Sleep Awareness Programs Aimed at Shift Workers and Residents

What you'll learn

Course overview

Concerns regarding the adverse effects of sleep deprivation on resident health led to the implementation of resident duty-hour restrictions in July 2003 by the Accreditation Council for Graduate Medical Education (ACGME).1 These mandates restrict duty hours to a maximum of 80 per week, with 30-hour consecutive shifts, provision of 10 hours off between duty periods, and 1 day off per week.2-7 Because these restrictions still include extended shifts of up to 30 hours, and because compliance is poor, the effectiveness of these limits in achieving their primary aim of reducing sleep loss and fatigue remains questionable.8-9 To work effectively under these conditions, it is imperative that house staff come to work as rested as possible. Obtaining adequate levels of preventive and recovery sleep in the setting of acute sleep deprivation is important to reducing the effects of a cumulative sleep debt. According to the American Academy of Sleep Medicine, 7 to 9 hours of preventive sleep before anticipated sleep loss in a normal, healthy population helps to defend against sleep deprivation.10 Under the conditions of chronic sleep deprivation characteristic of residency training, obtaining 8 to 10 hours of sleep is more appropriate. Recovery from on-call sleep loss is also important to restore baseline alertness. Although recovery sleep is traditionally defined as 2 nights of extended sleep, more recent literature supports longer recovery periods after acute sleep deprivation