Observational studySleep2017
Sleep and Alertness in Medical Interns and Residents: An Observational Study on the Role of Extended Shifts.
Observational study in Sleep, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04304703 (Remote Physiologic Monitoring of Resident Wellness and Burnout), which is not on this map. Cited by 44 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Remote Physiologic Monitoring of Resident Wellness and Burnout
Who cites it
44 citing papers in PubMed, 1 synthesis or guideline pooled it.
- The impact of shift work schedules on PVT performance in naturalistic settings: a systematic review.International archives of occupational and environmental health · 2021Pooled it
- Trial
- Chronic sleep restriction greatly magnifies performance decrements immediately after awakening.Sleep · 2019Trial
- Sleep and Alertness in a Duty-Hour Flexibility Trial in Internal Medicine.The New England journal of medicine · 2019Trial
- On-call work schedules, sleep knowledge, and sleep quality in medical trainees: results from a UK pilot study.Journal of thoracic disease · 2026Article
- Association between impaired objective alertness and poor subjective health: a study on physicians' work-style reform surveillance in Japan.Industrial health · 2026Article
- Within-person differences in night-shift burden and well-being after ICU versus non-ICU night shifts among resident physicians: a paired survey study.BMC medical education · 2026Article
- Fatigue and Associated Factors Among Intern Doctors in Bangladesh: A Cross-Sectional Study.Health science reports · 2025Article
- Relationship between shift scheduling, sleep knowledge and sleep quality in medical trainees: protocol for a global cross-sectional survey.Journal of thoracic disease · 2025Article
- Burnout among Otolaryngology Residents: The Impact of Age, Gender, and Sleep.Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India · 2025Article
- Impact of shift durations on sleep, fatigue, and wellness among neonatologists: a cross-sectional survey analysis.Journal of perinatology : official journal of the California Perinatal Association · 2025Article
- Perspective: Improving the understanding of sleep deprivation and strategies for fatigue management across the medical education continuum: a call to action.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Towards a National System-Level Intervention: Characterization of Burnout Among Trainees of Saudi Postgraduate Healthcare Professions Programs.Healthcare (Basel, Switzerland) · 2025Article
- Objective alertness, rather than sleep duration, is associated with burnout and depression: A national survey of Japanese physicians.Journal of sleep research · 2025Article
- Sleep, chronotype, social jetlag, and mental health in resident physicians: a cross-sectional study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2024Article
- Sleep, Well-Being, and Cognition in Medical Interns on a Float or Overnight Call Schedule.JAMA network open · 2024Observational
- Article
- Predicting neurobehavioral performance of resident physicians in a Randomized Order Safety Trial Evaluating Resident-Physician Schedules (ROSTERS).Sleep health · 2024Article
- "Multivariate analysis of the impact of sleep and working hours on medical errors: a MICE approach".BMC public health · 2023Observational
- Impact of sleep deficiency on surgical performance: a prospective assessment.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2023Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors.
Funding
Abstract
Study Objectives: Fatigue from sleep loss is a risk to physician and patient safety, but objective data on physician sleep and alertness on different duty hour schedules is scarce. This study objectively quantified differences in sleep duration and alertness between medical interns working extended overnight shifts and residents not or rarely working extended overnight shifts. Methods: Sleep-wake activity of 137 interns and 87 PGY-2/3 residents on 2-week Internal Medicine and Oncology rotations was assessed with wrist-actigraphy. Alertness was assessed daily with a brief Psychomotor Vigilance Test (PVT) and the Karolinska Sleepiness Scale. Results: Interns averaged 6.93 hours (95% confidence interval [CI] 6.84-7.03 hours) sleep per 24 hours across shifts, significantly less than residents not working overnight shifts (7.18 hours, 95% CI 7.06-7.30 hours, p = .007). Interns obtained on average 2.19 hours (95% CI 2.02-2.36 hours) sleep during on-call nights (17.5% obtained no sleep). Alertness was significantly lower on mornings after on-call nights compared to regular shifts (p < .001). Naps between 9 am and 6 pm on the first day post-call were frequent (90.8%) and averaged 2.84 hours (95% CI 2.69-3.00 hours), but interns still slept 1.66 hours less per 24 hours (95% CI 1.56-1.76 hours) compared to regular shift days (p < .001). Sleep inertia significantly affected alertness in the 60 minutes after waking on-call. Conclusions: Extended overnight shifts increase the likelihood of chronic sleep restriction in interns. Reduced levels of alertness after on-call nights need to be mitigated. A systematic comparison of sleep, alertness, and safety outcomes under current and past duty hour rules is encouraged.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.