title: Effects of call on sleep and mood in internal medicine residents.
abstract: Residents on call experience decreased total sleep time (TST) and increased dysphoria. This study monitored changes in mood and sleepiness for 3 post-call days. Fifty-two internal medicine residents participated in the study. The residents wore actigraphs for the 4 to 9 days of the study. Each morning resident completed mood scales, a sleepiness scale, and estimated their prior night TST. The residents were on a 1-in-4 schedule. Call decreased subjective- and actigraphy-derived TST to less than 4 hr. During the 3 days post call, mood measures improved. Tension, depression, and anxiety stabilized on the first post-call day following the first night of off-call sleep during which the residents obtained about 7 hr of sleep. Vigor, fatigue, and confusion stabilized on the second post-call day. The Epworth Sleepiness Scale dropped to less than 11 after 1 post-call night and continued to decrease up to 3 post-call days. The effects of call linger past the first recovery night. For these residents, recovery sleep appeared inadequate, and the negative effects of call persisted across succeeding off-call days. Thus, for these residents on a 1-in-4 schedule, call affects their mood for much of the time when off call and potentially their personal and professional interactions during this period as well.
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, TX 77030, USA. mwrose@bcm.tmc.edu
authors.forename: Mary
authors.initials: M
authors.lastname: Rose
authors.forename: Thomas
authors.initials: T
authors.lastname: Manser
authors.forename: J Catesby
authors.initials: JC
authors.lastname: Ware
mesh_terms: D000328:Adult; D000339:Affect; D001007:Anxiety / Q000209:etiology; D002983:Clinical Competence; D003863:Depression / Q000209:etiology; D005221:Fatigue / Q000209:etiology; D005260:Female; D006801:Humans; D007388:Internal Medicine; D007396:Internship and Residency / Q000379:methods*; D008297:Male; D012890:Sleep / Q000502:physiology; D012892:Sleep Deprivation / Q000150:complications* / Q000503:physiopathology* / Q000523:psychology; D013315:Stress, Psychological / Q000209:etiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D014940:Work Schedule Tolerance / Q000523:psychology*