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

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. [ABSTRACT FROM AUTHOR]