title: Impact of protected sleep period for internal medicine interns on overnight call on depression, burnout, and empathy.
abstract: BACKGROUND
  Patient safety and sleep experts advocate a protected sleep period for residents.
  
  
  OBJECTIVE
  We examined whether interns scheduled for a protected sleep period during overnight call would have better end-of-rotation assessments of burnout, depression, and empathy scores compared with interns without protected sleep periods and whether the amount of sleep obtained during on call predicted end-of-rotation assessments.
  
  
  METHODS
  We conducted a randomized, controlled trial with internal medicine interns at the Philadelphia Veterans Affairs Medical Center (PVAMC) and the Hospital of the University of Pennsylvania (HUP) in academic year 2009-2010. Four-week blocks were randomly assigned to either overnight call permitted under the 2003 duty hour standards or a protected sleep period from 12:30 am to 5:30 am. Participants wore wrist actigraphs. At the beginning and end of the rotations, they completed the Beck Depression Inventory (BDI-II), Maslach Burnout Inventory (MBI-HSS), and Interpersonal Reactivity Index (IRI).
  
  
  RESULTS
  A total of 106 interns participated. There were no significant differences between groups in end-of-rotation BDI-II, MBI-HSS, or IRI scores at either location (P > .05). Amount of sleep while on call significantly predicted lower MBI-Emotional Exhaustion (P < .003), MBI-Depersonalization (P < .003), and IRI-Personal Distress (P < .006) at PVAMC, and higher IRI-Perspective Taking (P < .008) at HUP.
  
  
  CONCLUSIONS
  A protected sleep period produced few consistent improvements in depression, burnout, or empathy, although depression was already low at baseline. Possibly the amount of protected time was too small to affect these emotional states or sleep may not be directly related to these scores.
authors.forename: Judy A
authors.initials: JA
authors.lastname: Shea
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Bellini
authors.forename: David F
authors.initials: DF
authors.lastname: Dinges
authors.forename: Meredith L
authors.initials: ML
authors.lastname: Curtis
authors.forename: Yuanyuan
authors.initials: Y
authors.lastname: Tao
authors.forename: Jingsan
authors.initials: J
authors.lastname: Zhu
authors.forename: Dylan S
authors.initials: DS
authors.lastname: Small
authors.forename: Mathias
authors.initials: M
authors.lastname: Basner
authors.forename: Laurie
authors.initials: L
authors.lastname: Norton
authors.forename: Cristina
authors.initials: C
authors.lastname: Novak
authors.forename: C Jessica
authors.initials: CJ
authors.lastname: Dine
authors.forename: Ilene M
authors.initials: IM
authors.lastname: Rosen
authors.forename: Kevin G
authors.initials: KG
authors.lastname: Volpp