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. 2004 Feb;61(2):167–170. doi: 10.1136/oem.2002.006197

Attention and working memory in resident anaesthetists after night duty: group and individual effects

P Bartel 1, W Offermeier 1, F Smith 1, P Becker 1
PMCID: PMC1740704  PMID: 14739384

Abstract

Aims: To investigate the effects of a single period of night duty on measures of attention and working memory in a group of residents (registrars) in anaesthesiology. Emphasis was placed on individual deficits using a reference point of the equivalent effect of a blood alcohol concentration (BAC) >0.05% determined by other researchers.

Methods: There were 33 subjects aged 26–42 years. Night duty was performed on a weekly basis. Baseline assessments were conducted at either 08 15 or 08 55 preceding night duty and repeated 24–25 hours later, just after the completion of duty. Questionnaires included items regarding duration of sleep and the Stanford Sleepiness Scale. A battery of four reaction time (RT) tasks of increasing difficulty, lasting approximately 35 minutes, was administered on a personal computer. These ranged from simple RT to progressively more complex RT tasks incorporating working memory. A significant change was regarded as >15% deterioration in respect of speed or accuracy.

Results: The mean duration of sleep preceding night duty was 7.04 hours and 1.66 hours during the period of night duty. Intergroup comparisons revealed significant prolongation in mean response speed in the first three tests. Mean accuracy was significantly reduced only in respect of the two more complex tests. A >15% deterioration in response speed occurred in up to 30% of subjects on a single task, rising to 52% (17/33) overall. Deterioration occurred in a patchy distribution in most subjects, involving no more than one or two of the four tasks. As regards accuracy, the prevalence of deterioration increased with task complexity.

Conclusions: Results are in general agreement with previous group analyses. A new dimension was added by the analysis of a broad spectrum of individual response to sleep deprivation. The effects of sleep loss in residents cannot be overlooked, even in a relatively benign work schedule.

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Selected References

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  1. Ayuso-Mateos J. L., Pereda M., Gómez Del Barrio A., Echevarria S., Fariñas M. C., García-Palomo D. Slowed reaction time in HIV-1-seropositive intravenous drug users without AIDS. Eur Neurol. 2000;44(2):72–78. doi: 10.1159/000008200. [DOI] [PubMed] [Google Scholar]
  2. Casagrande M., Violani C., Curcio G., Bertini M. Assessing vigilance through a brief pencil and paper letter cancellation task (LCT): effects of one night of sleep deprivation and of the time of day. Ergonomics. 1997 Jun;40(6):613–630. doi: 10.1080/001401397187919. [DOI] [PubMed] [Google Scholar]
  3. Dawson D., Reid K. Fatigue, alcohol and performance impairment. Nature. 1997 Jul 17;388(6639):235–235. doi: 10.1038/40775. [DOI] [PubMed] [Google Scholar]
  4. Doran S. M., Van Dongen H. P., Dinges D. F. Sustained attention performance during sleep deprivation: evidence of state instability. Arch Ital Biol. 2001 Apr;139(3):253–267. [PubMed] [Google Scholar]
  5. Feyer A. M. Fatigue: time to recognise and deal with an old problem. BMJ. 2001 Apr 7;322(7290):808–809. doi: 10.1136/bmj.322.7290.808. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Harrison Y., Horne J. A. The impact of sleep deprivation on decision making: a review. J Exp Psychol Appl. 2000 Sep;6(3):236–249. doi: 10.1037//1076-898x.6.3.236. [DOI] [PubMed] [Google Scholar]
  7. Hoddes E., Zarcone V., Smythe H., Phillips R., Dement W. C. Quantification of sleepiness: a new approach. Psychophysiology. 1973 Jul;10(4):431–436. doi: 10.1111/j.1469-8986.1973.tb00801.x. [DOI] [PubMed] [Google Scholar]
  8. Koslowsky M., Babkoff H. Meta-analysis of the relationship between total sleep deprivation and performance. Chronobiol Int. 1992 Apr;9(2):132–136. doi: 10.3109/07420529209064524. [DOI] [PubMed] [Google Scholar]
  9. Kuo A. A. Resident overnight call--an idea past its time? West J Med. 2001 Mar;174(3):180–181. [PMC free article] [PubMed] [Google Scholar]
  10. Lichtor J. L., Zacny J., Lane B. S., Good M. L. Research grant report: how does night call affect next-day performance in anesthesia? J Clin Monit. 1996 May;12(3):277–278. doi: 10.1007/BF00857650. [DOI] [PubMed] [Google Scholar]
  11. Miller E. N., Satz P., Visscher B. Computerized and conventional neuropsychological assessment of HIV-1-infected homosexual men. Neurology. 1991 Oct;41(10):1608–1616. doi: 10.1212/wnl.41.10.1608. [DOI] [PubMed] [Google Scholar]
  12. Narang V., Laycock J. R. Psychomotor testing of on-call anaesthetists. Anaesthesia. 1986 Aug;41(8):868–869. doi: 10.1111/j.1365-2044.1986.tb13136.x. [DOI] [PubMed] [Google Scholar]
  13. Orton D. I., Gruzelier J. H. Adverse changes in mood and cognitive performance of house officers after night duty. BMJ. 1989 Jan 7;298(6665):21–23. doi: 10.1136/bmj.298.6665.21. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Owens J. A., Veasey S. C., Rosen R. C. Physician, heal thyself: sleep, fatigue, and medical education. Sleep. 2001 Aug 1;24(5):493–495. doi: 10.1093/sleep/24.5.493. [DOI] [PubMed] [Google Scholar]
  15. Pilcher J. J., Huffcutt A. I. Effects of sleep deprivation on performance: a meta-analysis. Sleep. 1996 May;19(4):318–326. doi: 10.1093/sleep/19.4.318. [DOI] [PubMed] [Google Scholar]
  16. Richardson G. S., Wyatt J. K., Sullivan J. P., Orav E. J., Ward A. E., Wolf M. A., Czeisler C. A. Objective assessment of sleep and alertness in medical house staff and the impact of protected time for sleep. Sleep. 1996 Nov;19(9):718–726. [PubMed] [Google Scholar]
  17. Samkoff J. S., Jacques C. H. A review of studies concerning effects of sleep deprivation and fatigue on residents' performance. Acad Med. 1991 Nov;66(11):687–693. doi: 10.1097/00001888-199111000-00013. [DOI] [PubMed] [Google Scholar]
  18. Weinger Matthew B., Ancoli-Israel Sonia. Sleep deprivation and clinical performance. JAMA. 2002 Feb 27;287(8):955–957. doi: 10.1001/jama.287.8.955. [DOI] [PubMed] [Google Scholar]
  19. Wesnes K. A., Walker M. B., Walker L. G., Heys S. D., White L., Warren R., Eremin O. Cognitive performance and mood after a weekend on call in a surgical unit. Br J Surg. 1997 Apr;84(4):493–495. [PubMed] [Google Scholar]
  20. Williamson A. M., Feyer A. M. Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication. Occup Environ Med. 2000 Oct;57(10):649–655. doi: 10.1136/oem.57.10.649. [DOI] [PMC free article] [PubMed] [Google Scholar]

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