RT Journal
A1 McCall TB
T1 SLeep deprivation and performance of residents
JF JAMA
JO JAMA
YR 1989
FD February 10
VO 261
IS 6
SP 859
OP 859
DO 10.1001/jama.1989.03420060063016
UL http://dx.doi.org/10.1001/jama.1989.03420060063016
AB To the Editor.— 
    In their article entitled "Sleep Deprivation and Resident Performance," Deaconson et al1 state, "The strength of our study is its design." They could not be more wrong; the study's design is so flawed that their results and conclusions must be questioned.The subjects were surgical residents working every other night on call. The residents served as their own controls: the study compared them when sleep deprived—after a night on call—with when rested—after a night off. The authors assumed that residents who slept the previous night were rested, but this is hardly a safe assumption.The effects of acute sleep deprivation last far longer than 24 hours.2 Many residents describe difficulty concentrating "the day after the day after" a night on call—precisely when the rested controls were tested. The authors fail to consider that the control group may also have been sleep deprived, both acutely, as