EMTC Weekly Article: Sleep Deprivation and Errors

posted by Sabah Iqbal

Article 1: 

Is Sleep Deprivation the Reason the Romney Campaign Is Blowing it?

October 6, 2012 in the Huffington Post POLITICS

Article 2: 

Sleep Loss in resident physicians: the cause of medical errors?

Kramer M, in Front Neurol. 2010 Oct 20;1:128.

Dear fellow EM providers,

This week's article is brought to you late due to the cumulative effects of sleep deprivation. While my particular round of sleep deprivation is caused by grant writing, many of us - nurses, techs, physicians - suffer the effects of sleep deprivation from overnight shifts.

The two articles that follow discuss sleep deprivation in two different scenarios not unlike our own:

In the first, Arianna Huffington muses that many of Mitt Romney's major mis-steps may have come from chronic sleep deprivation - he seems to sleep only 3-4 hours at night, with blackberry at his side.

The second article is a fantastic review article of sleep and residency. It begins with an overview of the Libby Zion case - the famous case that led NY to cap resident work hours and goes through the literature on sleep causing depressed immune responses, simulations of sleep deprivation, and all sorts of other intersting factoids.

As someone who trained under the NY resident rules, I find the outcomes post-resident work hour rules to be fascinating (they were never shown to truly improve patient care!)... but first, some interesting key points from the article, in case you don't have time to read it all:

1) In the sleepy person, caffeine may be the equivalent of a 3 hour nap (yeah starbucks!)

2) Shear intensity of work hours is more important than shear volume of work hours: thus the overnight for the ED doctor or nurse is significantly more taxing than it is for the overnight hospitalist doctor or inpatient nurse,

3) Overnight shifts have been associated with increased risk of needle sticks, increased risk of pre-term labor and IUGR in pregnant residents, impaired driving ability, and poor health.

Enjoy and sorry for the delay... I haven't been sleeping recently...