This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Social Bookmarking   What's this?

Timothy F. Deaconson, MD; Daniel P. O'Hair, MD; Marlon F. Levy, MD; Martha B.-F. Lee, PhD; Arthur L. Schueneman, PhD; Robert E. Condon, MD

JAMA. 1988;260(12):1721-1727.

Abstract
Cognitive and complex motor performance may be impaired by extended sleep deprivation, but objective data concerning the effects in residents of the sleep deprivation engendered by usual hospital on-call schedules are scant and conflicting. We studied three cohorts of surgical residents (N = 26) who were on call every other night. Each resident kept a sleep diary, gave a self-assessment of motivation and fatigue, and underwent a battery of psychometric tests each morning for 18 or 19 days. The psychometric tests measured cognition, discernment, visual and auditory vigilance, and rapid eye-hand coordination. Sleep deprivation was defined as the lack of four hours of continuous sleep during the preceding 24 hours, and it occurred during 89% of the on-call nights. Daily testing in a repeated-measures design allowed each participant to serve as his or her own control. Sleep deprivation did not affect overall cognitive or motor performance. Further analysis of the correlation between sleep parameters (total sleep and longest uninterrupted sleep interval) and performance on each component of the psychometric test battery identified changes in performance on some tests but only trivial effects due to sleep. The assumption that sleep deprivation associated with usual on-call schedules impairs cognitive and motor performance of residents such that clinical care of patients may be compromised is not supported by our observations.

(JAMA 1988;260:1721-1727)

Author Affiliations
From the Departments of Surgery (Drs Deaconson, O'Hair, Levy, and Condon) and Biostatistics (Dr Lee), The Medical College of Wisconsin, Milwaukee, and the Department of Surgery, Loyola University Medical Center, Maywood, Ill (Dr Schueneman).

Footnotes
Reprint requests to Department of Surgery, The Medical College of Wisconsin, 8700 W Wisconsin Ave, Room 1014, Milwaukee, WI 53226 (Dr Condon).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Trucks, Planes, and Scalpels: Is There an Evidence-Based Approach to Surgeons' Working Hours?
Leff et al.
Arch Surg 2007;142:817-820.
FULL TEXT  

Orthopaedic In-Training Examination Scores: A Correlation with USMLE Results
Black et al.
JBJS 2006;88:671-676.
ABSTRACT | FULL TEXT  

Neurobehavioral Performance of Residents After Heavy Night Call vs After Alcohol Ingestion
Arnedt et al.
JAMA 2005;294:1025-1033.
ABSTRACT | FULL TEXT  

Acute Sleep Deprivation in the Thoracic Surgical Resident Does Not Affect Operative Outcomes
Ellman et al.
Ann. Thorac. Surg. 2005;80:60-65.
ABSTRACT | FULL TEXT  

Night Call Does Not Impair Learning of Laparoscopic Skills
DeMaria et al.
SURG INNOV 2005;12:145-149.
ABSTRACT  

Sleep deprivation does not affect operative results in cardiac surgery
Ellman et al.
Ann. Thorac. Surg. 2004;78:906-911.
ABSTRACT | FULL TEXT  

Sleep Loss and Fatigue in Residency Training: A Reappraisal
Veasey et al.
JAMA 2002;288:1116-1124.
ABSTRACT | FULL TEXT  

Effects of 2 Patterns of Prehospital Care on the Outcome of Patients With Severe Head Injury
Di Bartolomeo et al.
Arch Surg 2001;136:1293-1300.
ABSTRACT | FULL TEXT  

Moonlighting by Psychiatric Residents
Matthews et al.
Acad. Psychiatry 1998;22:170-180.
ABSTRACT | FULL TEXT  

Do Actions Reported by Physicians in Training Conflict With Consensus Guidelines on Ethics?
Green et al.
Arch Intern Med 1996;156:298-304.
ABSTRACT  

The Impact of a Regulation Restricting Medical House Staff Working Hours on the Quality of Patient Care
Laine et al.
JAMA 1993;269:374-378.
ABSTRACT  

Guidelines for Surgical Residents' Working Hours: Intent vs Reality
Schwartz et al.
Arch Surg 1992;127:778-783.
ABSTRACT  

Legislated Limits for Housestaff Training
Root and Nation
ANN INTERN MED 1992;116:694-696.
ABSTRACT  

Effects of a Night-Float System on Resident Activities and Parent Satisfaction
Lieu et al.
Arch Pediatr Adolesc Med 1992;146:307-310.
ABSTRACT  

Effect of a Change in House Staff Work Schedule on Resource Utilization and Patient Care
Gottlieb et al.
Arch Intern Med 1991;151:2065-2070.
ABSTRACT  

Resident Work Hours and Working Environment in Otolaryngology: Analysis of Daily Activity and Resident Perception
Strunk et al.
JAMA 1991;266:1371-1374.
ABSTRACT  

Late-Night Admissions: Resident Education and Sleep Patterns
Lieu et al.
JAMA 1990;264:2124-2124.
 

Residents' Views of the Value of Moonlighting
McCue et al.
Arch Intern Med 1990;150:1511-1513.
ABSTRACT  

Survey of Residents' Attitudes Toward Reform of Work Hours
Ruby et al.
Arch Surg 1990;125:764-768.
ABSTRACT  

Medication Prescribing Errors in a Teaching Hospital
Lesar et al.
JAMA 1990;263:2329-2334.
ABSTRACT  

Sleep Deprivation and Performance of Residents: The Power of the Study
Pascoe
JAMA 1989;262:775-775.
ABSTRACT  

Sleep Deprivation and Performance of Residents
McCall
JAMA 1989;261:859-859.
ABSTRACT  

The Ravelled Sleeve of Care: Managing the Stresses of Residency Training
Colford
JAMA 1989;261:889-893.
ABSTRACT  

Sleep Deprivation and Performance of Residents
Schwartz
JAMA 1989;261:859-859.
ABSTRACT  

Sleep Deprivation and Performance of Residents
Ritchie
JAMA 1989;261:859-860.
ABSTRACT  

SLEEP DEPRIVATION DOES NOT IMPAIR RESIDENTS' PERFORMANCE
JWatch General 1988;1988:5-5.
FULL TEXT