Sleep quality, sleep habits, and chronotypes of medical interns at the beginning of their training

Chok Limsuwat MD, Pantaree Aswanetmanee MD, Mustafa Awili MD, Ahmed Raziuddin MD, Supat Thammasitboon MD

ABSTRACT

Introduction: Despite the implementation of resident work hour regulations, studies have not consistently shown beneficial changes in residents’ sleep quality or duration. We hypothesized that inter-individual sleep-related differences may exist prior to training and the pre-existing sleep health and habits may impact training.

Objective: To determine interns’ baseline sleep quality, sleep hygiene, chronotypes, and their correlates at the beginning of their residency training program.

Methods: A cross-sectional study using an anonymous “Resident Sleep Survey” included baseline demographic information and questionnaires, including the Epworth Sleepiness Scale (ESS), the Pittsburgh’s Sleep Quality Index (PSQI), the Morningness-Eveningness Questionnaire (MEQ), and the Sleep Hygiene Index (SHI).

Results: One hundred and twenty-nine subjects participated the study; 45.7 % (n=59) were male and 18.6 % (n=24) were married. Twenty percent of interns had an ESS >10. The PSQI revealed that 28% of interns had poor sleep hygiene. The mean sleep efficiency was 91.2 ±7.4% estimated from the PSQI. Non-married interns had a lower prevalence of morning chronotypes (22.3% vs. 45.8%, p=0.02). Morning chronotype interns had a lower ESS score (6.1 ±3.1 vs. 7.6 ±3.6, p=0.03) and a lower SHI (29 ±7.0 vs. 34.3 ±7.1, p=0.003).

Conclusion: About a quarter of interns had poor sleep quality and excessive daytime sleepiness prior to their training. Non-morning chronotype interns appeared to have more daytime sleepiness and poorer sleep quality. Since pre-existing sleep problems may adversely affect learning, we suggest that strategies to improve sleep hygiene and quality in this specific population should be emphasized early in their training.

Keywords: Sleep quality, chronotype, Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Morningness-Eveningness Questionnaire, Sleep Hygiene Index

Article citation: Limsuwat C, Aswanetmanee P, Awili M, Raziuddin A, Thammasitboon S. Sleep quality, sleep habits, and chronotypes of medical interns at the beginning of their training. The Southwest Respiratory and Critical Care Chronicles 2017;5(20):4-11.
From: Pulmonary Diseases, Critical Care, and Environmental Medicine, Tulane University Health Sciences Center, New Orleans, LA; Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Submitted: 5/14/2017
Accepted: 7/10/2017
Reviewer: Gilbert Berdine MD
Conflicts of interest: none