Monitoring Sleep, Wellbeing, and Glucose Metabolism in PGY1s

Overview

Overnight on-call schedules can impact sleep, wellbeing, and alertness, which can be detrimental on the performance, physical and mental health of residents. Moreover, rotating shift work may have a long-term negative health impact (e.g. increased risk of diabetes). Within the National University Hospital (NUH), two different systems of rotating on-call schedules are implemented. In the night float system, residents work from 8 pm to 8 am for 5 – 7 consecutive nights once every month, compared to the traditional overnight on-call system, where each resident is on call for 4-6 nights per month (7 am – 5 pm, followed by overnight call until 8 am the next morning). The aim of the current study is to track sleep, wellbeing, and glucose metabolism during the different phases of the night float and traditional on-call schedules.

Full Title of Study: “Monitoring Sleep, Wellbeing, and Glucose Metabolism in Postgraduate Year 1 Doctors on Traditional and Float Call Shifts”

Study Type

  • Study Type: Observational
  • Study Design
    • Time Perspective: Prospective
  • Study Primary Completion Date: June 2023

Detailed Description

Overnight on-call schedules can impact sleep, wellbeing, and alertness, which can be detrimental on the performance, physical and mental health of residents. Moreover, rotating shift work may have a long-term negative health impact (e.g. increased risk of diabetes). Within the National University Hospital (NUH), two different systems of rotating on-call schedules are implemented. In the night float system, residents work from 8 pm to 8 am for 5 – 7 consecutive nights once every month, compared to the traditional overnight on-call system, where each resident is on call for 4-6 nights per month (7 am – 5 pm, followed by overnight call until 8 am the next morning). The aim of the current study is to track sleep, wellbeing, and glucose metabolism during the different phases of the night float and traditional on-call schedules. The availability of accurate mobile methodologies to monitor sleep and metabolic health provide new avenues for the improvement of sleep health and well-being. Wearable sleep tracking devices and smartphone apps provide remarkable opportunities for non-invasive, longitudinal sleep detection. Measurement of sleep during different stages of the shift schedule (baseline, on-call, recovery) can provide detailed insights into the temporal impact of the different schedules. Moreover, self-reported ratings of sleep quality, wellbeing, and time-use (delivered through phone-based e-diary methods) can further detail the mental health impact associated with these schedules. Wearable continuous glucose monitoring systems (CGMS) provide a minimally invasive means of passively tracking ambulant interstitial fluid glucose levels in real time.

Interventions

  • Device: CGM
    • Wearable continuous glucose monitoring systems (CGMS) provide a minimally invasive means of passively tracking ambulant interstitial fluid glucose levels in real time.
  • Device: Oura ring
    • Wearable sleep tracking device
  • Behavioral: Cognitive tasks and questionnaires
    • Participants will be prompted daily to fill out a short set of wellbeing questions and perform a short alertness test on their mobile phones and laptop.

Arms, Groups and Cohorts

  • Traditional call
    • In the traditional overnight on-call system, each resident is on call for 4-6 nights per month (7 am – 5 pm, followed by overnight call until 8 am the next morning)
  • Float call
    • In the night float system, residents work from 8 pm to 8 am for 5 – 7 consecutive nights once every month

Clinical Trial Outcome Measures

Primary Measures

  • Sleep
    • Time Frame: 8 weeks
    • Sleep duration and timing will be measured
  • Wellbeing
    • Time Frame: 8 weeks
    • Participants will complete a daily micro questionnaire delivered through a mobile phone-based application. We will examine mood ratings and stress ratings.
  • Glucose monitoring
    • Time Frame: 2 weeks
    • Blood glucose will be recorded using a wearable continuous glucose monitoring sensor (CGM: FreeStyle Libre Pro iQ by Abbott). CGM period will be individually scheduled to coincide with at least one cycle of day shift-night shift- recovery for each participant.
  • Alertness
    • Time Frame: 8 weeks
    • Participants will complete a daily set of cognitive games, delivered through a mobile phone-based application. The outcome measure from the games is a 3-min psychomotor vigilance task measuring sustained attention. Specifically, we examine median reaction time and lapses (reaction time > 500ms).

Participating in This Clinical Trial

Inclusion Criteria

  • NUHS Postgraduate year 1 doctors – Above 21 years of age – Completing their year 1 rotations in 2021 or 2022 Exclusion Criteria:

  • As this is an observational study with minimal risk, in an restricted pool of participants, no further exclusion criteria will be applied for participation.

Gender Eligibility: All

Minimum Age: 21 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: Accepts Healthy Volunteers

Investigator Details

  • Lead Sponsor
    • National University, Singapore
  • Provider of Information About this Clinical Study
    • Principal Investigator: Michael W.L. Chee, Professor – National University, Singapore
  • Overall Contact(s)
    • Stijn Agus Adrianus Massar, PhD, +65 66015238, mdcsaam@nus.edu.sg

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