Biophysiological stress and sleep deprivation among abdominal transplant surgery fellows: A prospective multi-institutional study using a wearable device

Background: Transplant surgery fellowship is physically and emotionally demanding. The objective of this study was to characterize biophysiological stress and sleep patterns among transplant surgery fellows. Methods: Participating fellows wore a biophysical monitor over a 28-day period and completed biweekly surveys. Sleep patterns were dichotomized as normal or sleep deprived, and heart rate variability (HRV) was used to assess stress. Results: Seventeen fellows participated. Fellows were frequently sleep deprived (43.9% of nights) and stress was near universal (87.2% of days). Burnout was reported by 2 fellows (11.8%). Only 4 fellows (23.5%) reported compliance with the Transplant Accreditation and Certification Council managed time policy; these fellows experienced fewer days of stress than non-compliant fellows (79.8% vs 89.2% p = 0.02). Conclusions: This is the first study to quantify sleep deprivation and stress among transplant fellows. Future work is needed to evaluate the effects of sleep deprivation, and stress on burnout and patient outcomes.