Baseline sleep dysfunction among matriculating interns

Work hour limitations for graduate medical trainees, motivated by concerns about patient safety, quality of care, and trainee well-being, continue to generate controversy. Little information about sleep habits and the prevalence of sleep disorders among residents is available to inform policy in this area.

To evaluate the sleep habits of matriculating residents, postgraduate year-1 (PGY-1).

An anonymous, voluntary, self-administered survey study was used with 3 validated questionnaires: the Pittsburgh Sleep Quality Index, the Insomnia Severity Index, and the Epworth Sleepiness Scale, which were fielded to PGY-1 residents entering the Accreditation Council for Graduate Medical Education-accredited programs at Massachusetts General Hospital and/or Brigham and Women's Hospitals in June and July 2009.

Of 355 eligible subjects, 310 (87%) participated. Mean sleep time for PGY-1 residents was 7 hours and 34 minutes, and 5.6% of PGY-1 residents had Pittsburgh Sleep Quality Index global scores greater than 5, indicating poor quality sleep. Using multiple linear and ordinal logistic regression models, men had higher Pittsburgh Sleep Quality Index sleep latency scores, whereas women and those with children had higher Epworth Sleepiness Scale daytime sleepiness scores, and 18% of PGY-1 residents had abnormal amounts of daytime sleepiness based on the Epworth Sleepiness Scale. The Insomnia Severity Index identified 4.2% of PGY-1 residents with moderate insomnia.

Some PGY-1 residents may begin residency with sleep dysfunctions. Efforts to provide targeted help to selected trainees in managing fatigue during residency should be investigated.