Wada Hiroo, Basner Mathias, Cordoza Makayla, Dinges David, Tanigawa Takeshi
Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Unit for Experimental Psychiatry, Division of Sleep and Chronobiology, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
J Sleep Res. 2025 Feb;34(1):e14304. doi: 10.1111/jsr.14304. Epub 2024 Aug 12.
Approximately 40% of Japanese physicians report working more than 960 hr of overtime annually, with 10% exceeding 1860 hr. To protect their health, annual overtime limits went into effect in 2024. The objective of this study was to investigate associations of self-reported sleep duration with psychological health and objective alertness. This was a cross-sectional National Survey for The Work Style Reform of Long Working Physicians. Physicians self-reported daily sleep duration, burnout (Abbreviated Maslach Burnout Inventory), depression (Center for Epidemiologic Studies Depression Scale) and traffic accidents. Alertness was then evaluated using the brief Psychomotor Vigilance Test. Of 20,382 physicians invited, 1226 completed the survey and brief Psychomotor Vigilance Test. Daily sleep duration was inversely associated with weekly work hours (β = -5.4; 95% confidence interval -6.8 to -4.0, p < 0.0001). Sleep duration < 6 hr and ≥ 8 hr per day was associated with slower responses on the brief Psychomotor Vigilance Test (adjusted p < 0.05). An additional 10 hr worked per week was associated with a 0.40 point (95% confidence interval 0.08-0.72) increase in burnout severity and a 1.7% (95% confidence interval 0.1-3.3%) increase in odds of reporting a traffic accident. Increased brief Psychomotor Vigilance Test lapses, indicating lower alertness, were associated with worse symptoms of depression (β = 0.23 points; 95% confidence interval 0.14-0.31, p < 0.0001) and burnout (β = 0.25 points; 95% confidence interval 0.13-0.36, p < 0.0001). This study emphasizes the importance of sufficient sleep to maintain alertness, and supports limiting work hours for Japanese physicians to protect psychological health. Performance on the brief Psychomotor Vigilance Test may be a useful indicator of psychological health.
约40%的日本医生报告称每年加班时长超过960小时，其中10%超过1860小时。为保护他们的健康，年度加班时长限制于2024年开始生效。本研究的目的是调查自我报告的睡眠时间与心理健康及客观警觉性之间的关联。这是一项针对长时间工作医生工作方式改革的全国性横断面调查。医生们自我报告每日睡眠时间、职业倦怠（简明马氏职业倦怠量表）、抑郁（流行病学研究中心抑郁量表）及交通事故情况。随后使用简易精神运动警觉性测试评估警觉性。在受邀的20382名医生中，1226人完成了调查及简易精神运动警觉性测试。每日睡眠时间与每周工作时长呈负相关（β = -5.4；95%置信区间为-6.8至-4.0，p < 0.0001）。每天睡眠时间<6小时及≥8小时与简易精神运动警觉性测试中较慢的反应相关（校正p < 0.05）。每周额外工作10小时与职业倦怠严重程度增加0.40分（95%置信区间为0.08 - 0.72）及报告交通事故的几率增加1.7%（95%置信区间为0.1 - 3.3%）相关。简易精神运动警觉性测试失误增加，表明警觉性降低，与更严重的抑郁症状（β = 0.23分；95%置信区间为0.14 - 0.31，p < 0.0001）及职业倦怠（β = 0.25分；95%置信区间为0.13 - 0.36，p < 0.0001）相关。本研究强调了充足睡眠对于维持警觉性的重要性，并支持限制日本医生的工作时长以保护心理健康。简易精神运动警觉性测试的表现可能是心理健康的一个有用指标。
