Vineet Arora, MD, MA; Carrie Dunphy, BS; Vivian Y. Chang, BA; Fawaz Ahmad, MS; Holly J. Humphrey, MD; David Meltzer, MD, PhD
Acknowledgments: The authors thank Dr. Eve Van Cauter, Dr. Kristen Knutson, and Mr. Armand Ryden of the University of Chicago Sleep Laboratory for their financial support and assistance during the study; Ms. Jennifer Higa for her assistance in manuscript preparation; and Ms. Joyce Keldsen in Paging Services at University of Chicago Hospitals for her support and assistance in obtaining paging logs. They also thank Julie Johnson, PhD; Juned Siddique, DrPH; and Paul Rathouz, PhD for their helpful commentary on analytic issues. Finally, the authors thank Dr. Harvey Golomb from the Department of Medicine for his financial support and encouragement and Dr. James Woodruff, Internal Medicine Residency Program Director, for the enthusiastic support and participation of the interns, residents, and chief residents of the 2003–2004 University of Chicago Internal Medicine Residency Program.
Grant Support: By the University of Chicago Department of Medicine and the Pritzker School of Medicine. Drs. Arora and Meltzer are supported by the National Institute for General Medical Sciences (1 R01 GM075292-01 [Effectiveness of TEACH Research]). Dr. Meltzer and Mr. Ahmad were supported by the Agency for Healthcare Research and Quality (R01 10597 [A Multicenter Trial of Academic Hospitalists]) while most of the work was performed. Ms. Dunphy was supported by the Pritzker School of Medicine Summer Research Program; Ms. Chang was supported by a short-term training grant (5 T35DK062719-16).
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Vineet Arora, MD, MA, University of Chicago, 5841 South Maryland Avenue, MC 2007, AMB W216, Chicago, IL 60637; e-mail, email@example.com.
Current Author Addresses: Drs. Arora and Meltzer: University of Chicago, 5841 South Maryland Avenue, MC 2007, AMB B200, Chicago, IL 60637.
Ms. Dunphy, Ms. Chang, and Dr. Humphrey: University of Chicago Pritzker School of Medicine, 924 East 57th Street, Chicago, IL 60637.
Mr. Ahmad: University of Arkansas for Medical Sciences College of Medicine, 4301 West Markham, Little Rock, AR 72205.
Author Contributions: Conception and design: V. Arora, F. Ahmad, H.J. Humphrey, D. Meltzer.
Analysis and interpretation of the data: V. Arora, C. Dunphy, V.Y. Chang, F. Ahmad, H.J. Humphrey, D. Meltzer.
Drafting of the article: V. Arora, C. Dunphy, V.Y. Chang, H.J. Humphrey, D. Meltzer.
Critical revision of the article for important intellectual content: V. Arora, C. Dunphy, V.Y. Chang, H.J. Humphrey, D. Meltzer.
Final approval of the article: V. Arora, C. Dunphy, F. Ahmad, H.J. Humphrey, D. Meltzer.
Provision of study materials or patients: V. Arora, F. Ahmad, H.J. Humphrey, D. Meltzer.
Statistical expertise: V. Arora, C. Dunphy, D. Meltzer.
Obtaining of funding: V. Arora, V.Y. Chang, H.J. Humphrey, D. Meltzer.
Administrative, technical, or logistic support: V. Arora, C. Dunphy, V.Y. Chang, F. Ahmad, H.J. Humphrey, D. Meltzer.
Collection and assembly of data: V. Arora, C. Dunphy, V.Y. Chang, F. Ahmad, D. Meltzer.
Arora V., Dunphy C., Chang V., Ahmad F., Humphrey H., Meltzer D.; The Effects of On-Duty Napping on Intern Sleep Time and Fatigue. Ann Intern Med. 2006;144:792-798. doi: 10.7326/0003-4819-144-11-200606060-00005
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Published: Ann Intern Med. 2006;144(11):792-798.
In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) restricted resident duty hours because of concerns about the effects of sleep deprivation on physician health and patient care (1-6). Of note, extended work shifts up to 30 consecutive hours are still allowed. However, the limit is already challenged by studies demonstrating improved attention and reductions in medication errors and motor vehicle accidents with shifts that are much shorter in duration (7-9). While these studies have focused on the optimal length of a shift, little attention has been devoted to another evidence-based method of reducing fatigue. Naps are a proven method of alleviating fatigue in workers in the transportation and manufacturing industries who work long shifts (10-13). In fact, naps of even less than 1 hour have been shown to reduce fatigue (10). Because of this, several groups, including the Agency for Healthcare Research and Quality, endorse naps as a method to relieve fatigue in long work shifts (14). In addition, the American Academy of Sleep Medicine, in its educational program designed for physicians-in-training, recommends naps to relieve fatigue (15).
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