Monitoring Sleep, Wellbeing, and Glucose Metabolism in PGY1s

Recruiting

• Conditions: Sleep; Glucose Metabolism Disorders
• Interventions: Device: CGM; Device: Oura ring; Behavioral: Cognitive tasks and questionnaires

• Registration Number: NCT05695235
• Lead Sponsor: National University of Singapore

Brief Summary

Overnight on-call schedules can impact sleep, wellbeing, and alertness, which can be detrimental on the performance, physical and mental health of residents. Moreover, rotating shift work may have a long-term negative health impact (e.g. increased risk of diabetes). Within the National University Hospital (NUH), two different systems of rotating on-call schedules are implemented. In the night float system, residents work from 8 pm to 8 am for 5 - 7 consecutive nights once every month, compared to the traditional overnight on-call system, where each resident is on call for 4-6 nights per month (7 am - 5 pm, followed by overnight call until 8 am the next morning). The aim of the current study is to track sleep, wellbeing, and glucose metabolism during the different phases of the night float and traditional on-call schedules.

Detailed Description

Overnight on-call schedules can impact sleep, wellbeing, and alertness, which can be detrimental on the performance, physical and mental health of residents. Moreover, rotating shift work may have a long-term negative health impact (e.g. increased risk of diabetes). Within the National University Hospital (NUH), two different systems of rotating on-call schedules are implemented. In the night float system, residents work from 8 pm to 8 am for 5 - 7 consecutive nights once every month, compared to the traditional overnight on-call system, where each resident is on call for 4-6 nights per month (7 am - 5 pm, followed by overnight call until 8 am the next morning). The aim of the current study is to track sleep, wellbeing, and glucose metabolism during the different phases of the night float and traditional on-call schedules.

The availability of accurate mobile methodologies to monitor sleep and metabolic health provide new avenues for the improvement of sleep health and well-being. Wearable sleep tracking devices and smartphone apps provide remarkable opportunities for non-invasive, longitudinal sleep detection. Measurement of sleep during different stages of the shift schedule (baseline, on-call, recovery) can provide detailed insights into the temporal impact of the different schedules. Moreover, self-reported ratings of sleep quality, wellbeing, and time-use (delivered through phone-based e-diary methods) can further detail the mental health impact associated with these schedules.

Wearable continuous glucose monitoring systems (CGMS) provide a minimally invasive means of passively tracking ambulant interstitial fluid glucose levels in real time.

Study Timeline

• Study Start: 2022-01-01
• Study First Submitted: 2022-12-27
• Status Verified: 2023-01
• Study First Submitted QC: 2023-01-13
• Last Update Submitted: 2023-01-22
• Study First Posted: 2023-01-23
• Last Update Posted: 2023-01-25
• Primary Completion: 2023-06
• Study Completion: 2023-06

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 80

Inclusion Criteria

• NUHS Postgraduate year 1 doctors
• Above 21 years of age
• Completing their year 1 rotations in 2021 or 2022

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Exclusion Criteria

• As this is an observational study with minimal risk, in an restricted pool of participants, no further exclusion criteria will be applied for participation.

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Float call	Cognitive tasks and questionnaires	In the night float system, residents work from 8 pm to 8 am for 5 - 7 consecutive nights once every month
Float call	CGM	In the night float system, residents work from 8 pm to 8 am for 5 - 7 consecutive nights once every month
Traditional call	Oura ring	In the traditional overnight on-call system, each resident is on call for 4-6 nights per month (7 am - 5 pm, followed by overnight call until 8 am the next morning)
Traditional call	CGM	In the traditional overnight on-call system, each resident is on call for 4-6 nights per month (7 am - 5 pm, followed by overnight call until 8 am the next morning)
Traditional call	Cognitive tasks and questionnaires	In the traditional overnight on-call system, each resident is on call for 4-6 nights per month (7 am - 5 pm, followed by overnight call until 8 am the next morning)
Float call	Oura ring	In the night float system, residents work from 8 pm to 8 am for 5 - 7 consecutive nights once every month

Primary Outcome Measures

Name	Time	Method
Wellbeing	8 weeks	Participants will complete a daily micro questionnaire delivered through a mobile phone-based application. The investigators will examine mood ratings and stress ratings. Participants will be asked to respond to questions such as "How are you feeling right now?", rating their response from 'Negative' to 'Positive' on a 100-points sliding bar, "How stressed are you feeling right now?", rating their response from 'Not at all stressed' to 'Very stressed' on a 100-points sliding bar.
Alertness	8 weeks	Participants will complete a daily set of cognitive games, delivered through a mobile phone-based application. The outcome measure from the games is a 3-min psychomotor vigilance task measuring sustained attention. Specifically, the investigators examine median reaction time and lapses (reaction time \> 500ms).
Sleep	8 weeks	Sleep duration and timing will be measured
Glucose monitoring	2 weeks	Blood glucose will be recorded using a wearable continuous glucose monitoring sensor (CGM: FreeStyle Libre Pro iQ by Abbott). CGM period will be individually scheduled to coincide with at least one cycle of day shift-night shift- recovery for each participant.

Trial Locations

Locations (1)

National University of Singapore; 🇸🇬 Singapore, (No States Listed), Singapore