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Does Sleep Deprivation Impair Orthopaedic Surgeons’ Cognitive and Psychomotor Performance?

O’Brien, Michael J. MD; O’Toole, Robert V. MD; Newell, Mary Zadnik ScD, OTR/L, MEd; Lydecker, Alison D. MPH; Nascone, Jason MD; Sciadini, Marcus MD; Pollak, Andrew MD; Turen, Clifford MD; Eglseder, W. Andrew MD

Journal of Bone & Joint Surgery - American Volume: 7 November 2012 - Volume 94 - Issue 21 - p 1975–1981
doi: 10.2106/JBJS.K.00958
Scientific Articles
Supplementary Content
Disclosures

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.

1Department 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

2Department of Epidemiology and Public Health, University of Maryland School of Medicine, 10 South Pine Street, MSTF 360A, Baltimore, MD 21201

Copyright 2012 by The Journal of Bone and Joint Surgery, Incorporated
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