Power Naps Raise Doctors Performance Level

Protected sleep hours for medical residents increased overnight sleep duration and alertness the next morning, according to a new study.

Researchers at the Philadelphia VA Medical Center (Pennsylvania, USA) conducted a randomized controlled trial involving 106 interns and senior medical students to evaluate the feasibility and consequences of protected sleep periods during extended duty. Twelve 4-week blocks were randomly assigned to either a standard intern schedule or a protected five-hour sleep period with cell-phone sign out; participants were asked to wear wrist actigraphs and complete sleep diaries. The main outcome measures were hours slept during the protected period on extended duty overnight shifts.

The results showed that participants with protected sleep had a mean 2.86 hours of sleep versus 1.98 hours among those who did not have protected hours of sleep. The participants felt more alert and were less sleepy after on-call nights in the intervention group. The scheduled sleep group also had significantly better scores on psychomotor vigilance tests than those in the control group. The researchers found however, that the additional time for sleep did not translate into significantly improved outcomes for patients. The study was published on December 5, 2012, in the Journal of the American Medical Association (JAMA).

“In the past decade, the ACGME has twice modified duty hour standards for physicians in training, with these changes motivated by an interest in reducing fatigue among house staff, reducing the rate of medical errors, and improving quality of care,” concluded lead author Kevin Volpp, MD, PhD, and colleagues.

In 2011, the Accreditation Council for Graduate Medical Education requirements (ACGME; Chicago, IL, USA), which is responsible for the accreditation of post-MD medical training programs within the United States, implemented a rule that no longer allow residents to work shifts longer than 16 hours, although the current study was conducted prior to that rule.

Related Links:
Philadelphia VA Medical Center
Accreditation Council for Graduate Medical Education requirements