Cardiac Autonomic Modulation during on-Call Duty under Working Hours Restriction

Abstract

Background: Medical residency is a time of high stress and long working hours, which increase the risk of cardiovascular disease. This study aimed to investigate the autonomic modulation of resident physicians throughout the on-call duty cycle. Methods: Spectral analysis of heart rate variability (HRV) was used to compute cardiac parasympathetic modulation (high-frequency power, HF) and cardiac sympathetic modulation (normalized low-frequency power, LF%, and the ratio of LF and HF, LF/HF) of 18 residents for a consecutive 4-day cycle. Results: Male residents show reduced cardiac sympathetic modulation (i.e., higher LF/HF and LF%) than the female interns. Medical residents' cardiac parasympathetic modulation (i.e., HF) significantly increased on the first and the second post-call day compared with the pre-call day. In contrast, LF% was significantly decreased on the first and the second post-call day compared with the pre-call day. Similarly, LF/HF was significantly decreased on the second post-call day compared with the pre-call day. LF/HF significantly decreased on the first post-call day and on the second post-call day from on-call duty. Conclusion: The guideline that limits workweeks to 80 h and shifts to 28 h resulted in reduced sympathetic modulation and increased parasympathetic modulation during the two days following on-call duty.

Investigation of the Role of Anxiety and Depression on the Formation of Phantom Vibration and Ringing Syndrome Caused by Working Stress during Medical Internship

“…A more objective method is necessary for mechanism investigation. For example, the well-validated neurophysiological measurements of autonomic modulation, such as heart rate variability [23][24][25][26], may also make it possible to evaluate the role of HPA axis in the formation of these hallucinations. Moreover, our study participants were all medical interns, which limited the generalizability of our findings.…”

“…Finally, we estimated work hours through the official schedule of the hospital but did not measure the actual work hours of each participant. Quantifying the stressors during the internship, such as using the mobile app to automatically record medical interns' work hours real-time [26,27], could strengthen our understanding of the relationship between stress and these hallucinations.…”

Subjective well-being and month-long LF/HF ratio among deskworkers

“…If the R-R interval exceeded the mean value ± 3 SD, the interval was considered erroneous or nonstationary and was rejected [ 46 ]. HRV analyses in frequency domain are performed through spectral decomposition of the R-R interval signal using fast Fourier transform methods and then decomposed into the following frequency components in absolute power values (ms 2 ): LF: 0.04–0.15 Hz, and HF: 0.15–0.4 Hz [ 28 , 46 , 47 ]. The LF and HF were estimated every 5 min, and the LF/HF ratio was calculated by dividing the power of the LF and HF bands [ 46 ].…”

Respuesta Autonómica de estrés en estudiantes de Doctorado

“…En el caso de estudiantes del área médica se ha mostrado que prevalecen patologías asociadas al estrés, en residentes de postgrado de medicina en situaciones de cirugía real (Quick et al, 2019;Chien, Chen, Lin, Lin & Lin, 2020). En este colectivo médico también se ha evaluado la prevalencia de síntomas de depresión, ansiedad y agotamiento en la práctica, planteando la necesidad de establecer controles desde los estudios de pre y postgrado (Fond et al, 2019).…”