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Scientific Articles   |    
Does Sleep Deprivation Impair Orthopaedic Surgeons’ Cognitive and Psychomotor Performance?
Michael J. O’Brien, MD1; Robert V. O’Toole, MD1; Mary Zadnik Newell, ScD, OTR/L, MEd1; Alison D. Lydecker, MPH2; Jason Nascone, MD1; Marcus Sciadini, MD1; Andrew Pollak, MD1; Clifford Turen, MD1; W. Andrew Eglseder, MD1
1 Department of Orthopaedics, R Adams Cowley Shock Trauma Center, University of Maryland, 22 South Greene Street, T3R62, Baltimore, MD 21201. E-mail address for R.V. O’Toole: rvo3@yahoo.com
2 Department of Epidemiology and Public Health, University of Maryland School of Medicine, 10 South Pine Street, MSTF 360A, Baltimore, MD 21201
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Investigation performed at R Adams Cowley Shock Trauma Center, University of Maryland, Department of Orthopaedics, Baltimore, Maryland

This article was chosen to appear electronically on September 26, 2012, in advance of publication in a regularly scheduled issue.



Disclosure: One or more of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of an aspect of this work. In addition, one or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2012 by The Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2012 Nov 07;94(21):1975-1981. doi: 10.2106/JBJS.K.00958
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Abstract

Background: 

Sleep deprivation may slow reaction time, cloud judgment, and impair the ability to think. Our purpose was to study the cognitive and psychomotor performances of orthopaedic trauma surgeons on the basis of the amount of sleep that they obtained.

Methods: 

We prospectively studied the performances of thirty-two orthopaedic trauma surgeons (residents, fellows, and attending surgeons) over two four-week periods at an urban academic trauma center. Testing sessions used handheld computers to administer validated cognitive and psychomotor function tests. We conducted a multivariate analysis to examine the independent association between test performance and multiple covariates, including the amount of sleep the night before testing.

Results: 

Our analysis demonstrated that orthopaedic surgeons who had slept four hours or less the night before the test had 1.43 times the odds (95% confidence interval, 1.04 to 1.95; p = 0.03) of committing at least one error on an individual test compared with orthopaedic surgeons who had slept more than four hours the previous night. The Running Memory test, which assesses sustained attention, concentration, and working memory, was most sensitive to deterioration in performance in participants who had had four hours of sleep or less; when controlling for other covariates, the test demonstrated a 72% increase in the odds of making at least one error (odds ratio, 1.72 [95% confidence interval, 1.02 to 2.90]; p = 0.04). No significant decrease in performance with sleep deprivation was shown with the other three tests.

Conclusions: 

Orthopaedic trauma surgeons showed deterioration in performance on a validated cognitive task when they had slept four hours or less the previous night. It is unknown how performance on this test relates to surgical performance.

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    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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