Effect of Reducing Interns’ Weekly Work Hours on Sleep and Attentional Failures

Details

• Personal Author:
  Cade BE ; Cronin JW ; Czeisler, Charles A. ; Evans EE ; Katz JT ; Landrigan CP ; Lee CJ ; Lilly CM ; Lockley SW ; Rothschild JM ; Stone PH
• Description:
  Background: Knowledge of the physiological effects of extended (24 hours or more) work shifts in postgraduate medical training is limited. We aimed to quantify work hours, sleep, and attentional failures among first-year residents (postgraduate year 1) during a traditional rotation schedule that included extended work shifts and during an intervention schedule that limited scheduled work hours to 16 or fewer consecutive hours. Methods: Twenty interns were studied during two three-week rotations in intensive care units, each during both the traditional and the intervention schedule. Subjects completed daily sleep logs that were validated with regular weekly episodes (72 to 96 hours) of continuous polysomnography (r=0.94) and work logs that were validated by means of direct observation by study staff (r=0.98). Results: Seventeen of 20 interns worked more than 80 hours per week during the traditional schedule (mean, 84.9; range, 74.2 to 92.1). All interns worked less than 80 hours per week during the intervention schedule (mean, 65.4; range, 57.6 to 76.3). On average, interns worked 19.5 hours per week less (P<0.001), slept 5.8 hours per week more (P<0.001), slept more in the 24 hours preceding each working hour (P<0.001), and had less than half the rate of attentional failures while working during on-call nights (P=0.02) on the intervention schedule as compared with the traditional schedule. Conclusions: Eliminating interns' extended work shifts in an intensive care unit significantly increased sleep and decreased attentional failures during night work hours. [Description provided by NIOSH]
• Subjects:
  Health Personnel Occupational Health Safety Shift Work Schedule Sleep Sleep Initiation And Maintenance Disorders
• Keywords:
  Health-care-personnel Medical-personnel Shift-work Shift-workers Sleep-deprivation Statistical-analysis Surveillance-programs
• ISSN:
  0028-4793
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  351
• Issue:
  18
• NIOSHTIC Number:
  nn:20025825
• Citation:
  N Engl J Med 2004 Oct; 351(18):1829-1837
• Contact Point Address:
  Dr. Czeisler at the Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 221 Longwood Ave., Boston, MA 02115
• Email:
  caczeisler@hms.harvard.edu
• Federal Fiscal Year:
  2005
• Performing Organization:
  Brigham and Women's Hospital
• Peer Reviewed:
  True
• Start Date:
  20010930
• Source Full Name:
  New England Journal of Medicine
• End Date:
  20060929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d925059a38d395952e5f8b85bb03cc570cc77e452066fb8490bc1d1e4c237d2ba6b1861f61ee4df8a25e96a1c9f52cc8c596d5a969f5a2e1285cd748e8beb4a3
• Download URL:
  https://stacks.cdc.gov/view/cdc/197041/cdc_197041_DS1.pdf
• File Type:
  [PDF - 109.80 KB ]