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Open Access Highly Accessed Research article

Sleep and recovery in physicians on night call: a longitudinal field study

Birgitta Malmberg1*, Göran Kecklund2, Björn Karlson1, Roger Persson3, Per Flisberg4 and Palle Ørbaek3

Author Affiliations

1 Occupational and Environmental Medicine, Dept of Laboratory Medicine, Lund University, Lund, Sweden

2 Stress Research Institute, University of Stockholm, Stockholm, Sweden

3 National Research Centre for the Working Environment, Copenhagen, Denmark

4 Department of Anaesthesiology and Intensive care, Skåne University Hospital, Lund, Sweden

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BMC Health Services Research 2010, 10:239  doi:10.1186/1472-6963-10-239

Published: 15 August 2010

Abstract

Background

It is well known that physicians' night-call duty may cause impaired performance and adverse effects on subjective health, but there is limited knowledge about effects on sleep duration and recovery time. In recent years occupational stress and impaired well-being among anaesthesiologists have been frequently reported for in the scientific literature. Given their main focus on handling patients with life-threatening conditions, when on call, one might expect sleep and recovery to be negatively affected by work, especially in this specialist group. The aim of the present study was to examine whether a 16-hour night-call schedule allowed for sufficient recovery in anaesthesiologists compared with other physician specialists handling less life-threatening conditions, when on call.

Methods

Sleep, monitored by actigraphy and Karolinska Sleep Diary/Sleepiness Scale on one night after daytime work, one night call, the following first and second nights post-call, and a Saturday night, was compared between 15 anaesthesiologists and 17 paediatricians and ear, nose, and throat surgeons.

Results

Recovery patterns over the days after night call did not differ between groups, but between days. Mean night sleep for all physicians was 3 hours when on call, 7 h both nights post-call and Saturday, and 6 h after daytime work (p < 0.001). Scores for mental fatigue and feeling well rested were poorer post-call, but returned to Sunday morning levels after two nights' sleep.

Conclusions

Despite considerable sleep loss during work on night call, and unexpectedly short sleep after ordinary day work, the physicians' self-reports indicate full recovery after two nights' sleep. We conclude that these 16-hour night duties were compatible with a short-term recovery in both physician groups, but the limited sleep duration in general still implies a long-term health concern. These results may contribute to the establishment of safe working hours for night-call duty in physicians and other health-care workers.