A survey to describe sleep-facilitating substances used by Canadian emergency physicians

Because night shifts disrupt the normal circadian rhythm, sleep management is crucial for emergency physicians. The purpose of the survey was to describe the use of sleep-facilitating substances (SFSs) by emergency physicians before or after a night shift and to evaluate factors associated with their use.

All members of the Canadian Association of Emergency Physicians with a Canadian postal address were mailed a copy of the survey. Canadian physicians were eligible if they worked at least one night shift per month and spent 50% or more of their time in emergency medicine. Logistic regression was used to identify characteristics most predictive of using SFSs before or after a night shift.

Of the 1621 surveys mailed, 805 were returned completed, for a response rate of 49.6%. Of these, 628 respondents met inclusion criteria and 215 respondents (34%) reported consuming at least one SFS in their career to help them sleep around a night shift. The use of an SFS before a night shift was associated with the use of SFSs after a night shift (odds ratio [OR] 3.8; 95% confidence interval [CI] 2.4-5.9) and the use of SFSs at other times (OR 3.8; 95% CI 2.1-6.6). The use of SFSs after a night shift was associated with the use of a sleep-facilitating technique before a night shift (OR 2.1; 95% CI 1.3-3.3); use of an SFS before a night shift (OR 4.0; 95% CI 2.4-6.4); use of SFSs at other times (OR 4.7; 95% CI 2.6-8.4); and success of a nap before the night shift (OR 0.46; 95% CI 0.25-0.83).

The rate of SFS use is similar in emergency physicians and other shift workers. Emergency physicians who use SFSs before or after a night shift are more likely to use them at other times as well, and less likely to use them if they nap successfully prior to a night shift.