6. Sleep deprivation during residency

Sleep deprivation is the norm in medical training. But does it have to be? Residents typically work a mix of day and night shifts with some shifts lasting more than 24 hours. I sit down with the incredible Dr. Gabriela De Bruin to discuss the effects of this sleep deprivation on residents and patients. We review the medical literature on the topic and discuss alternative work schedules. Dr. Gabriela De Bruin is a neurologist at Washington University who specializes in the treatment of patients with sleep disorders.

Time stamps:

– 02:40: Dr. De Bruin background

– 10:08: Non-medical book recommendation

– 11:25: Sleep deprivation during residency

– 12:23: Acute vs chronic sleep deprivation

– 14:30: How much sleep should you get each night?

– 17:30: Adverse health effects of sleep deprivation

– 22:50: Sleep deprivation and cognition, attention, and motor skills

– 25:18: Sleep deprivation compared to alcohol intoxication

– 28:17: Personal perception of sleepiness

– 31:50: Research on the impact of sleep on patient care

– 35:48: Sleep deprivation and length of stay and patient mortality

– 39:30: Duty hours reform

– 44:36: Impact of duty hours on patient safety outcomes

– 48:48: Why didn’t duty hours reform improve patient outcomes?

– 51:38: Long shifts vs a night float system

– 57:50: Strategies to reduce and mitigate the effects of sleep deprivation


Dr. De Bruin report no relevant financial disclosures. Brain Boy Neurology reports no relevant financial disclosures.


  1. Dawson, Drew, and Kathryn Reid. “Fatigue, alcohol and performance impairment.” Nature 388.6639 (1997): 235-235 (https://www.nature.com/articles/40775)
  2. Landrigan, Christopher P., et al. “Effect of reducing interns’ work hours on serious medical errors in intensive care units.” New England Journal of Medicine 351.18 (2004): 1838-1848 (https://www.nejm.org/doi/full/10.1056/NEJMoa041406)
  3. Lockley, Steven W., et al. “Effect of reducing interns’ weekly work hours on sleep and attentional failures.” New England Journal of Medicine 351.18 (2004): 1829-1837. (https://www.nejm.org/doi/full/10.1056/NEJMoa041404)
  4. Desai, Sanjay V., et al. “Education outcomes in a duty-hour flexibility trial in internal medicine.” New England Journal of Medicine 378.16 (2018): 1494-1508 (https://www.nejm.org/doi/full/10.1056/NEJMoa1800965)