Sleep and Alertness Among Interns in Intensive Care Compared to General Medicine Rotations: A Secondary Analysis of the iCOMPARE Trial.

التفاصيل البيبلوغرافية
العنوان:	Sleep and Alertness Among Interns in Intensive Care Compared to General Medicine Rotations: A Secondary Analysis of the iCOMPARE Trial.
المؤلفون:	Cordoza M; is a Lecturer, University of Pennsylvania., Basner M; is a Professor, University of Pennsylvania., Asch DA; is a Professor, University of Pennsylvania, and Practicing Physician, Corporal Michael J. Crescenz Veterans Affairs Medical Center., Shea JA; is a Professor, University of Pennsylvania., Bellini LM; is a Professor, University of Pennsylvania., Carlin M; is a Project Manager, University of Pennsylvania., Ecker AJ; is a Senior IT Project Leader, University of Pennsylvania., Malone SK; is an Assistant Professor, New York University., Desai SV; is a Professor, Johns Hopkins University., Katz JT; is Vice Chair for Education, Brigham and Women's Hospital., Bates DW; is Division of General Internal Medicine Chief, Brigham and Women's Hospital., Small DS; is a Professor, University of Pennsylvania., Volpp KG; is a Professor, University of Pennsylvania, and Practicing Physician, Corporal Michael J. Crescenz Veterans Affairs Medical Center., Mott CG; is Chief Technology Officer, Pulsar Informatics., Coats S; is Lead Project Coordinator, Pulsar Informatics., Mollicone DJ; is Chief Executive Officer, Pulsar Informatics., Dinges DF; is a Professor, University of Pennsylvania; and iCOMPARE Research Group.
المصدر:	Journal of graduate medical education [J Grad Med Educ] 2021 Oct; Vol. 13 (5), pp. 717-721. Date of Electronic Publication: 2021 Oct 15.
نوع المنشور:	Journal Article
اللغة:	English
بيانات الدورية:	Publisher: Accreditation Council for Graduate Medical Education Country of Publication: United States NLM ID: 101521733 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1949-8357 (Electronic) Linking ISSN: 19498357 NLM ISO Abbreviation: J Grad Med Educ Subsets: MEDLINE
أسماء مطبوعة:	Original Publication: Chicago, ILL : Accreditation Council for Graduate Medical Education
مواضيع طبية MeSH:	Internship and Residency* , Work Schedule Tolerance*, Critical Care ; Humans ; Sleep ; Wakefulness
مستخلص:	Background: Medical interns are at risk for sleep deprivation from long and often rotating work schedules. However, the effects of specific rotations on sleep are less clear. Objective: To examine differences in sleep duration and alertness among internal medicine interns during inpatient intensive care unit (ICU) compared to general medicine (GM) rotations. Methods: This secondary analysis compared interns during a GM or ICU rotation from a randomized trial (2015-2016) of 12 internal medicine residency programs assigned to different work hour limit policies (standard 16-hour shifts or no shift-length limits). The primary outcome was sleep duration/24-hour using continuous wrist actigraphy over a 13-day period. Secondary outcomes assessed each morning during the concomitant actigraphy period were sleepiness (Karolinska Sleepiness Scale [KSS]), alertness (number of Brief Psychomotor Vigilance Test [PVT-B] lapses), and self-report of excessive sleepiness over past 24 hours. Linear mixed-effect models with random program intercept determined associations between each outcome by rotation, controlling for age, sex, and work hour policy followed. Results: Of 398 interns, 386 were included (n = 261 GM, n = 125 ICU). Average sleep duration was 7.00±0.08h and 6.84±0.10h, and number of PVT lapses were 5.5±0.5 and 5.7±0.7 for GM and ICU, respectively (all P > .05). KSS was 4.8±0.1 for both rotations. Compared to GM, ICU interns reported more days of excessive sleepiness from 12am-6am (2.6 vs 1.7, P < .001) and 6am-12pm (2.6 vs 1.9, P = .013) and had higher percent of days with sleep duration < 6 hours (27.6% vs 23.4%, P < .001). GM interns reported more days with no excessive sleepiness (5.3 vs 3.7, P < .001). Conclusions: Despite ICU interns reporting more excessive sleepiness in morning hours and more days of insufficient sleep (<6 hours), overall sleep duration and alertness did not significantly differ between rotations. Competing Interests: Conflict of interest: The authors declare they have no competing interests.
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معلومات مُعتمدة:	K99 NR019862 United States NR NINR NIH HHS
تواريخ الأحداث:	Date Created: 20211101 Date Completed: 20211102 Latest Revision: 20221003
رمز التحديث:	20221213
مُعرف محوري في PubMed:	PMC8527933
DOI:	10.4300/JGME-D-21-00045.1
PMID:	34721802
قاعدة البيانات:	MEDLINE

الوصف
تدمد:	1949-8357
DOI:	10.4300/JGME-D-21-00045.1