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. 2024 Feb 1;20(2):221-227.
doi: 10.5664/jcsm.10820.

Association between sleep health and rates of self-reported medical errors in intern physicians: an ancillary analysis of the Intern Health Study

Amanda B Hassinger  1 , Chiara Velez  2 , Jia Wang  3 , M Jeffery Mador  4 , Gregory E Wilding  5 , Archana Mishra  4
Affiliations

Association between sleep health and rates of self-reported medical errors in intern physicians: an ancillary analysis of the Intern Health Study

Amanda B Hassinger et al. J Clin Sleep Med. .

Abstract

Study objectives: Reduced sleep duration and work hour variability contribute to medical error and physician burnout. This study assesses the relationships between physician performance, burnout, and the dimensions of sleep beyond hours slept.

Methods: This was an ancillary analysis of 3 years of data from an international prospective cohort study: the Intern Health Study. Actigraphy data from 3,654 intern physicians capturing sleep timing, regularity, efficiency, and duration were used individually and combined as a composite sleep health index to measure the association of multidimensional sleep patterns on self-reported medical errors and burnout.

Results: From 2017-2019, interns' work hours decreased by 4 hours per week and total sleep time also decreased (6.7 to 5.99 hours), and sleep efficiency, timing, and regularity all worsened (all P < .05). In the 21.2% of participants who committed an error, there was no difference in sleep duration, timing, or regularity. Lower sleep efficiency was associated with higher odds of committing an error (P = .003) and higher burnout scores (P < .001). Although overall sleep quality was poor in the entire cohort, interns in the lowest quintile of sleep duration, regularity, and efficiency had higher burnout scores than those in the best quintile.

Conclusions: Sleep efficiency, not duration, was associated with increased self-reported medical errors and burnout in intern physicians. Overall sleep quality and duration worsened despite fewer hours worked. Future studies on physician burnout should measure all aspects of sleep health.

Citation: Hassinger AB, Velez C, Wang J, Mador MJ, Wilding GE, Mishra A. Association between sleep health and rates of self-reported medical errors in intern physicians: an ancillary analysis of the Intern Health Study. J Clin Sleep Med. 2024;20(2):221-227.

Keywords: burnout; intern burnout; medical error; physician sleep; sleep efficiency.

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Conflict of interest statement

All authors have seen and approved the manuscript. Work for this study was performed at the University at Buffalo Jacobs School of Biomedical Sciences and the University at Buffalo School of Public Health and Health Professions, Buffalo, New York. This was an unfunded study. The authors report no conflicts of interest. The views expressed are those of the authors and do not reflect the official policy or position of the United States Air Force, Department of Defense, or the United States Government. This study is a secondary analysis of the Intern Health Study, Dr. Sen, University at Michigan (NCT01809080).

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