Improving Sleep Hygiene of Medical Interns<subtitle>Can the Sleep, Alertness, and Fatigue Education in Residency Program Help?</subtitle>
Abstract
BACKGROUND: Because of concerns regarding sleep deprivation, the Accreditation Council for Graduate Medical Education limits duty hours and endorses education regarding sleep loss for residents. We assessed the effectiveness of a 60- to 90-minute lecture, the Sleep, Alertness, and Fatigue Education in Residency (SAFER) program, on sleep loss and recovery sleep in residents adhering to Accreditation Council for Graduate Medical Education duty hours. METHODS: From July 1, 2003, through June 24, 2005, interns from the inpatient medicine service at the University of Chicago were asked to wear wristwatch activity monitors. In March 2005, interns received the SAFER program intervention. We used fixed-effects linear regression to estimate within-subject mean sleep per call day (on-call, precall, postcall, and second-day postcall sleep). These estimates were compared with recommended minimum levels of preventive (7 hours of precall) and recovery (16 hours during the 2 days after call) sleep in healthy populations using 2-tailed t tests. These analyses were repeated to test the effect of the SAFER program. RESULTS: Fifty-eight of 81 interns (72%) participated for 147 intern-months (63%). Interns on call slept an average of 2.84 hours (95% confidence interval, 2.75-2.93 hours). Interns obtained less than recommended amounts of recovery sleep (14.06 hours [95% confidence interval, 13.84-14.28 hours]; P < .001). Intern preventive sleep was also less than recommended (6.47 hours [95% confidence interval, 6.39-6.56 hours]; P < .001). Interns attempted to compensate for their acute sleep loss; for each hour of on-call sleep loss, they received 18 minutes (95% confidence interval, 7-30 minutes) more recovery sleep (P = .003). The SAFER program had no significant beneficial effect on intern sleep. CONCLUSIONS: Under the current duty-hour regulations of the Accreditation Council for Graduate Medical Education, residents continue to be sleep deprived. The SAFER program has no impact on resident precall or postcall sleep.
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Among medical residents, long work hours and shift work lead to insufficient sleep duration.
“Among medical residents, long work hours and shift work have been shown to lead to insufficient sleep duration.218–221”
From Sleep, Health, and Society (2017) · cites this paper as [220]
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- Authors
- Arora, V. M.
- Affiliations
- University of Chicago (US)
- Corresponding author
- Arora, Vineet M.
- ORCID
- Arora, Vineet M.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2007-09-10
- Volume
- 167
- Issue
- 16
- Pages
- 1738
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2042127799
- Cited by
- 63
- References
- 30
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 2 · 2023: 3 · 2022: 5 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 3 · 2015: 2 · 2014: 6 · 2013: 4 · 2012: 2
- FWCI
- 4.69
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Health Sciences › Medicine › Emergency Medicine › Hospital Admissions and Outcomes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- sleep hygiene, medical interns, sleep deprivation, recovery sleep, duty hours, Accreditation Council for Graduate Medical Education, sleep education, alertness, fatigue, graduate medical education
- MeSH terms
- Clinical Competence, Education, Medical, Graduate, Mental Fatigue, Follow-Up Studies, Humans, Hygiene, Illinois, Internal Medicine, Internship and Residency, Prognosis, Prospective Studies, Sleep, Time Factors, Incidence, Dyssomnias
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