Let sleeping anesthetists lie

Sleeping on the job is never a good idea, but with physicians there are of course significant concerns with respect to the safety of his or her patients. The present joint US-Canadian study investigated the effects of partial sleep deprivation on the clinical performance and the quality of patient care. In detail, they analyzed the effect of partial sleep deprivation on 21 pediatric anesthesiologists after a 17-h overnight call (3 pm-7 am) regarding mood status and cognitive skills, and compared the results to those during regular working hours. The outcome should serve as a wake-up call: Sleep deprivation affects the total mood status of anesthesiologists and, worryingly, also impacts their cognitive skills.

The anesthetists were assessed 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). The authors employed the ‘Profile of Mood States’ to evaluate six different mood states, and then used the sum of all mood scores (minus vigor) to calculate a Total Mood Disturbance (TMD) score as global estimate of affective state. In addition, all anesthetists underwent simple cognitive tests to assess cognitive skills.

Unsurprisingly to anyone who has ever worked a nightshift, feelings such as tension, anger, fatigue, confusion, TMD, irritability, feeling jittery, and sleepiness rose after sleep deprivation, while parameters such as vigor, energy and confidence plummeted after a night call shift; the physicians also reported being less talkative. All these findings were statistically significant.

“Partial sleep deprivation affects the total mood status of anesthetists and impacts their cognitive skills”, summarize the authors. They warn that these findings are particularly relevant in a context of increased work expectation, and suggest that changes to increase the workload might impact the safety of patients and the quality of the provided health care.

Source: Haleh Saadat et al.: "Time to talk about work-hour impact on anesthesiologists. The effects of sleep deprivation on Profile of Mood States and cognitive tasks", Pediatric Anesthesia, Jan 2016.

 

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