To bed or not to bed: the sleep question?

Brown, Chris, Abdelrahman, Tarig, Lewis, Wyn, Pollitt, John and Egan, Richard 2020. To bed or not to bed: the sleep question? Postgraduate Medical Journal 96 , pp. 520-524. 10.1136/postgradmedj-2018-135795

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Abstract

Background Sleep deprivation and fatigue from long-shift work impacts doctors' personal safety, inhibits cognitive performance and risks clinical error. The aim of this study was to assess the sleep quality of surgical trainees participating in European Working Time Directive-compliant training rotations within a UK deanery. Methods A trainee cohort numbering 38 (21 core, 17 higher surgical trainees, 29 men and 9 women, median age 31 (25–44 years)) completed a sleep diary over 30 days using the Sleep Time (Azumio) smartphone application and triangulated with on-call rosters to identify shift patterns. The primary outcome measure was sleep quality related to rostered clinical duties. Results Consecutive 1152 individual sleep episodes were recorded. The median time asleep (hours:min) was 6:29 (5:27–7:19); the median sleep efficiency was 86% (80%–93%); the median light sleep (hours:min) was 2:50 (1:50–3:49); and the median rapid eye movement (REM) sleep (hours:min) was 3:20 (2:37–4:07). Significant adverse sleep profiles were observed in trainees undertaking emergency on-call duty when compared with elective (non-on-call) duty; the median time asleep (hours:min) 5:49 vs 6:43 (p<0.001); the median sleep efficiency was 85% vs 87% (p<0.001); the median light sleep (hours:min) was 2:16 vs 2:58 (p<0.001); and REM sleep (hours:min) was 2:57 vs 3:27 (p<0.001). Recovery of sleep duration, efficiency and quality necessitated five full days of time. Conclusion Surgical emergency on-call duty adversely influences sleep quality. Proper consideration of fail-safe rota design, prioritising sleep hygiene, recovery and well-being, allied to robust patient safety and quality of care should be made a priority.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Medicine
Publisher:	BMJ Publishing Group
ISSN:	0032-5473
Date of First Compliant Deposit:	18 May 2020
Date of Acceptance:	26 November 2019
Last Modified:	17 Mar 2021 02:27
URI:	https://orca.cardiff.ac.uk/id/eprint/131770

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