Effect of Night Float Call on Sleep and Activity Patterns Among Anesthesia Residents

NCT05043038 | Completed

• 1 other identifier: 51495
• Study Type: observational
• Target: 55
• Locations: 1 country
• Sites: 1

Brief Summary

With increasing awareness about physician fatigue and its effect on patient safety, residency programs are increasingly transitioning to a night float call system. In other industries, multiple night shifts in a row can cause a disruption in the circadian rhythm, sleep debt, shift work disorder, that is related to chronic medical conditions such as obesity and cardiovascular disease. We will evaluate the effect of different call structures on resident activity, sleep and self reported measures of wellness using a commercially available Fitbit device.

Conditions

Sleep Disorder, Shift Work; Fatigue; Sleep Disturbance

Keywords

Medical Education; Physician Well-Being; Internship and Residency; Work Schedule Tolerance; Fatigue; physician Burnout; Sleep Disruption

Outcome Measures

Primary Outcomes (5)

• Change in Total Sleep Hours During Night Float

  The investigators will compare total sleep hours per 24 hour period during a baseline week, a night float week, and a recovery week

  3 weeks

• Change in Rapid Eye Movement Sleep Hours During Night Float

  The investigators will compare total Rapid Eye Movement sleep hours per 24 hour period during a baseline week, a night float week, and a recovery week

  3 weeks

• Change in Daily Steps during Night Float Week

  The investigators will compare Steps per 24 hour period during a baseline week, a night float week, and a recovery week

  3 weeks

• Trends and Recovery Time in Total Sleep Hours, Rapid Eye Movement, and Daily Steps during a random night call schedule

  The investigators will compare change in fitbit sleep and steps data during random call night schedule and recovery after the call night during the obstetric anesthesia rotation

  4 weeks

• Comparison in sleep and activity patters between a night float call schedule and a random night call schedule

  The investigators will compare trends in sleep hours, REM sleep, and steps between night float and random call schedule. Time to recovery to baseline sleep patterns will be assessed.

  4 weeks

Secondary Outcomes (3)

• Cohort 1: Change in PROMIS Positive Affect, Sleep Disturbance and Fatigue Scores During Night Float Week

  3 weeks

• Cohort 2: Change in PROMIS Positive Affect, Sleep Disturbance, and Fatigue Scores throughout the Obstetric Anesthesia Rotation

  3 weeks

• Change in PROMIS Positive Affect, Sleep Disturbance and Fatigue Scores over the study period in a night float versus a random call night system

  4 weeks

Study Arms (2)

General Anesthesia Night Float

The residents will be followed over a three week period - one week prior to night float (baseline), the week of night float, and one week after night float (recovery). Participants will be asked to fill out PROMIS surveys weekly.

Obstetric Anesthesia Rotation

The residents will be followed and asked to wear the fitbit over a four week period during their rotation. Participants will complete three PROMIS surveys over the four week rotation, and as well as a follow-up PROMIS survey one week after the study period has completed

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

We will recruit participants who are PGY2-5 and part of the Stanford Hospital Department of Graduate Medical Education, which means they will generally be between 26-36 years of age. We will aim to recruit an equal number of males and females which is reasonable give the demographic distribution of Anesthesia residents. Finally, we aim to have a people with a variety of races and ethnicity involved but this will not be specifically targeted or evaluated due to the limited pool of eligible subjects.

You may qualify if:

• All residents (PGY2-5) who have been scheduled for either general operating room night float call or obstetric anesthesia rotation

You may not qualify if:

• Participants who report taking prescription medications that may effect alertness during the study period will not be enrolled.

Sponsors & Collaborators

• Stanford University: lead

Study Sites (1)

Stanford Hospital

Palo Alto, California, 94305, United States

Location

Related Publications (7)

• Belayachi J, Benjelloun O, Madani N, Abidi K, Dendane T, Zeggwagh AA, Abouqal R. Self-perceived sleepiness in emergency training physicians: prevalence and relationship with quality of life. J Occup Med Toxicol. 2013 Sep 21;8(1):24. doi: 10.1186/1745-6673-8-24.

  PMID: 24053730 BACKGROUND

• Asken MJ, Raham DC. Resident performance and sleep deprivation: a review. J Med Educ. 1983 May;58(5):382-8. doi: 10.1097/00001888-198305000-00003.

  PMID: 6343602 BACKGROUND

• Cavallo A, Jaskiewicz J, Ris MD. Impact of night-float rotation on sleep, mood, and alertness: the resident's perception. Chronobiol Int. 2002 Sep;19(5):893-902. doi: 10.1081/cbi-120014106.

  PMID: 12405552 BACKGROUND

• Davis MC, Kuhn EN, Agee BS, Oster RA, Markert JM. Implications of transitioning to a resident night float system in neurosurgery: mortality, length of stay, and resident experience. J Neurosurg. 2017 Apr;126(4):1269-1277. doi: 10.3171/2016.5.JNS152585. Epub 2016 Jul 8.

  PMID: 27392266 BACKGROUND

• Dunn LK, Kleiman AM, Forkin KT, Bechtel AJ, Collins SR, Potter JF, Kaperak CJ, Tsang S, Huffmyer JL, Nemergut EC. Anesthesiology Resident Night Float Duty Alters Sleep Patterns: An Observational Study. Anesthesiology. 2019 Aug;131(2):401-409. doi: 10.1097/ALN.0000000000002806.

  PMID: 31149926 BACKGROUND

• Nizamuddin SL, Nizamuddin J, Latif U, Tung A, Klafta JM, Lee SM, Ku CM, Stahl DL, Lee J, Shahul SS. Be Active and Be Well? A Cross-sectional Survey of US Anesthesia Residents. J Educ Perioper Med. 2020 Apr 1;22(2):E640. doi: 10.46374/volxxii-issue2-nizamuddin. eCollection 2020 Apr-Jun.

  PMID: 32939368 BACKGROUND

• Lee HA, Lee HJ, Moon JH, Lee T, Kim MG, In H, Cho CH, Kim L. Comparison of Wearable Activity Tracker with Actigraphy for Sleep Evaluation and Circadian Rest-Activity Rhythm Measurement in Healthy Young Adults. Psychiatry Investig. 2017 Mar;14(2):179-185. doi: 10.4306/pi.2017.14.2.179. Epub 2017 Mar 6.

  PMID: 28326116 BACKGROUND

MeSH Terms

Conditions

Sleep Disorders, Circadian Rhythm; Fatigue; Parasomnias

Condition Hierarchy (Ancestors)

Chronobiology Disorders; Nervous System Diseases; Dyssomnias; Sleep Wake Disorders; Occupational Diseases; Mental Disorders; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Alexandra Ruan, MD

  Stanford University

  STUDY DIRECTOR

• Pamela Flood, MD

  Stanford University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Clinical Assistant Professor

Study Record Dates

• First Submitted: August 24, 2021
• First Posted: September 13, 2021
• Study Start: August 1, 2019
• Primary Completion: November 30, 2021
• Study Completion: August 30, 2024
• Last Updated: December 18, 2024

Record last verified: 2024-12

Locations

US (1)