Naps and Drugs To Combat Fatigue and Sleepiness

The United States is progressing toward a 24-hour society as it grows dependent on shift work to meet the demands for increased productivity in the global economy. Consequently, sleep deprivation is a growing problem in the workplace. Sleepiness in shift and night work is as severe a problem as that of insomnia and is said to affect 75% of shift and night workers (1). It can cause disruptions in everyday function, including psychosocial distress, decreased cognitive performance, increased risk-taking behavior, and inappropriate decision making (2). Many industries have established specific rules to prevent performance impairment caused by long working hours, sleep restriction, and circadian dyschronosis.

The health industry has been slow to respond to concerns about the effects of sleep deprivation on physician health and patient care (3-5). In July 2003, the Accreditation Council for Graduate Medical Education (ACGME) did take action by restricting resident duty hours. Of note, the ACGME rules still allow extended work shifts of up to 30 consecutive hours, despite studies showing that shorter shifts are associated with fewer treatment errors (6). Moreover, no one has published clear safeguards against clouded professional judgment and poor response after long hours on task.

What can be done about sleepiness in the workplace? What are possible countermeasures, and how effective are they? The Agency for Healthcare Research and Quality and the American Academy of Sleep Medicine have endorsed naps to relieve fatigue during long work shifts (7, …