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High risk, low rest

A new framework for monitoring sleep vulnerability in emergency medicine

Bibliographic Data

ID22087956
AuthorsLaura Schmidt (0000-0001-8068-5609), Laura S Schmidt (0000-0001-8526-5662, Lyon 1 Université, corresponding author), Marion Trousselard (0000-0003-0592-4547, Interdisciplinarité en Santé Publique Interventions et Instruments de mesure complexes – Région Est), Clément Perez (Hospices Civils de Lyon), Eve Reynaud (0000-0002-7798-8366, Lyon 1 Université), Bérénice Valero (Centre Léon Bérard), Sophie Schlatter (0000-0003-0769-1521, Lyon 1 Université), Karim Tazarourte (0000-0002-3376-1258, Lyon 1 Université), Marion Douplat (0000-0003-1592-4065, Lyon 1 Université), Stéphanie Mazza (0000-0002-2750-1118, Lyon 1 Université)
Year2025
Volume13
Pages1679296-1679296
Publication date2025-10-31
Open AccessYes
TypeARTICLE
VenueFrontiers in Public Health (JOURNAL)
Journal identifiersISSN: 2296-2565 • E-ISSN: 2296-2565
PublisherFrontiers Media SA (PUBLISHER • CH)
DOI10.3389/fpubh.2025.1679296
PMID41246078
OpenAlexW4415723504
LanguageEN
Citations received1
References cited59

Background Shift work in emergency care settings disrupts circadian rhythms and sleep, increasing health risks and performance. A key aspect of addressing these challenges lies in predicting the burden of shift work to develop safer schedules. This study introduces the Shift Load Index (SLI) as an advanced and sensitive metric for quantifying recovery constraints and examined its association with objective sleep outcomes in emergency healthcare professionals. Methods A two-phase observational field study was conducted with 72 nurses and physicians from two French emergency departments. In the theoretical validation phase, 140 work shifts were analyzed using the SLI and compared to validated FAID Quantum fatigue scores. In the behavioral validation phase, weekly actigraphy data from 35 participants were analysed to assess time in bed, total sleep time, and Sleep Regularity Index (SRI). We employed generalized linear mixed-effects models to assess the association of SLI with sleep outcomes. Results SLI scores significantly predicted FAID Quantum scores (all p < 0.001). Emergency healthcare professionals obtained on average 6h 09 min of sleep for 8h09min in bed, with irregular sleep patterns (mean SRI = 52%). Higher SLI scores were associated with reduced time in bed ( β = −33.19, p < 0.001), shorter sleep ( β = −18.30, p < 0.001), and lower SRI ( β = −1.06, p < 0.001). SRI and total sleep time, as independent factors, together explained 48% of SLI variance (including random effects, 18% by fixed effects only). Discussion Higher shift load is associated with both reduced sleep quantity and regularity. The SLI provides a useful tool to assess recovery burden, with potential applications in optimizing shift schedules and informing fatigue risk management strategies for emergency healthcare professionals

Health care · MEDLINE · Risk management · Shift work · Occupational Health and Performance · Sleep and related disorders · Sleep and Work-Related Fatigue

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Citations per year1
Citation span2026 - 2026 (1)
Highly citedNo

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