0212 The Indirect Effect of Sleep Quality on Emotional Exhaustion through Emotion Regulation Difficulties and Perceived Stress in a Sample of U.S. Medical Students

Abstract

Introduction: Burnout, conceptualized as emotional exhaustion, depersonalization, and reduced personal accomplishment, often results in personal and professional repercussions and occurs in approximately 53% of U.S. medical students. Given the recursive nature of burnout and sleep difficulties, it is hypothesized that sleep difficulties may be maintained through work related stressors. Evidence suggests that sleep and emotion regulation function bidirectionally. Likewise, perceived stress may concurrently incline, magnify, and sustain sleep difficulties in student populations. Therefore, the specific impacts of emotion regulation difficulties, perceived stress, and sleep quality on medical student burnout were investigated in this study. Method(s): Data were collected from 111 medical students at a large, allopathic medical school. Participants completed a battery of online questionnaires including the Difficulties in Emotion Regulation Scale, the Pittsburgh Sleep Quality Index, the Perceived Stress Scale, and the Oldenburg Burnout Inventory. Result(s): The results suggest an indirect effect of sleep quality on emotional exhaustion through the serial mediated pathway of emotion regulation difficulties to perceived stress (beta = .0780, LLCI = .0135, ULCI = .1482). Lastly, when controlling for both mediators, the direct effect of sleep quality on emotional exhaustion was no longer significant (beta = .2035, ULCI =-.0317, ULCI = .4386). Conclusion(s): The findings suggest that emotion regulation difficulties and perceived stress symptoms function as intermediary variables in the association between sleep quality and emotional exhaustion (burnout) in medical students. The current study proposes a temporal progression whereby a decrease in sleep quality results in diminished emotion regulation abilities which subsequently leads to an increase in perceived stress likely resulting in emotional exhaustion, burnout. Based on these findings, decreased sleep quality, which is a previously established feature of burnout, might also be perceived to maintain or worsen burnout (i.e., emotional exhaustion) through the mediated pathways of emotion regulation difficulties and perceived stress.