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Updated: Jan 3, 2026

Collecting Sleep, Circadian, Fatigue, and Performance Data in Complex Operational Environments
Published on: August 8, 2019
Sleep and stress before and after duty across residency years under 2017 ACGME hours
Benjamin McManus1, James W Galbraith2, Karen Heaton3
1University of Alabama at Birmingham, Department of Psychology, United States.
Introduction:
Residents may differentially experience high stress and poor sleep across multiple post-graduate years (PGYs), negatively affecting safety. This study characterized sleep and stress among medical and surgical residents across multiple PGYs and at specific times surrounding duty.
Method:
Thirty-two medical and surgical residents (Mage = 28.6 years; 56% male) across PGYs 1-5 participated in 3 appointments (immediately before duty, after duty, and on an off day) providing 96 data points. Sleep, stress, and occupational fatigue were measured by both self-report and objectively (actigraphy, salivary coritsol).
Results:
Residents averaged 7 h of actigraphy-estimated sleep per night but varied ±3 h day-to-day. Residents reported clinically poor sleep quality. Life stress decreased by PGY-2. All residents averaged elevated life stress values. Poor sleep quality did not differ among PGY cohorts.
Discussion:
Poor sleep quality is similar between early residency cohorts (PGY-1) and later residency cohorts (PGY-3+). Persistent fatigue is highest in later residency cohorts. Even the most experienced residents may struggle with persisting fatigue. Current hour policies may have shortcomings in addressing this risk.
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