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On-call duty effects on sleep-state physiological stability in male medical interns.

Lin YH, Ho YC, Lin SH, Yeh YH, Liu CY, Kuo TB, Yang CC, Yang AC - PLoS ONE (2013)

Bottom Line: We hypothesized that sleep stability decreased in medical interns during on-call duty.The medical interns had significantly reduced stable sleep, and displayed increased latency to the first epoch of stable sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights.Interns also had significantly increased rapid-eye-movement (REM) sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.

ABSTRACT

Background: On-call duty among medical interns is characterized by sleep deprivation and stressful working conditions, both of which alter cardiac autonomic modulation. We hypothesized that sleep stability decreased in medical interns during on-call duty. We used cardiopulmonary-coupling (CPC) analysis to test our hypothesis.

Methods: We used electrocardiogram (ECG)-based CPC analysis to quantify physiological parameters of sleep stability in 13 medical interns during on-call and on-call duty-free periods. There were ten 33.5-h on-call duty shifts per month for interns, each followed by 2 on-call duty-free days, over 3 months. Measurements during sleep were collected before, during, and after an on-call shift. Measurements were repeated 3 months later during an on-call duty-free period.

Results: The medical interns had significantly reduced stable sleep, and displayed increased latency to the first epoch of stable sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights. Interns also had significantly increased rapid-eye-movement (REM) sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights.

Conclusion: Medical interns suffer disrupted sleep stability and continuity during on-call night shifts. The ECG-based CPC analysis provides a straightforward means to quantify sleep quality and stability in medical staff performing shift work under stressful conditions.

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Related in: MedlinePlus

Patterns of sleep.(A) REM percentage of sleep on different days; (B) Stable sleep percentage of sleep on different days; (C) Unstable sleep percentage of sleep on different days; The results are expressed as Mean ± SD. ##P<0.01 compared to duty-free day; #P<0.05 compared to duty-free day; *P<0.05 compared to pre-call day; **P<0.01 compared to pre-call day by generalized estimation equation, n = 13.
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pone-0065072-g002: Patterns of sleep.(A) REM percentage of sleep on different days; (B) Stable sleep percentage of sleep on different days; (C) Unstable sleep percentage of sleep on different days; The results are expressed as Mean ± SD. ##P<0.01 compared to duty-free day; #P<0.05 compared to duty-free day; *P<0.05 compared to pre-call day; **P<0.01 compared to pre-call day by generalized estimation equation, n = 13.

Mentions: The objective sleep indices derived from the CPC analysis are presented in Figs. 2 and 3. The periods of stable sleep significantly decreased during the on-call night (15.1% ±7.3%), compared to the pre-call night (28.1% ±12.9%, P = .0013) and the on-call duty-free night (26.7% ±11.9%, P = .0032). Longer periods of stable sleep occurred during the post-call night (24.2% ±16.3%) and the second-post-call night (24.3% ±15.0%), with no significant differences observed between the post-call nights and the pre-call night or the on-call duty-free night.


On-call duty effects on sleep-state physiological stability in male medical interns.

Lin YH, Ho YC, Lin SH, Yeh YH, Liu CY, Kuo TB, Yang CC, Yang AC - PLoS ONE (2013)

Patterns of sleep.(A) REM percentage of sleep on different days; (B) Stable sleep percentage of sleep on different days; (C) Unstable sleep percentage of sleep on different days; The results are expressed as Mean ± SD. ##P<0.01 compared to duty-free day; #P<0.05 compared to duty-free day; *P<0.05 compared to pre-call day; **P<0.01 compared to pre-call day by generalized estimation equation, n = 13.
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Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3672167&req=5

pone-0065072-g002: Patterns of sleep.(A) REM percentage of sleep on different days; (B) Stable sleep percentage of sleep on different days; (C) Unstable sleep percentage of sleep on different days; The results are expressed as Mean ± SD. ##P<0.01 compared to duty-free day; #P<0.05 compared to duty-free day; *P<0.05 compared to pre-call day; **P<0.01 compared to pre-call day by generalized estimation equation, n = 13.
Mentions: The objective sleep indices derived from the CPC analysis are presented in Figs. 2 and 3. The periods of stable sleep significantly decreased during the on-call night (15.1% ±7.3%), compared to the pre-call night (28.1% ±12.9%, P = .0013) and the on-call duty-free night (26.7% ±11.9%, P = .0032). Longer periods of stable sleep occurred during the post-call night (24.2% ±16.3%) and the second-post-call night (24.3% ±15.0%), with no significant differences observed between the post-call nights and the pre-call night or the on-call duty-free night.

Bottom Line: We hypothesized that sleep stability decreased in medical interns during on-call duty.The medical interns had significantly reduced stable sleep, and displayed increased latency to the first epoch of stable sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights.Interns also had significantly increased rapid-eye-movement (REM) sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights.

View Article: PubMed Central - PubMed

Affiliation: Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.

ABSTRACT

Background: On-call duty among medical interns is characterized by sleep deprivation and stressful working conditions, both of which alter cardiac autonomic modulation. We hypothesized that sleep stability decreased in medical interns during on-call duty. We used cardiopulmonary-coupling (CPC) analysis to test our hypothesis.

Methods: We used electrocardiogram (ECG)-based CPC analysis to quantify physiological parameters of sleep stability in 13 medical interns during on-call and on-call duty-free periods. There were ten 33.5-h on-call duty shifts per month for interns, each followed by 2 on-call duty-free days, over 3 months. Measurements during sleep were collected before, during, and after an on-call shift. Measurements were repeated 3 months later during an on-call duty-free period.

Results: The medical interns had significantly reduced stable sleep, and displayed increased latency to the first epoch of stable sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights. Interns also had significantly increased rapid-eye-movement (REM) sleep during the on-call night shift, compared to the pre-call and on-call duty-free nights.

Conclusion: Medical interns suffer disrupted sleep stability and continuity during on-call night shifts. The ECG-based CPC analysis provides a straightforward means to quantify sleep quality and stability in medical staff performing shift work under stressful conditions.

Show MeSH
Related in: MedlinePlus