The impact of sleep deprivation on sleepiness, risk factors and professional performance in medical residents.
BACKGROUND
Prolonged working hours and sleep deprivation can exert negative effects on professional performance and health.


OBJECTIVE
To assess the relationship between sleep deprivation, key metabolic markers, and professional performance in medical residents.


METHODS
We compared 35 residents working the in-house night shift with 35 senior year medical students in a cross-sectional cohort study. The Epworth Sleepiness Scale (ESS) questionnaire was administered and blood tests for complete blood count (CBC), blood chemistry panel, lipid profile and C-reactive protein (CRP) were obtained from all participants.


RESULTS
Medical students and medical residents were comparable demographically except for age, weekly working hours, reported weight gain, and physical activity. The ESS questionnaires indicated a significantly higher and abnormal mean score and higher risk of falling asleep during five of eight daily activities among medical residents as compared with medical students. Medical residents had lower high density lipoprotein levels, a trend towards higher triglyceride levels and higher monocyte count than did medical students. CRP levels and other laboratory tests were normal and similar in both groups. Among the residents, 5 (15%) were involved in a car accident during residency, and 63% and 49% reported low professional performance and judgment levels after the night shift, respectively.


CONCLUSIONS
Medical residency service was associated with increased sleepiness, deleterious lifestyle changes, poorer lipid profile, mild CBC changes, and reduced professional performance and judgment after working the night shift. However, no significant changes were observed in CRP or in blood chemistry panel. Larger prospective cohort studies are warranted to evaluate the dynamics in sleepiness and metabolic factors overtime.
Division of Internal Medicine, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Oleg
O
Pikovsky
Division of Internal Medicine, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Maly
M
Oron
Department of Medicine E, Rabin Medical Center (Beilinson Campus), Petah Tikva, Israel.
Arthur
A
Shiyovich
Department of Surgery and Soroka University Medical Center, Prywes Center for Medical Education, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Zvi H
ZH
Perry
Division of Internal Medicine, Soroka University Medical Center and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
Lior
L
Nesher
D000328:Adult; D006970:Disorders of Excessive Somnolence / Q000097:blood / Q000209:etiology / Q000523:psychology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007396:Internship and Residency; D007557:Israel; D008055:Lipids / Q000097:blood; D008297:Male; D008505:Medical Staff, Hospital / Q000523:psychology; D009043:Motor Activity; D012307:Risk Factors; D012892:Sleep Deprivation / Q000150:complications*; D013337:Students, Medical; D011795:Surveys and Questionnaires; D013647:Task Performance and Analysis; D015430:Weight Gain; D014940:Work Schedule Tolerance / Q000502:physiology / Q000523:psychology; D016526:Workload
D008055:Lipids