The Effect of Night Float Rotation on Resident Sleep, Activity, and Well-Being.

Area of Science:

• Medical Education
• Sleep Medicine
• Anesthesiology

Background:

• Night float call systems are increasingly used in residency programs to mitigate fatigue from sleep deprivation.
• Previous research indicates reduced sleep and efficiency during night float rotations.
• The impact on residents' physical and emotional well-being remains underdocumented.

Purpose of the Study:

• To investigate the effects of night float rotations on sleep patterns, fatigue, and affect in anesthesia residents.
• To assess the psychophysiological impact of night float schedules on trainee well-being.

Main Methods:

• Twenty-seven anesthesia residents tracked sleep and activity using wearable devices and completed NIH PROMIS surveys.
• Data collected during baseline, night float, and recovery weeks were compared using paired nonparametric analysis.
• Primary outcome: change in average daily sleep hours; secondary outcomes: REM sleep, daily steps, and NIH PROMIS scores for sleep disturbance, fatigue, and positive affect.

Main Results:

• Total average daily sleep hours did not differ between night float and baseline weeks.
• Residents experienced significantly less REM sleep during night float (P = .002).
• NIH PROMIS fatigue scores were significantly higher during night float (P = .0004) and remained elevated post-rotation (P = .029).
• Positive affect was reduced post-rotation but returned to baseline levels.

Conclusions:

• Night float rotations reduce REM sleep and positive affect, while significantly increasing fatigue, which persists after the rotation.
• Wearable trackers and PROMIS surveys effectively capture psychophysiological data relevant to resident well-being.
• Findings suggest potential areas for quality improvement initiatives in residency training programs.