Author Contributions: Dr Rothschild had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Study concept and design: Rothschild, Keohane, Lipsitz, Czeisler, Bates, Landrigan.
Acquisition of data: Rothschild, Keohane, Yoon, Williams, Wien.
Analysis and interpretation of data: Rothschild, Keohane, Rogers, Gardner, Lipsitz, Salzberg, Yu, Yoon, Wien, Landrigan.
Drafting of the manuscript: Rothschild, Keohane, Wien, Landrigan.
Critical revision of the manuscript for important intellectual content: Rothschild, Keohane, Rogers, Gardner, Lipsitz, Salzberg, Yu, Yoon, Williams, Czeisler, Bates, Landrigan.
Statistical analysis: Rothschild, Lipsitz, Yoon, Wien, Landrigan.
Obtained funding: Rothschild.
Administrative, technical, or material support: Rothschild, Keohane, Gardner, Salzberg, Yu, Williams, Bates, Landrigan.
Study supervision: Rothschild, Keohane, Rogers, Landrigan.
Financial Disclosures: Dr Landrigan reports serving as a paid consultant to the District Health Boards of New Zealand, providing recommendation on how to improve the scheduling and working conditions for junior doctors in New Zealand; Vital Issues in Medicine, developing an educational course for physicians on Shift Work Disorder (supported by an unrestricted educational grant from Cephalon Inc to Vital Issues in Medicine); and AXDev, to assist in the development of a study of Shift Work Disorder (supported by an unrestricted research grant from Cephalon Inc to AXDev). In addition, Dr Landrigan reports receiving monetary awards, honoraria, and travel reimbursement from multiple academic and professional organizations for delivering lectures on sleep deprivation and safety. Dr Czeisler reports receiving consulting fees from or serving as a paid member of scientific advisory boards for Actelion Ltd, Avera Pharmaceuticals Inc, Bombardier Inc, Cephalon Inc, Delta Airlines, Eli Lilly and Co, Fedex Kinko’s, Federal Motor Carrier Safety Administration (FMCSA), US Department of Transportation, Fusion Medical Education LLC, Garda Síoch á na Inspectorate (Dublin, Ireland), Hypnion Inc, Global Ground Support, Johnson & Johnson, Koninklijke Philips Electronics NV, Morgan Stanley, Sanofi-Aventis Group, Portland Trail Blazers, Respironics Inc, Sepracor Inc, Sleep Multimedia Inc, Sleep Research Society (for which Dr Czeisler served as president), Somnus Therapeutics Inc, Takeda Pharmaceuticals, Vanda Pharmaceuticals Inc, Vital Issues in Medicine, Warburg-Pincus, and Zeo Inc. Dr Czeisler reports owning an equity interest in Lifetrac Inc, Somnus Therapeutics Inc, Vanda Pharmaceuticals Inc, and Zeo Inc; and receiving royalties from McGraw Hill, the New York Times, and Penguin Press. Dr Czeisler reports receiving lecture fees from the Accreditation Council of Graduate Medical Education, Alfresa, American Physiological Society, Association of University Anesthesiologists, Baylor College of Medicine, Beth-Israel Deaconess Medical Center, Brown Medical School/Rhode Island Hospital, Cephalon Inc, Clinical Excellence Commission (Australia), Dalhousie University, Duke University Medical Center, Harvard University, Institute of Sleep Health Promotion, London Deanery, Morehouse School of Medicine, Mount Sinai School of Medicine, National Emergency Training Center, National Institutes of Health, North East Sleep Society, Osaka University School of Medicine, Partners HealthCare Inc, Sanofi-Aventis Inc, St Luke's Roosevelt Hospital, Takeda, Tanabe Seiyaku Co Ltd, Tokyo Electric Power Company, University of Michigan, University of Pennsylvania, University of Pittsburgh, University of Tsukuba, University of Virginia Medical School, University of Washington Medical Center, University of Wisconsin Medical School, World Federation of Sleep Research and Sleep Medicine