246 Comparing Caffeine Usage and Sleep Amongst Emergency Medicine Residents Based on Shift Times

Abstract

Shift work is one of the many stressors that emergency physicians need to solve as they strive to find a proper work-life balance. One of the way that shift workers combat shift work is by using caffeine or other stimulants. Finding the right balance means that shift workers must adjust their sleep schedule often. The goal of this study was to evaluate the amount of sleep that EM residents believe they’re getting based on shift times. This was an IRB-approved, prospective, observational study wherein EM residents wrote in individual sleep logs their sleep time, caffeine usage, and sleep aids for up to 6 months. 25/34 eligible EM residents completed some of their sleep logs and 14/34 completed their entire sleep log with decreased participation attributed to COVID-19. These logs were blinded to researchers and then compared based on shift (day, evening, night, off, post-nights). Shifts were 8-10 hours long and coded as either day (starting between 6a-10a), evening (starting between 11a-4p), night shift (starting between 9p-12a), post-night (day after night shift), or off. One way ANOVA tests were used to compare sleep and caffeine recorded by shift. Post hoc analysis using Bonferroni correction were performed to determine differences between groups. There were statistical differences between the sleep recorded and caffeine use by emergency medicine residents based on shift. Sleep time was highest during days off while caffeine usage was the lowest. On the contrary, sleep time was lowest after night shifts while caffeine usage was the highest. One way ANOVA for sleep time based on shifts was F (4, 1884)=15.61, p=1.45E-12. There was a significant difference between sleep time on days off (M=464.9, SD=106.6) compared to day shift (M=443.8, SD=90.1), p=0.004, evening shift (M=444.8, SD=89.1), p=0.0003, and night shift (M=398.8, SD=122.2, p=1.92E-13. There were also significant differences between day shift and night shift (p=8.14E-06) and evening shift and night shift (p=3.41E-08). The one way ANOVA for caffeine usage amongst shifts was significant at F (4, 1626)=11.91, p=1.55E-09. Statical differences were found between days off (M=158.0, SD=126.7) as compared to evening shifts (M=200.3, SD=138.3), p=5.49E-08 and also night shifts (M=220.9, SD=145.5), p=3.86E-08. Night shifts resulted in the lowest sleep and highest caffeine usage for emergency medicine residents. Days off and day shifts resulted in highest amount of sleep and lowest amounts of caffeine usage. Shift work remains a significant stressor on emergency residents’ work-life balance. Residents should attempt to make adjustments to their sleeping arrangements at home to improve their night shift sleep.