Sleep deprivation is assumed detrimental to physician performance. Over the past 30 years, increased efforts and attention to this issue have resulted in restriction of physician work hours. Since the death of Libby Zion in 1984, debate has raged among educators, sleep scientists, practitioners, and regulatory and legislative bodies about the contribution of lack of physician sleep to adverse patient outcomes.1 Investigation of this event by the Bell Commission culminated in the first law to restrict resident physician work hours in New York State to 80 hours per week.2 Between the enactment of that law (1989) and 2002, many attempts were made to establish an 80-hour work week standard for residents throughout the United States. Pressure from trainee unions such as the Committee of Interns and Residents/Service Employees International Union (CIR/SEIU) and Public Citizen, caused the Occupational Safety and Health Administration (OSHA) in the US Department of Labor to consider enacting regulations limiting work hours for trainees.3
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