Sleep quality and health related problems of shift work among resident physicians: a cross-sectional study.

OBJECTIVES

Shift work is defined as any irregular work schedule that extends beyond the usual 9 am to 5 pm time frame. Evidence from outside medicine suggests that it may be related to detrimental health outcomes. Our objective from this study is to evaluate sleep quality, health risks, and chronic diseases among post-graduate resident physicians who work on rotating shifts at a large tertiary health care center.

STUDY

DESIGN

A self-reported questionnaire-based cross-sectional study.

METHODS

Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI) while anxiety and depression were estimated through the four-item patient health questionnaire for anxiety and depression (PHQ-4). Associations between sleep quality and the following: Gender, PHQ-4 stage, year of residency, number of on-calls per month and subjective fatigue; memory impairment; and lack of concentration was investigated.

RESULTS

A total of 201 resident physicians participated in the study [60.7% males, median; IQR age: 27 years (26-29). More than one third of subjects were smokers, 41.3% were overweight, and 16.4% were obese. The majority (90%) reported poor sleep quality, 38.3% mild PHQ-4, 21.4% moderate PHQ-4, and 18.9% severe PHQ-4. Residents having six on-calls or more per month had significantly poorer sleep quality (p: 0.03), as well as higher anxiety and depression scores compared to their counterparts. Poor sleep quality was markedly associated with moderate PHQ-4, subjective fatigue, and lack of concentration (p: 0.026, 0.004 and 0.001, respectively). Subjective difficulty with concentration was reported in 86.6% of resident physicians and was significantly higher as the number of on-calls per month is 3 or more. Most residents report subjective fatigue (92.5%) while subjective memory impairment was prevalent in 68.7%. Irritable bowel syndrome was the most prevalent chronic disorder (13%), followed by heartburn or gastrointestinal ulcers and disc prolapse (6% and 3.5%, respectively).

CONCLUSIONS

Resident physicians have considerable risk for developing severe diseases. Our findings suggest that several modifications should be undertaken to enhance work facilities, limit working hours, and raise awareness among post-graduate resident physicians.