Author(s): BORGHI, S., BIZZOZERO, S., IMPERIALI, L., BANFI, G., VITALE, J.A., Institution: IRCCS OSPEDALE GALEAZZI-SANT'AMBROGIO, Country: ITALY, Abstract-ID: 1269

INTRODUCTION:
Sleep plays a crucial role in sustaining optimal physical and cognitive performance. Despite the demanding nature of surgical practice, sleep patterns and their potential impact on performance have been poorly investigated in surgeons, particularly in orthopaedic specialists. The primary aim of this study was to characterize the habitual sleep of a cohort of orthopaedic surgeons. The secondary aim was to evaluate changes in physical and cognitive performance following an early-morning surgical procedure in which participants served as first surgeons.
METHODS:
Fifteen orthopaedic surgeons were recruited. Sleep was assessed under habitual conditions for a minimum of seven nights per participant, yielding a total of 186 nights. Sleep was monitored using actigraphy (MotionWatch 8, CamNTech) and sleep diaries. Pre- (T0) and post- (T1) early-morning surgery assessments included: handgrip strength test (K-grip, Kinvent), Stroop test (reaction time and accuracy), and maximal isometric knee extensor strength using a digital dynamometer (K-push, Kinvent). Subjective sleepiness and perceived exertion were evaluated using the Karolinska Sleepiness Scale and the Borg CR-10 scale. All early‑morning surgical procedures, in which participants acted as first operators, began at approximately 7:30 a.m.
RESULTS:
Across the 186 monitored nights, 139 nights showed short sleep duration (<7 hours), and 15 nights showed poor sleep efficiency (<85%). Eleven of the fifteen surgeons were classified as short sleepers (total sleep time < 7 hours), and one as a poor sleeper (sleep efficiency < 85%). Regarding differences between T0 and T1 assessments (mean surgery duration: 108.8 minutes), paired t-tests revealed a significant decrease in dominant upper limb isometric strength (pre: 47.16 ± 9.46 kg; post: 45.83 ± 9.04 kg; p < 0.001). No significant differences emerged in knee extensor strength, Stroop reaction time and accuracy, sleepiness and perceived exertion.
CONCLUSION:
Adequate sleep is essential for maintaining optimal physical and cognitive functioning. In the analysed sample, sleep duration was below recommended guidelines in 11 out of 15 orthopaedic surgeons. While a single early-morning surgical procedure did not impair cognitive reaction or decision-making performance, it was associated with a significant reduction in dominant upper limb strength. These findings highlight an important and understudied issue, underscoring the need for further research on sleep and performance in the surgeon population.