Sleep Loss and Fatigue in Residency Training

Abstract

ONG WORK HOURS ARE A TIMEhonored tradition in most residency programs. Demanding schedules are often said to be necessary for learning and development of professionalism. The use of resident physicians to provide relatively inexpensive coverage has also become an important economical factor for teaching hospitals within the United States. Recent studies of the negative effects of sleep loss and fatigue, however, call this model into question. Any consideration of the impact of sleep loss and fatigue on medical training and patient care should be based on relevant data. In this article, we concentrate on 3 questions. First, is the quality of patient care jeopardized when residents are deprived of sleep? Second, is the well-being of residents at risk when they have not had adequate sleep? Third, what strategies are effective for overcoming the negative effects of sleep loss? We answer these questions by summarizing data on the effects of sleepiness and fatigue on cognitive function, the impact of sleep loss on residents' performance and health, and the effectiveness of countermeasures for sleep loss. REGULATION OF SLEEP AND ALERTNESS Sleep and wakefulness are highly regulated states of brain activity and behavioral responsiveness, governed

Night duty and decreased brain activity of medical residents: a wearable optical topography study

“…The total number of available residents was 40 residents. However, we eliminated N residents who did not meet the following inclusion criteria: (1) engaged in inpatient treatment for at least one month and (2) performed night duty at least twice. Exclusion criteria were (1) a history of sleep disorder or serious comorbid illness (i.e., diabetes, epilepsy); (2) current use of prescription sedative or stimulant; (3) not engaged in at least three night duty shifts during a 30-day period; and (4) right-handedness.…”

“…However, most residents are subject to considerable psychological stress, fatigue, and sleep deprivation, which has a major impact on all aspects of their lives, including detrimental effects on learning and clinical performance [1]. Numerous studies have linked fatigue and sleep deprivation of resident physicians to poor performance in neurobehavioral testing, lack of motivation, and attentional failure [2,3]. Disturbed sleep not only reduces the quality of life, but also deteriorates the psychological well-being of resident physicians [4].…”

Perceived sleepiness in Canadian anesthesia residents: a national survey

“…[1][2][3][4][5][6][7] This heightened attention has been driven by a growing body of literature on the deleterious effects of sleep deprivation on residents' wellbeing and performance. 2,3,[7][8][9][10] Studies have identified many domains affected by fatigue, including professionalism, learning, errors, and completion of complex cognitive tasks.…”

Estilo de vida e formação médica: impacto sobre o perfil nutricional

“…Entre os EM e MR, a privação do sono atinge status de condição cotidiana. As perturbações na dinâmica do sono podem expor estes indivíduos a diversos transtornos, entre eles: alterações cognitivas [43][44] ; dificuldade de aprendizado e de memorização e falta de motivação 45 ; e, com freqüência, causam irritabilidade, ansiedade e depressão 7,46 . Mais recentemente, estudos têm salientado a importância do sono no controle da massa corporal e na liberação de hormônios que atuam no controle da ingestão alimentar [47][48][49][50][51] , aspectos ainda não investigados entre EM ou MR.…”

“…O excesso de atividades acadêmicas na universidade e durante o aperfeiçoamento profissional na residência pode influenciar de forma negativa o estilo de vida de estudantes de Medicina (EM) e médicos residentes(MR) [2][3][4][5][6][7][8][9][10][11] . De maneira especial, destacam-se as consequências deletérias desta rotina sobre o comportamento alimentar, o nível de atividade física e o padrão de sono.…”