Sleep pattern, sleep problems and comorbidities among resident doctors at a tertiary care institution in India: a cross sectional study

Authors

  • Siddalingaiah H.S. Department of Community Medicine, Shridevi Institute of Medical Sciences and Research Hospital, Tumkur, India
  • Chandrakala D. Department of Anaesthesia, Shridevi Institute of Medical Sciences and Research Hospital, Tumkur, India
  • Amarjeet Singh Department of Community Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India

DOI:

https://doi.org/10.18203/2394-6040.ijcmph20175165

Keywords:

Sleep problems, Work stress, Resident doctors, Shift work, Sleep comorbidities

Abstract

Background: Sleep problems are a major concern in population working under stress such as resident doctors. Sleep has many health benefits; sleep problems are linked with short and long term adverse health outcomes. Aim was to study sleep pattern, problems and comorbidities among resident doctors.

Methods: A cross-sectional study design with a pre-validated sleep assessment proforma was used to collect information on socio-demographics, sleep pattern, sleep problems and comorbidities from 428 resident doctors found eligible for the study.

Results: 350 subjects returned the filled proforma (82% response rate). Mean daily sleep hours were 6.21 (SD, 1.39) and work hours 12.77 (SD, 3.63). Sleep time was night in 64.6%, day in 12%, and both in 23.4%. Monthly average of 5.8 night shifts and 2.03 duty offs were found. Visual analogue scale (0-10) mean scores for sleepiness and tiredness were 4.41 (SD, 2.55; 95% CI, 4.14-4.68; P<0.01) and 4.73 (SD, 2.62; 95% CI, 4.45-5.00; P<0.01) respectively. Presence of different symptoms related to sleep problems ranged from 7 to 26% and various problems interfering with sleep ranged from 10 to 25%. Comorbidities such as allergy (29.4%), jerky legs (24.3%), sinus infections (22.8%), restless leg syndrome (16.3%), snoring (8.3%), asthma/lung diseases (5.8%), chronic diseases (3.4%), severe snoring disturbing others (1.8%), and obstructive sleep apnoea (0.9%) were present.

Conclusions: Sleep problems were highly prevalent among resident doctors. The resident doctors were sleep-deprived, overworked, tired, excessively sleepy, and had significant presence of factors affecting circadian rhythm and sleep fragmentation. Various comorbidities were also present with varying prevalence. 

References

Stranges S, Tigbe W, Gomez-Olive FX, Thorogood M, Kandala NB. Sleep problems: an emerging global epidemic? Findings from the INDEPTH WHO-SAGE study among more than 40,000 older adults from 8 countries across Africa and Asia. Sleep. 2012;35(8):1173-81.

Horne J. Is there a sleep debt? Sleep. 2004;27(6):1047-9.

Jagannath A, Taylor L, Wakaf Z, Vasudevan SR, Foster RG. The genetics of circadian rhythms, sleep and health. Human molecular genetics. 2017;26(2):128-38.

Parthasarathy S, Carskadon MA, Jean-Louis G, Owens J, Bramoweth A, Combs D, et al. Implementation of Sleep and Circadian Science: Recommendations from the Sleep Research Society and National Institutes of Health Workshop. Sleep. 2016;39(12):2061-75.

Rajaratnam SM, Howard ME, Grunstein RR. Sleep loss and circadian disruption in shift work: health burden and management. Medical J Australia. 2013;199(8):11-5.

Kredlow MA, Capozzoli MC, Hearon BA, Calkins AW, Otto MW. The effects of physical activity on sleep: a meta-analytic review. J Behav Med. 2015;38(3):427-49.

Hale L, Emanuele E, James S. Recent Updates in the Social and Environmental Determinants of Sleep Health. Current Sleep Med Rep. 2015;1(4):212-7.

Mastin DF, Siddalingaiah HS, Singh A, Lal V. Excessive Daytime Sleepiness, Sleep Hygiene, and Work Hours Among Medical Residents in India. J Tropical Psychol. 2012;2.

Mastin DF, Bryson J, Corwyn R. Assessment of sleep hygiene using the Sleep Hygiene Index. J Behav Med. 2006;29(3):223-7.

Cedernaes J, Schioth HB, Benedict C. Determinants of shortened, disrupted, and mistimed sleep and associated metabolic health consequences in healthy humans. Diabetes. 2015;64(4):1073-80.

Roopa M, Deepa M, Indulekha K, Mohan V. Prevalence of sleep abnormalities and their association with metabolic syndrome among Asian Indians: Chennai Urban Rural Epidemiology Study (CURES-67). J Diabetes Sci Technol. 2010;4(6):1524-31.

