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Approved medical resident hours still resulting in sleepy doctors

ATS 2007, SAN FRANCISCO -- Medical residents working within the mandated maximum of 80 hours per week experience severe sleepiness, a finding that may have implications for both patient care and resident safety, according to a new study presented at the American Thoracic Society 2007 International Conference, on Sunday, May 20.

Previous studies have shown that sleep-deprived residents perform poorly in several areas like judgment and concentration and are at risk for motor vehicle accidents. There have been several instances where sleep-deprived residents have committed serious mistakes in patient care. This led the ACGME (Accreditation Council for Graduate Medical Education), in 2003, to limit their work hours to not more than 80 hours a week and 24 hours at a stretch. The impact of this standard has not been well studied.

"We need to be aware that, though residents are working within guidelines, they are reporting to work for a 24-hour shift already sleepy and, on post-call, exhibit sleepiness in the pathologic range. This degree of sleepiness is seen in medical conditions such as obstructive sleep apnea and narcolepsy. This has the potential to impact decisions about patient care, especially on a post-call day and has a bearing on their safety in driving home," says lead researcher Shyam Subramanian, M.D., Director of Sleep Services at the Baylor College of Medicine in Houston.

To find out how the work schedule affects residents, the researchers studied 20 residents the day before and the day after they were on-call for 24 hours at the hospitals Intensive Care Unit (ICU). The objective sleepiness was assessed using a test called Multiple Sleep Latency Test (MSLT). In this test, the residents rest comfortably with their eyes closed in a dark room for 20 minutes and their brain activity is continuously recorded. The test is based on the idea that the sleepier a person is, the faster he or she will fall asleep. To assess subjective sleepiness, eac
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Contact: Suzy Martin
smartin@thoracic.org
212-315-8631
American Thoracic Society
20-May-2007


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