Westchester, IL -- Medical residents are an integral component to the health care system and provide superior patient care in academic institutions during the course of their education and training. However, long work hours and extended shifts of up to 24 hours or more are common in residency programs, resulting in profound sleep deprivation and fatigue for many trainees.
The potential consequences of such deprivation are impairment in judgment, memory, vigilance, information management and, ultimately, delivery of patient care. Serious medical errors may result.
However, the adverse effects of sleep deprivation and fatigue experienced by medical residents are not limited to the hospital. Residents also experience impaired judgment, delayed reaction and impaired cognitive skills in their personal lives, with potentially dangerous results.
A study published in the January 13, 2005 edition of The New England Journal of Medicine examines the effects of extended-duration work shifts on medical interns outside the hospital. According to the study’s results, the risk for motor vehicle accidents increases for residents who are assigned extended shifts that restrict their sleep.
Moreover, near-miss accidents are also reported to increase with extended work hours. The authors describe these effects of sleep deprivation on driving as akin to the effects of alcohol consumption.
These findings underscore the importance of adequate, healthy sleep for performance and well being. The Accreditation Council for Graduate Medical Education (ACGME) has established stricter limits on resident work hours and shift duration.
Clearly, this issue must continue to be addressed within the medical community, and the significance of sleep deprivation must be recognized, not only in the medical profession, but also in a variety of other occupations in which public safety and personal well-being may be threatened by sleep deprivation.
The American Academy of Sleep Medicine (AASM) is dedicated to providing professional education that increases awareness of sleep and promoting standards that ensure physician and public safety. The AASM encourages residency programs to not only comply with ACGME standards but also educate their residents about the effects of sleep deprivation and fatigue.
In response, the AASM has developed an education module, S.A.F.E.R. M.D. (Sleep, Alertness and Fatigue Education in Residency). This educational program provides residency programs with information on sleep deprivation and its consequences, factors that put residents at risk, identifiers of sleepiness and fatigue as well as tools and strategies for alertness management.
Medical residency programs and residents must take the results of this report to heart and consider the potential impact of resident schedules and sleep deprivation as they formulate future guidelines and plans.