1356. "Nature's Soft Nurse" - Sleep Deficit in Neurosurgical Residents

Authors: Gary Robert Simonds, MD, FAANS; Cara Rogers; chris busch; Brendan Klein; John Entwistle; Brian Saway (Black Mountain, NC)

Introduction: The detrimental effects of even of a modicum of sleep deficit has been well documented. We are all familiar with the sleep deficit incurred from neurosurgical call. What is less well appreciated is the fact that many neurosurgical residents significantly limit their sleep on non-call nights. Methods: Through interviews of residents at other programs (via various meetings, visits, and courses) we "straw-polled" over 100 neurosurgical residents or recent graduates from over 30 programs about their sleep habits when not on call during their training years. Results: The grand majority of residents interviewed noted that they slept less than 7 hours a night when not on call. Lost sleep from call nights was countered by short naps the day after call. The majority of respondents estimated their non-call night sleep to be in the 5 to 6 hour range, with 5 hours the most common sited duration of sleep. Most respondents admitted to desiring significantly more sleep - on the order of 7-8 hours per night. Sleep was curtailed for a number of reasons, predominately to "squeeze in" activities that were being concentrated in the late evenings due to their long working days (activities of daily living, chart completion, research, reading, studying, eating, hobbies, exercise, intimacy, etc.). Conclusion: Despite the reduction in work hours and the limitation of call nights for the latest generation of neurosurgical residents, educational activities and activities of life continue to run well into the resident's evenings at the expense of much needed sleep. Such chronic sleep deficits run the risk of increased rates of burnout, depression, poor performance, and other maladaptive ramifications. Formal surveys on this topic should be initiated. Resident resilience activities should focus on education in sleep hygiene and the establishment of realistic evening goals and schedules.