English abstract
Objectives: Resident physicians are particularly prone to sleep disturbance due to long
shift hours and excessive workload. Despite the numerous measures undertaken to
improve their wellbeing, it is still unknown if limiting the work shift duration would
improve sleep quality. We sought to compare sleep quality, anxiety, and depression before
and after implementing duty hour limits. We also aim to evaluate how satisfaction with
life is related to sleep quality, anxiety, and depression. Methods: We used a self-reported
questionnaire to obtain data about sleep quality, anxiety, and depression using the
Pittsburgh Sleep Quality Index and Patient Health Questionnaire-4 (PHQ-4) scales,
respectively. Using data from a previous study, we compared those parameters before
and after implementing duty hour reduction across several specialties at King Abdullah
University Hospital, Jordan. Furthermore, we investigated residents' life satisfaction using
the Satisfaction with Life Scale. Results: One hundred and eighty residents filled the
questionnaire (median age = 26.5 years). Males reported higher rates of poor sleep quality
while females had higher rates of anxiety and depression. Decreasing the duration of oncall shifts from 32 to 24 hours decreased the prevalence of poor sleep quality from 91.5%
to 83.2% (p = 0.038), and smoking rates decreased from 30.4% to 12.5% (p < 0.001).
More than six on-calls per month were associated with poorer quality of sleep. Night float
shifts significantly decreased rates of moderate and severe PHQ-4 scores (p < 0.001). In
addition, 63.3% of residents were satisfied with life. Life satisfaction was associated with
enhanced sleep quality and lower PHQ-4 scores (p = 0.007 and p < 0.001, respectively).
Conclusions: Optimizing shift scheduling and duration can positively influence rates of
sleep quality, anxiety, depression, and smoking. More interventions should be tackled
along with duty hour limits to optimize residents' life satisfaction.
