title: Brief morning exposure to bright light improves subjective symptoms and performance in nurses with rapidly rotating shifts.
abstract: OBJECTIVE
  To investigate whether or not brief bright light (BL) exposure on workday mornings can improve health, performance and safety in nurses with rapidly rotating shifts.
  
  
  METHODS
  We conducted a randomized crossover study involving registered nurses at a teaching hospital working a two-shift system including the night shift. Participants were instructed to expose themselves to BL for 10 min on workday mornings.
  
  
  RESULTS
  A total of 61 participants were enrolled in the present study. Thirty-one participants received BL exposure in the first month, and the other 30 received it in the second month. Significant improvements were noted in the BL periods compared with the non-BL periods for self-assessed sleepiness at 10:00 on day-shift days evaluated using the Karolinska Sleepiness Scale, self-assessment of night sleep for day-shift days using the Visual Analogue Scale and for fatigue assessed using the Checklist Individual Strength Questionnaire. The estimated mean difference for each scale (95% confidence interval) was -0.55 (-0.91, -0.20), 0.37 (0.04, 0.70) and -2.13 (-3.78, -0.48), respectively. Mean response time evaluated using the psychomotor vigilance task test (PVT) showed significant improvement in the BL periods compared with the non-BL periods. No statistically significant differences were observed for sleepiness at 14:00, depression, number of PVT lapses or frequency of perceived adverse events and near misses.
  
  
  CONCLUSIONS
  Our findings suggest that brief BL exposure on mornings preceding a day shift is effective in improving sleepiness and performance during day-shift work, subjective nighttime sleep on day-shift days, and perceived fatigue for the preceding two weeks in rapidly rotating shift nurses.
authors: Department of Occupational Mental Health, Graduate School of Medical Sciences, Kitasato University, Japan. k-tanaka@kitasato-u.ac.jp
authors: Katsutoshi
authors: K
authors: Tanaka
authors: Masaya
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authors: Takahashi
authors: Mika
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authors: Tanaka
authors: Tomoki
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authors: Takanao
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authors: Nishinoue
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