Sleep, sleepiness and vigilance in emergency medicine

Emergency physicians on duty are subjected to sleep deprivation because of their profession. This has several consequences. First, the sleep deprivation can have operational consequences with regard to the physicians’ performance. Second, if this sleep deprivation is chronic, it might entail health consequences for these professionals. And third, their sleep when on duty, and thus subjected to an induced vigilance, might provide a physiopathological model to compare to the sleep in primary insomnia patients. In the Sleep-ER project, physicians on duty for 24 hours will be monitored with polysomnography, questionnaires, saliva and urine samples and tests regarding their cognitive performance during their time on duty, as well as during a 24 hours recovery period. We want to answer the following questions:

1. How does sleep during duty time (on call) compare to normal sleep ? Is there an effect of the cpgnitive and behavioural induced vigilance ?

2. Regarding perofrmance during a 24hrs shift, how does it evolve over time ? Can we relate subjective sleepiness and fatigue to electro-cortical activity and hormonal changes? Is there a point in time, whether on an interindividual basis or an intra-inidividual basis, that we can pinpoint as the performance “breaking point”?

3. How do the effects of a sleep deprivation for professional reasons compare to the effects of a similar deprivation in laboratory conditions ? Is there a motivational component in the coping mechanisms?

4. How does the sleep while on duty time compare to the sleep of a population of primary insomniacs? Is induced vigilance a valid model to approach the physiopathology of primary insomnia?

This study is conducted in the emergency medicine department of the Brugmann Hospital in Brussels, where it is coordinated by Dr Olivier Vermylen.