Effects of call on sleep and mood in internal medicine residents

Behav Sleep Med. 2008;6(2):75-88. doi: 10.1080/15402000801952914.


Residents on call experience decreased total sleep time (TST) and increased dysphoria. This study monitored changes in mood and sleepiness for 3 post-call days. Fifty-two internal medicine residents participated in the study. The residents wore actigraphs for the 4 to 9 days of the study. Each morning resident completed mood scales, a sleepiness scale, and estimated their prior night TST. The residents were on a 1-in-4 schedule. Call decreased subjective- and actigraphy-derived TST to less than 4 hr. During the 3 days post call, mood measures improved. Tension, depression, and anxiety stabilized on the first post-call day following the first night of off-call sleep during which the residents obtained about 7 hr of sleep. Vigor, fatigue, and confusion stabilized on the second post-call day. The Epworth Sleepiness Scale dropped to less than 11 after 1 post-call night and continued to decrease up to 3 post-call days. The effects of call linger past the first recovery night. For these residents, recovery sleep appeared inadequate, and the negative effects of call persisted across succeeding off-call days. Thus, for these residents on a 1-in-4 schedule, call affects their mood for much of the time when off call and potentially their personal and professional interactions during this period as well.

MeSH terms

  • Adult
  • Affect*
  • Anxiety / etiology
  • Clinical Competence*
  • Depression / etiology
  • Fatigue / etiology
  • Female
  • Humans
  • Internal Medicine
  • Internship and Residency / methods*
  • Male
  • Sleep / physiology
  • Sleep Deprivation / complications*
  • Sleep Deprivation / physiopathology*
  • Sleep Deprivation / psychology
  • Stress, Psychological / etiology
  • Surveys and Questionnaires
  • Time Factors
  • United States
  • Work Schedule Tolerance / psychology*