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Sleep Deprivation, Physician Performance, and Patient Safety

Eric J. Olson, MD, FCCP; Lisa A. Drage, MD; R. Robert Auger, MD
Author and Funding Information

Affiliations: From the Center for Sleep Medicine (Drs. Olson and Auger), Division of Pulmonary and Critical Care Medicine (Dr. Olson), Department of Dermatology and Mayo School of Graduate Medical Education (Dr. Drage), and Department of Psychiatry and Psychology (Dr. Auger), Mayo Clinic, Rochester, MN.

Correspondence to: Eric J. Olson, MD, FCCP, Center for Sleep Medicine, Mayo Clinic, 200 First St. SW, Rochester, MN 55905; e-mail: olson.eric@mayo.edu


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/site/misc/reprints.xhtml).

For editorial comment see page 1194


© 2009 American College of Chest Physicians


Chest. 2009;136(5):1389-1396. doi:10.1378/chest.08-1952
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Long work hours, overnight call duty, and rotating shifts are implicit features of hospital medical practice. Rigorous schedules have been deemed necessary to fulfill the professional obligation of patient beneficence, to optimize trainee learning, and to respond to economic realities. However, the resultant disruption and restriction of physicians' sleep produce demonstrable neurobehavioral impairments that may threaten other fundamental professional mandates, such as that of primum non nocere (“first, do no harm”). This article provides a basic overview of sleep/wake regulatory processes, examines the impact of physician schedules on sleep/wake homeostasis, summarizes the laboratory-demonstrated effects of sleep loss on humans, highlights recent literature on the personal and professional effects of sleep loss on physicians, and, finally, discusses the specific countermeasure of work-hour limits applicable to resident physicians but not attending physicians.

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