This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (108)  • Contact me when this article is cited  Related Content  • Similar articles in JAMA  Topic Collections  • Quality of Care, Other  • Alert me on articles by topic

A Reappraisal

Sigrid Veasey, MD; Raymond Rosen, PhD; Barbara Barzansky, PhD; Ilene Rosen, MD; Judith Owens, MD, MPH

JAMA. 2002;288:1116-1124.

Reduced sleep time is commonplace for many interns and residents. Recent studies, however, suggest that sleep loss and fatigue result in significant neurobehavioral impairments in healthy young adults. We reviewed studies addressing the effects of sleep loss on cognition, performance, and health in surgical and nonsurgical residents. We describe the effectiveness of countermeasures for sleepiness, including recent work-hour restrictions. A more complete understanding of the issues of sleep loss during residency training can inform innovative strategies to minimize the effects of sleepiness and fatigue on patient care and resident safety.

Author Affiliations: University of Pennsylvania School of Medicine, Philadelphia (Drs Veasey and I. Rosen); University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, New Brunswick (Dr R. Rosen); American Medical Association, Chicago, Ill (Dr Barzansky); and Brown University School of Medicine, Providence, RI (Dr Owens).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Recent Accreditation Council for Graduate Medical Education Initiatives Have Not Been Shown to Improve the Education of Cardiology Fellows
Bashore and Wang
Circulation 2008;118:532-537.
FULL TEXT  

Development of a Five-Dimensional Measure of Adult Sleep Quality
Fortunato et al.
Educational and Psychological Measurement 2008;68:488-514.
ABSTRACT  

Work patterns and fatigue-related risk among junior doctors
Gander et al.
Occup. Environ. Med. 2007;64:733-738.
ABSTRACT | FULL TEXT  

Improving Sleep Hygiene of Medical Interns: Can the Sleep, Alertness, and Fatigue Education in Residency Program Help?
Arora et al.
Arch Intern Med 2007;167:1738-1744.
ABSTRACT | FULL TEXT  

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  

Impact of the 80-Hour Workweek on Patient Care at a Level I Trauma Center
Salim et al.
Arch Surg 2007;142:708-714.
ABSTRACT | FULL TEXT  

43316 - SELF-PERCEIVED IMPACT OF SLEEP DEPRIVATION IN ANESTHESIA RESIDENTS
Naik et al.
Canadian J. Anesthesia 2007;54:43316-43316.
ABSTRACT | FULL TEXT  

Safe design of healthcare facilities
Reiling
Qual Saf Health Care 2006;15:i34-i40.
ABSTRACT | FULL TEXT  

Pediatric Residency Duty Hours Before and After Limitations
Cull et al.
Pediatrics 2006;118:e1805-e1811.
ABSTRACT | FULL TEXT  

The effects of coffee and napping on nighttime highway driving: a randomized trial.
Philip et al.
ANN INTERN MED 2006;144:785-791.
ABSTRACT | FULL TEXT  

The effects of on-duty napping on intern sleep time and fatigue.
Arora et al.
ANN INTERN MED 2006;144:792-798.
ABSTRACT | FULL TEXT  

Naps and drugs to combat fatigue and sleepiness.
Guilleminault and Ramar
ANN INTERN MED 2006;144:856-857.
FULL TEXT  

Burnout and Internal Medicine Resident Work-Hour Restrictions
Gopal et al.
Arch Intern Med 2005;165:2595-2600.
ABSTRACT | FULL TEXT  

The Effects of Work-Hour Limitations on Resident Well-being, Patient Care, and Education in an Internal Medicine Residency Program
Goitein et al.
Arch Intern Med 2005;165:2601-2606.
ABSTRACT | FULL TEXT  

Near-miss errors in laboratory blood test requests by interns
Chow et al.
QJM 2005;98:753-756.
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  

Hospitalwide adverse drug events before and after limiting weekly work hours of medical residents to 80
Mycyk et al.
Am J Health Syst Pharm 2005;62:1592-1595.
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  

Resident Burnout
Thomas
JAMA 2004;292:2880-2889.
ABSTRACT | FULL TEXT  

Graduate Medical Education Research in the 21st Century and JAMA On Call
Lim and Golub
JAMA 2004;292:2913-2915.
FULL TEXT  

Systematic Review: Effects of Resident Work Hours on Patient Safety
Fletcher et al.
ANN INTERN MED 2004;141:851-857.
ABSTRACT | FULL TEXT  

Effect of Reducing Interns' Weekly Work Hours on Sleep and Attentional Failures
Lockley et al.
NEJM 2004;351:1829-1837.
ABSTRACT | FULL TEXT  

Effect of Reducing Interns' Work Hours on Serious Medical Errors in Intensive Care Units
Landrigan et al.
NEJM 2004;351:1838-1848.
ABSTRACT | FULL TEXT  

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

Reducing Resident Work Hours: Unproven Assumptions and Unforeseen Outcomes
Charap
ANN INTERN MED 2004;140:814-815.
FULL TEXT  

Adverse Effects of Modest Sleep Restriction on Sleepiness, Performance, and Inflammatory Cytokines
Vgontzas et al.
J. Clin. Endocrinol. Metab. 2004;89:2119-2126.
ABSTRACT | FULL TEXT  

More Than a Matter of Time
Jones
Pediatrics 2004;113:1396-1398.
FULL TEXT  

Fellowship training, workload, fatigue and physical stress: a prospective observational study
Parshuram et al.
CMAJ 2004;170:965-970.
ABSTRACT | FULL TEXT  

Circadian variations in acute myocardial infarction: Patients or health care delivery?
Spencer and Becker
J Am Coll Cardiol 2003;41:2143-2146.
FULL TEXT  

Residents' Work Hours
Crausman et al.
NEJM 2003;348:664-666.
FULL TEXT  

Residents' hours of work
Philibert and Barach
BMJ 2002;325:1184-1185.
FULL TEXT  

The Debate over Residents' Work Hours
Steinbrook
NEJM 2002;347:1296-1302.
FULL TEXT