Sleeping and working hours of residents at a national university hospital in Japan.

This study aimed to examine the status of time spent working and sleeping by resident doctors before the introduction of the New Training System for Residents in Japan. A time-budget survey was conducted over a 4-wk period on 102 residents at the Shiga University of Medical Science Hospital, and the response rate among residents was 76% of a total of 2,722 person-days. The average number of hours spent sleeping was the lowest and spent in the hospital including commuting time was the highest in residents of the surgery department, at 4.4 h and 18.9 h, respectively. Forty percent of residents reported dozing off at work, with the incidence rate being highest in residents of the surgery department (0.7 times/person-day). Dozing appeared to occur in response to the lack of sleep and fatigue, since the same residents slept longer on nights before days they reported not dozing off than on nights before days when they did doze off. Strong correlations were observed between the number of sleeping and working hours and between working hours and the number of patients in a resident's care. In order to maintain high standards of training and to get sufficient sleep it is therefore necessary for residents to manage their work and the number of patients in their care.