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To bed or not to bed: the sleep question?
Chris Brown1, Tarig Abdelrahman2, Wyn Lewis2
1School of Surgery, Cardiff University School of Postgraduate Medical and Dental Education, Cardiff, UK chrisbrown87@doctors.org.uk.
Postgraduate Medical Journal
|December 26, 2019
Summary
Long shifts and emergency on-call duties significantly reduce surgical trainees
Area of Science:
- Medical Education
- Sleep Medicine
- Surgical Training
Background:
- Sleep deprivation and fatigue from long work shifts negatively impact doctors' safety, cognitive function, and patient care.
- Assessing sleep quality in surgical trainees under European Working Time Directive (EWTD)-compliant rotations is crucial.
Purpose of the Study:
- To evaluate the sleep quality of surgical trainees during EWTD-compliant training rotations in a UK deanery.
- To identify the impact of clinical duties, particularly emergency on-call shifts, on trainee sleep patterns.
Main Methods:
- 38 surgical trainees (core and higher) completed a 30-day sleep diary using a smartphone app.
- On-call rosters were used to correlate sleep data with specific shift patterns.
- Primary outcome: sleep quality in relation to rostered clinical duties.
Main Results:
- 1152 sleep episodes were analyzed, revealing a median sleep time of 6:29 and sleep efficiency of 86%.
- Emergency on-call duty significantly worsened sleep profiles compared to elective duties (e.g., reduced sleep time, efficiency, and REM sleep).
- Full sleep recovery required approximately five days.
Conclusions:
- Surgical emergency on-call duties have a detrimental effect on the sleep quality of trainees.
- Prioritizing fail-safe rota design, sleep hygiene, and well-being is essential for patient safety and quality of care.
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