Examining How Gender, Race/Ethnicity, and Clinical Roles Moderate the Association Between Sleep and Burnout.

Abstract

Objectives: Sleep disturbance and burnout are common in emergency department health care workers (HCWs), and the 2 are linked. This cross-sectional study evaluated whether gender, race/ethnicity, and clinical roles moderate the association between sleep quality and burnout among emergency department HCWs (N = 129).

Methods: Sleep was assessed with the Pittsburgh Sleep Quality Index (Pittsburgh Sleep Quality Index > 5: poor sleep) and Insomnia Severity Index (Insomnia Severity Index > 8: insomnia). The abbreviated Maslach Burnout Inventory-9 assessed the burnout dimensions of emotional exhaustion, depersonalization , and reduced personal accomplishment . Emotional exhaustion > 9 and either (or both) depersonalization > 6 or personal accomplishment < 9 indicated burnout. Logistic regressions were computed for the association of poor sleep and insomnia with burnout for gender, race/ethnicity, and job role separately.

Results: Poor sleep quality, insomnia, and burnout were seen in 64%, 59%, and 24% of participants, respectively. Poor sleep was more frequently reported in Black, Indigenous, and People of Color (BIPOC) HCWs vs non-BIPOC (72.9% vs 52.5%, P = .017). Overall, poor (vs not poor) sleep quality was associated with burnout (odds ratio [OR], 3.14; 95% CI, 1.14-8.64). There was a significant poor sleep-burnout relationship in women (OR, 4.52; 95% CI, 1.10-18.60) that was not seen in men. The poor sleep-burnout relationship was significantly stronger in attending physicians (OR, 6.92; 95% CI, 1.44-33.24) vs registered nurses (OR, 0.28; 95% CI, 0.03-2.30; P value for group ∗ predictor interaction term = .021).

Conclusion: BIPOC HCWs had worse sleep quality than non-BIPOC HCWs, and the relationship between sleep quality and burnout was affected by gender and clinical role. These findings highlight the importance of person-level factors in the sleep-burnout relationship in HCWs.