Impact of 24-Hour On-Call Shifts on Headache in Medical Residents: A Cohort Study

Headache. 2020 Jul;60(7):1427-1431. doi: 10.1111/head.13861. Epub 2020 Jun 3.

Abstract

Background: During 24-hour on-call shifts medical residents are exposed to diverse circumstances such as sleep deprivation and stress.

Objective: Our aim is to assess the effect of 24-hour on-call shifts on medical residents' headache-related disability.

Methods: The Migraine Disability Assessment Scale (MIDAS), the Headache Impact Test (HIT-6), the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS) questionnaires were administered to medical residents who had never performed on-call shifts at baseline and 6 months after beginning 24-hour on-call shifts. Scores were compared.

Results: About 66 medical residents completed this study. About 21.2% (n = 14) had history of migraine, 42.4% (n = 28) had a history of tension-type headache (TTH) and 12.1% (n = 8) had a history of both migraine and TTH. Among medical residents with migraine, the median MIDAS score was significantly higher after starting 24-hour on-call shifts than at a baseline (4.0 vs 8.0; Wilcoxon, P = .001), meaning that, on average, disability increased from little or no disability, to moderate disability. No difference in HIT-6 scores was found. The median score of PSQI and HADS was higher at 6 months (PSQI: 7.0 vs 8.0; P = .003), (HADS: 5.0 vs 8.0; P < .001) for the general group.

Conclusions: In medical residents with migraine, migraine-related disability increased after starting 24-hour on-call shifts. We also found a worsening in depression and anxiety symptoms and self-reported sleep quality in medical residents with and without headache history.

Keywords: headache; migraine; shift-work; tension-type headache.

MeSH terms

  • Adult
  • Anxiety / etiology
  • Cohort Studies
  • Depression / etiology
  • Disabled Persons
  • Female
  • Humans
  • Internship and Residency* / statistics & numerical data
  • Male
  • Migraine Disorders / etiology*
  • Occupational Stress / complications*
  • Physicians* / statistics & numerical data
  • Shift Work Schedule / adverse effects*
  • Sleep Deprivation / complications*
  • Sleep Wake Disorders / etiology
  • Tension-Type Headache / etiology*
  • Time Factors
  • Young Adult