Hughes KE, Hughes PG, Hughes MJ. Sleep and Lifestyle Habits of Osteopathic Emergency Medicine Residents During Training. J Am Osteopath Assoc 2018;118(8):e45–e50. doi: 10.7556/jaoa.2018.113.
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Duty hours were enacted in 2003 with the intent to improve patient safety and resident well-being. However, limited data exist regarding improvements in residents’ well-being since the implementation of these restrictions.
To examine osteopathic emergency medicine (EM) resident characteristics regarding sleep and lifestyle habits and duty hour reporting.
A convenience sample of osteopathic EM residents was surveyed at a statewide conference in May 2014. The conference included 177 residents from 15 osteopathic EM residencies. Data regarding demographics, sleep and lifestyle habits (including work-related motor vehicle incidents [MVIs] and chemical aid use for sleep/wakefulness), and duty hour reporting were collected. The Epworth Sleepiness Scale (ESS) score was calculated, with a score greater than 10 indicating sleep disturbance.
Of the 128 residents (72%) who returned the survey, approximately two-thirds were female, were currently on an EM rotation, and were training in suburban emergency departments with more than 60,000 annual visits. Only 35% of respondents slept 8 or more hours per night during an EM rotation, and 63% admitted to weight change during residency. Forty-two percent of respondents had a work-related MVI, which was more likely to occur if their ESS score was greater than 11 (P<.03). Mean (SD) ESS score was 9.9 (4.8; range, 0-24). Respondents reported using chemical aids for staying awake or going to sleep on a mean (SD) of 6.9 (9.3) days per month (range, 0-30). The majority of respondents (84%) reported strict duty hour enforcement policies, few (17%) had ever been asked to falsify reports, and more than half (56%) had ever voluntarily reported false hours.
Most residents surveyed slept fewer than 8 hours per night and had a weight change during EM residency training. The majority of residents used a chemical aid for sleep or wakefulness. Nearly half of residents surveyed met criteria for disordered sleep, which was associated with a higher occurrence of MVIs.
a For this survey, “chemical aid” was described as medication (prescribed or illicit), alcohol, >1 energy drink per day, or >5 cups of coffee per day.
b Motor vehicle incidents included non-crash sleep events (eg, falling asleep at a stoplight).
c The Epworth Sleepiness Scale is an 8-item tool in which respondents respond regarding the likeliness of falling asleep in 8 situations, from 0 (would never doze off) to 3 (high chance of dozing off), for a total possible score of 0 to 24. Scores >10 indicate sleep disturbance and potential need for clinical intervention.
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