For medical interns working extended-duty overnight shifts, a protected sleep period of 5 hours is feasible and can increase time slept by interns and alertness the following morning, according to 2 randomized controlled trials conducted in parallel at 2 Philadelphia hospitals.
The protected sleep intervention led to an increase in the average amount of time slept of about 50% from 2 hours to 3 hours, a reduction in the proportion of interns who didn’t sleep at all overnight from about 18% to about 6%, a 50% reduction in the proportion with disturbed sleep, and improvements in cognitive function postcall.
“To the extent that protected sleep periods are feasible and improve alertness, they may provide a reasonable alternative to mandated shorter shifts,” the authors say.
“Effect of a Protected Sleep Period on Hours Slept During Extended Overnight In-hospital Duty Hours Among Medical Interns” is published in JAMA.
The protected sleep period concept has not been widely implemented “because up until now it was not thought to be feasible,” first author Kevin Volpp, MD, PhD, staff physician, Philadelphia Veterans Affairs (VA) Medical Center and professor, medicine and health care management, Perelman School of Medicine and the Wharton School, University of Pennsylvania, Philadelphia, told Medscape Medical News.
“Previous efforts to do this,” he explained, “had resulted in low adherence rates.” In a University of Chicago study published in 2006, the rate was only 22%. “We achieved 98% adherence rates by making protected sleep periods part of the standard intern schedule,” Dr. Volpp said.