title: Sleep disturbances predict prospective declines in resident physicians' psychological well-being.
abstract: BACKGROUND
  Medical residency can be a time of increased psychological stress and sleep disturbance. We examine the prospective associations between self-reported sleep quality and resident wellness across a single training year.
  
  
  METHODS
  Sixty-nine (N=69) resident physicians completed the Brief Resident Wellness Profile (M=17.66, standard deviation [SD]=3.45, range: 0-17) and the Pittsburgh Sleep Quality Index (M=6.22, SD=2.86, range: 12-25) at multiple occasions in a single training year. We examined the 1-month lagged effect of sleep disturbances on residents' self-reported wellness.
  
  
  RESULTS
  Accounting for residents' overall level of sleep disturbance across the entire study period, both the concurrent (within-person) within-occasion effect of sleep disturbance (B=-0.20, standard error [SE]=0.06, p=0.003, 95% confidence interval [CI]: -0.33, -0.07) and the lagged within-person effect of resident sleep disturbance (B=-0.15, SE=0.07, p=0.037, 95% CI: -0.29, -0.009) were significant predictors of decreased resident wellness. Increases in sleep disturbances are a leading indicator of resident wellness, predicting decreased well-being 1 month later.
  
  
  CONCLUSIONS
  Sleep quality exerts a significant effect on self-reported resident wellness. Periodic evaluation of sleep quality may alert program leadership and the residents themselves to impending decreases in psychological well-being.
authors.affiliation: Department of Emergency Medicine, University of Arizona, Tucson, AZ, USA; amin@aemrc.arizona.edu.
authors.forename: Alice A
authors.initials: AA
authors.lastname: Min
authors.affiliation: Department of Psychology, University of Arizona, Tucson, AZ, USA.
authors.forename: David A
authors.initials: DA
authors.lastname: Sbarra
authors.affiliation: Department of Emergency Medicine, University of Arizona, Tucson, AZ, USA.
authors.forename: Samuel M
authors.initials: SM
authors.lastname: Keim
mesh_terms: D001291:Attitude of Health Personnel; D006304:Health Status; D006801:Humans; D007396:Internship and Residency; D008603:Mental Health; D011446:Prospective Studies; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology* / Q000523:psychology
keywords: residency training; sleep quality; wellness