Monitoring Sleep, Wellbeing, and Glucose Metabolism in PGY1s

Monitoring Sleep, Wellbeing, and Glucose Metabolism in Postgraduate Year 1 Doctors on Traditional and Float Call Shifts

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.

Study Overview

• Status: Recruiting
• Conditions: Glucose Metabolism Disorders; Sleep
• Intervention / Treatment: Device: CGM; Device: Oura ring; Behavioral: Cognitive tasks and questionnaires

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 Type: Observational
• Enrollment (Anticipated): 80

Contacts and Locations

• Study Contact: Name: Stijn Agus Adrianus Massar, PhD; Phone Number: +65 66015238; Email: mdcsaam@nus.edu.sg

Study Locations

• Singapore
  • (No States Listed)
    • Singapore, (No States Listed), Singapore, 117597
      • Recruiting
      • National University of Singapore
      • Contact: Michael WL Chee, MBBS; Phone Number: +65 65164916; Email: michael.chee@nus.edu.sg
      • Contact: Alyssa Ng; Phone Number: +6584044909; Email: alyssa.ng@u.nus.edu

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 21 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

NUHS Postgraduate year 1 doctors

Description

Inclusion Criteria:

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

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.

Study Plan

How is the study designed?

Design Details

• Observational Models: Case-Control
• Time Perspectives: Prospective

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Traditional call; 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)	Device: CGM; Wearable continuous glucose monitoring systems (CGMS) provide a minimally invasive means of passively tracking ambulant interstitial fluid glucose levels in real time.; Device: Oura ring; Wearable sleep tracking device; Behavioral: Cognitive tasks and questionnaires; Participants will be prompted daily to fill out a short set of wellbeing questions and perform a short alertness test on their mobile phones and laptop.
Float call; In the night float system, residents work from 8 pm to 8 am for 5 - 7 consecutive nights once every month	Device: CGM; Wearable continuous glucose monitoring systems (CGMS) provide a minimally invasive means of passively tracking ambulant interstitial fluid glucose levels in real time.; Device: Oura ring; Wearable sleep tracking device; Behavioral: Cognitive tasks and questionnaires; Participants will be prompted daily to fill out a short set of wellbeing questions and perform a short alertness test on their mobile phones and laptop.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sleep	Sleep duration and timing will be measured	8 weeks
Glucose monitoring	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.	2 weeks
Wellbeing	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.	8 weeks
Alertness	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).	8 weeks

Collaborators and Investigators

• Sponsor: National University, Singapore

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2022
• Primary Completion (Anticipated): June 1, 2023
• Study Completion (Anticipated): June 1, 2023

Study Registration Dates

• First Submitted: December 27, 2022
• First Submitted That Met QC Criteria: January 13, 2023
• First Posted (Actual): January 23, 2023

Study Record Updates

• Last Update Posted (Actual): January 25, 2023
• Last Update Submitted That Met QC Criteria: January 22, 2023
• Last Verified: January 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Metabolic Diseases; Glucose Metabolism Disorders
• Other Study ID Numbers: NUHSsleepstudy

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: No

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No