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2 results

  • Chapter 28 - Myotonic dystrophy and sleepiness

  • from Section 3 - Medical, Psychiatric and Neurological Causes Of Sleepiness
  • Edited by Michael J. Thorpy, Michel Billiard
  • Book:
    Sleepiness
    Published online:
    04 February 2011
    Print publication:
    27 January 2011, pp 316-328

  • Summary

    This chapter reviews the manner in which sleep deprivation and circadian misalignment lead to impaired performance among healthcare providers. Several sleep and circadian factors affect the performance of physicians-in-training as well as other healthcare providers. In addition to acute sleep restriction, residents suffer chronic sleep restriction. Extended-duration work shifts also increase the likelihood of fatigue-related, self-reported medical errors. As learning is central to medical residency, any factor impairing resident learning is of concern. The only randomized evidence regarding elimination of 30-h shifts, and substitution with 16-h shifts, suggests that errors could in fact decrease by more than double this amount with widespread implementation of a 16-h shift limit. Lab- and field-based studies show us that extended resident shifts impair cognition and likely impair learning. Such impairment translates into error, poor patient care, and resident harm.

  • Effects of rapid versus slow accumulation of eight hours of sleep loss

  • CHRISTOPHER L. DRAKE, TIMOTHY A. ROEHRS, ELENI BURDUVALI, ALICIA BONAHOOM, MARK ROSEKIND, THOMAS ROTH
  • Journal:
    Psychophysiology / Volume 38 / Issue 6 / November 2001
    Published online by Cambridge University Press:
    09 January 2002, pp. 979-987
    Print publication:
    November 2001

  • The present study assessed alertness, memory, and performance following three schedules of ∼8 hr of sleep loss (slow, intermediate, and rapid accumulation) in comparison to an 8-hr time in bed (TIB) sleep schedule. Twelve healthy individuals aged 21–35 completed each of four conditions according to a Latin Square design: no sleep loss (8-hr TIB for 4 nights; 2300–0700), slow (6-hr TIB for 4 nights; 0100–0700), intermediate (4-hr TIB for 2 nights; 0300–0700), and rapid (0-hr TIB for 1 night) sleep loss. On each day, participants completed a multiple sleep latency test (MSLT), a probed-recall memory task, a psychomotor vigilance task, a divided attention task, and the Profile of Mood States. “Rapid” sleep loss produced significantly more impairment on tests of alertness, memory, and performance compared to the “slow” accumulation of a comparable amount of sleep loss. The impairing effects of sleep loss vary as a function of rate, suggesting the presence of a compensatory adaptive mechanism operating in conjunction with the accumulation of a sleep debt.