The effects of a mid-day nap on the neurocognitive performance of first-year medical residents: A controlled interventional pilot study

Abstract

Purpose: Despite shorter duty hours, fatigue remains a problem among medical residents. The authors tested the effect of a short, mid-day nap on the cognitive functioning and alertness of first-year internal medicine (IM) residents during normal duty hours.
Method: This was a controlled, interventional study performed between July 2008 and April 2010. The authors recruited a nap group of 18 residents and a rest (control) group of 11 residents. Investigators connected all participants to an ambulatory sleep monitor before the beginning of their shifts in order to monitor rolling eye movements, a proxy for attention failures. At mid-day, both groups took Conner’s Continuous Performance Test (CPT II) to evaluate their cognitive functioning and then were placed in a reclining chair designed for napping. The authors instructed nap group residents to nap for up to 20 minutes and chatted with control group residents to prevent them from napping. All residents took the CPT II again immediately after the intervention. Residents’ attention failures were recorded until the end of the workday. The authors compared the mean outcome parameters of the two groups through analysis of variance, using effect-of-treatment and baseline covariates.
Results: Nap group participants slept a mean of 8.4 ± 3.0 minutes. Compared with controls whose cognitive functioning and number of attention failures did not change from morning to afternoon, the nap group’s cognitive functioning improved and their number of attention failures decreased.
Conclusions: A short, mid-day nap can improve cognitive functioning and alertness among first-year IM residents.