Observational Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. May 14, 2017; 23(18): 3330-3337
Published online May 14, 2017. doi: 10.3748/wjg.v23.i18.3330
Stress and sleep quality in doctors working on-call shifts are associated with functional gastrointestinal disorders
Soo-Kyung Lim, Seung Jin Yoo, Dae Lim Koo, Chae A Park, Han Jun Ryu, Yong Jin Jung, Ji Bong Jeong, Byeong Gwan Kim, Kook Lae Lee, Seong-Joon Koh
Soo-Kyung Lim, Seung Jin Yoo, Chae A Park, Han Jun Ryu, Yong Jin Jung, Ji Bong Jeong, Byeong Gwan Kim, Kook Lae Lee, Seong-Joon Koh, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Boramae Hospital, Seoul 156-707, South Korea
Dae Lim Koo, Department of Neurology, Seoul National University Boramae Hospital, Seoul National University College of Medicine, Seoul 156-707, South Korea
Author contributions: Lim SK and Koh SJ have contributed equally to this article; Lim SK, Yoo SJ, Koo DL and Koh SJ were the guarantors and designed the study; Lim SK, Park CA and Ryu HJ participated in the acquisition, analysis, and interpretation of the data; Lim SK and Koh SJ participated in the interpretation of the data, and drafted the Initial manuscript; Lim SK, Jung YJ, Jeong JB, Kim BG and Lee KL and Koh SJ revised the article critically for important intellectual content.
Institutional review board statement: The present study was reviewed and approved by Institutional Review Boards of Seoul National University Boramae Hospital.
Informed consent statement: All respondents submitted informed written consent prior to study enrollment.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Seong-Joon Koh, MD, PhD, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Boramae Hospital, 5 Gil 20, Boramae-Road, Dongjak-Gu, Seoul 156-707, South Korea. jel1206@snu.ac.kr
Telephone: +82-2-8702234 Fax: +82-2-870-3866
Received: January 24, 2017
Peer-review started: February 1, 2017
First decision: February 23, 2017
Revised: March 8, 2017
Accepted: April 12, 2017
Article in press: April 12, 2017
Published online: May 14, 2017
Abstract
AIM

To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call shifts.

METHODS

In this cross-sectional observation study, using the Rome III Questionnaire and Pittsburgh Sleep Quality Index (PSQI), we analyzed 170 doctors with 24 hour-on-call shifts.

RESULTS

Among the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48 (28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores (PSQI) (8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm (83.3% vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work (81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD (OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality (PSQI ≥ 6) was a predictor of IBS (OR = 4.17, 95%CI: 1.92-19.02, P = 0.016).

CONCLUSION

Physicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs.

Keywords: Psychosocial stress, Sleep, 24 hour-on-call shift, Doctors, Functional gastrointestinal disorders

Core tip: The aim of this study is to investigate the role of sleep quality and psychosocial stress as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call shifts. Our study showed a higher prevalence of FGIDs in doctors with 24 hour-on-call shifts. This is the first attempt to provide evidence of the interplay between sleep impairment, psychosocial stress, and higher workload in the pathogenesis of FGIDs. Our survey data is trustworthy, as doctors were enrolled as subjects, rather than the general population.