Sleep deprivation and physician performance: Why should I care?

Steven K. Howard, MD

Fatigue is a timely topic-for society as well as health care. In health care, most of the discussion of fatigue has focused on work hours. Curtailing resident work hours has had both advocates and critics. Yet limitations on work hours may never be enough. In its large national surveys, the National Sleep Foundation found that we are a society of chronic undersleepers. Because of the many competing interests in our 24/7 world, a physician working 20 hours a week may still come to work fatigued. A culture change is required: it should be unacceptable to come to work impaired from any cause. In this article, I review sleep physiology, discuss some relevant studies on sleep in a health care environment, and present recommendations to help counter the effects of fatigue.