ACOG Committee Opinion No. 730: Fatigue and Patient Safety
Fatigue and sleep deprivation may affect a health care provider’s skills and communication style, and also may affect clinical outcomes. The National Sleep Foundation recommends 7–9 hours of sleep per night for an adult. However, there are no current guidelines limiting the volume of deliveries and procedures performed by a single individual or on the length of time he or she may be on call. Medical literature has shown that even a single night of missed sleep measurably affects cognitive performance. When adults do not sleep at least 5 hours per night, language and numeric skills, retention of information, short-term memory, and concentration all decrease on standardized testing. Speed of performance may be affected more than accuracy. Sleep deprivation may affect mood to a greater degree than it affects cognitive or motor performance, and, thus, may have a significant effect on a physician’s ability to communicate effectively. To help mitigate resident fatigue, programs must train all faculty members and residents to recognize the signs of fatigue and sleep deprivation. The medical directors of outpatient units and chairs of hospital departments of obstetrics and gynecology may consider developing call schedules and associated policies that balance the need for continuity of care and the health care providers’ need for rest. Designing standardized procedures also may protect against fatigue-related errors. Physicians at all stages in their careers need to be conscious of the demands placed on them professionally and personally and should balance those demands with rest to avoid excessive fatigue or overcommitment.