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To the Editor: The study by Dr Arnedt and colleagues¹ investigated the effect of heavy night call on neurobehavioral performance of residents. I am concerned that the methods that were chosen for this study used situations that are so far from the reality of resident night call as to limit the practical conclusions that can be reached. Participants were not allowed to ingest caffeine after noon, to nap, or to ingest food or drink within 4 hours of testing. However, caffeine is a strong stimulant that helps individuals remain alert,^2-3 and the benefits of food, drink, and naps are obvious to all who have experienced nights and subsequent days with less than optimal sleep.

Unless residency has changed since I completed it, we often drank coffee, caught a nap, or undertook some procedure to keep awake. What is needed is true effectiveness studies. Residents should be tested and, if they . . . [Full Text of this Article]

Daniel Merenstein, MD
djm23@georgetown.edu
Department of Family Medicine
Georgetown University Medical Center
Washington, DC

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