Effects of Aerobic Exercise Training on Nurses' Sleep Quality, Fatigue, Attention and Cortisol Profile

Study Overview
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Brief Summary
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Shift work in nursing has been found to result in sleep disruption and sleep deprivation, and in sleepiness or fatigue at work. Slow reaction, insufficient attention and poor judgement often come with increased fatigue, which contributes to a high risk of accident and patient safety. Studies have shown that aerobic exercise is helpful in promoting high sleep quality. The study is conducted a prospective parallel randomized trial is performed to 60 nurses with low sleep quality. The subjects are randomly assigned to: (i) the experimental group, in which aerobic exercise training is given; (ii) the control group, in which the subjects kept their original lifestyles. The study aims to investigate the effects of aerobic exercise training on nurses' sleep quality, fatigue, attention and cortisol profile.

Detailed Description
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When work shifts and lifestyles change, the synchronous relationship between the body's biological clock and the environment, i.e., circadian rhythms, is disrupted, resulting in insufficient sleep and insomnia. Shift work in nursing has been found to result in sleep disruption and sleep deprivation, and in sleepiness or fatigue at work. Slow reaction, insufficient attention and poor judgement often come with increased fatigue, which contributes to a high risk of accident and patient safety. Studies have shown that aerobic exercise is helpful in promoting high sleep quality, whereas few researchers have argued over how aerobic exercise training improves sleep quality in nurses. The study is conducted in two stages. Previous stage, we conducted with a cross-sectional study design with convenience sampled 200 participants to fill out the Chinese Pittsburgh Sleep Quality Index (CPSQI) questionnaire for screen the low sleep quality (CPSQI > 5) participants. A total of 200 nurses were recruited, and 199 valid samples were collected, 108 participants were found to have low sleep quality (CPSQI > 5). The study will adopt a prospective, longitudinal, parallel-group comparative study, randomly sample from previously screen low sleep quality participants, then random assign to experimental (aerobic exercise) and control (routine activity) groups, and actigraphy sleep recording, saliva samples and attention data will be collected. The study aims to investigate the effects of aerobic exercise training on nurses' sleep quality, fatigue, attention and cortisol profile. The findings of the study could provide guidelines on improving nurses' fitness and sleep quality.

Official Title
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Effects of Aerobic Exercise Training on Nurses' Sleep Quality, Fatigue, Attention and Cortisol Profile: A Randomized Controlled Trial

Conditions
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Nurse, Attention, Aerobic Exercise, Sleep Quality, Fatigue, Cortisol

Intervention / Treatment
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* Behavioral: aerobic exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Full-time Female nursing staff members Worked 8 hours per shift Had at least 1 year of work experience. Exclusion Criteria: Had used sedatives, hypnotics, antihistamines, or hormonal drugs within the 4 weeks before commencing the study Pregnant Were diagnosed as having sleep or stress disorders, or experienced sleep problems owing to concurrent insomnia or sleep apnea.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The study will randomly sample from previously screen low sleep quality participants, then random assign to experimental (aerobic exercise) and control (routine activity) groups
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: aerobic exercise training<br>three times a week, a total of twenty-four times in eight weeks | Behavioral: aerobic exercise<br>* the experimental group, in which aerobic exercise training is given three times a week, a total of twenty-four times in eight weeks<br>|
| No Intervention: control<br>routine activity | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Total sleep time sleep change | The actigraphy reported on sleep parameters of the amount of actual sleep minutes | The 1st workday 8:00AM to 5th workday 8:00AM of 4th, 8th, and 12th week | 
| Wake after sleep onset change | The actigraphy reported on the amount of minutes they were awake between sleep onset and wake time. | The 1st workday 8:00AM to 5th workday 8:00AM of 4th, 8th, and 12th week | 
| Sleep efficiency change | The actigraphy reported on sleep parameters of percentage of time asleep while in bed from lights off to lights on. | The 1st workday 8:00AM to 5th workday 8:00AM of 4th, 8th, and 12th week | 
| Seep onset latency change | The actigraphy reported on sleep parameters of the minutes between lights off and first sleep episode. | The 1st workday 8:00AM to 5th workday 8:00AM of 4th, 8th, and 12th week | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Simple visual reaction time testing | Psychomotor Vigilance Task Monitor to test simple visual reaction time | Before and after work, the test are completed within 5 min | 
| Saliva cortisol | Diurnal cortisol concentration | Collected at awakening [0 min] and at 30 min, 6 hours, and 12 hours after awakening |