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September 6, 2006

Association of Extended Work Shifts, Vascular Function, and Inflammatory Markers in Internal Medicine Residents: A Randomized Crossover Trial

JAMA. 2006;296(9):1049-1054. doi:10.1001/jama.296.9.1049

To the Editor: Sleep loss during extended work shifts is common in medical training.1 Pathophysiological consequences of sleep loss include increased daytime blood levels of proinflammatory cytokines, which may contribute to daytime sleepiness and decline in neurobehavioral function.1-3 Increased proinflammatory cytokines in response to sleep loss may also affect cardiovascular health as inflammation within the vascular wall is thought to play an important role in the pathogenesis of atherosclerosis.4 We tested the hypothesis that sleep loss during extended work shifts is associated with evidence of vascular inflammation and dysfunction.