Monday December 29, 2008
Sleepy residents: Are they sleepy in ICU

Recent study by Reddy and Surani * help to explore it further. The purpose of this study was to provide an objective assessment of daytime sleepiness in medical residents working in the medical ICUs. Sleep times for 2 days/nights prior to call and on the day/night of on-call were assessed by actigraphy and sleep diaries. On-call and post-call measurements of residents’ sleepiness were measured both objectively, by means of a modified MSLT (2 nap sessions), as well as subjectively, by Stanford Sleepiness Scale.

Results: Showed that despite an average sleep time of 7.15 h on nights leading to the call, Mean Sleep Latency (MSL) on the on-call day was 9 +/– 4.4 min compared to the MSL on the post call day of 4.8 +/–4.1 min. On the post-call day 14 residents (70%) had MSL values less than 5 min suggesting severe sleepiness as compared to 6 (30%) on the on-call day.

Conclusion: Results demonstrate that residents working in the ICU despite reductions in work hours demonstrate severe degree of sleepiness post-call.


Editorial comment: IOM recently came up with the suggestion to decrease the continuous straight work hour to 16 hrs, and if to go for 30 hrs then between 10 pm and 8 am, the resident should be given a break of 5 uninterrupted hours free of any duty or call.

* Dr. Surani is one of the co-editor for this website. We congratulate him on publication of his new paper.



Reference: click to get abstract

Reddy R, Guntupalli K, Surani S, Alapat P, Subramanian S. Sleepiness in Medical intensive care unit residents. Chest online first Nov 18. Chest, doi:10.1378/chest.08-0821