Sleep Deprivation and Performance of Residents

To the Editor.—  Deaconson and colleagues¹ concluded that their data did not support an assumption that sleep deprivation adversely effects the capacity of residents to exhibit the cognitive and motor functions needed to provide appropriate patient care. The authors, however, overlook some key points. Even if cognitive and motor function are preserved, other physician attributes such as judgment, compassion, and interpersonal skills are necessary for good patient care.Residents' comments at a recent house staff support meeting² reinforce these concerns. Residents expressed strong convictions that sleep deprivation adversely affects patient care. Many residents talked about different kinds of mistakes they had made that they ascribed to sleep deprivation: giving the wrong antibiotic, overlooking diagnoses, mistranscribing orders, and falling asleep while writing up a history (and sometimes continuing to write while inspired by a dream—one resident was surprised to find in the morning that he had written under his