Division of Pulmonary/Critical Care/Sleep Medicine, Stony Brook University, Department of Veterans Affairs Medical Center, Northport, New York 11768, USA.
Acad Med. 2012 Oct;87(10):1428-33. doi: 10.1097/ACM.0b013e3182676b37.
Despite shorter duty hours, fatigue remains a problem among medical residents. The authors tested the effect of a short, mid-day nap on the cognitive functioning and alertness of first-year internal medicine (IM) residents during normal duty hours.
This was a controlled, interventional study performed between July 2008 and April 2010. The authors recruited a nap group of 18 residents and a rest (control) group of 11 residents. Investigators connected all participants to an ambulatory sleep monitor before the beginning of their shifts in order to monitor rolling eye movements, a proxy for attention failures. At mid-day, both groups took Conner's Continuous Performance Test (CPT II) to evaluate their cognitive functioning and then were placed in a reclining chair designed for napping. The authors instructed nap group residents to nap for up to 20 minutes and chatted with control group residents to prevent them from napping. All residents took the CPT II again immediately after the intervention. Residents' attention failures were recorded until the end of the workday. The authors compared the mean outcome parameters of the two groups through analysis of variance, using effect-of-treatment and baseline covariates.
Nap group participants slept a mean of 8.4±3.0 minutes. Compared with controls whose cognitive functioning and number of attention failures did not change from morning to afternoon, the nap group's cognitive functioning improved and their number of attention failures decreased.
A short, mid-day nap can improve cognitive functioning and alertness among first-year IM residents.
尽管工作时间缩短了，但疲劳仍然是住院医师面临的一个问题。作者测试了在正常工作时间内，短时间午休对第一年内科住院医师认知功能和警觉性的影响。
这是一项在 2008 年 7 月至 2010 年 4 月间进行的对照干预研究。作者招募了 18 名午休组住院医师和 11 名休息（对照）组住院医师。研究人员在开始轮班之前，通过佩戴便携式睡眠监测仪连接所有参与者，以监测眼球滚动，这是注意力不集中的一个指标。在中午时分，两组人员都进行了康纳连续注意力测试（CPT II），以评估他们的认知功能，然后他们被安排在专门用于午睡的躺椅上。作者指示午休组住院医师午睡不超过 20 分钟，并与对照组住院医师交谈，以防止他们午睡。所有的住院医师在干预后立即再次进行 CPT II 测试。记录住院医师的注意力不集中情况，直到工作日结束。作者通过分析方差比较两组的平均结果参数，使用治疗效果和基线协变量。
午休组参与者平均睡眠时间为 8.4±3.0 分钟。与对照组相比，对照组的认知功能和注意力不集中的次数从早上到下午没有变化，而午休组的认知功能得到了改善，注意力不集中的次数减少了。
短暂的午间小睡可以改善第一年内科住院医师的认知功能和警觉性。
