Thimmapuram Jayaram, Pargament Robert, Tredici Sonya Del, Bell Theodore, Yommer Deborah, Daoud Dana, Powell Frankie, Madhusudhan Divya K
Internal Medicine, WellSpan York Hospital, York, Pennsylvania, United States.
WellSpan Pulmonary and Sleep Medicine, WellSpan York Hospital, York, Pennsylvania, United States.
Ann Neurosci. 2021 Jan;28(1-2):47-54. doi: 10.1177/09727531211039070. Epub 2021 Sep 23.
Medical residents are vulnerable to poor sleep quality due to intense work shifts and academic load. Studies objectively quantified with sleep quantity and quality among resident physicians are limited. Meditation techniques have been shown to improve sleep but are rarely studied in this population. The aim of the present study is to evaluate sleep patterns of internal medicine residents and the effect of a structured Heartfulness meditation program to improve sleep quality.
A total of 36 residents participated in a pre-post cohort study from January 2019 through April 2019. Sleep was monitored during a one-week outpatient rotation with two validated assessment tools, namely consensus sleep diary and actigraphy. After four intervening weeks, when the residents returned to the same rotation, Heartfulness meditation was practiced and the same parameters were measured. At the end of the study period, an anonymous qualitative feedback survey was collected to assess the feasibility of the intervention.
All 36 residents participated in the study (mean age 31.09 years, SD 4.87); 34 residents (94.4%) had complete pre-post data. Consensus sleep diary data showed decreased sleep onset time from 21.03 to 14.84 min ( = .01); sleep quality and restfulness scores increased from 3.32 to 3.89 and 3.08 to 3.54, respectively ( < .001 for both). Actigraphy showed a change in sleep onset time from 20.9 min to 14.5 min ( = .003). Sleep efficiency improved from 83.5% to 85.6% ( = .019). Wakefulness after initial sleep onset changed from 38.8 to 39.9 min ( = .682). Sleep fragmentation index and the number of awakenings decreased from 6.16 to 5.46 ( = .004) and 41.71 to 36.37 ( = .013), respectively.
Residents obtained nearly 7 h of sleep during outpatient rotation. Findings suggest a structured Heartfulness meditation practice to be a feasible program to improve subjective sleep onset time and several objective measures among resident physicians.
由于高强度的轮班工作和学业负担，住院医师容易出现睡眠质量差的情况。针对住院医师的睡眠数量和质量进行客观量化研究的相关研究有限。冥想技巧已被证明可以改善睡眠，但在这一人群中很少被研究。本研究的目的是评估内科住院医师的睡眠模式以及结构化的心灵冥想计划对改善睡眠质量的效果。
共有36名住院医师参与了从2019年1月至2019年4月的一项前后对照队列研究。在为期一周的门诊轮转期间，使用两种经过验证的评估工具，即共识睡眠日记和活动记录仪来监测睡眠情况。在四周的干预期后，当住院医师回到相同的轮转岗位时，进行心灵冥想练习并测量相同的参数。在研究期结束时，收集了一份匿名的定性反馈调查问卷，以评估干预措施的可行性。
所有36名住院医师都参与了研究（平均年龄31.09岁，标准差4.87）；34名住院医师（94.4%）有完整的前后数据。共识睡眠日记数据显示，入睡时间从21.03分钟减少到14.84分钟（P = 0.01）；睡眠质量和安宁程度评分分别从3.32提高到3.89以及从3.08提高到3.54（两者P均<0.001）。活动记录仪显示入睡时间从20.9分钟变为14.5分钟（P = 0.003）。睡眠效率从83.5%提高到85.6%（P = 0.019）。初始入睡后的清醒时间从38.8分钟变为39.9分钟（P = 0.682）。睡眠片段化指数和觉醒次数分别从6.16降至5.46（P = 0.004）和从41.71降至36.37（P = 0.013）。
住院医师在门诊轮转期间获得了近7小时的睡眠。研究结果表明，结构化的心灵冥想练习是一项可行的计划，可改善住院医师的主观入睡时间和多项客观指标。