Bayon V, Laaban JP, Leger D. Metabolic and cardiovascular comorbidities and sleep disorders. La Revue du praticien. 2007;57(14):1565-8.

Dosi C, Riccioni A, Della Corte M, Novelli L, Ferri R, Bruni O. Comorbidities of sleep disorders in childhood and adolescence: focus on migraine. Nature Sci Sleep. 2013;5:77-85.

Foley KA, Sarsour K, Kalsekar A, Walsh JK. Subtypes of sleep disturbance: associations among symptoms, comorbidities, treatment, and medical costs. Behavioral Sleep Med. 2010;8(2):90-104.

Mysliwiec V, McGraw L, Pierce R, Smith P, Trapp B, Roth BJ. Sleep disorders and associated medical comorbidities in active duty military personnel. Sleep. 2013;36(2):167-74.

Sarsour K, Morin CM, Foley K, Kalsekar A, Walsh JK. Association of insomnia severity and comorbid medical and psychiatric disorders in a health plan-based sample: Insomnia severity and comorbidities. Sleep Med. 2010;11(1):69-74.

Tarasiuk A, Greenberg-Dotan S, Brin YS, Simon T, Tal A, Reuveni H. Determinants affecting health-care utilization in obstructive sleep apnea syndrome patients. Chest. 2005;128(3):1310-4.

Howard SK, Gaba DM, Rosekind MR, Zarcone VP. The risks and implications of excessive daytime sleepiness in resident physicians. Acad Med. 2002;77(10):1019-25.

Newman AB, Spiekerman CF, Enright P, Lefkowitz D, Manolio T, Reynolds CF, et al. Daytime sleepiness predicts mortality and cardiovascular disease in older adults. The Cardiovascular Health Study Research Group. J American Geriatrics Soc. 2000;48(2):115-23.

Erren TC, Morfeld P, Stork J, Knauth P, von Mulmann MJ, Breitstadt R, et al. Shift work, chronodisruption and cancer?--The IARC 2007 challenge for research and prevention and 10 theses from the Cologne Colloquium 2008. Scandinavian J Work, Environment Health. 2009;35(1):74-9.

Hansen J, Lassen CF. Shift work and risk of cancer and coronary heart diseases. Ugeskrift for laeger. 2014;176(2):146-9.

Erren TC, Falaturi P, Morfeld P, Knauth P, Reiter RJ, Piekarski C. Shift work and cancer: the evidence and the challenge. Deutsches Arzteblatt Int. 2010;107(38):657-62.

Bharti B, Malhi P, Kashyap S. Patterns and problems of sleep in school going children. Indian Pediatr. 2006;43(1):35-8.

Dinakar C, Galagali P, Kumar SA, Abhishekh HA. Adolescent sleep problems and behavior: a school survey. Indian J Pediatr. 2014;81(7):726-7.

Giri P, Baviskar M, Phalke D. Study of sleep habits and sleep problems among medical students of pravara institute of medical sciences loni, Western maharashtra, India. Annals Medical Health Sci Res. 2013;3(1):51-4.

Gupta R, Lahan V, Bansal S. Subjective sleep problems in young women suffering from premenstrual dysphoric disorder. North American J Med Sci. 2012;4(11):593-5.

Kaur G, Sharma V, Singh A. Association of sleep quality with general health: an Indian college students study. Int J Med Sci Public Health. 2015;4(12):1767.

Kaur G, Singh A. Excessive daytime sleepiness and its pattern among Indian college students. Sleep Medicine. 2017;29:23-8.

Murthy CL, Bharti B, Malhi P, Khadwal A. Sleep Habits and Sleep Problems in Healthy Preschoolers. Indian J Pediatr. 2015;82(7):606-11.

Ravikiran SR, Kumar PM, Latha KS. Sleep problems in preschool and school aged rural Indian children. Indian Pediatr. 2011;48(3):221-3.

Sandia National Laboratories, Sandia Corporation. Health Benefits employee Services. HBE preventive health sleep assessment form California Lockheed Martin; 2007. Available at: http//hbe.sandia.gov. Accessed on 10 April 2008.

Hayashino Y, Fukuhara S, Suzukamo Y, Okamura T, Tanaka T, Ueshima H, et al. Relation between sleep quality and quantity, quality of life, and risk of developing diabetes in healthy workers in Japan: the High-risk and Population Strategy for Occupational Health Promotion (HIPOP-OHP) Study. BMC Public Health. 2007;7:129.

