Sleep, Well-Being, and Cognition in Medical Interns on a Float or Overnight Call Schedule

作者：Stijn A. A. Massar, Xin Yu Chua, Ruth L F Leong, Hosein Aghayan Golkashani, Zhenghao Pu, Alyssa Ng, Ju Lynn Ong, Chun Siong Soon, Nicholas Beng Hui Ng, Mae Yue Tan, Jeremy Bingyuan Lin, Marion Aw, Michael W.L. Chee · 发表于：JAMA Network Open · 年份：2024 · DOI：10.1001/jamanetworkopen.2024.38350 · 被引用次数：17 · 研究领域：Sleep and Work-Related Fatigue、Sleep and related disorders、Hospital Admissions and Outcomes

Importance: Extended work hours and night shifts are essential in health care, but negatively affect physician sleep, well-being, and patient care. Alternative schedules with shorter work hours and/or reduced irregularity might mitigate these issues. Objective: To compare sleep, well-being, and cognition between interns working irregular, extended shifts (call schedule), and those working a more regular schedule with restricted hours (float schedule). Design, Setting, and Participants: In this observational longitudinal cohort study, interns in a Singapore-based teaching hospital were studied for 8 weeks from January 2022 to July 2023. Data were analyzed from July 2023 to July 2024. Exposure: Participants worked either regular approximately 10-hour workdays, interspersed with 24 hour or more overnight calls 4 to 5 times a month, or a float schedule, which included regular approximately 10-hour workdays, and 5 to 7 consecutive approximately 12-hour night shifts every 2 months. Exposure was based on departmental training and operational needs. Main Outcomes and Measures: Sleep was measured with wearable sleep trackers and an electronic diary. Day-to-day well-being and cognitive assessments were collected through a smartphone application. Assessments included the Sleep Regularity Index (SRI; determines the probability of an individual being in the same state [sleep or wake] at any 2 time points 24 hours apart, with 0 indicating highly random sleep patterns and 100 denoting perfe...