Sleep deprived doctors are putting patients at risk according to researchers.

Medical institutions should put into place policies to minimize the likelihood of a sleep-deprived doctor performing elective surgery, researchers said Wednesday in an editorial.

Falling asleep in the surgical suite occurs far less often than do negative outcomes associated with sleep deprivation, said Dr. Charles A. Czeisler, chief of the Division of Sleep Medicine at the Brigham and Women's Hospital in Boston, Massachusetts, and professor of sleep medicine at Harvard Medical School.

"The level of impairment is profound well before you get to the point of being so exhausted that you fall asleep," he said.

Czeisler cited a study that compared performing surgery after a sleepless night to driving with a blood-alcohol of 0.1%, a level considered legally drunk in all 50 states and the District of Columbia.

The risk extends to the most senior physicians. A study published last year in the Journal of the American Medical Association showed that patients of sleep-deprived faculty surgeons faced an 83% increased risk of complications, the authors said, citing massive hemorrhage and organ injury as the most common examples. They defined a sleep-deprived doctor as one who had had less than a six-hour opportunity for sleep between procedures during a previous on-call night.

The Accreditation Council for Graduate Medical Education has restricted first-year residents' work hours to no more than 16 hours of continuous work followed by at least eight hours off duty, but physicians in their second year of training and beyond face no such restrictions.

Few institutions have imposed restrictions on doctors on call to ensure they don't wind up being scheduled for surgery the next morning, said Dr. Michael Nurok, lead author of the NEJM study.



Links:
http://www.cnn.com/2010/HEALTH/12/29/sleepy.surgeons/index.html?hpt=C2

http://healthysleep.med.harvard.edu/