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Protected sleep time can improve alertness for medical staff study

Margaret Jack  By Margaret Jack   |   Posted in Sleep Research   |   Last updated: Friday 7th December 2012

A study has found that a period of 5 hours of protected sleep for a medical intern who has worked a shift longer than 16 hours can help reduce fatigue levels and improve alertness. Previously the protected sleep period has not been widely adopted because up until now it hasn't been thought to be feasible.

In 2009 a report was published by the Institute of Medicine about resident work hours and work schedules to improve the safety of patients and recommended a protected sleep period of 5 hours after a shift between 16-30 hours to help reduce the risk of fatigue-related errors. At this time there was a lack of data to back up their ideas but argued that the evidence of other hazardous errors in other professions could also be linked to medicine.

This week a study reported the results from two randomised controlled trials; examining the feasibility and consequences of periods of protected sleep on interns working at the Philadelphia VA Medical Centre and the Hospital of the University of Pennsylvania. There were a total of 103 interns and senior medical staff that took part; 44 worked at the VA centre, 16 at the hospital and 43 worked at both. The intern year was divided into twelve 4 week blocks where they were all randomly assigned to the standard intern schedule of an overnight shift of up to 30 hours or the protected sleep schedule (protected sleep time from 12.30 am- 5.30am). During the protected sleep time interns were required to hand over their work phone to other night staff and wear wrist actigraphs – a device that measures physical movement – and complete a sleep diary.

The average amount of sleep during the protected period at the VA Centre was 2.86 hours, while at the hospital it was 3.04 hours. The interns who were on-call for up to 30 hours in the VA centre and the hospital only got 1.98 hours and 2.04 hours respectively. It was also found that the protected sleep study team were less likely to be sleepy after on-call nights and morning alertness after their shift was increased.

The researchers believe that a period of protected sleep should be a standard part of an intern's schedule, and hope to do a follow up study to back up these new found results.

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