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February 10, 1989

Sleep Deprivation and Performance of Residents

Author Affiliations

Lancaster, Pa

Lancaster, Pa

JAMA. 1989;261(6):860. doi:10.1001/jama.1989.03420060063021

To the Editor. —  In the recent study of Deaconson et al1 entitled "Sleep Deprivation and Resident Performance," there seem to be major flaws in the design of the study. The authors state that performance was measured "close to the presumed nadir" and when "impaired performance was likely to be identified." I suggest that performance was measured at the presumed zenith and that the lack of significant difference in performance between study groups is not surprising. Daily testing took place between 6 AM and 8 AM, the earliest time following periods of rest, no matter how long or short. This is the time of day during which residents are nearing the zenith of performance: the time at which they are most rested. This flaw is further supported by the authors themselves, who noted no statistical difference in motivation or fatigue between the study groups.It is also erroneous to