title: Time to talk about work-hour impact on anesthesiologists: The effects of sleep deprivation on Profile of Mood States and cognitive tasks.
abstract: BACKGROUND
  A physician's fatigue raises significant concerns regarding personal and patient safety. Effects of sleep deprivation on clinical performance and the quality of patient care are major considerations of today's health care environment.
  
  
  OBJECTIVE
  To evaluate the impact of partial sleep deprivation after a 17-h overnight call (3 pm-7 am) on the mood status and cognitive skills of anesthesiologists in an academic clinical hospital setting, as compared to these parameters during regular working hours.
  
  
  METHODS
  Taking circadian rhythm into account, the following measures were assessed in 21 pediatric anesthesiologists at two time points over the course of the study; (i) between 7 and 8 am on a regular non call day, and (ii) between 7 and 8 am after a 17-h in-house call (3 pm-7 am). Six mood states were assessed using the Profile of Mood States. A Total Mood Disturbance (TMD) score was obtained as the sum of all mood scores minus vigor. The total score provides a global estimate of affective state. Simple cognitive tests were similarly administered to assess cognitive skills. A two-tailed paired t-test was used to compare data between regular and post call days. A P < 0.05 was used.
  
  
  RESULTS
  The study cohort included 21 pediatric anesthesiologists at a tertiary care children's hospital. Tension, anger, fatigue, confusion, TMD, irritability, feeling jittery, and sleepiness were significantly affected (P < 0.05). A decrease in vigor, energy, and confidence was observed after a night call shift (P < 0.05). There was also a decrease in being "talkative" after the call shift (P < 0.05).
  
  
  CONCLUSIONS
  Partial sleep deprivation affects the total mood status of anesthesiologists and impacts their cognitive skills. These findings are particularly relevant in a context of increased work expectation, particularly on clinical performance in our modern medical system. Such observations suggest that there may be changes that impact the safety of our patients and the quality of health care that is provided.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.|Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Haleh
authors.initials: H
authors.lastname: Saadat
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.|Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA.|Department of Anesthesia and Critical Care Medicine, The University of Toronto, Toronto, ON, Canada.
authors.forename: Bruno
authors.initials: B
authors.lastname: Bissonnette
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Dmitry
authors.initials: D
authors.lastname: Tumin
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.|Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Arlyne
authors.initials: A
authors.lastname: Thung
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: Julie
authors.initials: J
authors.lastname: Rice
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.
authors.forename: N'Diris
authors.initials: N
authors.lastname: Barry
authors.affiliation: Department of Anesthesiology and Pain Medicine, Nationwide Children's Hospital, Columbus, OH, USA.|Department of Anesthesiology, The Ohio State University College of Medicine, Columbus, OH, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Tobias
mesh_terms: D000328:Adult; D000776:Anesthesiology / Q000706:statistics & numerical data*; D015984:Causality; D002940:Circadian Rhythm; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003072:Cognition Disorders / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D005221:Fatigue / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology* / Q000523:psychology; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data; D012892:Sleep Deprivation / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D014940:Work Schedule Tolerance / Q000502:physiology* / Q000523:psychology
keywords: fatigue; night call; physician wellness; work-hour limitation