Impact of acute and chronic sleep restriction on PVT performance: a study of medical residents

Details

• Personal Author:
  Anderson C ; Cade BE ; Czeisler, Charles A. ; Flynn-Evans EE ; Lockley SW ; Sullivan JP
• Description:
  Introduction: Under controlled laboratory conditions, chronic sleep restriction of 3 to 6 hrs/night for 7-14 nights gradually degrades Psychomotor Vigilance Task (PVT) performance. Less is known about whether this accumulative decrement occurs outside the laboratory. US medical residents work 24- to 30-hr extended shifts twice per week, resulting in both acute and chronic sleep loss. Here, we address the impact of working repeated extended duration work shifts on PVT performance. Methods: Seventeen PGY-1 medicine residents (26-32y, 7F) worked 30-hour shifts twice per week in an intensive care unit (ICU) for three weeks, such that they worked at least six extended duration shifts; this followed 3 weeks of non-extended shifts. Subjects completed 10-min PVTs 3-6 times at regular intervals across each extended duration shift. Mean log reaction time (RT) and transformed lapses greater than 500ms (square root of vn+ square root of v(n+1)) were assessed for change over time (extended shifts block 1-6). Controlling for time of day, we assessed differences in performance at the start and end of each shift as a function of the number of extended shifts. Results: Mean RT and lapses worsened with increasing number of extended shifts (one-way repeated measures ANOVA, p<0.05, p<0.02, respectively), with post hoc comparisons showing performance to be worse during the last two extended shifts as compared to the first two (p<0.008). For overnight performance (23:00-08:00h), there was a significant effect of extended shift number for mean RT (p<0.05) but not lapses. For day-time performance (7:00h-14:00h), both mean RT and lapses showed a significant worsening with increasing number of extended shifts (p<0.009, p<0.003, respectively) and time on shift (p<0.002, p<0.0005, respectively). Conclusion: Residents working traditional on-call schedules exhibit poorer performance in the second half of each 24-30-hr extended shift as a result of acute sleep deprivation, and show a chronic deterioration in performance with increasing number of extended shifts. [Description provided by NIOSH]
• Subjects:
  Aging Circadian Rhythm Health Personnel Laboratories Men Occupational Health Safety Shift Work Schedule Sleep Sleep Initiation And Maintenance Disorders Women

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• Keywords:
  Age-groups Circadian-rhythms Health-care-personnel Humans Laboratory-testing Medical-personnel Psychomotor-function Shift-work Sleep-deprivation Sleep-disorders Statistical-analysis

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• ISSN:
  0161-8105
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Abstract or Summary
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  32
• NIOSHTIC Number:
  nn:20045320
• Citation:
  Sleep 2009 Jun; 32(Abstract Suppl):A160
• Federal Fiscal Year:
  2009
• Performing Organization:
  Brigham and Women's Hospital
• Peer Reviewed:
  False
• Start Date:
  20010930
• Source Full Name:
  Sleep
• Supplement:
  Abstract Supplement
• End Date:
  20060929
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:b1ad89d2f816317014a86878912158107a4df67044e26f426df2fa6b8d9a24fbb1dc28a471bb65aedb9a8c5af21f874cfc8b1758e8c37c5c5703fc5ff63fb6f9
• Download URL:
  https://stacks.cdc.gov/view/cdc/200779/cdc_200779_DS1.pdf
• File Type:
  [PDF - 545.79 KB ]