Abstract

BackgroundSleepiness is a significant problem among residents due to chronic sleep deprivation. Recent studies have highlighted medical errors due to resident sleep deprivation. We hypothesized residents routinely use pharmacologic sleep aids to manage their sleep deprivation and reduce sleepiness.MethodsA web-based survey of US allopathic Emergency Medicine (EM) residents was conducted during September 2004. All EM residency program directors were asked to invite their residents to participate. E-mail with reminders was used to solicit participation. Direct questions about use of alcohol and medications to facilitate sleep, and questions requesting details of sleep aids were included.ResultsOf 3,971 EM residents, 602 (16%) replied to the survey. Respondents were 71% male, 78% white, and mean (SD) age was 30 (4) years, which is similar to the entire EM resident population reported by the ACGME. There were 32% 1st year, 32% 2nd year, 28% 3rd year, and 8% 4th year residents. The Epworth Sleepiness Scale (ESS) showed 38% of residents were excessively sleepy (ESS 11–16) and 7% were severely sleepy (ESS>16). 46% (95 CI 42%–50%) regularly used alcohol, antihistamines, sleep adjuncts, benzodiazepines, or muscle relaxants to help them fall or stay asleep. Study limitations include low response and self-report.ConclusionEven with a low response rate, sleep aid use among EM residents may be common. How this affects performance, well-being, and health remains unknown.

Highlights

  • Sleepiness is a significant problem among residents due to chronic sleep deprivation

  • We aimed to determine the prevalence of sleep aid use among Emergency Medicine (EM) residents

  • The instrument was developed based on the experiential input from 40 emergency medicine residents participating in the educational program

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Summary

Introduction

Sleepiness is a significant problem among residents due to chronic sleep deprivation. Recent studies have highlighted medical errors due to resident sleep deprivation. Sleep deprivation among resident physicians is of growing concern. Sleep deprivation is a cause of fatigue, which is characterized by decreased work capacity and efficiency accompanied by feelings of weariness, sleepiness, or tiredness [1]. Research on resident sleep deprivation has primarily focused on the detrimental impact of fatigue on patient care [1,2,3]. Various specialties, including Obstetrics and Gynecology [4], General Surgery [5], Pediatrics [6], and Internal Medicine [2,3] have shown sleep deprivation among residents negatively affects performance. Fatigue arising from extended work shifts and shift work have been implicated as impacting both physical and psychological disorders, ranging from an increased risk of motor vehicle crashes [9,10], depression [11], and (page number not for citation purposes)

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