Assessment of Sleep Features, Mental Health Outcomes, and Alcohol and Tobacco Consumption in Residents and Fellows in Otolaryngology Before and During the COVID-19 Pandemic

Abstract

The workload of many residents and fellows in otolaryngology-head and neck surgery has particularly increased during the COVID-19 pandemic; however, outcomes associated with mental health status and sleep remain unclear.OBJECTIVE To assess the sleep, mental status, and alcohol and tobacco consumption habits of residents and fellows before the COVID-19 pandemic (before March 10, 2020) and during the pandemic period (after March 10, 2020). DESIGN, SETTING, AND PARTICIPANTSThis cohort study included residents and fellows of 6 university hospitals of European regions with a high prevalence of COVID-19 cases. Survey development, data collection, and analyses were performed from March 10, 2020, to June 30, 2021. MAIN OUTCOMES AND MEASURES Residents and fellows were invited to respond to a survey assessing management of treatment in patients with COVID-19 and related work features; stress and mental health status (Beck Depression Inventory); sleep features (Insomnia Severity Index); and alcohol and tobacco consumption. RESULTS Of 220 potential participants, 128 residents and fellows (58.2%) completed the evaluations. No demographic data on mean (SD) age and sex or gender were collected. The prepandemic mean (SD) score of the Beck Depression Inventory (3.1 [2.8]) significantly increased after the start of the pandemic (mean [SD] score, 4.2 [4.1]; difference, -1.1; 95% CI, −1.96 to −0.24; d = 0.31), and the prepandemic mean (SD) score of the Insomnia Severity Index (4.9 [4.1) significantly increased after the start of the pandemic (mean [SD] score, 6.0 [4.9]; difference, 1.1; 95% CI, 0.00-2.2; d = 0.25). Insomnia concerned 46% of participants (51 of 112), and depression concerned 47% of participants (55 of 116) during the pandemic. The mean (SD) prepandemic alcohol consumption (1.7 [2.3] IU per week) significantly increased after the start of the pandemic (mean [SD], 2.9 [4.0] IU per week; difference, 1.2; 95% CI, 0.40-2.00; d = 0.37). Residents and fellows who were mobilized in COVID-19 units reported significant increases of workload (r = 0.2; 95% CI, 0.1-0.3), stress level (r = 0.2; 95% CI, 0.1-0.3), and alcohol consumption (for 5-10 IU per week: mean [SD] prepandemic, 11 [8] IU per week vs postpandemic, 20 [16] IU per week; d = 0.37) and a worsening of sleep status (for moderate insomnia: mean [SD] prepandemic Insomnia Severity Index, 4 [3] vs postpandemic, 15 [12]; d = 0.25). There was a significant association between alcohol consumption and the Beck Depression Inventory score (r = 0.4; 95% CI, 0.2-0.6). The mean (SD) consumption of tobacco decreased from 2.1 (1.3) to 0.9 (1.5) (difference, -1.20; 95% CI, −1.50 to −0.85; d = 0.85). CONCLUSIONS AND RELEVANCEResults of this cohort study suggest that the workload of residents and fellows increased during the pandemic, which may be associated with a worsening of mental health and sleep status and an increase of alcohol consumption.

The Early-Childhood Hearing Screening Program in a Low-Income Setting—Reply

“…To the Editor We were pleased to read the recent article by Chebib et al 1 The effects of COVID-19 on resident physician training are not yet fully understood and present a wide range of effects, from issues in educational objectives to mental distress. There is some evidence pointing out that younger and less experienced health professionals, such as resident physicians, are more prone to suffer mental distress when facing unforeseen situations, such as the COVID-19 pandemic.…”

“…In fact, being a resident seems to be a risk factor for substance misuse, 4 as well as having a heavy workload. 1 Both substance misuse and mental distress in health care workers are associated with suboptimal patient care.…”

“…In Reply We thank Drs Zhang and Wang for their interest and commentary on our article. 1 They have raised some important points. As you mentioned, in this protocol, children who passed the 2-tiered hearing screening did not proceed with formal audiologic evaluation to determine the true sensitivity and specificity of the hearing screening against this gold standard.…”

iSleepFirst: burnout, fatigue, and wearable-tracked sleep deprivation among residents staffing the medical intensive care unit

“…Burnout can threaten care quality, patient safety, and has had detrimental effects on the healthcare system [ 4 , 5 ]. Resident burnout increased during COVID-19 with up to 45% of residents self-reporting poor sleep quality, increased workload, and sleep deprivation during the pandemic [ 1 , 2 , 6 , 7 ]. As many as half of physicians had a self-reported sleep disorder or excessive sleepiness during this time [ 6 , 8 ].…”

Psychological Issues and Alcohol Consumption in Resident and Fellow Physicians in Otolaryngology Before and During the COVID-19 Pandemic

“…The increase in workload during the pandemic reported by Chebib et al also should be an alarming sign of a poor experience for resident physicians in terms of learning. This rise probably was not owing to their usual otolaryngology–head and neck surgery activities, and recent evidence has shown that increased workload is associated with impaired learning in resident physicians, independent of the training area.…”