Societies, and the American Academy of Allergy, Asthma and Immunology Program Directors. Dr Czeisler reports receiving research prizes with monetary awards from the American Academy of Sleep Medicine, American Clinical and Climatological Association, Association for Patient-Oriented Research, National Institute for Occupational Safety and Health, National Sleep Foundation, and Sleep Research Society; receiving clinical trial research contracts from Cephalon Inc, Merck & Co Inc, and Pfizer Inc; receiving an investigator-initiated research grant from Cephalon Inc. Dr Czeisler reports that his research laboratory at the Brigham and Women's Hospital has received unrestricted research and education funds and/or support for research expenses from Cephalon Inc, Koninklijke Philips Electronics NV, ResMed, and the Brigham and Women's Hospital. The Harvard Medical School Division of Sleep Medicine, which Dr Czeisler directs, has received unrestricted research and educational gifts and endowment funds from Boehringer Ingelheim Pharmaceuticals Inc, Cephalon Inc, George H. Kidder, Gerald McGinnis, GlaxoSmithKline, Herbert Lee, Hypnion, Jazz Pharmaceuticals, Jordan's Furniture, Merck & Co Inc, Peter C. Farrell, Pfizer, ResMed, Respironics Inc, Sanofi-Aventis Inc, Sealy Inc, Sepracor Inc, Simmons, Sleep Health Centers LLC, Spring Aire, Takeda Pharmaceuticals, and Tempur-Pedic. The Harvard Medical School/Division of Sleep Medicine has received gifts from many outside organizations and individuals including Aetna US Healthcare, Alertness Solutions Inc, American Academy of Sleep Medicine, Axon Sleep Research Laboratories Inc, Boehringer Ingelheim Pharmaceuticals Inc, Brigham & Women's Hospital Department of Medicine, Bristol-Myers Squibb, Catalyst Group, Cephalon Inc, Clarus Ventures, Comfortaire Corporation, Committee for Interns and Residents, Eli Lilly and Co, Farrell Family Foundation, Fisher & Paykel Healthcare Corporation, George H. Kidder, GlaxoSmithKline, Gosule, Butkus & Jesson LLP, Hypnion Inc, Innovative Brands Group (Nature's Rest), Jordan's Furniture, King Koil Sleep Products, Land and Sky, Merck Research Laboratories, MPM Capital, Neurocrine Biosciences Inc, Orphan Medical/Jazz Pharmaceuticals, Park Place Corporation, Pfizer Global Pharmaceuticals, Pfizer Healthcare Division, Pfizer Inc, Purdue Pharma LP, PR21, ResMed Inc, Respironics Inc, Sanofi-Aventis Inc, Sanofi-Synthelabo, Sealy Mattress Company, Sealy Inc, Select Comfort Corporation, Sepracor Inc, Simmons Co, Sleep Ave LLC, SleepCare LLC, Sleep Health Centers LLC, Spring Air Mattress Co, Takeda Pharmaceuticals, Tempur-Pedic Medical Division, Total Sleep Holdings, Vanda Pharmaceuticals Inc, and the Zeno Group. The Harvard Medical School/Division of Sleep Medicine Sleep and Health Education Program has received educational grant funding from Cephalon Inc, Takeda Pharmaceuticals, Sanofi-Aventis Inc, and Sepracor Inc. Dr Czeisler reports being the incumbent of an endowed professorship provided to Harvard University by Cephalon Inc and holds a number of process patents in the field of sleep/circadian rhythms (eg, photic resetting of the human circadian pacemaker). Since 1985, Dr Czeisler has also served as an expert witness on various legal cases related to sleep and/or circadian rhythms.
Funding/Support: This study was supported by a grant from the Rx Foundation, Cambridge, Massachusetts.
Role of the Sponsor: The Rx Foundation had no role in the design and conduct of the study; the collection, preparation, or interpretation of the data; or the preparation or approval of the manuscript.
Additional Contributions: We thank Cathy Foskett, RN for her contributions in chart abstractions and data collection. She received salary support from the grant.