title: A survey to describe sleep-facilitating substances used by Canadian emergency physicians.
abstract: BACKGROUND
  Because night shifts disrupt the normal circadian rhythm, sleep management is crucial for emergency physicians. The purpose of the survey was to describe the use of sleep-facilitating substances (SFSs) by emergency physicians before or after a night shift and to evaluate factors associated with their use.
  
  
  METHODS
  All members of the Canadian Association of Emergency Physicians with a Canadian postal address were mailed a copy of the survey. Canadian physicians were eligible if they worked at least one night shift per month and spent 50% or more of their time in emergency medicine. Logistic regression was used to identify characteristics most predictive of using SFSs before or after a night shift.
  
  
  RESULTS
  Of the 1621 surveys mailed, 805 were returned completed, for a response rate of 49.6%. Of these, 628 respondents met inclusion criteria and 215 respondents (34%) reported consuming at least one SFS in their career to help them sleep around a night shift. The use of an SFS before a night shift was associated with the use of SFSs after a night shift (odds ratio [OR] 3.8; 95% confidence interval [CI] 2.4-5.9) and the use of SFSs at other times (OR 3.8; 95% CI 2.1-6.6). The use of SFSs after a night shift was associated with the use of a sleep-facilitating technique before a night shift (OR 2.1; 95% CI 1.3-3.3); use of an SFS before a night shift (OR 4.0; 95% CI 2.4-6.4); use of SFSs at other times (OR 4.7; 95% CI 2.6-8.4); and success of a nap before the night shift (OR 0.46; 95% CI 0.25-0.83).
  
  
  CONCLUSIONS
  The rate of SFS use is similar in emergency physicians and other shift workers. Emergency physicians who use SFSs before or after a night shift are more likely to use them at other times as well, and less likely to use them if they nap successfully prior to a night shift.
authors.affiliation: Division of Emergency Medicine, Department of Pediatrics, Hôpital Ste-Justine, Université de Montréal, Montréal, Quebec, Canada. benoit.bailey@umontreal.ca
authors.forename: Benoit
authors.initials: B
authors.lastname: Bailey
authors.forename: Lubomir
authors.initials: L
authors.lastname: Alexandrov