This Article Full Text Free Full Text (PDF) Free All Versions of this Article: chest.06-1398v1 131/6/1685    most recent Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Parthasarathy, S. Articles by Sullivan, B. Search for Related Content PubMed PubMed Citation Articles by Parthasarathy, S. Articles by Sullivan, B.

Sleep and Well-Being of ICU Housestaff^*

^* From the Section of Pulmonary and Critical Care Medicine (Drs. Parthasarathy and Budhiraja), Southern Arizona VA Health Care System, Tucson, AZ; Loyola University Medical Center (Ms. Hettiger), Maywood, IL; and Washington University (Dr. Sullivan), St. Louis, MO.

Correspondence to: Sairam Parthasarathy, MD, Division of Pulmonary and Critical Care Medicine, Southern Arizona Veterans Administration Health Care System, 3601 South Sixth Ave, Tucson, AZ 85723; e-mail: spartha{at}arc.arizona.edu

Abstract

Background: Our understanding of the effect of the Accreditation Council for Graduate Medical Education (ACGME)-mandated work-hour limitation on physicians’ quality of life, sleepiness, and sleep-work habits is evolving. In this study, we sought to determine the effect of work-hour reduction on quality of life in residents and fellows (ICU housestaff) when subject to the ACGME-compliant schedule of one institution. To determine the effect of work-hour reduction on subjective and objective measures of sleepiness in ICU housestaff at a center.

Methods: A single-center study of 34 residents and 10 fellows who were studied before and after the ACGME-mandated work-hour limitation went into effect in July 2003.

Results: In a single center, after the work-hour reduction, residents reported statistically significant but minor improvements in sleep time, subjective sleepiness, and some aspects of quality of life (p < 0.05). Both before and after work-hour limitations, subjective sleepiness and quality-of-life indexes deteriorated during the course of the ICU rotation. Following work-hour reductions, subjective sleepiness improved (p < 0.05), but objective sleepiness was unchanged (p = 0.6). Moreover, after the implementation of work-hour reductions, 59%, 43%, and 25% of the ICU team had mean sleep latency < 10, 7, and 5 min, respectively, with 14% of the team manifesting sleep-onset rapid eye movement periods (signifying severe sleepiness) before beginning their extended work-hour period.

Conclusions: In ICU housestaff, at a single center, small benefits to quality of life and subjective sleepiness were realized by an ACGME-compliant work-hour schedule. Significant levels of objective sleepiness, however, remained. Further measures may need to be undertaken to address the persistence of sleepiness in ICU housestaff. These findings may not be generalized outside of the scheduling system studied.

Key Words: internship and residency • patient safety • quality of life • sleep deprivation • work schedule tolerance

This article has been cited by other articles:

				J. A. Owens, A. Avidan, D. Baldwin, and C. Landrigan Improving Sleep Hygiene Arch Intern Med, June 9, 2008; 168(11): 1229 - 1230. [Full Text] [PDF]