on-call conditions on anxiety, sleep and performance, with sleep poorest when the likelihood of missing the alarm is high. The adverse impacts on sleep and performance outcomes while on-call may be mitigated by the implementation of workplace systems to reduce the likelihood of missing alarms (e.g., having two available options for contacting on-call workers).
© 2018 Elsevier. This manuscript version is made available under the CC-BY-NC-ND 4.0 license: http://creativecommons.org/licenses/by-nc-nd/4.0/ This author accepted manuscript is made available following 12 month embargo from date of publication (September 2018) in accordance with the publisher’s archiving policy.