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Association of Extended Work Shifts, Vascular Function, and Inflammatory Markers in Internal Medicine Residents: A Randomized Crossover Trial
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To the Editor: Sleep loss during extended work shifts is common in medical training.1 Pathophysiological consequences of sleep loss include increased daytime blood levels of proinflammatory cytokines, which may contribute to daytime sleepiness and decline in neurobehavioral function.1-3 Increased proinflammatory cytokines in response to sleep loss may also affect cardiovascular health as inflammation within the vascular wall is thought to play an important role in the pathogenesis of atherosclerosis.4 We tested the hypothesis that sleep loss during extended work shifts is associated with evidence of vascular inflammation and dysfunction.
Methods
We studied 22 healthy Internal Medicine residents (15 men and 7 women; mean age, 29 years) in a prospective, single-blind, crossover design during an intensive care unit rotation (extended overnight work shifts every fourth night). Of 48 potential participants, 24 declined, most often due to the protocol requirement to abstain from caffeine, and 2 were ineligible due to medication use. No . . . [Full Text of this Article]
Haoyi Zheng, MD, PhD;
Milan Patel, MD;
Katarzyna Hryniewicz, MD;
Stuart D. Katz, MD
stuart.katz@yale.edu
Yale University School of Medicine
New Haven, Conn
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