![]() ![]() Their use has been implemented effectively in other high-reliability organizations, such as transport and military, where they are employed extensively 9. Some of the best potential to combat sleep deprivation is offered by pharmacological countermeasures, for example stimulant drugs such as caffeine. ![]() Other methods such as exercise and napping have been tested, with varying degrees of success 7, 8. Sleep deprivation and fatigue are known to be detrimental to psychomotor performance to a degree that may be equivalent to a blood alcohol level of 0♱0 per cent, higher than the legal driving limit in the UK (0♰8 per cent) 6.Īlthough the optimal countermeasure to sleep deprivation is sleep itself, this is not always pragmatic or possible. Sleep deprivation may impair clinical performance and have a deleterious effect on cognitive function, and reduces the ability of medical interns to diagnose cardiac arrhythmias 5. Sleep deprivation and fatigue have been widely shown to have an adverse effect on mood and cognitive and motor performance 4. The potential effects on surgical training resulting from the implementation of working hour restrictions imposed by the European Working Time Directive (EWTD) and 80-h working week restrictions in the USA have been debated extensively 1–3. Subjective sleepiness was also improved, but not to baseline levels. Negative effects of sleep deprivation on reaction time were reversed when caffeine (307 ms versus 299 ms in rested state P = 0♲14) or caffeine plus taurine (326 versus 299 ms P = 0♱10) was administered. Sleep-deprived subjects receiving placebo had slower reaction times (377 versus 299 ms P = 0♰08) and a higher score on the Stanford Sleepiness Scale (6 versus 2 points P = 0♰01) than rested surgeons. Caffeine restored psychomotor skills to baseline for time taken (37 versus 35 s P = 0♱01), although the number of errors remained significantly greater than in the rested state (63 versus 59 P = 0♰46). ![]() Sleep-deprived participants receiving the placebo took longer (median 41 versus 35 s P = 0♰16), were less economical with movement (3♲5 versus 2♹5 m P = 0♰16) and made more errors (66 versus 59 P = 0♰21) on the laparoscopic task compared with the rested state. Baseline performance was recorded for 18 participants in the rested state. ![]()
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