Cited by 143Sleep and Work-Related FatigueCircadian rhythm and melatoninHospital Admissions and Outcomes

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The Relationship Between Shift Work, Sleep, and Cognition in Career Emergency Physicians

Machi, Mari S., Staum, Matthew, Callaway, Clifton W., Moore, Charity, Jeong, Kwonho, Suyama, Joe, Patterson, P. Daniel, Hostler, David·2012·Academic Emergency Medicine

DOI 10.1111/j.1553-2712.2011.01254.x

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Abstract

ACADEMIC EMERGENCY MEDICINE 2012; 19:85–91 © 2012 by the Society for Academic Emergency Medicine Objectives: The 24‐hour physician coverage of the emergency department (ED) requires shift work, which can result in desynchronosis and cognitive decline. We measured changes in cognition and sleep disturbance in attending emergency physicians (EPs) before and after day and overnight shifts. Methods: Thirteen EPs were tested before and after day and overnight shifts using the Paced Auditory Serial Addition Test (PASAT), the University of Southern California Repeatable Episodic Memory Test (REMT), the Trail Making Test (TMT), and the Stroop Color‐Word Test. Sleep quality and fatigue were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Chalder Fatigue Questionnaire (CFQ). Saliva samples were collected from each physician immediately before and after day shifts and night shifts for neurohormonal assays. Results: Significantly fewer words were recalled on the REMT after both day (−2.4, 95% confidence interval [CI] = −4.4 to −0.4) and overnight shifts (−4.6, 95% CI = −6.4 to −2.8). There was a significant postshift increase in words recalled from the last third of the REMT list after overnight shifts (6.6, 95% CI = 2.8 to 10.4). Sleep quality was worse in EPs (mean PSQI = 4.8, SD ± 2.5) compared to the normal population, with 31% of subjects reporting poor sleep quality. Postshift fatigue was correlated with the perceived difficulty of the shift. Salivary cortisol and melatonin demonstrated diurnal variation consistent with normal circadian rhythms. Morning cortisol peak was decreased or delayed in samples from physicians after a night shift. Conclusions: These data indicate that short‐term memory appears to decline after day and overnight shifts and confirms the high incidence of disturbed sleep in this population.

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Authors: Machi, M. S., Staum, M., Callaway, C. W., Moore, C., Jeong, K., Suyama, J., Patterson, P. D., & Hostler, D.
Affiliations: University of Pittsburgh (US)
Corresponding author: Patterson, P. Daniel
Hostler, David
ORCID: Callaway, Clifton W.
Jeong, Kwonho
Patterson, P. Daniel
Hostler, David
Venue: Academic Emergency Medicine
Publisher: Wiley
Published: 2012-01
Volume: 19
Issue: 1
Pages: 85-91
ISSN: 1069-6563 (ISSN-L)
1553-2712
DOI: 10.1111/j.1553-2712.2011.01254.x
OpenAlex: W2104733269
Cited by: 143
References: 24
Citations by year: 2026: 6 · 2025: 14 · 2024: 8 · 2023: 8 · 2022: 13 · 2021: 11 · 2020: 13 · 2019: 15 · 2018: 9 · 2017: 5 · 2016: 7 · 2015: 11 · 2014: 11 · 2013: 6 · 2012: 6
FWCI: 14.56
Type: journal article
Language: en
Open access: closed
Licence: onlinelibrary.wiley.com/termsAndConditions#vor (vor, 4 d)
Locations: Academic Emergency Medicine (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health (5u01hl077871-11)
National Heart, Lung, and Blood Institute (U01-HL077871)
National Center for Research Resources (KL2RR024154)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Health Sciences › Nursing › Leadership and Management › Hospital Admissions and Outcomes
Keywords: shift work, emergency physicians, sleep disorders, cognitive performance, short-term memory, fatigue, circadian rhythm, salivary cortisol, salivary melatonin, jet lag, night shift work, day shift, episodic memory
MeSH terms: Adult, Career Choice, Circadian Rhythm, Cognition, Emergency Medicine, Female, Humans, Male, Medical Staff, Hospital, Middle Aged, Neuropsychological Tests, Prospective Studies, Mental Recall, Sleep Wake Disorders, Work Schedule Tolerance

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The Relationship Between Shift Work, Sleep, and Cognition in Career Emergency Physicians

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