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Médecine du travail du personnel hospitalier

Napping on the Night Shift: A Study of Sleep, Performance, and Learning in Physicians-in-Training

Auteur     Jennifer McDonald
Auteur     Darryl Potyk
Auteur     David Fischer
Auteur     Brett Parmenter
Auteur     Teresa Lillis
Auteur     Lindsey Tompkins
Auteur     Angela Bowen
Auteur     Devon Grant
Auteur     Amanda Lamp
Auteur     Gregory Belenky
Volume     5
Numéro     4
Pages     634-638
Publication     Journal of graduate medical education
Date     Dec 2013
Résumé     BACKGROUND: Physicians in training experience fatigue from sleep loss, high workload, and working at an adverse phase of the circadian rhythm, which collectively degrades task performance and the ability to learn and remember. To minimize fatigue and sustain performance, learning, and memory, humans generally need 7 to 8 hours of sleep in every 24-hour period. METHODS: In a naturalistic, within-subjects design, we studied 17 first- and second-year internal medicine residents working in a tertiary care medical center, rotating between day shift and night float every 4 weeks. We studied each resident for 2 weeks while he/she worked the day shift and for 2 weeks while he/she worked the night float, objectively measuring sleep by wrist actigraphy, vigilance by the Psychomotor Vigilance Task test, and visual-spatial and verbal learning and memory by the Brief Visuospatial Memory Test-Revised and the Rey Auditory-Verbal Learning Test. RESULTS: Residents, whether working day shift or night float, slept approximately 7 hours in every 24-hour period. Residents, when working day shift, consolidated their sleep into 1 main sleep period at night. Residents working night float split their sleep, supplementing their truncated daytime sleep with nighttime on-duty naps. There was no difference in vigilance or learning and memory, whether residents worked day shift or night float. CONCLUSIONS: Off-duty sleep supplemented with naps while on duty appears to be an effective strategy for sustaining vigilance, learning, and memory when working night float.

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