Respiratory-Related Sleep Disorders Section
Sleep health and fatigue mitigation during medical training
Medical trainees may experience acute or chronic sleep deprivation due to extended work hours and shift-work sleep schedules. Extended work hours may lead to serious medical errors, percutaneous injuries, prolonged task completion, and car crashes or near misses while driving (Landrigan, et al. N Engl J Med. 2004;351:1838; Ayas, et al. JAMA. 2006;296[9]:1055; Taffinder, et al. Lancet. 1998;352[9135]:1191; Barger, et al. N Engl J Med. 2005 Jan 13;352[2]:125).
Chronic sleep restriction also results in neurobehavioral and cognitive dysfunction without a proportionate increase in self-perceived sleepiness [Belenky, et al. J Sleep Res. 2003;12[1]:1; Van Dongen, et al. Sleep. 2003;26[2]:117). In 1987, when sleep deprivation was cited as a major cause of 18-year-old Libby Zion’s death, the ACGME restricted residents from working more than 80 hours per week. ACGME mandates that training programs provide yearly fatigue mitigation education.
A “Sleep Alertness and Fatigue Education in Residency” module may be purchased through the American Academy of Sleep Medicine. While one-time education opportunities are available, there remains a need for access to longitudinal, individualized tools during varying rotations and circumstances, as education alone has not been shown to improve sleep quality (Mazar D, et al. J Clin Sleep Med. 2021;17[6]:1211). The American Thoracic Society Early Career Professional Working Group offers individualized lectures to training programs. Wake Up and Learn is a sleep education program for children and teens that is currently being expanded for medical trainees.
Further data are needed to see if longitudinal and individualized support can promote better sleep quality among trainees.
Aesha Jobanputra, MD
Section Member
Sreelatha Naik, MD
Member-at-Large