Wakefulness on Demand: The Use of Sleep Aids and Stimulants among Emergency Physicians in Saudi Arabia

Background: Emergency medicine (EM) physicians often work irregular shifts that can disrupt their circadian rhythms, leading to sleep deprivation. The use of sleep aids and stimulants to mitigate these effects is a growing concern. Yet limited data exist on the extent of and factors influencing their use among EM physicians, particularly in Saudi Arabia. Objective: This study aimed to describe the prevalence and types of pharmacological and non-pharmacological sleep aids and stimulants used by EM physicians in Saudi Arabia, explore the factors influencing their usage, and assess their impact on sleep quality and patient care. Methods: A cross-sectional, web-based survey was conducted among 198 EM physicians working in various hospitals across Saudi Arabia. The survey, developed by a certified sleep medicine physician, collected data on demographics, sleep patterns, the use of sleep aids and stimulants, and their perceived impact on patient care. The calculated target sample size was 375, with a 95% confidence level and a 4% margin of error. Results: Of the respondents, 53% reported using pharmacological sleep aids, with antihistamines being the most commonly used (64.8%). Non-pharmacological aids, such as watching television and reading, were used by 77.8% of participants. A significant correlation was found between the use of sleep aids and the presence of insomnia (P ≤ 0.0001), as well as the belief that shift work negatively affects sleep (P ≤ 0.0001). Additionally, 86.4% of participants used stimulants to maintain wakefulness, with caffeine being the most common stimulant (97%). Despite these high rates of sleep aid and stimulant use, only 9.5% of participants felt that sleep aids negatively affected patient care, and 5.5% expressed concern about stimulants impacting care quality. Conclusion: The use of sleep aids and stimulants among EM physicians in Saudi Arabia is prevalent, reflecting international trends. While insomnia and shift work-related sleep disruption were strongly linked to the use of these substances, demographic factors such as age, gender, and experience did not show significant correlations. The potential health risks of these practices and their impact on patient care warrant further investigation, and strategies to improve sleep hygiene and work schedules should be considered to mitigate the adverse effects of shift work.