The impact of working night shifts on cardiac autonomic nervous regulation during the six-minute walk test in nurses.

Abstract

Background: Clinical nurses frequently face the necessity of working night shifts, often with insufficient opportunities for timely sleep recovery, which may negatively impact autonomic nervous system regulation. The aim of this study was to evaluate changes in heart rate variability (HRV) after the six-minute walk test (6MWT) in nurses post-night shift and to explore the impact of night shift work on cardiac autonomic regulation.

Methods: Thirty-five female nurses, with a mean age of 28.7 years (range 21.0-37.0 years), participated in this study. On the first and second mornings after a night shift, the nurses performed the 6MWT. During the test, electrocardiogram (ECG) signals, blood pressure, and walking distance were recorded simultaneously.

Results: Compared with the second postshift morning, on the first postshift morning, nurses presented higher ratings of perceived exertion (RPE), higher Borg scale scores, and a slower pulse rate before and after the 6MWT but covered a shorter walking distance. Additionally, HRV indicators such as the SDNN, RMSSD, pNN50, TP, VLF, LF, and HF were all higher on the first postshift morning. Regarding the amplitude of cardiac autonomic nervous regulation, variations in the RMSSD and pNN50 were both greater during the 6MWT on the first postshift morning, although there was no significant difference in post-6MWT recovery.

Conclusions: Night shifts appear to increase the activity of the autonomic nervous system in nurses on the first postshift morning and exert a greater inhibitory effect on parasympathetic activity during the 6MWT. Therefore, it is important to ensure timely recovery sleep and improve autonomic regulation after working night shifts.

Keywords: Heart rate variability; Night shift; Autonomic nervous system; Six-minute walk test; Nurses.

Trial registration: This study was retrospectively registered in the Clinicaltrials.gov. Registration Date: August 1, 2024.

Clinicaltrials: gov ID: NCT06542510.