Brief (<4 hr) sleep episodes are insufficient for restoring performance in first-year resident physicians working overnight extended-duration work shifts

Sleep
Melissa A St HilaireHarvard Work Hours Health and Safety Group

Abstract

The Accreditation Council for Graduate Medical Education (ACGME) recently reinstated extended-duration (24-28 hr) work shifts (EDWS) for postgraduate year 1 (PGY-1) resident physicians. This study examined the relationship between overnight sleep duration during EDWS and subsequent "post-call" performance in PGY-1 resident physicians. Thirty-four PGY-1 resident physicians (23 males; 24-32 years) were studied between 2002 and 2004 during 3-week Q3 "on-call" rotation schedules in the Medical and Cardiac Intensive Care Units at Brigham and Women's Hospital in Boston. Daily sleep logs (validated by ambulatory polysomnography) were collected and the 10 min psychomotor vigilance task (PVT) was administered every ~6 hr during each EDWS. Generalized estimating equations were used to examine the relationship between overnight sleep duration and PVT performance "post-call" (0500-1900 hr). Postcall performance during EDWS was compared with sessions matched for time-of-day and weeks-into-schedule in the same resident physician during an intervention schedule that eliminated EDWS. Resident physicians obtained an average of 1.6 ± 1.5 hr cumulative sleep overnight during EDWS (<4 hr on 92% of nights). PVT attentional failures were significant...Continue Reading

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Citations

Jun 6, 2020·Journal of Pediatric Orthopedics·Vishwas R Talwalkar, Jennifer Weiss
Jun 10, 2020·Journal of Sleep Research·Andrea BallesioCristiano Violani
Jan 31, 2021·American Journal of Obstetrics and Gynecology·Fokkedien H M P TummersUNKNOWN Fit to Perform collaborators
Feb 24, 2021·Pediatrics·Shadab A RahmanUNKNOWN ROSTERS STUDY GROUP

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