Clinical Performance in Critical Care Simulation under Sleep Deprivation: Effects of Power Napping in the Recovery...

Area of Science:

• Medical Education
• Sleep Medicine
• Anesthesiology

Background:

• Sleep deprivation is prevalent among anesthesia residents, negatively impacting critical skills.
• Napping is a recommended fatigue management strategy, but its efficacy in healthcare professionals is understudied.
• This study investigated the impact of a 30-minute nap on simulated crisis performance post-24-hour shift.

Purpose of the Study:

• To evaluate the effect of a nap opportunity on simulated crisis performance in sleep-deprived anesthesia residents.
• To assess the influence of napping on both technical and non-technical clinical skills.
• To explore the relationship between nap duration and performance outcomes.

Main Methods:

• Anesthesia residents underwent two testing sessions: one rested and one after a 24-hour shift inducing sleep deprivation.
• Participants were randomized to a nap opportunity or a control group during the sleep-deprived condition.
• Actigraphy measured sleep and nap duration; simulated crisis performance was the primary endpoint, with technical and non-technical skills as secondary endpoints.

Main Results:

• Residents with a nap opportunity showed a 7.4% improvement in overall simulated clinical performance compared to controls (p=.018).
• Non-technical skills, including leadership and resource utilization, were significantly higher in the nap group (p=.016).
• Longer nap durations were exploratory associated with better performance across multiple domains, particularly technical skills (p=.010).

Conclusions:

• A 30-minute nap opportunity can enhance clinical performance in sleep-deprived anesthesia residents.
• Nap opportunity, duration, and prior sleep deprivation differentially affect technical and non-technical skills.
• Findings support the integration of napping and recovery strategies into medical education and scheduling for improved resident well-being and performance.