Abstract: Slide Presentations |


Haven R. Malish, MD*; Kendra Becker, MD; Sam Eljammal, MD; Ahmet Baydur, MD
Author and Funding Information

University of Southern California, Los Angeles, CA


Chest. 2009;136(4_MeetingAbstracts):67S. doi:10.1378/chest.136.4_MeetingAbstracts.67S-c
Text Size: A A A
Published online


PURPOSE:  This study is designed to assess the direct effects of sleep deprivation on medical residents by measuring the level of exhaled nitric oxide (FeNO), a marker of systemic inflammation. Given that other pro-inflammatory markers are elevated in sleep deprivation, we hypothesized that FeNO will be increased in sleep deprived subjects.

METHODS:  Medical residents at our institution were notified of the study via email. A screening questionnaire included clinical predictors for obstructive sleep apnea (OSA) and Epworth scale. Using a parallel cross-over design, residents were assigned randomly to either the non-call group or the call group. Both groups were screened for exclusionary criteria. Call group participants required two sequential FeNO measurements, one while on-call and the next 24 hours following.

RESULTS:  Seventeen residents responded with the initial screening questionnaire. None had more than a 7% pre-test probability for OSA as determined by previously established clinical prediction formulas. Average Epworth 7.1 (±SD 4.1). Eleven residents were eligible and underwent complete testing. Two residents were excluded for recent NSAID use, 1 for cold symptoms, 1 for not completing the questionnaire, 1 for test administered incorrectly, and 1 for not following-up with the post-call FeNO measurement. The length of time spent sleeping by the non-call (n=8), immediately pre-call (n=5), and immediately post-call (n=5) groups were 6.4 (±SD 0.8) hours, 6.7 (±1.2) hours, and 3.7 (±3.3) hours, respectively. Mean FeNO in the non-call, pre-call and post-call groups were 12.3 ±0.8 ppm, 18.3 ±8.6 ppm, and 19.2 ±9.9 ppm, respectively (ANOVA, p<0.05).

CONCLUSION:  FeNo levels are elevated in residents engaged in regular in-house overnight call in as little as two weeks when compared to their non-call counterparts. The greater FeNO level on the day of call when compared to the non-call group in spite of greater average sleep time the night prior suggests that the inflammatory state lingers for at least 72 hours after call.

CLINICAL IMPLICATIONS:  FeNO is increased in sleep-deprived medical residents, supporting the concept that sleep deprivation gives rise to a pro-inflammatory state.

DISCLOSURE:  Haven Malish, No Financial Disclosure Information; No Product/Research Disclosure Information

Wednesday, November 4, 2009

2:15 PM - 3:15 PM




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

CHEST Journal Articles
  • CHEST Journal
    Print ISSN: 0012-3692
    Online ISSN: 1931-3543