In Reply: Sleepiness is
pervasive in modern 24-hour society and results from multiple
identifiable factors. Excessive sleepiness increases the likelihood of
making critical errors while working or driving, particularly at night
and during the early morning hours. Certainly, as Dr Smith states, the
common cold and many other illnesses, as well as certain medications,
influence sleepiness and fatigue and thus may impair driving and work
performance efficiency.
The public health consequences of long-term sleep deprivation can
be profound and are a concern for health care workers, military and
public safety personnel, nuclear power plant operators, and workers in
transportation and manufacturing industries. We appreciate Dr Sloan's
concern about the excessive work hours of house officers and the impact
of sleep deprivation on physician job performance. While the
consequences of long working hours among house staff are important and
merit further study, this issue was beyond the scope of the Council on
Scientific Affairs report.