Monday, January 20, 2014


"The drug of choice...........EXERCISE"

Sleep & Rest

There are three pillars to the health equation:  Diet, Exercise and Sleep.  All three are important and you can arrange them to suit your order.  So far we have been considering exercise as our main topic.  We started out with a description, followed it with some of the benefits (goals) and included topics for beginners to more advanced trainees of an exercising program.  We will come back to the subject of exercise on and off, again influenced by what our reader's desire to include in this blog.

Some of the better sources of sleep information can be found at the National Sleep Foundation (, ScienceDaily (, WebMD (, and Sleep, (

In a study reported in ScienceDaily dated 12/4/2012 an article labeled "Protected 'Power Naps' Prove Helpful for Doctors in Training to Fight Fatigue" was the result of study of two groups of medical residency doctors. This involved 106 interns from the Hospital of the University of Pennsylvania and the Philadelphia VA Medical Center.  The standard intern shift of 30 hours overnight was compared to the protracted sleep period shift - during a twelve 4-week blocks.  During the study, the participants in the protected sleep group increased the amount of time they slept while on call by 50% (from two to three hours on average).  They also decreased the overall amount of time they were awake, reducing periods of no sleep while on extended duty, and the study participants reported far less sleep disturbances, helping to improve overall sleep quality. The participants felt less fatigued after on-call nights in the protected sleep group.

By accepting sleep at strategically assigned times, the residents were also able to maintain consistent contact with their patients and stay with them during their first critical 24 hours in the hospital, while improving alertness.  It was also noted that decreasing the overall amount of time that participants were awake is particularly important, as continuous periods of wakefulness are a major predictor of work-related performance errors.

Boiled down, the need for sleep helps reduce fatigue, errors, while increasing and improving transition in patient care.  As a result of sleep studies, the July 2011 the medical residency programs across the country revamped physician-trainees' schedules to comply with new work-hour restrictions imposed the the Accreditation Council on Graduate Medical Education (ACMGE).  First-year residents are no longer permitted to work more than 16 hours at a time.