Sleep Patterns of Resident Physicians and the Effect of Heartfulness Meditation

Main Goal and Fundamental Concept:

The primary objective of this study was to assess the sleep patterns of internal medicine residents and evaluate the impact of a structured Heartfulness meditation program on improving their sleep quality. The core hypothesis posited that incorporating Heartfulness meditation could enhance both subjective and objective sleep parameters among resident physicians, a group often subjected to sleep disturbances due to demanding work schedules.

Technical Approach:

The researchers conducted a pre–post cohort study involving 36 internal medicine residents from January to April 2019. The study design included:

Baseline Assessment: During a one-week outpatient rotation, participants' sleep was monitored using two validated tools:

• Consensus Sleep Diary (CSD): Captured subjective sleep parameters.
• Actigraphy: Provided objective measurements of sleep patterns.

Intervention: After a four-week interval, during which residents returned to the same rotation, they engaged in a structured Heartfulness meditation program.

Post-Intervention Assessment: The same sleep parameters were measured using CSD and actigraphy.

Feedback Collection: An anonymous qualitative survey was administered at the end of the study to assess the feasibility and acceptability of the meditation intervention.

Distinctive Features:

• Objective and Subjective Measures: The study uniquely combined both subjective (CSD) and objective (actigraphy) tools to assess sleep, providing a comprehensive evaluation.
• Specific Population Focus: Targeted internal medicine residents, a group particularly vulnerable to sleep disturbances, thus addressing a critical gap in existing research.
• Structured Meditation Program: Implemented a specific form of meditation (Heartfulness), offering insights into its applicability and benefits in a high-stress medical training environment.

Experimental Setup and Results:

Participants: 36 residents participated; 34 (94.4%) completed both pre- and post-intervention assessments.

Key Findings:

• Sleep Onset Time: Decreased from 21.03 to 14.84 minutes (CSD) and from 20.9 to 14.5 minutes (actigraphy), indicating faster sleep initiation.
• Sleep Quality and Restfulness Scores: Improved significantly, with CSD scores increasing from 3.32 to 3.89 and 3.08 to 3.54, respectively.
• Sleep Efficiency: Enhanced from 83.5% to 85.6% as per actigraphy data.
• Sleep Fragmentation and Awakenings: Fragmentation index reduced from 6.16 to 5.46, and the number of awakenings decreased from 41.71 to 36.37.

These results suggest that the Heartfulness meditation program positively influenced various aspects of sleep among the participants.

Advantages and Limitations:

Advantages:

• Feasibility: Demonstrated that a structured meditation program can be integrated into the demanding schedules of medical residents.
• Comprehensive Assessment: Utilized both subjective and objective tools, strengthening the validity of findings.

Limitations:

• Sample Size: The relatively small cohort limits the generalizability of the results.
• Study Design: Absence of a control group restricts the ability to attribute improvements solely to the meditation intervention.
• Short-Term Assessment: The study evaluated immediate effects; long-term benefits remain unexamined.

Conclusion:

The study indicates that incorporating a structured Heartfulness meditation program is both feasible and beneficial in improving sleep parameters among internal medicine residents. The significant enhancements in sleep onset time, quality, and efficiency underscore the potential of meditation as a non-pharmacological intervention for sleep disturbances in high-stress medical environments. However, further research with larger, randomized controlled trials is warranted to substantiate these findings and explore long-term impacts.