Bryson WJ, Mastin DF. Sleep hygiene predictors of excessive daytime sleepiness and poor subjective sleep quality. J Psychol Practice. 2013;18:88-104.

Brown FC, Buboltz WC, Jr., Soper B. Relationship of sleep hygiene awareness, sleep hygiene practices, and sleep quality in university students. Behav Med. 2002;28(1):33-8.

LeBourgeois MK, Giannotti F, Cortesi F, Wolfson AR, Harsh J. The relationship between reported sleep quality and sleep hygiene in Italian and American adolescents. Pediatrics. 2005;115(1):257-65.

Kryger. MH, Roth. T, Dement. WC. Principles and Practice of Sleep Medicine. 6 ed. Philadelphia, PA: Elsevier; 2017.

von Bonsdorff MB, Strandberg A, von Bonsdorff M, Tormakangas T, Pitkala KH, Strandberg TE. Working hours and sleep duration in midlife as determinants of health-related quality of life among older businessmen. Age Ageing. 2017;46(1):108-12.

Wang F, Yeung KL, Chan WC, Kwok CC, Leung SL, Wu C, et al. A meta-analysis on dose-response relationship between night shift work and the risk of breast cancer. Annals of oncology: official J European Soc Med Oncol. 2013;24(11):2724-32.

Shneerson JM. Nature of Sleep and its Disorders. In: Shneerson JM, editor. Sleep Medicine: A guide to sleep and its disorders. Massachusetts, USA: Blackwell Publishing Ltd; 2005:5.

Arora VM, Georgitis E, Woodruff JN, Humphrey HJ, Meltzer D. Improving sleep hygiene of medical interns: can the sleep, alertness, and fatigue education in residency program help? Arch Intern Med. 2007;167(16):1738-44.

Holbrook MI, White MH, Hutt MJ. Increasing awareness of sleep hygiene in rotating shift workers: arming law-enforcement officers against impaired performance. Percept Mot Skills. 1994;79(1):520-2.

Owens JA, Avidan A, Baldwin D, Landrigan C. Improving sleep hygiene. Arch Intern Med. 2008;168(11):1229-30.

Stepanski EJ, Wyatt JK. Use of sleep hygiene in the treatment of insomnia. Sleep Med Rev. 2003;7(3):215-25.

Weiss MD, Wasdell MB, Bomben MM, Rea KJ, Freeman RD. Sleep hygiene and melatonin treatment for children and adolescents with ADHD and initial insomnia. J Am Acad Child Adolesc Psychiatry. 2006;45(5):512-9.

Accardo JA, Marcus CL, Leonard MB, Shults J, Meltzer LJ, Elia J. Associations between psychiatric comorbidities and sleep disturbances in children with attention-deficit/hyperactivity disorder. Journal of developmental and behavioral pediatrics. JDBP. 2012;33(2):97-105.

Dorow P, Thalhofer S. Restless legs syndrome and periodic leg movements during sleep in patients with sleep apnea--a therapeutic problem? Pneumologie. 1997;51(3):716-20.

Abdel-Aziz M, Ibrahim N, Ahmed A, El-Hamamsy M, Abdel-Khalik MI, El-Hoshy H. Lingual tonsils hypertrophy; a cause of obstructive sleep apnea in children after adenotonsillectomy: operative problems and management. Int J Pediatr Otorhinolaryngol. 2011;75(9):1127-31.

Okubo R, Kondo M, Hoshi SL, Yamagata K. Cost-effectiveness of obstructive sleep apnea screening for patients with diabetes or chronic kidney disease. Sleep breathing Schlaf Atmung. 2015;19(3):1081-92.

Chiang CL, Chen YT, Wang KL, Su VY, Wu LA, Perng DW, et al. Comorbidities and risk of mortality in patients with sleep apnea. Annals Med. 2017;49(5):377-83.

Cintra FD, Poyares D, Guilleminault C, Carvalho AC, Tufik S, de Paola AA. Cardiovascular comorbidities and obstructive sleep apnea. Arquivos brasileiros de cardiologia. 2006;86(6):399-407.

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Published

2017-11-23

How to Cite

H.S., S., D., C., & Singh, A. (2017). Sleep pattern, sleep problems and comorbidities among resident doctors at a tertiary care institution in India: a cross sectional study. International Journal Of Community Medicine And Public Health, 4(12), 4477–4484. https://doi.org/10.18203/2394-6040.ijcmph20175165

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Original Research Articles