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Effect of reducing interns' weekly work hours on sleep and attentional failures.

Authors
Lockley-SW; Cronin-JW; Evans-EE; Cade-BE; Lee-CJ; Landrigan-CP; Rothschild-JM; Katz-JT; Lilly-CM; Stone-PH; Czeisler-CA
Source
N Engl J Med 2004 Oct; 351(18):1829-1837
NIOSHTIC No.
20025825
Abstract
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.
Keywords
Shift-work; Shift-workers; Health-care-personnel; Statistical-analysis; Surveillance-programs; Medical-personnel; Sleep-deprivation
Contact
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
CODEN
NEJMAG
Publication Date
20041028
Document Type
Journal Article
Email Address
caczeisler@hms.harvard.edu
Funding Type
Grant
Fiscal Year
2005
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-007567
Issue of Publication
18
ISSN
0028-4793
Source Name
New England Journal of Medicine
State
MA
Performing Organization
Brigham and Women's Hospital
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