Key result
16-hour nightshifts among pediatric residents significantly reduced regional cerebral oxygen saturation (68.2% to 64.6%, p<0.001) and MoCA scores (28.4 to 27.7, p<0.001) at 24 hours.
Why the study?
On-call shifts are linked to impaired cognition and alertness, but whether sleep deprivation reduces regional cerebral oxygen saturation (rScO2) was unknown.
Does sleep deprivation following 16-h nightshifts reduce cerebral oxygen saturation and cognitive function in pediatric residents?
Observational (n=50)
Does sleep deprivation following 16-h nightshifts reduce cerebral oxygen saturation and cognitive function in pediatric residents?
Extended 16-hour nightshifts without a post-call day cause transient reductions in cerebral oxygen saturation and cognitive function in pediatric residents.
Answers are grounded in this paper and cite their sources.
May support limiting extended shifts in residency training; hypothesis-generating for effects on clinical performance and patient outcomes.
BACKGROUND In-training physicians frequently experience acute sleep deprivation periods due to the on-call shifts’ lengths. Many studies showed that on-call shifts are associated with negative impacts on cognitive function, alertness, and mood. Near-infrared spectroscopy (NIRS) is a useful non-invasive tool for regional cerebral oxygen saturation (rScO2) monitoring. We hypothesized that rScO2 might be decreased in sleep-deprived brains. OBJECTIVE This study aimed to determine effects of sleep deprivation following the nightshifts on rScO2 and cognitive function. METHODS This prospective study included 50 in-training pediatricians. The rScO2 was monitored using two rScO2 sensors placed on the forehead at pre on-call (T0), immediate post-call (T16), 24-h from pre on-call (T24), and 48-h from pre on call (T48) in each physician. All physicians continued their working without post-call day. The mathematical test was performed at T0, T16, T24, and T48 and the Montreal cognitive assessment (MoCA) test at T0 and T24. RESULTS The mean (SD) rScO2 at immediate post-call [65.8%(5.3)] and 24-h from pre on-call [64.6%(6.4)] were significantly declined from pre on-call [68.2%(5.6)], p<0.001, and then returned to baseline at 48-h from pre on-call [68.9%(5.5)]. The mathematical test scores were not different among all-time points. The mean (SD) MoCA score was significantly decreased at 24-h from pre on-call [T0, 28.4(1.4) to T24, 27.7(1.8), p<0.001]. Seven out of 50 pediatricians (14%) had MoCA scores lower than normal (less than 25). CONCLUSIONS The 16-h nightshifts and continuous working among in-training pediatricians might cause a transient reduction of rScO2, which, could led to decreased cognitive function scores.
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Junsawat et al. (2023) conducted an observational in Sleep deprivation (n=50). 16-hour nightshifts and continuous working vs. Pre on-call baseline was evaluated on Regional cerebral oxygen saturation (rScO2) at 24 hours from pre on-call (p=<0.001). 16-hour nightshifts among pediatric residents significantly reduced regional cerebral oxygen saturation (68.2% to 64.6%, p<0.001) and MoCA scores (28.4 to 27.7, p<0.001) at 24 hours.
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