Study shows naps improve residents' alertness on call

Some experts say the data suggest that protected nap time should be included for on-call residents.

By Myrle Croasdale, AMNews staff. July 17, 2006.

Even just 40 minutes more sleep while on in-hospital call significantly improves medical residents' alertness, according to a new study. Authors said that suggests it might be possible to extend residents' call periods beyond the 30-hour limit if naps are included.

Researchers at the University of Chicago spent a year studying 38 first-year residents' fatigue after 30 hours on call. Internal medicine interns were assigned to a nap schedule for two weeks of each month. During the nap schedule, they could sign over their pagers to a night-float resident from midnight to 7 a.m. so they could finish their work and sleep. During the other two weeks, they worked a standard schedule and were not allowed to sign over their pagers.

Researchers found that interns on the nap schedule slept an average of 185 minutes -- 41 minutes longer than on the standard schedule. That resulted even though the majority of interns retained responsibility for the patients they had admitted that day, only forwarding pages for the 30 or more patients they were covering for other interns.

The interns also reported less fatigue, according to the study published in the June 6 Annals of Internal Medicine.

Vineet Arora, MD, lead author of the study and an instructor of medicine at the University of Chicago, said that since the research project was finished, all interns on the general medicine service there are encouraged to sign over their pagers for night-float coverage after midnight.